Rene, Glen, et al,
I agree totally, and Rene that was a great response to Jennifer. I certainly don't have a solution or solutions to the low pay problem, but understanding it as best we can is necessary for improvement and remediation. And I think it was Chuck who pointed out that there has been some improvement. That is correct and a good thing too.
I believe the point has been made about education and that is critical. The Histology world has made tremendous strides educationally. This may be preaching to the choir a bit, but hopefully communicating in this forum will help those indirectly involved with Histology (technically), yet directly involved financially, get a better handle on just how valuable we are.
Rene, your points are well made. The clinical lab mind-set, for the most part, is that Histology is a walk in the park. While the rest of the clinical lab (for some reason) is at a higher level than Histology. I found Jennifer's point, about pathologists not making final decisions, before releasing results to clinicians, a bit curious. As a Med Tech, you are not diagnosing a patient, the clinician is. As a Histotech, you are not diagnosing the patient, the clinician is as well, albeit with input from a pathologist, via path report, etc. At times, clinicians are not diagnosing off clinical lab results, until there is input from a pathologist as well. That is why pathologists are the medical directors of clinical labs, even though their closest working relationships are usually with Histology.
Also, the world of Histology has exploded, exponentially in the last 20-30 years. This is not to say that the clinical lab world hasn't ramped up technically as well. To the contrary, all lab service has taken tremendous technical leaps. However, automation has more readily suited the clinical lab for the most part. This has put even more pressure on Histology to meet the demands for turnaround times and staff shortages. Even though we've got great new, innovative technology there is a manual and artistic element to Histology that does not exist in the clinical lab. I've been told, the day is coming when automation will do Histology from beginning to end. In the meantime, you'd be hard pressed to replace a deft hand and a keen eye in most Histology applications.
Jennifer, believe me, I'm glad your stress has been reduced doing Histology instead of clinical lab work. I take that as a compliment, a compliment to the nature of our work and the type of people doing it. Despite the money differences, I can't tell you how many times I've thanked my lucky stars to be working in Histology and with Histologists. I know this is anecdotal, but in my experience, most of Histology folks just haven't been wound as tight as other laboratorians I've encountered. Getting back to stress for a moment...having a surgeon and/or a pathologist pacing behind you while cutting a difficult frozen is a unique sensation never felt in the clinical lab. Same thing applies to any Moh's service.
Lastly, I believe, more is being asked of Histology today than ever before. More...learning more in shorter periods of time, doing more with less (staff and money) and having more of an impact in patient diagnoses and avenues of treatment.
The irony is that some people just expect this...continued improvement, increased workload, etc. Yet, Histologists are supposed to just keep quiet, and be thankful for what compensation comes their way. At my last job, unionization was leveraged to help alleviate this situation. I was on the other side of the fence, but could certainly appreciate the wherefore and the why. Please understand, my comments are not meant to minimize the importance of clinical labs or the hard working personnel in them. I'm trying to help shine a light onto the much deserving Histologist and the Histology world. I'm off my soapbox now, thanks.
Thomas Jasper HT (ASCP) BAS
Central Oregon Regional Pathology Services
Bend, Oregon 97701
From: email@example.com [mailto:firstname.lastname@example.org] On Behalf Of Rene J Buesa
Sent: Monday, May 19, 2008 6:16 AM
To: Jennifer MacDonald
Cc: Dawson, Glen; email@example.com; firstname.lastname@example.org
Subject: RE: [Histonet] Salary Scales
My main issue is with the samples: in histology they are usually UNIQUE, small, solid and if lost or damaged they cannot be replaced at all. That fact makes the decisions taken regarding that sample more transcendental.
Unless you are dealing with a blood sample taken during a physiological or medical crisis, any blood sample can be redrawn if damaged or lost, and that makes the samples sometimes a non issue within the ML.
I am not referring to the technical part of reading a blood differential count or releasing a result.
Blood counts now are done automatically and what the MT has to do is to check on flagged cells, like a cytotech reading the least "normal" cells in a PAP smear "read" by an automaton.
A MT has to make sure that the controls in a run are within the established limits, and if that is the case, then it is normal to release the results that, if out of the limits, come also flagged by the instrument.
What I am referring to also is that when confronted with a foreseeable workload increment the manager in the medical lab starts looking for a more efficient and productive analytical instrument, but confronted with an increment in the number of surgical cases, the manager in the histology lab can only hope to be able to hire more qualified personnel.
I don' say that there are no decisions to make by the MT, what I am trying to point out is that those decisions, because of the special characteristics of the samples, have more permanent consequences in histology.
I am also saying that those differences are not reflected in the salaries, always higher for the MT even when the work for the MT is automated in about 80% of the tests, and it does not reach 30% for the histology lab.
Jennifer MacDonald wrote:
While I agree with Renee that histotechs have to make many decisions, I don't necessarily agree that they make more decisions that other areas in the lab. I worked in the clinical lab for many years and had to make many decisions regarding the adequacy of a specimen and interpret the QC before that result could be released. Manual differentials require that the tech know the morphology of all cell types. Cross matching blood for transfusions requires interpretation before that blood can be released for transfusion to the patient. An error in cross-matching can kill the patient. I can tell you that my stress level as a Medical Technologist was much higher than my stress level as Histotechnician. There are many more examples where the knowledge and judgement of the tech will determine the outcome of patient result reporting and treatment. The pathologist does not make the final decision for the Med Tech before they release results to the clinician. We were also responsible for notifying the clinician when the patient results were critical.
Rene J Buesa
Sent by: email@example.com 05/15/2008 09:22 AM
"Dawson, Glen" , firstname.lastname@example.org cc
RE: [Histonet] Salary Scales
And it will keep that way until histotechs star demanding what is deserved!
Have you realized that histotechs are the only specialists in the medical lab that have to make decisions all along the process?
When to reject a too thick slice of tissue to assure proper processing?
What part to embed to cut?
Up to where trim the block discarding parts of the specimen FOR EVER?!
Which section to take or which to discard FOR EVER?!
When to stop differentiation in a special stain?
There is no other area of the ML that has to take so many decisions, and they are better paid. And will be until the HTs decide to take action and demand what is deserved.
Just my opinion (as usual!).
"Dawson, Glen" wrote:
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