What Caused the Current Shortage of Medical Laboratory Technologists and What Steps Need to Be Taken to Solve the Problem

Editor's Notes: A similar article was published at CLPMag.com on September 22, 2022 (linked below). Since then, medical laboratories have made meaningful progress in addressing the shortage of qualified medical laboratory technologists by adopting a combination of practical workforce strategies. Retention has become a key priority, with laboratories improving compensation, offering incentives, creating clearer career pathways, and taking steps to reduce burnout. Many labs have also redesigned workflows, so licensed technologists can focus their expertise on high-value analytical and clinical responsibilities. 

Read the CLP Article: The Causes and Potential Solutions for the Current Shortage of Clinical Laboratory Technologists

At the same time, investments in automation and modern laboratory information system (LIS) software solutions have helped labs increase throughput per full-time employee by reducing manual steps, errors, and rework. Many organizations have also strengthened the talent pipeline through partnerships with MLS/MLT programs, paid internships, and expanded training and onboarding initiatives to bring new hires up to speed more quickly.

Despite this progress, the workforce challenge is far from solved. Vacancy rates remain high, retirements continue, and educational capacity has not yet caught up with demand. Sustained investment, policy support, and continued innovation remain essential to ensure long-term workforce stability for clinical laboratories.

Change, Disruption, and the Rising Strain on the Clinical Laboratory Workforce

As the Greek philosopher Heraclitus famously stated, "Change is the only constant in life."

There’s no question that the world has changed significantly in recent years. Clinical laboratories have experienced this transformation firsthand, particularly those providing diagnostic services in laboratory medicine, anatomic pathology, and molecular diagnostics. Many of the pandemic-driven disruptions that reshaped the laboratory industry continue to influence staffing, workflows, operations, and patient care today. 

The result has been an unpredictable demand for lab services, supply chain shortages, and, most alarming, high stress on the clinical laboratory workforce. In particular, the pandemic brought the long-standing shortage of qualified laboratory professionals into sharp focus, transforming it from a looming concern into an immediate and highly consequential challenge.

This carries significant implications for the healthcare industry, as behind the scenes at nearly every point along the care continuum stands a vital contributor: the medical laboratory scientist.

Clinical Laboratories: A Foundational Pillar of U.S. Healthcare 

In the United States, approximately 14 billion laboratory tests are performed annually in more than 260,000 Clinical Laboratory Improvement Amendments (CLIA)-certified laboratories. Although laboratory services account for only a small share of annual U.S. healthcare spending, approximately 3 percent, the clinical laboratory remains a foundational pillar of the nation's healthcare system.

Medical laboratory scientists who perform this work are clinical laboratory technicians and technologists, histotechnologists, or cytotechnologists.

"What has happened is an affirmation of what has been true since the beginning of the laboratory profession; our laboratories save lives," said Dr. James Crawford, Senior Vice President for Laboratory Services at Northwell Health and Professor and Chair of Pathology/Lab Medicine at the Donald & Barbara Zucker School of Medicine at Hofstra/Northwell.

Crawford is also a founding member and Chairman of the Board at Project Santa Fe, the originator of the concept of Clinical Laboratory 2.0.

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Staffing Shortage: A Growing Concern Years in the Making

Laboratory-based diagnostic testing is the highest-volume activity in healthcare, with lab tests playing a role in nearly every patient encounter. Yet as demand for diagnostic services continues to grow, the laboratory industry faces a persistent challenge: a significant shortage of qualified clinical laboratory professionals needed to perform this essential work. 

The laboratory industry is estimated to be short between 20,000 and 25,000 qualified technologists, with approximately 335,000 professionals currently employed nationwide. That equates to roughly one laboratory technologist for every 1,000 U.S. residents and represents a workforce shortfall of about 7 percent. Without meaningful intervention, this gap is likely to widen as demand for laboratory services continues to grow. 

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What’s Causing the Shortage, and What Can Be Done?

Crawford and his colleagues are well aware of this disturbing trend. His top objective is to advocate for more qualified professionals to join the laboratory workforce.

So, where to start?

According to the doctor, qualified candidates often aren't aware of their options.

"Nursing, physician assistants, and other healthcare professions have received more publicity coverage, especially over the last 20 years," he observed. "In recent times, the visibility of the laboratory profession has been poor, being virtually unknown to school counselors, both at the high school and college associate degree level. In general, it takes knowing someone or being influenced by someone in the field to get hooked."

That was the case for Crawford, who fell in love with laboratory science thanks to his uncle, a research scientist who took him under his wing when he was just a grade school student.

"Through my uncle, I saw how cool laboratory science was," he said.

Crawford noted that many clinical laboratory management training programs remain underenrolled and that the profession has a largely "mature" demographic profile, resulting in experienced professionals exiting the workforce faster than new entrants are entering.

"I think we have to look at ourselves and say, 'Have we done the job we need to do to publicize our profession?' To me, that is the clarion call of our time," he said. 

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Career Growth Opportunities and Starting Salaries 

Improved publicity and awareness will certainly help, but they address only part of the challenge. To meaningfully close the gap, laboratories must also make career advancement pathways more visible and align compensation more closely with that of other healthcare professions.

"We have to make it clear that it's an exciting job, one that has true career growth potential, and one that compensates on a competitive basis," Crawford explained.

He used the example of a laboratory technologist potentially spending a career at the same workstation for 40 years as unappealing to a young person. He emphasized that a clearly defined path for advancement must be visible to attract talented individuals to the profession and to ensure a strong pipeline of new leadership as more experienced personnel retire.

"There is a great need for leadership in this profession, and experienced people who aspire to leadership can take on those responsibilities," continued Crawford. "We need to make evident what is already true, that medical laboratory scientists can grow into roles like manager, director, senior director, assistant vice president, vice president, and even beyond."

Being competitive on starting salary is another barrier that needs to be addressed to reverse the trend and hire the best and the brightest.

The average cost for a degree in medical laboratory science is roughly $100,000, a prohibitive figure when you also consider that medical lab technologists are routinely paid significantly less than other medically trained professionals like nurses, physician associates, physical therapists, and pharmacists.

"I think there is an effort now that has not previously occurred, but we have to see it through, and seeing it through means getting to the frontlines of the educational pipeline and making the necessary adjustments in terms of awareness of the profession, its career ladder, and compensation," Crawford said. 

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The Three Pillars of a Modern Medical Laboratory

Crawford believes that process improvement, advanced technology, and qualified, talented personnel can help alleviate the staffing burden medical laboratories face.

For him, process improvement ultimately centers on deploying the workforce more effectively during periods of stress, ensuring long-term sustainability by enabling every role and department to operate at its highest strengths.

"If you do the ergonomics on an experienced laboratory worker, you're likely to find that the non-productive activities for their training and expertise take up a substantial fraction of their time," he said.

He also noted that in times of crisis, this situation is magnified.

So how can laboratory leaders drive process improvements that deliver greater efficiency across the lab?

Crawford used Northwell Health as an example, suggesting that an in-system laboratory network successfully servicing 23 hospitals and over 800 ambulatory care sites wouldn't be possible without optimized efficiency.

"You can't do this without standardizing your laboratory information system (LIS software), your equipment, your SOPs, your reagents, and the proficiencies and competencies of your personnel," he said. "It's not one size fits all, since you want to have a high degree of alignment with individual health system site needs, so you can flex and adjust as needed while always serving the institutional mission."

Crawford also explained how operational informatics can help laboratories align quantitative performance metrics with strategic objectives, leading to meaningful improvements. As one example, he suggested aligning a laboratory’s 24-hour workforce with routine specimen arrival patterns to ensure adequate staffing during peak volumes and reduce operational bottlenecks and stress. 

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The Role of IT Support and Laboratory Information System Software 

Workforce development, retention, career growth, and technology. Crawford believes the laboratory community must check all four boxes to emerge successfully from the current staffing crisis.

So, how can IT and a modern medical laboratory information system software help solve the problem?

He said it starts at square one.

"How can we make laboratory software systems work most efficiently, with as few keystrokes as possible, and with limited opportunity for key entry error? That's the starting point," he said, noting there are always better ways to engineer the workplace and maximize the ability for people to be successful. "The IT design of technology and the laboratory information system software that supports it are both hugely important."

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Modern, Comprehensive, and Flexible Laboratory Information System Software 

As laboratories struggle to recruit, retain, and develop qualified professionals for future leadership roles, the value of modern clinical and pathology LIS systems has become increasingly clear.

When implemented effectively, clinical laboratory and pathology software can help address long-term staffing challenges by automating time-consuming manual processes and enabling skilled laboratory professionals to focus on higher-value tasks that require their expertise.

For example, labs with modern, comprehensive, and flexible LIS systems, such as the all-in-one LigoLab Medical LIS & Lab RCM Informatics Platform, can build and string together rules that create advanced LIS lab automation where manual processes once resided.

The best LIS systems also maximize interoperability with electronic health records (EHR), analytical instruments, and third-party services, such as laboratory billing (lab revenue cycle management) systems, virtually eliminating the risk of data entry errors and lost specimens.

In addition to automating laboratory workflow management wherever possible and eliminating manual steps, LigoLab's modern laboratory information system offers advanced medical laboratory solutions that support fully customizable lab reports and multiple distribution channels tailored to customer preferences. All that's required is a bit of training, and LIS lab personnel can configure these preferences themselves. No IT background is needed.

LigoLab's value proposition extends beyond its advanced laboratory information system functions, offering an all-in-one LIS software solution in which the lab information system module and the laboratory revenue cycle management (RCM) module share the same lab database software and infrastructure, eliminating prohibitive data silos and the need to synchronize across multiple disparate laboratory software systems.

This unique arrangement also enables the laboratory billing process (RCM cycle) to begin when the lab order is initiated, a real advantage that directly impacts a lab's denial rate and revenue capture.

When done right, the best laboratory information system software can become the lab's de facto information department, offering the finest technology and 24/7 hands-on support.

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What Does the Future Hold?

Although the current challenge is monumental, Crawford remains an optimist.

"I'm so enthusiastic about what we can do to help promote the value of the laboratory," he said. "Medical science is spectacular, and I would like to think that the ability of our society to combine access to healthcare with population health, while addressing social determinants of health to help the human condition, would be a draw for the leaders of tomorrow to join our profession."

"The potential is there, and we're capable of doing it. That's why my top advocacy goal is the laboratory workforce," he concluded. 

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About Dr. James Crawford, MD, PhD

Senior Vice President, Laboratory Services, Northwell Health; Professor and Chair, Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell; Chairman of the Board, Project Santa Fe Foundation - Clinical Laboratory 2.0

Throughout his distinguished career, Dr. Crawford has strongly advocated for pathology and the clinical laboratory profession, working to ensure this essential discipline is firmly embedded in the next era of patient-centered healthcare. He’s a founding member of Project Santa Fe, which advances the concept of Clinical Laboratory 2.0 and encourages laboratories to move away from the traditional transactional payment model to a value-based one that drives better outcomes.

Credited as an author on more than 300 publications, he also serves as Editor-in-Chief of Academic Pathology, the official journal of the Association of Pathology Chairs (APC). In 2021, the APC recognized his contributions to the field with its Distinguished Service Award. 

He received his MD and PhD from Duke University School of Medicine, and completed his postgraduate training in anatomic and gastrointestinal pathology at Brigham and Women's Hospital. That was followed by a fellowship in hepatic pathology at the Royal Free Hospital in London.

Ready to Help Your Lab Overcome Staffing Challenges?

A modern laboratory information system software can help your organization reduce reliance on manual tasks, free up skilled staff for higher-value work, and build a more sustainable operation even amid ongoing workforce shortages. Act now, speak with a product specialist, and learn how LigoLab can help alleviate staff shortages. 

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Frequently Asked Questions About the Medical Laboratory Technologist Shortage

How large is the current shortage of medical laboratory technologists?

The industry is estimated to be short between 20,000 and 25,000 laboratory technologists, with roughly 335,000 currently employed nationwide, a shortfall of about 7 percent, or one technologist for every 1,000 U.S. citizens.

What are the main causes of the shortage?

Key factors contributing to the shortage include limited public awareness of the laboratory profession compared with other healthcare careers, under-enrollment in training programs, an aging workforce retiring faster than new professionals can enter the field, and starting salaries that often trail those of other medically trained professions. 

How much does it cost to earn a degree in medical laboratory science?

The average cost is roughly $100,000, a significant investment, given that medical lab technologists are often paid less than comparably trained professionals such as nurses, physician associates, physical therapists, and pharmacists.

What are Dr. Crawford's three pillars for addressing the staffing crisis?

Dr. Crawford identifies process improvement, advanced technology, and qualified, talented personnel as the three pillars needed to alleviate the staffing burden on modern medical laboratories.

How can process improvement help labs cope with staffing shortages?

Process improvement focuses on deploying the workforce more effectively, standardizing systems, equipment, and SOPs across sites, and aligning staffing schedules with actual specimen volume to reduce stress at peak times.

How can a laboratory information system help address staffing shortages?

A modern laboratory information system reduces reliance on manual, time-consuming tasks through automation, interoperability with EHRs and instruments, and configurable reporting, freeing skilled staff to focus on higher-value clinical work instead of repetitive administrative tasks.

What progress has been made since this article was first published?

Labs have made progress through improved retention strategies, workflow redesign, automation, and investments in modern LIS software, and stronger partnerships with MLS/MLT training programs. However, vacancy rates remain high, and the challenge is not fully solved.