Microbiology Is Getting Hammered...

...when it comes to funding and resources. And this will have serious ramifications for your health. In talking to a hospital clinical microbiologist today, he told me that microbiology labs in hospitals and states are suffering from two problems.

The first problem is that, unlike the Chemistry and Hematology laboratories which have been able to cut their personnel due to technological advances, most of the work done in microbiology laboratories is still labor intensive. Most microbiological diagnoses require isolating strains to pure cultures, and there's no rapid or cheap way to do this. This means that the laboratories are cutting back to 'essential' tests, increasing the risk of a delayed or faulty diagnosis.

The second problem is that qualified medical/microbiology technicians are difficult to find. Many of the programs that used to train techinicians are closing due to low enrollment. Why are so few students enrolling? Because the pay sucks. A nurse with an equivalent amount of schooling can make twice as much as a medical technician. Nurses have strong, aggressive unions, while the medical technicians do not.

So what does this mean? Medical technicians are some of the oldest employees at hospitals and public laboratories, and within five to ten years, we will have a shortage of qualified techinicians. It also means that we will be less likely to recruit quality personnel to these positions. Ironically, as these labs become more technically sophisticated, the need for talented personnel becomes all the more critical. As state and federal budgets continue to get hammered (unless one is in the bioterrorism or biopreparedness bidness), the odds that medical techicians will see their salaries increase significantly are pretty slim. It doesn't look like this problem is going to be resolved anytime soon.

And remember: these are the people who will run the tests that your doctor uses to diagnose you.

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Couldn't there be some technological progress? I thought that people were getting good at blasting DNA from seawater against libraries of bacteria to find out what types are there. Couldn't something similar be used - automated to a high degree to test for the limited number of strains we test for today? This sounds like an opportunity to me...

Markk & Mike-

Molecular diagnostics ARE making headway into the clinical lab - especially with the widespread acceptance of real-time PCR (google recent ASM Honoree Frank Cockerill, Mayo). Now that detection methods have moved beyond the radiolabeled probes and blot era; many labs have moved to make room in their budgets for molecular testing. The problem is, a clinical molecular Dx lab will not turn a profit for at leat the first 5 years of it's existence, and that's WITH someone at it's helm that can knowledgeably select the right mix of tests to bring in to start the lab up (google Karen Kaul, Evanston Hospital). How many hospitals are willing to put there money where there mouth is to bring this in-house? (not many). A lab I used to work in is now screening every patient admitted for community acquired MRSA using real time PCR, and has seen initial reports of a positive (financial) impact in it's infection control indicators (in terms of preventing CA-MRSA to gain a foothold in house).

And as Mike says, none of what I've mentioned above even TOUCHES on the fact that there is a MAJOR shortage of technologists with ANY training in molecular methodologies beyond running perfectly kitted FDA approved tests. This is one of the major stumbling blocks in the way of the realization of the promise of molecular methods in the clinical arena. I have maintained this stance since moving from research into the clinical lab in 1988, and have spent the intervening years doing what I can to show others the light, including guest lecturing at some of the remaining Med Tech programs and heavy involvement in ASM branches.

Last year, San Francisco Statue University tried to shutter it's med tech program. This is a school run with state tax revenue; and a program that annually has ~20 students, and graduates an overwhelming number of those students on to passing the CA licensing exam for CLS' (clinical laboratory scientists, yes, we are the only state that does not recognize national licensure). These graduates are waited for with baited breath by the clinical laboratory community in CA (to a 100% job placement rate), and yet this state university could not see the value of this program until a coalition of clinical laboratory personnel rubbed the University Regents' collective nose in these facts.

The truly sad thing is that the general public REMAINS unaware of how much MDs rely on the expertise of a clinical microbiologist to help bring them the correct information. Perhaps if they knew how many times WE were asked by some doc ""what should I use to treat this"......
(sorry, can ya tell this is a subject that gets me on my soapbox?)

By Chromosome Crawl (not verified) on 23 Jun 2006 #permalink

Are the Creation Science institutes not picking up the slack by encouraging a new generation of young Christians to pursue Christ-centered biology careers? Surely the Discovery Institute is inspiring young people to flock to the sciences.

By Chuck the Lucky (not verified) on 23 Jun 2006 #permalink