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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Why License Tour Guides but not Laboratorians?

Published May 11, 2014 1:24 PM by Glen McDaniel

A recent article in the Economist made me chuckle. It covers in a deliberately humorous way, the story that tour guides in Washington, DC must be licensed, or face stiff fines.


The idea is that a certain body of knowledge is needed and the public can be fleeced or shortchanged if everyone and their uncle start offering tours of the city to gullible, fee-paying tourists.  If you think about it, tour guides probably need to be trained, there might even be a good reason for some standardization of facts. But how detrimental could it be if a guide does not seek the extra training required and pay the government a fee to be licensed?


The reality is that many careers (which cannot even realistically be called professions) are required to be licensed. Generally,  licensure is required to protect the public in some way. For many professions it is important that there be a demonstrated minimum level of knowledge and that service is delivered according to guidelines. Why doesn’t medical laboratory lab science fall into such an important category?


Can you think of a situation in which an untrained-or undertrained- individual could provide incorrect results that could affect patient care? What about providing blood and blood products? Why does the government not have a vested interest in protecting the public health un such areas?


The Economist article continues, “In the 1950s only one American worker in 20 needed a permit from the government; today that figure is around one in three. Some jobs, such as doctors, clearly need strict controls. But some states require licenses for florists and interior designers.”


They could have added barbers, masseuses, cosmetologists, realtors, electricians, nail technicians and a host of others. In fact, I could go on and on with that list. What is ironic is that medical laboratory science is missing from the long list. There are still, in 2014, only a small handful of states (and US possessions) that license laboratorians.


The distraction often used by opponents of personnel licensure is that of the constantly increasing cost of running government. I have suggested in the past, and still believe, that states can minimize the administrative costs of licensure by using reciprocity (as nurses, attorneys and many other professions do). If you have a “clean” license in one state you will be accepted by another state without too many hassles. Instead of developing and controlling their own exams, states can accept recent national certification in lieu of a state exam, except in those very unusual areas where the state requires some narrow body of knowledge.  Once a data base is set up, a clerk reporting to a volunteer Board of Licensure can monitor licensure as just a part of his/her job. Cost can be minimal.


Continuing education can be mandated, including issues that relate to state law or healthcare issues that the state feels are especially important.


None of us wants to pay any more fees than we have to. But what if for a nominal sum you would be licensed, ensuring job protection from unqualified competitors and protecting the public health at the same time? I fear that the protest against paying a small licensure fee has made the fight for licensure more difficult and has unwittingly increased competition for jobs and artificially depressed wages. If an employer can legally take all comers, that diminishes the value of certified professionals. Sometimes we really can be our own worst enemies.


Is it really more important to license the guy who points out the Washington monument to a group of tourists than it is to license those individuals who use critical thinking and independent judgment to provide over 70 percent of information used to make medical decisions?


I  live and work in the Bahamas now. For personal reasons I am working in hospitality right now. But I am ASCP US trained MT. I never understood why our profession does not give two hoots about itself. Here MTs have to be registered and no one would ever dare hire someone who is not certified.

I have also worked in Jamaica as a Med Tech and there they have an agency called Professions Supplementary to Medicine. Every  graduate MT has to register with that agency and it is illegal to work without it. It is also illegal to work unless you register with the PSM board and have your professional card issued by the Board.

In Jamaica they dont call it a license but obviously that is what it is since you must have it to practice and can be fined otherwise.

You can work in the lab and perform menial tasks under an MT, but you cannot call yourself an MT, you cannot work alone and no one will hire you as such unless you are a fully trained certified MT who has their card from PSM.   It is because of this license that MTs in the Caribbean have respect, decent pay and a real profession.

Why are we still having this debate in the US?  It's crazy.

J. Paul May 16, 2014 11:37 AM

Good article. Thank you. What I want to say is that a license gives someone power to do something. I remember how proud and empowered I felt when I got my learner's permit to drive  at 16.

I could finally drive my mom shopping. I could borrow  the car to run errands as long as I had a fully licensed driver with me. I felt like a grown man. I had freedom. I had power.

Pathologists like to be the head honchos although our profession has changed. We used to be just pathologist helpers back in the day, and they want to hold on to the power. We do the work, we have the knowledge but they want the power. They bill for tests that we perform. That is why pathologists have fought licensure so much.

I am glad we have licenses in New York. Some MTs complain about the cost. But we know the person we are working beside in the lab is fully qualified. You cant say that in every city in the US. I work in NYC and I know for a fact we get paid more than MLS/MLTs in neighboring states. Why? Because of licensure.

There is so much more benefits from licensure. We have more upsides than downsides. We need to fight for licensure and enjoy the benefits. Come on, guys.

Bernard Taylor May 11, 2014 9:25 PM
Brooklyn NY

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