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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Clinical Laboratory Licensure Threatened in Georgia

Published February 21, 2010 4:14 PM by Glen McDaniel

There is a bill winding its way through the Georgia General Assembly that threatens clinical laboratory licensure in the state. Sponsored by a nurse legislator, the bill HB 994 has had 2 reads.

Ostensibly the intention is to save money. After all, those pesky visits from state inspectors eat up more in terms of employee salaries and other resources than the cash-strapped state can afford. It makes sense to cut cost wherever possible and one always starts with the most disposable or unpopular programs. Alternatively, slash those programs where the constituents are so wimpish or uninterested that they won't protest.

Given the importance of the clinical laboratory in healthcare, I am surprised that this fool-hardy decision is being pushed by a healthcare provider who should know better. Equally disappointing, however, is the fact that contacts within the legislature indicate that letters of protest from clinical laboratorians have been few and far between. Laboratorians have traditionally seen any regulatory oversight as just another financial burden and more work. It is also habitual not to get too excited by changes which are not seen as directly affecting their individual livelihood. "I will still have MY job, so I dont care."

What about patient safety? What about preventing greedy, unqualified entrepreneurs from operating sub-standard laboratories? What about ensuring a minimum in personnel qualification, knowing that CLIA is just a baseline which still allows the hiring of unqualified staff as long as there is skeleton staff of qualified personnel available?

How do you think nurses or pharmacists or physicians would react if their profession was being threatened with deregulation? I think how clinical laboratorians respond in this case -and similar cases- speak volumes about how they feel about themselves and their profession.

Such inactivity and apathy speak volumes to those outside the profession.

26 comments

It seems a little harsh to assume that people in this field do not care about the deregulation of their profession. If the laws change, wouldn't that make them more like other professions such as a plumber where they could still continue their work, but they would have to work to maintain reputable services?

GramJ January 31, 2011 10:26 AM

Does anyone have an update on this law.  I have been searching for info but, surprisingly, have not found much.  I am planning on a move to Atlanta, and it would be interesting to have more info.  Thanks in advance.

Tam

Tam December 30, 2010 7:55 PM

I am very surprised.Is this worldwide?

The other day I was sharing with a Kenyan friend of mine about the poor state of the laboratory profession in Uganda.No voice, each of us focusing on only ourselves and the jobs, never the career.It turned out that they were not any different. I only wish we would all wake up and embrace this very important career.

Proscovia Nampijja, laboratory - Laboratory Scientist March 16, 2010 6:22 AM
Kampala, Uganda

As an update to this Georgia law: I wrote to every single member of the Health and Human Services Committee, the sponsors, my own representative, the Speaker and a few others.  I received responses from only 2 representatives - Barbara Sims (District 119) and Sean jerguson (District 22). Both representatives promsed to take a serious look at the proposed law.

Rep Sims offered to bring my concerns to the author and sponsors of the bill as well as the Chair of the Committee.

Rep Jerguson said he was not really versed on the details, but my concerns seemed valid and so he would educate himself on the bill before voting for it. Sounds like a good idea to me!

Yesterday the bill was reported favorably out of committee. However from what few details I can gather, large parts of the bill relating to removing personnel standards were retracted (leaving the original intact). I am not so sure about the facility licensure portion.

I will keep you posted as details become available to me.

Glen McDaniel March 12, 2010 2:47 PM

I just emailed ASCP abou the issues in GA and sent them the link, I wonder what IF ANY they are going to do.

I will keep you posted.

John MLS (ASCP) March 9, 2010 9:31 PM

This profession is the worst out there. Do you wonder why we have a shortage? We do not even control out own licensing agency. We do not even have standards for hiring lab personell.

This profession can go to hell. I am applying to PA school this year, and hope to get out of the terrible profession. This profession is going to undergo BRAIN DRAIN, that mean all the bright MT students will leave this so called profession for profession with standards (Pharmacy, PA, PT).

No one will do anything about the license in GA, NONONE CARES ABOUT THIS PROFESSION, ITS JUST A PAYCHECK.  Like the previous poster said, this is not career, its a job, like working at walmart, clock in, clock out.

When I get to PA school, I will never look back at the lab, just to warn all the new students to never even look into this field. Only if you want to drive a Toyota Carrolla the rest of your life and rent a apartment.

JERRY BS MT (ASCP) March 8, 2010 9:57 PM

Those who say we as MTs have no voice are the ones who are not using their own voice.  As a united group we can educate folks as to the highly technical work we do and defeat this repeal of the State of Georgia licensure law.  We are not doing this to sing our own praises, this needs to be done to assure all the patient's under OUR care get the best care possible.

Cindy March 1, 2010 3:24 PM
GA

A workmate and I were talking about this in the break room the other day when a pathologist came in and asked us what we were talking about. He said he had not heard about the new law, but he said he supported it!

I spoke up and said we needed qualified techs and he said as long as there was a pathologist in charge we could train non Med Techs cheaper  to do the job. After all the new computerized instruments are so accurate these days. Right!!

This is a guy I liked and who I have to explain basic things to about chemistry QC and hematology slides. He would be lost without us.

He usually asks a senior tech in hematology to look at his fluids to identify cells and he has the nerve to say THEY/pathologists are enough to assure accurate results.

I am hurt and mad, but it also shows pathologists will never, ever, ever help us to be independent, they are not our friends. They are only in it for themsleves. We have to do this with or without pathology support and even call them out when they claim to be the ones who know it all.

S. K. MT(AMT) February 28, 2010 6:05 PM
Jonesboro GA

First I would like to respond to those who do not feel that the lab is a profession.  The lab is a profession and has a career ladder if one opts to explore that option.

I have been in the laboratory profession for 20 years and have learned that the doctors will respect your opinions if you respect them and develop a relationship in which they learn to trust your judgement and opinions.  

I currently work as a laboratory manager in which the physicians, physician assistants and nurse practioners all come into the lab on a daily basis to seek more information regarding thier patients, what lab tests to order next, what interpretations mean, and to inquire on the patients previous history of lab tests (which we look up in the LIS system).

As for pathologists, they want to learn....at least the ones that I have worked with over the lab 20 years.  My current pathologist comes for her quarterly visit, we sit down at the desk and I explain what I am doing in the lab, new charts for QA, daily, weekly, quarterly maintenance, etc.  She is always pleasant, listens, asked questions and learns.  I am always explaining the CLIA regs and she is thankful for the lessons learned.

In order for these changes to take place in the lab, we cannot have the attitude as displayed in the above responses that the doctors, pathologist and nurses are better than the lab profession.  They are not better than us, nor are we better than they are.  

You do have a voice, JOIN the ASCLS in you local state, then go to the annual Legislative Days (march 15 and 16, 2010) and speak to your representatives, congress, and senators.  

Join the committees at your facility so that you have a voice for your laboatory department.

Write a newspaper article and send it to all the surrounding town newspapers for publication.

Organize a healthfair, offer homemade pamphlets on laboratory testing, hand out information regarding laboratory programs in your state or hand out general information about our profession  to those attending.

Vist your local high school science class and explain our profession so that they know that nursing is not thier only option in health care field.

You can make a difference and it BEGINS WITH YOU!

Christine Winkel, MS MT MLS(ASCP)CM

KSCLS Southwest Kansas District Representative

Christine Winkel, MLS(ASCP) - Laboratory Manager, Ashland Health Center February 23, 2010 6:43 PM
Ashland KS

This will be a ripple effect... Just wait, your state will be the next one, but for the time being continue to pay your dues and become a member of the mighty ASCP because they'll stand for you through thick and thin. HA! YES Lu, I would love for us to have a nationwide STRIKE! Spearhead it! I'm ready!

EV February 23, 2010 5:35 PM
OK

Please, let's not make this just about our wages and job security. This issue is so much bigger than that - it not only affects our profession, but the entire society as we are talking about patient's safety.

Barbara Kraj February 23, 2010 10:20 AM
Augusta GA

CA has the highest pay because the state has standards and the California Association for Medical Laboratory Technology, or CAMLT sets out to protect these standards. What is happening in Georgia would not happen if they had a lobby group like the CAMLT to look out for state licensure.

www.camlt.org/mem.html

"CAMLT is your strong central voice. Over the past few years, California has undergone sweeping changes in the laws regulating our laboratories and our profession. CAMLT has represented the laboratory profession in the legislative and regulatory discussions leading to these changes, sometimes with the help of other organizations and sometimes alone. We attempt to keep our members aware of the issues that affect our profession and in turn ask for input from our members.

CAMLT will continue to fight for laws and regulations that assure quality laboratory health care for California's patient population. CAMLT believes that proper training standards combined with continuing education is needed to maintain the professionalism of our laboratory workforce and will continue to oppose those who insist on removing the professionalism in health care.

Your membership is the best way to demonstrate your support of CAMLT's goals. Your personal commitment and membership dues mean that CAMLT can continue to have strong, active legislative representation in Sacramento."

CLS in CA February 23, 2010 12:14 AM

Excellent resources, Barbara.

You are correct; it's very easy to Google email addresses and phone numbers.

Not only should clinical laboratorians  write and call, they should solicit help from friends, neighbors, pastors, family, other healthcare professionals they work with.

Get a patient whose life was saved by timely, accurate clinical lab findings or someone who has some improved quality of life because of tests performed by certified laboratorians ina  licensed laboratory  on a regular basis for renal function tests pre/post dialysis, PT for coagulation therapy, CBC for a leukemia patient in remission, CD4 cell count for a patient on HIV therapy.

When you call  or write, personalize the issue  for the recipient. It's not sufficient to plea your case for a job.

Indicate the importance of clinical lab science in medical decision making. Explain the training/certification involved. Point out that even barbers, manicurists and food vendors have licenses.

Point out that if the legislator and his/her family needed the services of a clinical laboratory, if this legislation is passed there will be no guarantee of an accurate result. What if they were bleeding or having a heart attack? What if a diagnosis is missed (or a false positice given) for HIV, diabetes, cancer. Those are issues everyone can relate to. Be graphic!  Be personal!

CLIA ensures very minimum criteria. What if the profit motive encourages businesses and individuals to circumvent the minimal regs to maximize their margins? This is possible without licensure.

It's estimated that every 10 calls/letters represent something like a thousand similar opinions. Ask for a response as well. It has to hit home, be graphic and get as many respondents as possible to join you.  

Glen McDaniel February 22, 2010 8:38 PM

I am going to write a bill repealing mandatory licensure for nurses.

Kyle BS MT (ASCP) February 22, 2010 8:25 PM

Re: Unity asking who to contact:

This bill is in committee and has been assigned to Health and Human Resources.  These individuals may be looked up on the internet for their (or their aids) e-mail addresses/phone numbers. I looked up my rep. Mrs. Sims Barbara.Sims@house.ga.gov

and her staff member: Sharla.Shockley@house.ga.gov

Rhonda, Medows, M.D.

Commissioner and State Health Officer

Georgia Department of Community Health

2 Peachtree Street, N.W.

Atlanta, Georgia 30303

M. Rony Francois, M.D., MSPH, PH.D.

Director of the Division of Public Health

Georgia Department of Community Health

2 Peachtree Street, N.W.

Atlanta, Georgia 30303

Doug Colburn

Health Care Facility Regulation

Georgia Health Department of Community Health

32 Peachtree Street, N.W.

Atlanta, Georgia 30303

I would also send a letter to:

Sharon Doughtery, Attorney

Georgia Department of Community Health

2 Peachtree Street, N.W.

Atlanta, Georgia 30303

These are all district reps (I obtained the list during our last ASCLS-GA meeting):

Sharon Cooper- Chariman from  the 41st District which is Cobb Co.

Ed Rynders- Vice Chariman  from the 152 District which is Colquitt, Dougherty, Lee and Worth Counties

Buddy Carter is Secretary from the 159th District which is Chatham and Effingham

Members:

Name                              District         Counties

Charice Byrd                   20               Cherokee

Mark Butler                     18                Carroll, Haralson

Mike Cheokas                 134               Marion, Schley, Sumter,Talbot

Doug Collins                    27                Hall, Lumpkin

Katie Dempsey                13               Floyd

Elly Dobbs                        53              Fulton

Karla Drenner                  86              Dekalb

J. Craig Gordon               162             Chatham

Tom Graves                     12               Gordon, Pickens, Bartow

Bill Hembree                     67               Douglas

Michele Henson                87              Dekalb

Wayne Howard                121             Richmond

Sistie Hudson                   124             Glascock, Hancock, McDuffie,  

                                                          Putnam, Taliaferro, Warren                                                                        

Sean Jerguson                 22              Cherokee

Sheila Jones                     44               Cobb, Fulton

Margaret Kaiser                59               Fulton

Mike Keown                       173            Grady Thomas

Barry Loudermilk                14             Bartow, Floyd

John Lunsford                    110           Butts, Henry, Newton

Gene Maddox                     172           Dekalb, Grady

Fran Millar                           79             Dekalb

Billy Mitchell                        88              Dekalb, Gwinnett

Alisha Thomas Morgan        39             Cobb

Howard Mosby                    90             Dekalb, Henry

Don Parsons                        42            Cobb

Allen Peake                          137          Bibb

Nikki Randall                         138         Bibb

Carl Rogers                           26           Hall

Tony Sellier                            136        Bibb, Crawford, Houston, Lamar,

                                                           Upson, Monroe, Peach

Robbin Shipp                           58        Dekalb, Fulton

Barbara Sims                           119      Columbia, Richmond

Mikey Stephens                       161      Chatham

Pam Stephenson                     92         Dekalb, Rockdale

Joe Wilkinson                          52         Fulton

Barbara Kraj February 22, 2010 7:42 PM
Augusta GA

SO HOW DO WE DO IT? IS THERE A NAME? TELEPHONE #? EMAIL ADDRESS?

WHO DO WE CONTACT TO STOP THIS BILL?

UNITY BS CLS (NCA), MT (AMT), MT (ASCP) February 22, 2010 6:49 PM

"We have no voice"?

We need to MAKE our own voice, BE our own voice.

We are our worst enemy because of apathy.

Thanks for the article Glen. As we attempt licensure in Minnesota, I will keep this type of foolishness in mind.

I'm proud to work in the lab, and I'm proud of my co workers, from Phleb on up. I think it’s silly to think we have to just take this and roll over. I hope Georgia’s laboratorians don’t just sit there and take this and hope they see the big picture.

People, we need to step up, or we have ourselves to blame.

Tymm Brown, MLS February 22, 2010 4:58 PM
MN

These are precisely the arguments I used in my letter to Columbia County rep. Hopefully, if we are persistent, we can stop the Bill.

Barbara Kraj February 22, 2010 3:35 PM
Augusta GA

It is really sad when I got my hair cut and noticed she was licensed. I asked her what happends if your not licensed, she said she could not cut hair, that SHE WOULD BE REPORTED TO THE BOARD, if she cut hair without a license. Her license can be recpricated to all 50 states, so this assures her of a job that somone cannot do off the streets.

So the sad thing is, I guess the cosmetologist board (hairdressers?) has UNITY and created standards.

So now lets talk about when we release patient results, or identify a blast, or type a patient, you would think that NEEDS A NATIONAL LICENSE LIKE HAIRDRESSERS? You wouldnt want a Medical Assistant with 6 months of school, without any theory to try to call a BLAST FROM A ATYPICAL LYMPH?

Now lets get to the fact at hand, WE ARE THE ONLY ANCILLARY PROFESSION WITHOUT OUR OWN BOARD AND LICENSING AGENCY.

RNs, PT, OT, Dietary, Pharmacy, Xray HAS THEIR OWN BOARD!

I am hoping with the creating and opening of the doctorate in clinical laboratory science, we will have strong professionals that will now create standards for the profession. HOPEFULLY CREATING A BOARD FOR THE LABORATORIAN like the rest of the ancillary field.

DCLS PROGRAMS WILL OPEN SOON, I HOPE IT WILL NOT BE TOO LATE.

Joe BS MT (ASCP) February 22, 2010 11:04 AM

I have contacted Columbia County representative to GA Congress, Barbara Sims regarding this. I hope we can educate our legislators on how SUBSTANDARD CLIA is and who will be running diagnostic tests in absence of Laboratory Licensure (or Personnel Licensure for that matter...).

I don't know when HB 994 will be voted on exactly. We are planning on having a roundtable on that subject during our annual ASCLS-GA meeting in Savannah on March 26. Details soon at www.asclsgeorgia.org

Barbara Kraj February 22, 2010 8:38 AM
Augusta GA

So then, what is to be done?  Do any of us really know what to do?  If so, I would like to start hearing less complaining and more about what could be done to address our issues.  I know everyone is tired of beating their heads on a huge brick wall everyday, but we can't ever give up!  

Stephanie Schaible, Transfusion - MT February 22, 2010 8:23 AM
Ogden UT

Quite frankly I'm surprised it hasn't happened sooner and in a lot more states.  The importance of the lab and the results on which the physicians depend have never held pride of place and probably never will for all the reasons listed in the comments above.  I found it interesting that one techs lab answered to a pharmacist, we had just the opposite scenario in a former place I worked when the Imaging director left, they had to answer to the lab director.  It didn't work very well and now the hospital has both a lab and imaging head.

I do believe we're part of the problem.  For some reason, Medical Laboratory Scientists (isn't that the newest name?) seem extremely willing to complain among themselves and even go to conferences and express their dissatisfaction but they won't do anything to "rock the boat".  I've never seen a lab go on strike or have a contingency go to the board of directors of a facility and demand better wages and recognition.  The nurses organized many years ago and that's when they started making way more money than I.  I'm old and when I first became an MT, I made more money than all my nurse counterparts - then they got smart and we didn't.  

Lu Hubert, Blood Bank - MT III , College Station Medical Center February 21, 2010 10:34 PM
College Station TX

That's why I don't work in a laboratory anymore. It is not a career, it's just a job and even though I performed my job duties as I should and worked for the patient I did not feel like I was really helping to the best of my ability. I also did not like the way the nurses and doctors spoke to us and disregarded our knowledge.%0d%0a%0d%0aThere is no voice in the lab, no leadership in the lab, no one who will actually listen to us in a lab and if we do say something we get reprimanded by those who do not run the lab but control the money.%0d%0a%0d%0aThose of us who work in a lab or used to work in a lab do not get the respect of the profession as we deserve. We know how important it is for lab work to be done and properly, yet those who are not in the profession and those who control the money do not get the importance of what lab results mean in regards to how a patient is being treated or the impact of healthcare with lab results.%0d%0a%0d%0aIt's just too bad also, that many lab professionals don't band together and unite to make the lab a better place all around . %0d%0a%0d%0aI'm moving on to much better things. A better career outside the laboratory and more respect for what I do.%0d%0a%0d%0a

Joy Lewis February 21, 2010 8:48 PM
FL

You are right about that pathologists are doctors first and foremost. They side with doctors on the floors and just happen to have offices in the lab. Half the time they really have no idea about what we actually do, but they still have the final say about lab.

I worked for a small hospital and when the lab manager left they did not replace her to save money. Instead, they made us report to a pharmacist. He didnt have  a clue. He changed our schedules, didnt understand why we "wasted" so much quality control and basically questioned everything because he just didnt understand lab. he wanted us to save money by training our secretary to take blood in outpatient. When she said she didnt want to, he fired her. He couldnt see why we couldnt just train everyone on the job to do everything.

No one complained to administration. We will whine if we have to change departments or help out a co-worker, but wont say a word if they make us report to someone totally inappropriate. The pathologists continued to sign everything official but they totally sided with the pharmacist instead of the lab. We felt we had no one to go to.

That's the kind of world we live in. Pathologists are in charge but will oppose the CLS or MTs every chance they get.

Most of us just want to survive and get a pay check so we wont rock the boat. We are just going along to get along till retirement.

Jenna W. MT(ASCP) February 21, 2010 8:32 PM

Glenn.

We have no voice, the pathologist will never advocate for higher pay, this is why there is a shortage.

I am in this JOB to survive and survive only, I am applying for pharmacy school, that is when I will be in a CAREER, that I feel has standards and their own board memebers.

The lab is a job, much like being a plumber, I would never consider this a career like a pharmacist, physical therapist or OT.

That is why the MTs do not care less if the license goes or not, this is not a career, its a job. A job without standards, so why not let someone off the streets runs samples and see what happends.

When I get into pharmacy school will be the best day of my life, I will burn my MT degree and certification.

Todd MT (ASCP) February 21, 2010 6:52 PM

WHAT CAN WE DO? WE DO NOT EVEN HAVE OUR OWN BOARD MEMBERS OR CONTROL OUR OWN CERTIFYING AGENCY.

ARE WE GOING TO EMAIL THE ASCP? THE PATHOLOGIST DO NOT CARE IF A CHIMP RUNS THE INSTRUMENTS. THIS IS WHY OUR CAREER IS TERRIBLE, NO LEADERSHIP.

WE NEED A ORGANIZATION AND BOARD MEMBERS THAT IS FOR THE LABORATORIAN, NOT THE PATHOLOGIST.

IF A OPTOMETRIST (OD) SCOPE OF PRACTICE IS THREATED BY A

OPTHAMALAGIST (MD), THE OPTOMETRIST WILL GO TO THEIR BOARD THE ABO (AMERICAN BOARD OF OPTOMETRY).

WHERE ARE WE GOING TO GO? THE ASCP?, THIS PROFESSION IS A JOKE AND WILL ALWAYS BE A STEPPING STONE

UNITY BS CLS (NCA), MT (AMT), MT (ASCP) February 21, 2010 6:17 PM

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