Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 11: Laboratory and Pharmacy Services

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 11: Laboratory and Pharmacy Services


Clinical Laboratory TechnologistsClinical Laboratory Technologists

• History of the Profession– Late 1800s, early 1900s: establishment of first clinical labs

– World War I: technicians took on pathologists’ & bacteriologists’ duties

– 1928: Board of Registry (BOR) created by ASCP

– Graduates of BOR exam known as “medical technologists”

– 1933: American Society for Clinical Laboratory Science (ASCLS) formed

– 1973: National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) formed

– Name changed to “clinical laboratory technologists” recently


Clinical Laboratory Technologists (cont’d)Clinical Laboratory Technologists (cont’d)

• Education– Bachelor’s in medical technology or a life science is standard

– Associate’s degree required by CLIA for advanced lab personnel

– Programs offered by universities & hospitals

– Academic classes & clinical experience (3+1 or 4 + 1 program)

– Master’s & doctoral programs available

– 215 accredited programs



• Course Work

– Anatomy & physiology

– Immunology

– Microbiology

– Statistics

– Hematology

– Chemistry

– Urinalysis

– Quality assurance & improvement

– Safety & government regulations & standards

– Communication & teamwork skills

– Ethics & professionalism

– Educational techniques

– Research design & practice

– Laboratory operations



• Licensure, Registration, and Certification

– Licensure or registration

• Required by some states

• Requires bachelor’s degree & passing exam

– Certification

• Optional, but advantageous

• General & specialized

• Offered by several organizations



• General Duties

– Prepare specimens, perform tests on them, & interpret results

– Use complex instruments & equipment

– Check for accuracy

– Ensure proper function of equipment

– Monitor lab process for quality control

– Train subordinates in new techniques

– Design & develop research experiments



• Specialties

– Clinical chemistry

– Microbiology

– Blood bank

– Immunology

– Cytotechnology

– Molecular biology



• Personal Characteristics

– Responsible

– Reliable

– Thorough

– Accurate

– Good problem-solving skills

– Capable of working well under pressure

– Able to focus on complex tests

– Communication skills

– Capable of working independently



• Employment Opportunities and Trends

– >172,000 jobs

– Most jobs in hospitals

– 14% growth from 2008 to 2018

– Growth due to:

• More tests required for growing population

• Development of new tests



• Professional Organization: ASCLS

– Represents all lab personnel

– Advocates for lab occupations

– Monitors legislation

– Acts as liaison to Congress & federal & state agencies

– Emphasizes standards setting, continuing education, & personal & professional development

– Membership benefits: online courses, workshops, conferences, national meeting, etc.


Clinical Laboratory TechniciansClinical Laboratory Technicians

• History of the Profession

– Emerged in the 1960s

– Developed due to:

• New technologies, need for new tests

• Need to free up medical technologists

• Increasing popularity of 2-year community & junior colleges

• 1966: Allied Health Personnel Training Act—provided funding

– 1969: educational programs guidelines published & first exam

– 1973: entry-level competencies approved


Clinical Laboratory Technicians (cont’d)Clinical Laboratory Technicians (cont’d)

• Education

– Most have either:

• Associate’s degree from community or junior college

• Certificate from hospital, vocational or technical school, or military

– A few are trained on the job

– CLIA requires associate’s degree for advanced lab personnel




• Course Work

– Laboratory methodologies

– Specimen collection, processing, & analysis

– Use of lab results in diagnosis & treatment

– Communications

– Quality assessment

– Lab safety & regulations

– Information processing

– Ethical & professional conduct

– Professional development




– Licensure or registration

• Required in some states

• Requirements vary by state

– Certification


• Offered by several organizations



• Work Responsibilities

– Collect & prepare specimens for testing

– Conduct & monitor tests

– Analyze results of tests

– Record findings on computer or paper

– Report problems to supervisor

– Care for instruments & equipment

– Cross-match blood

– Care for specimens

– Train new employees




– Accuracy

– Good judgment

– Analytical skills

– Responsibility

– Precision

– Eye for detail

– Ability to work independently

– Ability to work under time pressure

– Teamwork skills

– Communication skills




– Rapid growth: 14% between 2008 & 2018

– Setting distribution:

• 45% in hospitals

• 15% in medical & diagnostic labs

• 14% in physician’s offices

• 8% in educational services



• Professional Organization: AMT

– Nationally & internationally recognized certification program

– Includes clinical laboratory technicians & technologists & others

– Promotes personal & professional growth & leadership skills

– Benefits:

• Continuing education opportunities

• Annual convention

• State society meetings & seminars

• Professional journal

• Online programs & career center


Laboratory AssistantsLaboratory Assistants


– Emerged in 1950s due to shortage of medical technologists

– State medical associations promoted training programs

– 1960s & 1970s: development of educational & certification standards

– 1962: development of a model training program

– 1963: first certified laboratory assistants graduated

– 1967: exam made a requirement for certification

– 1973: ASMT approved entry-level competencies


Laboratory Assistants (cont’d)Laboratory Assistants (cont’d)

• Education

– HS diploma or equivalent required

– Many are trained on the job

– Some complete formal training program

– Only a few accredited programs

– Programs:

• Last about 18 months

• Lead to a certificate

• Some combine training with phlebotomist & EKG training

• Include both course work & practical experience



• Course Work

– Laboratory assistant skills

– Introduction to health care

– Medical terminology

– Laboratory administrative skills

– Anatomy & physiology

– Medical laboratory safety

– Phlebotomy

– Computer applications

– Interpersonal & communication skills




– Licensure or registration required in some states

– Certification

• Certified Medical Laboratory Assistant (CMLA) credential

• Some programs prepare student for phlebotomist certification


– No professional organization for this occupation




– Collect & label samples

– Set up routine tests

– Prepare materials for analysis

– Perform low- to moderate-complexity tests

– Maintain storage system for specimens

– Deliver samples for testing

– Recognize & report errors

– Maintain equipment & supplies

– Enter patient data into computer

– Answer phones

– Process test orders

– Report results

– Do billing




– Strong organizational skills

– Eye for detail

– Ability to work both independently & as part of a team

– Interpersonal & communication skills

– Ability to work well under time pressure

– Ability to work quickly & accurately




– Shortage of personnel due to:

• Competition for qualified staff

• Lower compensation for lab work compared to other fields

– Increased opportunities due to:

• Aging baby boomers

• Low awareness of lab occupations


PharmacistsPharmacists


– Colonial America: doctors, apothecaries, & wholesale druggists

– Before Civil War: apothecaries trained by apprenticeship

– 1821: first professional association & first college of pharmacy

– After Civil War

• Pharmacy education shifted to state universities

• Albert B. Prescott: shifted focus to academic study

• State boards began licensing pharmacists

– 1900: pharmacy school association formed (later called AACP)

– 1920s: AACP adopted basic curriculum


Pharmacists (cont’d)Pharmacists (cont’d)

• Education

– PharmD degree required


– Entrance to program requires:

• At least 2 years of undergraduate work

• Most programs require PCAT

– Programs usually last 4 years

– “0-6” programs, for high school student applicants

– Residency programs following graduation increasingly required

– MS & PhD degrees available



• Course Work

– Pharmaceutical chemistry

– Pharmacology

– Business management

– Pharmacy practice

– A clinical component



• Licensure

– Required in all states

– Requires PharmD & passing several exams:

• All states: North American Pharmacists Licensure Exam (NAPLEX)

• Most states: Multistate Pharmacy Jurisprudence Exam (MPJE)




– Receive prescriptions & fill them

– Monitor work of technicians

– Counsel patients

– Confer with physicians & other health care professionals

– Maintain confidential medication records

– Plan, monitor, & evaluate drug treatment plans

– Complete third-party insurance forms

– Run a business




– Organizational skills

– Eye for detail

– Conscientiousness

– Reliability

– Strong analytical & problem-solving skills

– Good judgment & common sense

– Good communication & interpersonal skills

– Good teamwork skills





– Factors prompting growth:

• Increased demand for prescription drugs due to population growth

• New drugs becoming available


• 65% in community pharmacies




• Professional Organization: NPhA

– One of several professional associations for pharmacists

– Represents interests of minority pharmacists

– Works to advance standards of pharmaceutical care

– Works to stimulate interest in pharmacy as a career

– Benefits:

• Annual convention

• Regional meetings

• Continuing education

• Networking


Pharmacy TechniciansPharmacy Technicians


– Began with training program by U.S. Army in mid-1940s

– 1940s to 1960s: establishment of a formal system of training

– 1975: American Society of Health-System Pharmacists (ASHP) established

– 1982: accreditation standards established

– 1983: ASHP began accrediting programs

– 1990s: national certification program & model curriculum developed


Pharmacy Technicians (cont’d)Pharmacy Technicians (cont’d)

• Education

– Some trained on the job

– Most complete formal training

– Accredited programs must:

• Provide at least 600 hours of training over 15 or more weeks

• Cover topics stipulated in model curriculum

• Develop individualized training plan for each student

• Require extensive lab experience

• Offer an internship or externship in at least two settings

– HS diploma or equivalent required by some states



• Course Work

– Introduction to pharmacy

– Medical terminology

– Pharmacology

– Pharmacy math

– Commercial pharmacy practice

– Hospital pharmacy practice

– Pharmacy law & ethics

– Computer applications

– Psychology

– Speech or interpersonal communications



• Certification

– Required in some states, optional in most

– Offered by several organizations

– Requires passing a national exam

– Recertification required every 2 years via continuing education




– Accept a written prescription

– Review info on prescriptions for accuracy

– Prepare prescriptions

– Prepare prescription labels

– Choose proper containers & label them

– Price & file prescriptions

– Perform administrative tasks




– Responsibility

– Eye for detail

– Organizational skills

– Customer service skills

– Friendly, professional attitude

– Good teamwork skills

– Ability to work independently





– Factors prompting growth:

• Increased demand for prescription drugs due to population growth

• Pharmacy technicians taking on new roles


• 73% in retail pharmacies




• Professional Organizations

– American Association of Pharmacy Technicians (AAPT)

• Represents interests of members to public & health care organizations

• Helps technicians update their skills

• Provides continuing education programs, a national convention, & a career center

– National Pharmacy Technician Association (NPTA)

• Promotes professional development

• Advocates for the profession

• Conducts industry-related research

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Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 11: Laboratory and Pharmacy Services