Why medical laboratory professionals are decrying degradation by SRC

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The medical laboratory profession is one of the most critical jobs in saving lives, yet it is so hidden that even SRC’s job evaluation could not vividly recognize it. It is so unfortunate that a profession whose decisions are a matter of life and death can be so inconspicuous. Perhaps it is because medical laboratory professionals spend most of their time looking into microscopes and interacting with specimens from people than talking to people. Did you know that about 94% of objective data in a patient’s report emanates from the laboratory? This is the outcome of what medical laboratory professionals do in between collecting that blood, urine, stool or tissue specimen from you and handing over a lab report to you or your doctor. Laboratory diagnosis is evidence-based hence it is relied upon by all health professionals to guide their decision-making. Thus, the laboratory is the source of solutions for the most challenging task in healthcare; determining what is ailing the patient. Any healthcare facility is as good as its lab.

Academically smart students pursue the medical laboratory profession given the intensity of training required. For instance, in 2015, KUCCPS cut-off for joining MLS at University of Nairobi’s College of Health Sciences was 43.149, which was very close to medicine’s 45.350. Additionally, the diploma in medical laboratory science selects the best students compared to other healthcare diploma students in KMTC and other medical colleges. KMLTTB regulates the selection of students through indexing. Moreover, all medical laboratory students are required to undertake a supervised probation period and sit a comprehensive registration examination administered by KMLTTB after graduation to qualify to practice. In Kenya, Medical laboratory professionals constitute medical laboratory specialists (masters and PhD holders), medical laboratory officers (degree holders), medical laboratory technologists (diploma holders) and medical laboratory technicians (certificate holders). Their skill level is specialized given that laboratory diagnosis requires highly skilled, specially trained and KMLTTB certified medical laboratory professionals.

The intensive training and regulation are necessary because of the sensitivity of decisions that medical laboratory professionals make. Have you ever known that if a patient is administered with only 15ML of incompatible blood, they can get complications such as disseminated intravascular coagulation (formation of blood clots inside blood vessels in the body), kidney failure and even death? Medical laboratory professionals do blood donation, screening for infectious agents, compatibility testing, separation of blood products, storage and dispatch of blood for the right patient. A slight error in the clerical, procedural or quality assurance processes in the medical laboratory can lead to devastating consequences. Blood transfusion is one of the close to ten departments manned by medical laboratory professionals. Translate this to cancer testing, TB screening, paternity testing, and other “testing” that you have ever encountered in your visit to a hospital, including determining which drugs can clear a particular infection. Besides, this career entails using quantitative and statistical approaches to evaluate diagnostic equipment and methods to ensure that the results produced are accurate, reliable and timely for screening, diagnosis, and prognosis of diseases.

There is also need to know that the practice of medical laboratory profession is legally binding. This means that if you are treated for the wrong disease in a hospital, and it turns out that the laboratory test results had errors, the medical laboratory professional that conducted your tests can be prosecuted and charged in a court of law. Diagnosis of patients mainly relies on laboratory results. Since doctors and clinicians directly use the lab results to determine therapeutic procedures for patients, wrong decisions in the laboratory diagnosis process are replicated in the entire process of patient management. This is why no proficient medical laboratory officer can append a signature in a laboratory test report for tests they did not personally do. Cap253A, an act of parliament that regulates medical laboratory practice in Kenya, makes these professionals guilty of negligence or professional misconduct in case of errors in laboratory diagnosis. This can lead to admonishment, cancelling of the practising license, a fine by the board and prosecution (loss of job and numerous legal battles). This tells you that Medical laboratory professionals are the sole decision makers in laboratory services. They do not seek external advice or consultation for their judgments when producing laboratory results.

Additionally, medical laboratory professionals are held accountable for medical laboratory equipment, laboratory consumables and the entire infrastructure in the lab premises. They are also directly involved in the procurement of these supplies given the detailed specifications and verifications that must be adhered to. Given that the laboratory constitutes a significant proportion of the hospital resources, medical laboratory professionals have an important influence on financial measures for healthcare organizations. Thus, they are equipped with knowledge and skills in laboratory management, ethics, and law, given their roles in the administration of laboratories, decision-making and the fact that their practice is legally binding.

Beyond the knowledge and skills in screening, diagnosis and prognosis procedures, medical laboratory professionals must be knowledgeable in the pathophysiology (changes in the body brought by disease) of all conditions to inform their decision-making. For example, it requires knowledge of pathophysiology to decide that potassium levels above seven mmol/L or glucose levels below two mmol/L constitute medical emergencies and initiate the necessary medical procedures to save the patient. They must also be knowledgeable in forensic science to be in a position to handle forensic specimens that may come to the medical laboratories.

Every time you hear that an outbreak such as the most recent cholera outbreak at Weston Hotel and KICC is being investigated, you never hear them mention laboratory officers. Only a medical laboratory officer, after carrying out laboratory tests, can make the decision that indeed the pathogen is Vibrio cholera. Even investigation of the Ebola outbreak mainly relied upon the laboratory. Labs produce the reports and give out to other people to announce them, and all the credit goes to people whose contribution was minimal in the process. That notwithstanding, medical laboratory officers have to understand basics of epidemiology, biostatistics and public health because of their role in the investigation of epidemics, serosurveys, and screening.

Medical laboratories are the riskiest work environments in the healthcare organizations. The professionals are at a danger of contracting infections from patients while obtaining a sample and from specimens during laboratory analysis. Some procedures entail culturing pathogens for identification and susceptibility testing, which increases their infectivity. Besides, talking of biosecurity, the laboratory is the centre for potential bioweapons. Hence, every laboratory professional must contain that “potential” for the safety of the country and world as a whole.

It is demeaning, derogatory and disappointing for SRC to classify medical laboratory professionals as semi-skilled. Their skill level is specialized. More so, they are high-level skilled officers. This is why all medical laboratory professionals have raised their voice through the Kenya National Union of Medical Laboratory Officers calling upon SRC to reevaluate the medical laboratory profession with a keen look into its details to avoid misconceptions.

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