Hi Tim -

Thanks for responding to my post, but there still are some things that
concern me.

First - I agree that an education can only improve the performance of a tech
in the lab.  My concern is that even the Associates requirement does not
adequately specify what courses need to be taken.  I think if ,as you
suggested, you required Microbiology, Immunology, Cell Biology, Genetics,
Biochemistry and both Inorganic and Organic Chemistry as part of the
Associates degree requirement - Then I'll agree that it will "uplift the
profession" and improve the quality produced by the labs.  Otherwise, just
requiring so many hours of biology and so many of chemistry is meaningless.
Does that mean that a semester of ecology (which is a biology class at this
university) has the same relevence to our profession as an hour of
microscopic anatomy? Also, most associate programs in general lab technology
do not have a rotation in histology - so most of the procedures learned will
still be on the job trained.

Second, many have responded that the concern is with those entering the
field, not the ones already here. I understand that change needs to start
somewhere, but wouldn't it truly "advance our profession" by requiring only
an HTL perform certain procedures?  Or at the very minimum require all
technicians to receive meaninful continuing education credits, IHC
certification for those performing those procedures, and stricter regulatory
standards by those that govern our industry? Why does this higher
educational standard only apply to those entering the field?  I agree with
you that EVERY tech should understand the methods, but there are many
already in the field who do not.  It seems otherwise, this new requirement
will do very little if anything to improve either part of our profession.

My major concern lies in the regulation of our field.  It truly scares me
that there are some labs out there that have technicians performing
complicated testing that directly determines the type of treatment a patient
receives (such as breast cancer markers) with virtually no meaningful
regulation (from either the BOR or CAP).  Some of these techs - as I'm sure
you have seen - are so unintersted in the procedures they are doing and have
so little understanding of the theory that a mistake on their part could
easily be overlooked. One of the technicians I worked with in the past has
made me convinced of one thing - if anything like that is required for me or
a member of my family - I will have two labs test it!

As I stated previously, there are many areas of histology that do not
require education beyond a high school diploma.

If the main goal of this new regulation is truly to uplift our field and
increase the quality of slides produced - then require more education of ALL
- including the techs already in the field.  I'm sure this is an unpopular
view - as there are many subscribers of "the old school" to this list - but
if the BOR doesn't do that - I truly have to question why this is being
done.

Louri Caldwell, BS (Microbiology), HTL (ASCP)
College of Veterinary Medicine
University of Georgia


>From: "Morken, Tim" <tim9@cdc.gov>
>To: 'Louri Caldwell' <louri_c@hotmail.com>, histonet@pathology.swmed.edu
>Subject: RE: BOR Registry - Clarification
>Date: Tue, 12 Sep 2000 13:19:56 -0400
>
>Louri wrote,
>
><<Also, you'll have no better influence over the quality of
>the more complicated procedures produced by labs because you'll still have
>those who are HT grads or who were grandfathered in performing those
>procedures that supposedly require the additional education put forth by
>the
>
>BOR.>>
>
>Did you know that manicurists and barbers have tougher standards of
>pracatice than histotechs? All manicurists and barbers, by law, have to go
>through training and take a board exam to do their work. The reason is
>because there are a lot of ways a they can injure people through improper
>techniques.
>
>Doesn't it seem strange that, in most states, a person can go into a histo
>lab in the US with no training at all and be allowed to do the work? There
>are multitudes of people that have done just that. In one hospital I worked
>in we took a dishwasher and made him a histotech. He learned to do the
>cutting and stains and did well. It happened, however, that he had no idea
>what he was doing; he just followed the directions and managed to get
>things
>right (about the AFB control he would say "If the red dots are there, it's
>OK"). No matter how we worked with him he could not grasp chemistry and
>biology. He certainly is not one that you would want training anyone else!
>
>That's certainly a worst case scenario but it is what lab administrators
>will do when there are no requirements, as there are none in histology now.
>Why not? They save money by paying them less and work gets done. You only
>need certain education to be certified, not to get a job or work. There are
>thousands of uncertified techs working out there and I've seen many that
>are
>incompetent to work with modern technologies.
>
>Now, just because a person CAN be trained OJT to do these things doesn't
>mean we should do it that way. There is certainly no rule that says we owe
>it to people to give them a job just because they want one or are
>interested
>in a certain field. And why would we want people who don't want to put out
>the effort to meet some minimal standards? We're only cutting our own
>throats with that line of thinking.
>
>Quality control is the province of a lab. It has nothing to do with
>education reuirements needed to be certified. The fact that most histotechs
>are being trained by old-time techs just shows you thow the system has
>always worked, which is not to say it is a good system. Yes, many of those
>techs are excellent. But many are not. I doubt many of them would say  more
>education is worthless!
>
><<I was only trying to understand the purpose behind the AA
>requirement, as I do not see how this "advances our profession" as the
>previous arguements have stated.>>
>
>I don't understand why you can't see that taking chemistry, biology,
>physiology, anatomy and microbiology courses, to name a few, is good for
>histotechs. It would seem to be obvious how these would help a person do a
>better job!
>
>Learning any of these subjects outside of a formal course is very
>difficult,
>something only the most dedicated will be able to do. Learning them on the
>job will result in an incomplete education because you will only learn what
>you need to do the job at hand.
>
><<...you'll have no better control of the quality of training
>received unless you implement strict curriculum guidelines for the
>certification.>>
>
>It's true that at some point most histotechs learn the hands-on methods on
>the job. What they really learn at that time is dependent on who teaches
>them and how they apply themselves. The inconsistency in this part of the
>training is all the more reason to require certain formal education levels
>outside of the job.
>
>It is certainly true that there are only minimal standards for education
>right now. The requirements for college education are spelled out according
>to certain credit hours of chemistry, biology and other courses, not whole
>programs. That is a concern for the future (you may want to see the last
>ASCP Lab Medicine, which has an article which outlines and "ideal" B.S.
>program for histotechnology). Right now we need to get people with basic
>science education in the lab, not dishwashers!
>
><<It just appears that the BOR is trying to "advance the profession"
>through artificial requirements that in the end do not mean much.>>
>
>Sometimes you have to drag people kicking and screaming into the future!
>You'll only know the  "meaning" of all those requirements after you meet
>them and use them on the job.
>
><<Again, I do not feel that an HTL is required to perform those more
>complicated procedures - as I know many HT's that are high school grads
>with
>
>OJT that understand it as fully as those who have a degree.>>
>
>Wouldn't you rather have EVERY tech understand the methods, rather than
>"many", or more likely, only a few?
>
><<I just feel that the AA requirement hurts a lot of very capable people
>from
>entering the field, and it's going to be even harder to recruit individuals
>to work.>.
>
>Again, in most states anyone can enter the field now. The education
>requirement is only for certification. If a person is really interesed in
>making it a profession the AA degree won't be a big hurdle. As I said
>before, I believe the higher requirements will most likely attract more
>people to the field.
>
>As to being "hurt", how do you think people will feel when they realize
>they
>are not going to get promoted beyond a basic bench tech position because of
>their lack of education? Even if an institution is willing to give them a
>job at the most basic entry level it doesn't mean they will pass them up
>the
>ladder just because they can do a certain job. Anybody in any lab can tell
>you that education is the key to advancement. My experience is that those
>who are willing to get the education they need do the very best work in all
>circumstances. In fact, the good techs I know recognize a certain truth:
>the
>more you do in the lab the more you realize how much more education you
>need.
>
>Finally, Louri, I was shocked when I first started working in the histolab
>and found out that only one person had more than a high-school education.
>Out of five techs, one was really good, but he learned histotechnology in
>the military. The rest were OJT people and were average or below average in
>their histotech work(by my standards). I quickly realized that histology
>was
>the backwater of the lab. Since I had never even heard of the field before
>that (I was in EM) I could not even imagine that people working in a
>hospital lab would be so uneducated. Even later when we got a couple of
>bachelor-level people, they had degrees in things like environmental
>science
>and had little understanding of biochemistry, physiology or anatomy. They
>were able to learn much more quickly, however, while the others floundered
>with every new technology that came in.
>
>I have done consulting work in many labs to train people for
>immunochemistry
>and ISH. I can tell you that there are many, many labs out there that are
>just hangning on by a thread because the people working in them are just
>working in the dark. Yes, there is a shortage, but the last thing any
>respectable lab wants now days is more uneducated people!
>
>Tim Morken
>Atlanta
>
>
>-----Original Message-----
>From: Louri Caldwell [mailto:louri_c@hotmail.com]
>Sent: Tuesday, September 12, 2000 8:29 AM
>To: histonet@pathology.swmed.edu
>Subject: BOR Registry - Clarification
>
>
>To clarify my opinion as stated in the previous e-mail, I am against the
>requirement of an AA for an HT - and I was trained by a graduate of a
>technical school (not a histology program or an Associates Degree
>Program)who had extensive on-the job training.  She also is the best tech
>I've ever worked with.
>
>However, I was only trying to understand the purpose behind the AA
>requirement, as I do not see how this "advances our profession" as the
>previous arguements have stated.
>
>First of all - you'll have no better control of the quality of training
>received unless you implement strict curriculum guidelines for the
>certification.   Also, you'll have no better influence over the quality of
>the more complicated procedures produced by labs because you'll still have
>those who are HT grads or who were grandfathered in performing those
>procedures that supposedly require the additional education put forth by
>the
>
>BOR.  It just appears that the BOR is trying to "advance the profession"
>through artificial requirements that in the end do not mean much.
>
>Again, I do not feel that an HTL is required to perform those more
>complicated procedures - as I know many HT's that are high school grads
>with
>
>OJT that understand it as fully as those who have a degree.
>
>I just feel that the AA requirement hurts a lot of very capable people from
>entering the field, and it's going to be even harder to recruit individuals
>to work.  There are not enough of us out there as it is.
>
>Louri
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