Opinion Creative Commons, CC-BY
The Caduceus & Medical Laboratory Professionals - The Significance of Professional Identity!
*Corresponding author: Angela Tomei Robinson MS MLS ASCP cm, Laboratory Advocate, St. John’s University College of Pharmacy and Health Sciences, Queens, NY, USA.
Received: May 27, 2023; Published: June 12, 2023
What do the Caduceus and Medical Laboratory Professionals have in common? Technically-an exceedingly long historical identity crisis-misrepresentation!
Review the symbol of Medicine (and Laboratory Medicine)- is the correct name CADUCEUS or ROD? - an extremely interesting unique controversy. The Caduceus consists of two (2) snakes wrapped around a winged staff. This symbol is derived from Hermes Trismegistus- the ‘Father of Alchemy - or Mercury (following Greek/ Roman mythology). The Caduceus became ironically popular in the US when formally adopted in 1902 by the US Medical Corp. It is believed that an officer incorrectly assumed a medical link from a printer’s mark in a 19th century medical text.
On the other hand, the Rod is one (1) snake wrapped around a winged staff. This symbol is derived from the Rod of Asclepius - Aesculapius Greek son of Apollo - God of medicine and healing. The Rod is the symbol adopted by the American Medical Association since 1910. However, the Caduceus = the staff of the Greek messenger god Hermes - has often been mistaken for the name and symbol of Medicine-the Rod of Asclepius = the staff of the god of healing and medicine.
Similarly-so too have Medical Laboratory Professionals been historically burdened for so long with so many names inappropriately misrepresenting their identity. Laboratory plays a most integral critical key role in delivery of quality of care in Healthcare and Public Health. Yet - one of the most generally unknown, misunderstood, misrepresented, underappreciated, undervalued, and undercompensated medical professional - is precisely the one who with unwavering dedication and commitment and determination delivers that quality standard of laboratory testing required for patient care-the Medical Laboratory Professional.
So - what exactly is in a name?
Let’s review how the name originated - and how and where the name is today.
With the introduction of national board certification by ASCP in 1926 - the general generic term of Laboratory Technician began.
Medical Laboratory Technologist
By 1928, certifications through ASCP showed the 4-year graduate from accredited laboratory science as the Medical Laboratory Technologist. And by 1939, other certification professional societies were also established [1-3].
Clinical Laboratory Scientist
By 1977, a newly created and separate NCA certification developed the identification of Clinical Laboratory Scientists for the 4-year recipient of accredited laboratory science educational curriculum programs. The term Medical Laboratory Technician for ASCP and Clinical Laboratory Technician for NCA respectively were reserved to identify those with the 2-year degree in laboratory science [4,5].
So, depending on the professional certification- ASCP: American Society of Clinical Pathology; NCA: National Certification Association for Medical Laboratory Personnel; AMT: American Medical Technologists; AAB: American Assoc of Bio analyst; ISCLS: International Society for Clinical Laboratory Society - there have always been diverse names identifying the medical laboratory professional!
And in the final analysis - the laboratorian generally continues to be referred to as a Laboratory Technologist or Laboratory Technician - or even just ‘lab tech’.
This lack of conformity for identification of the medical laboratory professional has been ultimately a major obstacle and a drawback for the behind-the-scenes qualified board-certified medical laboratory professionals. Lack of nomenclature exacerbates the already lack of visibility with the public along with concurrent lack of media attention and limited legislative support [6,7]. Absence of a definitive identifiable name also fails to establish that necessary distinguished familiarity in comparison to other medical professionals. The outcome is an unfortunate lack of general knowledge by even other front line and easily identifiable health care colleagues who enjoy very distinctive names-doctor, nurse, pharmacist, physician assistant etc.
An ineffective presence of identity is accompanied by an acute incomprehension of who Medical Laboratory Professionals are along with their strategic role in Healthcare and Public Health. What follows is an unfortunate lack of full appreciation for the extensive education and clinical internship and definitive detailed competency required to become qualified board-certified medical laboratory practitioners. This inadequate identity too often imparts a misrepresentation with concurrent lack of appropriate respect and compensation which medical laboratory professionals have earned and rightfully deserve [8-10]. Furthermore, federal CLIA of 1988 under CMS continues to fail to acknowledge standardized entry level personnel standards of laboratory science education with certification by any of the professional societies. Instead, CLIA identifies testing by levels of complexities - recognizing only ‘Testing Personnel’.
This federal deficiency prompted the pursuit of state licensure- similar to all medical professionals in all states-to establish a body of knowledge and scope of practice and entry-level personnel standards with certification. Yet even those few states with right to practice profession licensure for medical laboratory professionals also exhibit varying licensure titles due to the varying naming of the professional based on previously varying certification processes:
California: Clinical Laboratory Scientist/ Medical Laboratory Technician
New York: Clinical Laboratory Technologist/ Clinical Laboratory Technician
In addition, applicants seeking a degree with a career are generally unaware of the opportunities in Laboratory Medicine struggle with searches - experiencing an inordinate disarray of nomenclature describing similar NAACLS accredited educational curriculum programs for 4-year and 2-year degrees:
CLS: Clinical Laboratory Science; MT: Medical Technology; MLS: Medical Laboratory Science; MLT: Medical Laboratory Technology; CLT: Clinical Laboratory Technology to Biomedical Sciences or Biomedical Technology etc.
Finally - HR employment job descriptions required for appropriate pay grade scales commensurate with education and experience are further confounded with the identification of employment of qualified medical laboratory professionals. It must also be recognized that over the course of time, ‘technologist’ became universally applied to diversified industries from general technology, architecture, computer, engineering, digital, service and even food. However, all this was about to change. The year 2009-after 30 years of discrepant naming with various certifications - both ASCP and NCA merged and became a joined certification agency known as ASCP BOC-and the dedicated focus on the standardization of the name commenced. This new certification body collaborated to the name designations of:
MLS - Medical Laboratory Scientists
MLT - Medical Laboratory Technicians.
With severe staffing shortages in Healthcare and Public Health- and how strategically critical it is to maintain quality personnel standards for laboratory testing - came the national recognition to accept standardization of name linking education and certification with job description.
Today-the participating professional societies who have collaborated and agreed to sponsor the position paper Standardization of the Professional Title of Medical Laboratory Professionals include:
BOC: American Society for Clinical Pathology Board of Certification; ASCP: American Society for Clinical Pathology; ASCLS: American Society for Clinical Laboratory Science; AAPA: American Assoc of Pathologist’s Assistants; AABB: Assoc for the Advancement of Blood & Biotherapies; AGT: Assoc of Genetic Technologists; ASC: American Society of Cytopathology; ASM: American Society for Microbiology; CLMA: Clinical Laboratory Management; NSH: National Society for Histotechnology; AMT: American Medical Technologists.
But this progressive path does not end until managers and HRs at facilities such as hospitals and reference laboratories - along with NAACLS accredited educational curriculum programs - and even the government at state and federal levels - also join this national professional movement to standardize the name of Medical Laboratory Professionals.
Finally, each medical laboratory professional needs to embrace the standardization of name. Every laboratorian needs to openly accept recognition of identity - and evolve from being referred to as ‘just a tech’ to similarly sharing how other medical professionals are dignified by their unique identifiable name-doctor, nurse, pharmacist, physician assistant etc.
The controversial representation of Caduceus and Rod finally resolved as art historians claim commercial organizations are more inclined to use the Caduceus while professional societies identify with the Rod. So too - the Identity of the Medical Laboratory Professional must be resolved on the path to one name dependent on educational degree with national board certification.
Next time a nurse or doctor or physician assistant or the public or media or legislator inquires for any assistance or feedback involving the laboratory. -remember to offer the name of the medical laboratory professionals who aid in the detection diagnosis and treatment of disease by performing and managing the complexity of laboratory testing for accuracy and precision of laboratory results for patient care –
Medical Laboratory Scientists
Medical Laboratory Technicians
In summary, exactly what’s in a name?
- (2022) AMT. Medical Technologists Transition to Medical Laboratory Scientists.
- (2023) ASCLS. Standardizing the Profession Title of Medical Laboratory Professionals.
- (2020) ASCP. Standardizing the Profession Title of Medical Laboratory Professionals.
- (2020) Bushnell, Jennifer Med MT (ASCP). Defining Our Identify. ASCLS TODAY.
- (2022) Rector, Claude MS MLS (ASCP)cm. What’s in a Name? ASCLS TODAY.
- Prakash M, Johnny J Carlton (2015) Things you Don’t Learn in Medical School: Caduceus. J Pharm Bio Allied Sci 7(Suppl 1): S49-S50.
- Soniak Matt (2012) What do Snakes and Sticks Have to Do with Doctors? AMA.
- (2023) Indeed. Types of Technologists and their Industries.
- (2022) Caduceus. pp. 1-9.
- (2022) Caduceus as a symbol of medicine. pp. 1-6.