Staffing: 2024’s Biggest Lab Operations Challenge

For years, the spotlight has been on laboratory recruitment and retention—but despite growing awareness of the need for skilled clinical lab professionals, the issue continues to drive concerns regarding the future of lab operations. When asked about the challenges labs faced in 2024, staffing was at the top of lab expert Anthony Killeen’s list. Here, Killeen forecasts the 2025 outlook for laboratory professionals, highlights promising developments, and offers lab leaders advice on relieving their personnel pressures.

Q: What key operational challenges did clinical laboratories face in 2024?

A: Staffing shortages have been reported by clinical laboratories for at least 30 years and this continues to be the biggest operational challenge labs face today.

A 2018 American Society for Clinical Pathology (ASCP) study found average vacancy rates of 7–11 percent in clinical labs, with rates as high as 21 percent in some areas.¹ Meanwhile, a 2020 ASCP vacancy survey showed an average five-year retirement rate of 12.3 percent.² In 2021, the Bureau of Labor Statistics projected that lab technologist and technician positions would increase by 11 percent by 2030.³ A Health Resources and Service Administration report projected an increase in demand for technologists of 22 percent between 2012 and 2025.⁴

Altogether, these surveys show what any laboratory medicine professional working in the field could tell you from personal experience—that an insufficient number of newly trained technologists are entering the field, particularly as previous generations of laboratory medicine professionals are retiring at historic rates.

The national shortage of medical laboratory personnel has significant implications for patient care. Both this year and in past years, the shortage has led to increased workloads and stress for current staff, raising risks of errors and delays in test results. In rural and underserved areas in particular, where staffing gaps are more pronounced, some laboratories face temporary closures due to a lack of personnel. This limits patient access to timely and essential diagnostic care, which in turn leads to a negative impact on overall health outcomes.

Q: What factors have contributed to these issues in 2024?

A: There are numerous factors contributing to these staffing shortages. One of the biggest is that the clinical laboratory workforce is aging, which means that many of the experienced professionals in the lab are now retiring or are planning to retire within the next five years.

Another major factor is salary. There is a significant disparity in pay for laboratory staff relative to their peers with similar training in other areas of health care. For example, a 2019 salary survey by ASCP reported that the average annual pay for a medical laboratory scientist (MLS) with a bachelor’s degree was $68,848.18 and that the average annual pay for a medical laboratory technician (MLT) with an associate’s degree was $50,304.78.⁵ In contrast, the Bureau of Labor Statistics stated that a registered nurse with a bachelor’s degree in nursing had a median pay of $77,600.

There is also a nationwide disparity between the need for trained medical lab professionals and the programs available to meet the training regulations. Even though the demand for laboratory medicine professionals is only growing, the National Accrediting Agency for Clinical Laboratory Sciences reported a 7 percent decline in MLS and MLT training programs between 2000 and 2020.⁶

Finally, clinical labs are still feeling the impact of COVID-19. The pandemic exacerbated the underlying issues that have hampered labs’ retention and recruitment efforts at a time when labs required an incredible expansion of molecular diagnostic testing capabilities. This significantly disrupted staffing and further reduced the stream of incoming graduates—something labs are still trying to rebound from today.

Q: What steps have been taken in the past year toward improvements in lab operations?

A: In September of this year, Rep. Deborah Ross (D-N.C.) introduced the Medical Laboratory Personnel Shortage Relief Act of 2024.⁷ If passed, this bill will be a significant step toward alleviating clinical laboratory staffing shortages, and ADLM has officially endorsed it.

The bill will include laboratory medicine professionals in the National Health Service Corps, which will prioritize recruitment and placement in areas facing shortages. It will also provide loan repayment incentives for medical laboratory personnel, which will alleviate financial burdens for new professionals and support a sustainable workforce by encouraging recent graduates to enter and remain in laboratory professions.

The act provides funding for educational programs as well, particularly for institutions prioritizing culturally competent care and interprofessional collaboration. By supporting educational pathways for underrepresented groups, this legislation promotes a diverse, well-prepared laboratory workforce capable of meeting the evolving demands of modern health care. This investment is critical to maintaining a robust pipeline of skilled laboratory personnel across healthcare settings nationwide.

This year, ADLM also launched its ADLM Scholars Program. The goal is to introduce select college students to ADLM and laboratory medicine career paths and to start building longstanding mentor-mentee relationships between these students and ADLM’s laboratory medicine experts. In addition to mentorship, the program provides students with the opportunity to attend numerous events during the ADLM Annual Meeting.

Q: What are the most likely operational challenges labs will face in 2025—and how can they be addressed?

A: I believe that staffing issues will continue to be the biggest operational challenge facing labs in 2025.

Although laboratory medicine is a vital component of today’s healthcare system, clinical laboratory professions provide limited career growth opportunities for the workforce. This is a major hurdle to retaining staff and one that lab leaders and administrators could help solve by providing a separate track for those with MLS credentials to advance within the lab and broader healthcare community.

Lab leaders could also consider using phlebotomists to alleviate shortages of lower-level technicians. Labs could offer phlebotomists on-the-job training or the field at large could develop a certification program for them.

Q: What one action would you like to see labs take to prepare for the challenges 2025 may bring?

A: One major thing all laboratory medicine professionals can do to help alleviate staffing shortages is raise awareness of lab staff as crucial members of the healthcare team. As we move into 2025, I strongly encourage labs to find ways to advocate for the value of laboratory medicine and to highlight the importance of lab results in health care—both to other healthcare professionals and to the public.

References:

1. Garcia E et al. The American Society for Clinical Pathology’s 2018 vacancy survey of medical laboratories in the United States. Am J Clin Pathol. 2019;152(2):155–168. doi:10.1093/ajcp/aqz046.
2. Garcia E et al. The American Society for Clinical Pathology 2020 Vacancy Survey of Medical Laboratories in the United States. Am J Clin Pathol. 2022;157(6):874–889. doi:10.1093/ajcp/aqab197.
3. U.S. Bureau of Labor Statistics. Clinical Laboratory Technologists and Technicians. October 19, 2021. https://web.archive.org/web/20211019103528/https://www.bls.gov/ooh/healthcare/clinical-laboratory-technologists-and-technicians.htm.
4. National Center for Health Workforce Analysis. Health Workforce Projections: Health Technologist and Technician Occupations. https://web.archive.org/web/20201021081553/https:/bhw.hrsa.gov/sites/default/files/bhw/nchwa/projections/healthtechnologisttechniciansapril2015.pdf.
5. Garcia E et al. American Society for Clinical Pathology’s 2019 Wage Survey of Medical Laboratories in the United States. Am J Clin Pathol. 2021;155(5):649–673. doi:10.1093/ajcp/aqaa197.
6. National Accrediting Agency for Clinical Laboratory Sciences. 2019 Annual Report. https://web.archive.org/web/20200925001906/https:/naacls.org/NAACLS/media/Documents/AnnualReport.pdf.
7. H.R.9849 – Medical Laboratory Personnel Shortage Relief Act of 2024. Congress.gov. September 25, 2024. https://www.congress.gov/bill/118th-congress/house-bill/9849/text.
8. Association for Diagnostics & Laboratory Medicine. ADLM Scholars Program. https://www.myadlm.org/community/diversity-equity-and-inclusion/current-adlm-dei-initiatives/adlm-scholars-program.

Anthony Killeen, MD, BCh, PhD, DABCC, FADLM, is president of the Association for Diagnostics & Laboratory Medicine (ADLM). He is also professor and vice-chair for clinical affairs at the University of Minnesota’s Department of Laboratory Medicine and Pathology. Killeen has held numerous leadership roles in laboratory medicine, including chairing the Chemistry Resource Committee, the Instrumentation Committee, and the Accuracy-Based Surveys Committee for the College of American Pathologists.