Do you ever wonder what happens to the tube of blood taken at a routine exam, or bedside in the hospital, and how several hours later you get a detailed report that tells you how your body is functioning? Or how that uncomfortable nose swab is used to detect the coronavirus? This is the work of medical laboratory scientists, who rigorously perform a plethora of laboratory tests in controlled and pristine environments to provide safe and accurate results. According to the CDC, on average 14 billion laboratory tests are conducted annually by medical laboratory professionals, and 70% of medical decisions depend on the findings from these tests.
The Hidden Faces of Healthcare
From analyzing cancer biomarkers to detecting dangerous pathogens, medical laboratory scientists work behind the scenes to improve and even save patient lives.
Yet, as patients we know little about these people who influence our care, and in some cases provide life-saving information. In 1975, the American Society for Clinical Laboratory Science started an annual “Medical Laboratory Professionals Week” in order to raise public understanding and appreciation of the field and the faces behind the work. In celebration of this tradition that took place last month, we talk to Joshua Cannon, MS, teaching assistant professor and education coordinator in the department of Medical Laboratory Sciences and Biotechnology. Read on to learn more about what medical laboratory scientists do and the impact they have on patient care.
What is the role of a medical laboratory scientist in healthcare?
The majority of medical laboratory scientists work in clinical or hospital laboratories, but we also work in reference laboratories like Quest Diagnostics or Labcorp, and other places like physician offices, industry, and more. While we don’t actually diagnose the patient ourselves, we provide the laboratory data that clinicians rely on to make most diagnoses. We also help in the management of a patient’s condition, through repeat testing. And in some cases, laboratory tests are needed to determine whether a certain course of action or treatment will be safe and/or effective. Our work helps to diagnose, manage and treat patients.
What does a day in the life of a medical laboratory scientist look like? What are some of the different tasks medical laboratory scientists do?
There are four main departments that medical laboratory scientists work in. The first one is clinical hematology, which is the study of blood and blood conditions. We can learn a lot about a patient, simply by looking at their blood under a microscope – we run tests to determine the number, shape, and other features of the different cells that make up our blood, like red blood cells, white blood cells, platelets etc. Hematology testing helps diagnose conditions like anemia, leukemia, lymphoma, coagulation disorders, hemophilia and even blood clots.
Pictured here is Gemma, identifying white blood cells in a patient specimen to help detect signs of infection.
Then there is clinical chemistry, which constitute literally thousands of tests. Most of these tests are done by analyzers or machines, but some are still done manually in very controlled conditions. These instruments measure things like glucose to help diagnose diabetes, proteins to help determine heart failure, and tumor markers to help detect cancer. We test a whole lot more though— electrolytes, vitamins, metabolites, enzymes, hormones, drugs. It’s almost like you name it, we can test it in our clinical chemistry labs.
Medical laboratory scientists like Valerie (left) and Amanda (right) run hundreds of clinical chemistry tests to help diagnose conditions like cancer, heart attack, diabetes etc.
There’s clinical microbiology: so any kind of infection that you could ever think of in any part of the body, we can take literally any specimen - a scraping from an eye to a piece of an organ or even bone – we can culture those specimens to see if pathogens are present. And then we can identify whether it’s a bacteria, parasite, virus, etc. and the specific kind so that doctors can prescribe the right medicine to treat the infection. We played a vital role in COVID-19 testing during the pandemic, a lot of nasal swabs came our way!
Clinical microbiologists like Jori work with specimens from bacteria and viruses to sputum and bone.
The fourth is blood banking. Say somebody needs a blood transfusion, we'll determine the patient’s blood type and screen for proteins called antibodies that could cause any issues during the transfusion. Then when we receive blood to give to this patient, we perform a cross-match between the donor blood and the patient’s blood to make sure there’s no reaction. Because if a patient receives blood that is unsafe or isn’t a match, it can be fatal.
Depending on what the patient’s needs are, we can also separate the blood into its different components. During the pandemic, you may have heard about patients donating and receiving plasma that contained antibodies against the coronavirus – a trained medical laboratory scientist can perform the work of separating out the plasma from the rest of the blood.
We do a lot of other things, but this is a broad overview!
Cytotechnologists like Kelly evaluate cellular specimens for the presence of various abnormalities, like precancerous cells, malignancy, and infection. Pictured here is a giant cell tumor of the bone.
What area do you work in?
Before I began teaching full time six years ago, I worked in a STAT laboratory that mainly ran hematology and clinical chemistry testing. My specialty is hematology. I fell in love with identifying different white blood cells under the microscope and correlating the various red blood cell morphologies you can see with disease. Looking into a microscope is like looking into a different world, and the fact that you can tell so much about a patient, simply by looking at a drop of their blood on a microscope slide is fascinating. It’s the reason I became a medical laboratory scientist.
How did the pandemic affect your profession and field?
The COVID-19 pandemic certainly highlighted the critical need for medical laboratory professionals and the impact we have on patient care – we performed literally millions of tests. We’ve never been thrown into the spotlight or even covered by the media like that before and it wasn’t always positive attention. Between the politicization of the virus, the rapid flux of information on the virus, the different variants, and the various at-home tests that weren’t always conclusive, testing got messy. I think that created a little mistrust and misconceptions around getting tested. Throughout the pandemic, medical laboratory scientists performed PCR testing, which is very accurate when performed correctly, though there is always a margin of false positives or negatives. It was hard to reassure the public of the rigor that goes into the testing we do.
During the course of the pandemic, there was also the unfolding trial of Theranos, the company that claimed hundreds of laboratory tests could be conducted from a single drop of blood. That whole debacle just highlighted the need for rigorous clinical laboratory science – the founder of Theranos had no training in the field or as a laboratory scientist, and one of the main whistleblowers was actually a scientist and laboratorian. It’s a cautionary tale, but I’m concerned that all the headlines may add to the negative thinking around laboratory professionals.
Not many people know about medical laboratory scientists...why do you think that is, and what do you want people to know?
A patient interacts with nurses, doctors, therapists – respiratory, physical, occupational etc. When you go to get a scan or x-ray, you interact with the imaging technologists. Even when you get blood drawn or donate blood, the person who collects your blood is typically a nurse or a phlebotomist. But we’re almost never in contact with the patient. We are so behind the scenes, that’s why our profession is so unknown. For a long time, we were termed as “medical technologist” or “lab technologist” – these terms don't describe what we do at all. We are medical laboratory scientists. I never allow my students to call themselves “lab techs” because it just completely erases what we do and it keeps us in this black box that is “the lab.” A patient doesn’t know what the lab is, and by saying “I work in the lab,” it keeps us in the shadows.
One of my biggest passions and one of the goals of “Medical Laboratory Professionals Week” is providing a face to our field and raising awareness about the impact we have on patient care. It’s letting people know – hey, I’m a medical laboratory scientist! And even though you've probably never seen me, if you've literally ever gotten any kind of laboratory work done from a routine screening like a blood test or pap smear, or a diagnostic test like a biopsy that could save your life, I impacted you and your care.
Q: Given that there is such limited patient interaction, do you ever wonder about the people behind the tests, especially when you can see something troubling or life-threatening in the labs?
Every specimen I test is not just a tube—it’s a patient, a life. It can be very difficult testing a specimen and knowing it’s a poor prognosis for the patient in the end. What I always remind myself is that I played a part in hopefully getting that patient the treatment and help they need.
What is your message to someone who might be interested in this field?
I would say if you are somebody who loves science, who has always enjoyed taking lab courses in high school or in college and you want to help people but not necessarily have direct patient contact – medical laboratory science is for you! It is really where science and healthcare meet. And even though we have limited patient interaction, we save lives every day.
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