Molecular Testing and Clinical Study
Molecular testing - the evaluation of the presence and absence of specific genetic markers in individuals - has advanced over the last decade. Diseases can now be detected relatively early, sometimes before the onset of symptoms. These early and precise diagnoses can save the patient from wrong treatments and long hospital stays while freeing up resources in the clinic to treat more people than before. If molecular testing can be incorporated as a routine procedure in the core clinical laboratory, instead of outsourcing it to commercial analysis labs, profits can be recovered that have been lost due to changes over the last decade in Medicare and healthcare.
While molecular labs often employ Molecular Genetic Technologists, clinical labs have the principal option to hire two different sorts of lab technicians; the Medical Lab Technician (MLT) and the Medical Lab Scientist (MLS). Differences between both types of occupation can be boiled down to the notion that MLSs generally have a longer training period with a broader range of subjects than MLTs (MLS is a 4 year degree, while MLTs get their degree often after a two year program). As a result, MLSs are often regarded as more autonomous and take on more responsibilities, for example, the training of new MLTs and other staff1. Depending on their level of autonomy, therefore, MLSs could serve as scientists to conduct Molecular Testing in a clinical lab. There could be a Molecular Genetic Technologist on staff to introduce the Medical Lab Scientist to the workload and protocols.
Subsequently, the MLS can work ever more efficiently without supervision in the lab. Thanks to their 4 years training in which they have learnt critical thinking and organizational skills as well as literature and database searches1, one might even expect that the MLS designs new genetic markers to test for new diseases. Having an MLS on staff seems to provide a host of advantages and benefits. Are there any potential drawbacks or disadvantages hiring an MLS to aid in the clinical laboratory development?
Benefits of Hiring an MLS
Clinical testing leads to better patient care.
Doing the clinical testing directly within the lab has several advantages for the patient. Most importantly, diagnosis can be fast - blood samples do not need to be sent out to analytical labs, but can be evaluated in-house. In addition, the correct diagnosis of molecular markers can help the attending physician to make the best judgment as to which treatment the patient should receive. Knowing the genetic contingent of the patient can also help designing a treatment plan for discharged patients, such that they can always get the best possible care even after the hospital visit.
MLSs are often skilled laboratory workers with a wide knowledge of protocols.
In the United States, a Medical Laboratory Scientist (MLS) usually earns a bachelor in a clinical, medical, biomedical or biological subject. Behind this degree is an education lasting for four years, often split into three years of coursework and one year of rotations in clinical lab, during which the aspiring MLS gets first insight into real experimental work in a clinical setting. That is a big advantage because it means that the MLS knows the basic steps in the lab; combined with the extensive scientific background acquired during his or her Bachelor Studies, the MLS can soon be expected to conduct his or her own research projects, with the possibility even of designing own biomarkers against new diseases the clinical lab wants to be prepared for. In brief, an MLS will be a versatile lab scientist who not only focuses on the reliable execution of protocols and the testing of patients, but also recognizes the need to design new research and diagnosis protocols. Through his ability to take on a leadership position in a lab, the MLS will also be able to train new technicians and other team members.
Disadvantages of Hiring an MLS
Upfront costs of testing platforms.
Medical and diagnostic equipment can be expensive. The most often used machines in Molecular Genetics are Thermo cycler for conducting Polymerase Chain Reactions (PCR). These machines have to be robust and precise at the same time, which means they have to be built for long-term duration, which can push the price of the lab equipment quickly up to $40 - $50,000; if one adds the maintenance and material costs that are necessary to run the machine, the price can get significantly higher (Molecular Biology and Genetics, 2015). The clinic has to carefully weigh the costs in time and money when outsourcing the sample analysis vs. using in-house solutions.
Medical Technology Schools. Medical Lab Technician (MLT) vs Medical Lab Scientist (MLS).
Olsen, L.A., Saunders, R.S., McGinnis, J.M. Patients Charting the Course: Citizen Engagement and the Learning Health System: Workshop Summary. National Academies Press (US).
Rohde, R.E. The hidden profession that saves lives. Web.
Molecular Biology and Genetics. Buying a new qPCR cycler? There are a few things you need to know. Web.