? Under the Microscope: Medical Laboratory Technologists in BC

A new report from the Health Sciences Association of BC puts a microscope on the critical role of medical laboratory technologists in the health care system – and how acute staffing shortages are causing burnout and delaying patient care.
 
Medical laboratory technologists (MLTs) are often invisible to the public, but health care would not function without them.
 
At least 70 per cent of medical decisions depend on medical laboratory results. And yet, British Columbia faces a critical shortage of MLTs who are required to analyze tissue samples, blood, and other body fluids.
 
Without MLTs, doctors would not be able to make accurate diagnoses and recommend appropriate treatments for patients. Shortages contribute to delayed diagnoses, growing wait lists, and health care strain.
 
Through interviews with frontline MLTs and statistical analysis, this report finds that staffing shortages are widespread and worsening in hospital labs across BC:

• In 2021, BC had 44.8 MLTs per 100,000 population – the lowest rate in Canada and behind Ontario (46.8), Quebec (53.7), and Alberta (56.4).
   
• Public sector staffing levels (as measured in full-time equivalent per capita) declined by 11% in BC between 2014 and 2023. In the Lower Mainland, there was an absolute reduction in staffing levels as well as on a per capita basis.
   
• Reliance on overtime to manage understaffing and shortages is apparent from data obtained from BC health authorities. Overtime increased in all health authorities – from 47% to 166% – between 2018/19 and 2021/22.
   
• At least 63 additional MLT full-time equivalents are required in order to avoid the use of overtime. As one key informant interviewed for this research stated, BC is missing at least one-third of its MLT workforce due to unfilled vacancies.
   
• When short staffing is so severe and overtime has been exhausted, health authority employers are increasingly contracting-in temp agency staff. Contracting-in is a form of health care privatization when a private, for-profit company is contracted to bring its own staff into a unionized workplace to do the work of unionized workers. The higher pay of contracted agency staff – working alongside lower-paid unionized MLTs – erodes morale and contributes to the hollowing out of the public sector workforce as permanent staff move to temp agency work.

The consequence of understaffing and shortages negatively affect patient care because labs must prioritize analysis for the emergency department and inpatient wards. Diagnoses can be delayed and wait lists bottleneck, thereby contributing to greater hospital strain.

Although the BC government has taken positive steps to address the shortages, much more action is required. The report makes recommendations to address the staffing crisis:

• Fill existing vacancies using targeted initiatives to support immediate recruitment.
   
• Increase baseline staffing levels in order to reverse declining per capita staffing levels, make workload manageable, and expand clinical leadership opportunities.
   
• Provincial funding for province-wide and health authority-directed recruitment.
   
• Stop contracting-in MLTs and other health science professionals, which contributes to the hollowing out of the public sector MLT workforce.
   
• Increase post-secondary training opportunities. In July 2022, the BC government added 16 new MLT seats at BCIT and 12 new seats at College of New Caledonia, but more seats are required.
   
• In addition to increasing the number of new MLTs in the province, BC must improve retention of the existing workforce. One of the four areas of focus in the BC government’s new health human resources strategy is retaining existing public sector professionals. HSA eagerly awaits concrete strategies, including workload standards, that will help address the retention crisis in BC’s health sector.

For many years, MLT compensation in BC has been among the lowest in Canada. However, the new Health Science Professionals Collective Agreement begins to significantly increase compensation to become more competitive with other provinces. And while compensation is not the only reason leading MLTs to avoid or leave public sector employment in BC, it is one of the most important factors contributing to recruitment and retention challenges.

The Health Sciences Association of BC represents over 20,000 specialized health care professionals, including over 2,300 medical laboratory technologists. The report can be downloaded here.