°®¶¹´«Ã½

March 20, 2023

Dear Chairman Sanders and Ranking Member Cassidy:

°®¶¹´«Ã½ (ASM) thanks you and members of the Committee for your interest in supporting the healthcare workforce, and we appreciate the opportunity to share our views as you consider bipartisan legislation to address the shortages and challenges across healthcare fields. Many of ASM’s 30,000 members work in clinical microbiology laboratories in a range of urban and rural settings, including, but not limited to, academic and university-based medical centers, large healthcare systems, private community hospitals, independent laboratories and public health laboratories. We urge you to include provisions in larger legislation to address the clinical microbiology laboratory professional shortages that our field has experienced for many years now, coupled with the lack of federally funded programs to address financial barriers to entering the field.  
 
Although ASM has known it for some time, the COVID-19 pandemic shone a spotlight on the critical need for a strong clinical laboratory workforce. These highly trained professionals have served on the front lines of the COVID-19 response, when the development, validation and deployment of timely, accurate and reliable diagnostics assumed even greater significance. Diagnostics enable and inform all aspects of infectious disease outbreak management—from surveillance and detection, to response, containment and recovery—but they also are part of routine patient care and public health surveillance.  
 
The pandemic only exacerbated an existing shortage in medical laboratory scientists and infectious disease laboratory professionals. In 2016, several years prior to the pandemic, the Bureau of Labor Statistics predicted we needed 12,000 new clinical laboratory professionals annually to meet rising demand. At that time the vacancy rate for medical laboratory scientists working in clinical microbiology laboratories was 6.25% and the vacancies for supervisory positions was nearly 4%. By 2018-19, the vacancy rates had grown to 10.56% and nearly 7%, respectively. These facts, coupled with the anticipated retirement of 20% of staff in microbiology departments over the coming years, set the stage for what has now become a full-blown crisis. ^1,2

In full support of clinical microbiologists, in gratitude for their commitment to the health and well-being of our society and in recognition of the added challenges that medical laboratory scientists have faced throughout the pandemic, ASM has sought to be proactive in determining the scope of the post-pandemic workforce challenges, including the critical staffing shortage, and developing recommendations for addressing them. Last year, ASM conducted a workforce survey, which was published in the Journal of Clinical °®¶¹´«Ã½. Reported shortages range from medical laboratory scientists performing testing at the bench to highly trained clinical microbiology directors, clinical microbiologists with PhDs or medical degrees.  

In addition to the labor shortages, Leber and colleagues’ survey showed the need for medical laboratory scientists is expected to grow by 11% between 2020 and 2030, a higher rate of growth than the overall average for all other health care occupations.³ But laboratories are finding it difficult to fill the current vacancies, let alone increase staffing to meet future needs. Reasons for this vary, but top-cited reasons included lack of qualified candidates, and lower compensation and benefits coupled with competition among facilities and other laboratory sections or healthcare professions with the ability to pay more. 

We must address the shortages and plan for the future. Otherwise, we will not only compromise routine healthcare, but we will also continue to experience testing crises whenever there is a public health emergency because the already-stretched laboratories will be unable to accommodate the workload. While the challenges facing the profession are myriad, the federal government can provide incentives and support. This support includes but is not limited to: 

• Establishment of loan forgiveness programs that include medical microbiologists and other medical laboratory scientists, both in and outside of public health settings. ASM supported the BIO Preparedness Workforce pilot that passed in December 2022 as part of year-end legislation. However, this program is just one small step toward a more comprehensive approach to supporting the workforce at the outset (education).

• Establishment of federal training grants for medical microbiologists and other medical laboratory scientists and professionals. Current programs do not cover these professionals, and hospitals and other healthcare facilities cannot function without clinical laboratories. 

• Diagnostic tests in infectious disease are reimbursed at lower rates than other types of tests; sometimes not fully covering the cost of the test. This has the downstream effect of devaluing the work of the laboratory and subsequently the profession, depressing salaries and in some cases, leading to substandard care.

We thank you for your leadership and appreciate your recognition of the need to support a strong pipeline of medical microbiologists and other laboratory scientists and other healthcare professionals. ASM and its members stand ready to assist you in this effort. If you have any questions, please contact Annie Scrimenti, ASM Senior Regulatory Affairs Specialist, at ascrimenti@asmusa.org.

Sincerely,
 

¹ Garcia, E et al. The American Society for Clinical Pathology’s 2016-2017 Vacancy Survey of Medical Laboratories In the °®¶¹´«Ã½ States. American Journal of Clinical Pathology, Volume 149, Issue 5, May 2018, Pages 387–400,
² Garcia, E et al. The American Society for Clinical Pathology’s 2018 Vacancy Survey of Medical Laboratories in the °®¶¹´«Ã½ States. American Journal of Clinical Pathology, Volume 152, Issue 2, August 2019, Pages 155–168,  
³ Leber, AL et.al The Hidden Crisis in the Times of COVID-19: Critical Shortages of Medical Laboratory Professionals in Clinical °®¶¹´«Ã½. J Clin Micro 2022; 60 (8) Downloaded from on 14 March 2023 by 66.208.62.130.