The letter by Jeffrey Tarrand, MD, about technologist licensure (September
2005, page 8) addresses a critical issue: the importance of pathologists’
support for clinical laboratory scientist/medical technologist licensure if
the profession is to grow and prosper. I agree with Dr. Tarrand that without
licensure in all 50 states (currently in only 15), the profession will continue
to diminish in numbers and impact. He is correct that there is little evidence
that pathologists are supporting licensure campaigns.
There is significant evidence, however, that pathologists have individually
and collectively, primarily through the CAP and the ASCP, done a great deal
to impede the licensure movement over the last 20 years. The recent defeat of
a licensure effort in Massachusetts, the latest in a long line, was primarily
due to the opposition of the CAP. Pathologists, despite recent improvements
in this area (too little, too late?), are the main reason that medical laboratory
professionals (clinical laboratory scientists, clinical laboratory technicians,
cytotechnologists, and histotechnologists) are the only health professional
group that is not licensed in all 50 states. Pathologists have consistently
put their own professional agenda before that of their medical laboratory “colleagues.”
I hope pathologists (and medical laboratory scientists) will wake up and smell
the coffee before it is too late. While they are at it, I also recommend that
- Use the titles we have selected for ourselves, not theirs.
- Encourage students to take true “peer” certification examinations
(National Certification Agency for Medical Laboratory Personnel) and allow
equal status to medical laboratory professionals in the administration of
the ASCP Board of Registry (better, but still under the ultimate control of
- Allow medical laboratory professionals full membership in the ASCP. I stopped
being an associate member many years ago when I realized I would never be
allowed the rights and privileges of full membership and would essentially
be limited to second-class status. Despite this, more clinical laboratory
scientists belong to ASCP than ASCLS (we have met the enemy, and they are
- Support medical laboratory training programs. Programs, especially in-hospital
programs, have closed primarily because of the lack of pathologist support.
Our long adolescence as a profession must finally come to an end. Pathologists
have to let us grow up and be their colleagues. Dr. Tarrand’s conclusion
is right on: “But if we ignore the problem and let the MT career vanish,
Wall Street will change the field radically or technologists will unionize.
Neither option serves the interest of patients or pathologists.” Nor does
it serve the interests of clinical laboratory scientists and other medical laboratory
Gregory E. Paquette, PhD, CLS(NCA)
Professor and Director
Clinical Laboratory Science Programs
Department of Cell
and Molecular Biology
University of Rhode Island
It’s a matter of compensation
Bravo to Jeffrey Tarrand, MD. Finally someone recognizes the value of
a licensed professional medical technologist. While the National Labor
Relations Board defines a medical technologist as a professional, the
rest of the health care industry does not, and many within the industry
strive to keep the status quo. This is because licensed professionals
are better compensated.
Any time MT licensure is discussed publicly, the parties against it cite
higher personnel costs and the lack of studies proving benefit. There
are no studies because it is not in the interest of the people who control
the laboratory industry to increase their personnel costs. Let’s
face it, the ASCP and the CAP are organizations for the benefit of pathologists.
The AMA successfully diluted CLIA ’88’s personnel requirements
for the same reasons.
It is a shame that an Associates of Science RN with no experience starts at
a much higher wage than a Bachelor of Science MT with over 20 years’ experience
earns. This is due mostly to supply and demand, but I do wonder if my employer
values me that much less. I have brought a lot of benefit to the hospitals for
which I have worked and I have been rewarded, but not to the extent of the transient
Our test volumes are rising, and testing is becoming more complex. Physicians
are becoming ever more dependent on laboratory results because of the increasing
demands on their time. Licensure of medical technologists with heightened requirements
for education and continuing education will help ensure quality laboratory results.
Higher educational requirements are an overall industry trend; an occupational
therapist needs a master’s degree and physical therapists and pharmacists
now need doctorates. Every other allied health professional is licensed. MTs
should be licensed too.
Tom McKinley, MT(ASCP)SC
Editor’s note: The CAP’s position on licensure was explained in
the November 2004 issue of CAPTODAY, page 16.
An ‘extraordinary asset’
Serving as a delegate for California, I recently attended CAP’05
in Chicago and participated in a reference committee and several conferences
while there. On more than one occasion, I heard the question, “Where’s
Jack?”—after which Jack Bierig would emerge from the back
of the room or someone would take off to find him and bring him to the
I would like to take this opportunity to note Mr. Bierig’s support
for the College and the respect accorded him by the pathologists and CAP
staff at the meeting, most of whom he knew on a first-name basis. Having
read his articles for years in CAPTODAY and upon the recommendation of
a pathologist friend in Atlanta, my small group consulted him during the
renegotiation of our hospital contract in 2004. His contribution to that
endeavor was invaluable. Our experience is that he is an extraordinary
asset for the College, both at individual and universal levels.
The most striking thing to me is that in all discussions, private and public,
Mr. Bierig bases his comments on the caveat that we are physicians and our first
responsibility is to our patients. Though he ably maneuvers the scope of our
practice concerns from professional malpractice issues to medical staff interactions
to government affairs, he keeps this presumption at the base of the algorithm.
I cannot imagine anyone else with a legal background being able to share this
basic understanding of who we are and what we are about. We are well served
with Jack Bierig as our advocate.
Pamela S. Bullock, MD
Pathology Medical Associates
of Orange County