Volume 73 - Fall 1999	Download

President’s Report Technological Change, Reimbursement Change, Program Change by Joeline D. Davidson, MBA, CLS(NCA), MT(ASCP) President, Board of Directors

For the proposed CLS/MT Essentials, the comments that have been received by letter, email and at meetings have been very mixed. At meetings where there was open discussion and full exchange of information, comments were most favorable. Where there was no exchange and comments were forwarded to the office, comments tended to indicate that the proposed Essentials were not fully understood and, in addition, described a graduate level program.

At its summer face to face meeting, the Executive Committee discussed how the trends in health care and technology impact programs. Among the issues considered were the following.

TECHNOLOGICAL CHANGE

• Technological changes are occurring at an increasingly accelerated rate.
• More "point-of-care" devices are being developed that require laboratory scientists to oversee the testing, quality assurance, quality control and calibration, as well as provide the appropriate education to users of these devices.
• More tests at the bedside mean fewer tests in the laboratory. Fewer tests coupled with better technology and automation result in fewer people needed in the laboratory.
• Laboratory scientists are needed to consult on laboratory issues such as appropriate testing, testing methods, problem solving, medical necessity, reimbursement and so forth.

REIMBURSEMENT CHANGE

Reimbursement reductions are forcing health care institutions to consolidate functions and to consider mergers and alliances which further reduce the number of technical and scientific professionals needed.

PROGRAM CHANGE

The number of CLS/MT programs has declined rapidly. There are now 277 accredited programs of which 20 are inactive. This is expected to continue as programs, particularly hospital-based, close due to economic pressures and consolidation of services. At the same time, the number of CLT/MLT programs has remained fairly stable.

It is clear that these environmental trends are indicators of a period of great transition. Change, such as that suggested by these trends as well as by the proposed job description in the draft Essentials, is difficult and often occurs slowly. Given all of these factors, I proposed to the Executive Committee that we must seriously consider "How do we get from here to there? How do we meet the needs of involved entities during the transition? What will entry level be in the future?"

It was decided that at the full Board meeting in October, the Executive Committee would suggest several options for the Board to consider. They are:

1. Accept the proposed Essentials
2. Modify the proposed Essentials to be more like the current Essentials
3. Do nothing and let the market generate inevitable change.

In developing these options, the Executive Committee reiterated that NAACLS should be a leader in setting standards for the future and that NAACLS should try to assist programs through the transition. Several points of strategy were developed to present to the Board of Directors:

1. Keep the current CLS/MT Essentials or perhaps modify them slightly
2. Use the proposed Essentials as a basis for a graduate level program
3. Sponsor a Futures Conference for clinical laboratory professionals where the functions of the various professional levels (Clinical Assistant, CLT/MLT, CLS/MT, and graduate) can be discussed and defined.

This is a summary of the Executive Committee's discussion and the points that will be presented to the Board. A full discussion will be held at the Board meeting in October when the Executive Committee recommendations will be presented. The decisions of the Board will be published after the meeting.

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