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Laboratory director positions for physicians

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Q  I was contacted by a recruiter the other day for a lab director position. It would be only a few hours per month, and sounded like a good opportunity. The recruiter promoted it as straightforward, flexible work, but that would add a steady supplement to my current full-time income. Is this legitimate? What does a part-time lab director do and how much should it pay?

A Yes – it’s most likely legitimate, and it’s worth looking into. Let’s start with a bit of background on labs and lab directors. The need for a lab director stems from the 1988 Clinical Laboratory Improvement Amendments, which you most likely have heard of as CLIA. These standards apply to all laboratory tests that are performed in clinical settings in the US, and established a program run by CMS that certifies labs which meet these standards.

Certain low-risk diagnostic tests are not subject to the same oversight and regulation as other tests. These are known as CLIA-waived tests, and include urine pregnancy tests, fecal occult blood testing, hemoglobin, glucose, lipids, and the like. Clinics that perform only CLIA-waived tests are not required to have a laboratory director. They merely need to enroll in the CLIA program, pay a fee, and follow the test instructions from the manufacturers.

Lab tests that aren’t CLIA-waived are categorized as either moderately complex or highly complex. The complexity of a test is determined during the FDA approval process, and is based on the level of expertise required for interpreting the result, the likelihood of error, and the degree of automation involved. Tests like cytology, PCR, and electrophoresis are high complexity.

Lab Director Qualifications

Laboratories that run non-waived clinical diagnostic tests are required to a director to oversee their systems and processes. Some of these labs aren’t a part of a physician practice or hospital. This is why physicians sometimes see job ads posted or are contacted by recruiters for lab director positions. For labs performing only moderately complex testing, the laboratory director can be a physician or a podiatrist, and this individual must have an active state license as well as 20 CME hours in approved lab director training or at least a year of non-waived lab supervision. An alternative to the training and experience requirement is a pathology board certification. PhDs and masters (and occasional bachelors) with certain certifications also qualify.

For labs performing high-complexity testing, a director with an MD or DO must be either certified in pathology, have had a year of lab training during residency, or have two years of experience supervising high complexity testing. The lab director can also be a PhD with certification by an approved board.

So, in most cases (unless you’re a pathologist), the opportunities you come across are for moderately complex labs. I should point out that some states have their own requirements on top of those required by CLIA.

Additional Job Requirements

The requirements for a lab director need to meet those laid out by CLIA and the state where the lab is located, at a minimum. The organization running the lab itself might have additional requirements hiring their own lab director. In addition to the qualifications, training, and experience mentioned above, you might see requirements for:

  • Experience working in a clinical laboratory
  • Experience supervising or working with certain types of lab tests (for example, a lab performing genetic testing may want their director to have experience specifically with genetic testing)
  • Research experience
  • Business knowledge
  • The typical “oral and written communication skills,” “ability to thrive in a fast-paced environment,” etc

Responsibilities of a Laboratory Director

If you meet the lab director requirements and are still with me here, let’s move on to what you’d actually be doing as part of the job. Typical responsibilities include:

  • Oversee the lab’s operations and processes
  • Review and sign off on logs, reports, and various CLIA requirements
  • Work with the lab’s leadership to adjust policies
  • Support quality improvement activities
  • Provide clinical expertise as needed

In a well-run laboratory with strong staff and good leadership, these tasks can often be accomplished with minimal, intermittent work on the part of the lab director. Many labs don’t need a full-time director to accomplish the job, which is why there are frequently part-time opportunities for physicians. Since the job requirements are largely administrative tasks and reviews, the work can often be done at any time, so there’s frequently a flexible schedule allowed for the lab director.

Medical Lab Director Compensation

The compensation will vary based on how much you’ll be required to play a part in the day to day operations of the lab, versus performing reviews from time to time. I’ve seen positions advertised in the range of $1000 to $1500 per month.

If the hiring manager provides an hourly rate or the number of hours you’d be required to work, it should be fairly straightforward to determine if the pay is adequate for you. Other labs may offer a set amount per month or per year for you to perform the duties necessary as the lab director. In this case, ask enough questions and talk to enough people within the organization to gain a solid grasp of the time and effort you’d need to put into a role. Use that information to estimate the time requirement, and decide what rate would make the position worth your time.

In addition to a director, a moderate-complexity lab is also required to have a technical consultant and a clinical consultant. These roles can be filled by the same individual serving as laboratory director, so be sure it’s clear when considering a position what exactly the expectations are for you.

If you don’t already have the training requirements completed, you can probably negotiate to have the cost of the lab director CME covered.

One final – but important – consideration here is your own professional risk. Your signature and your medical license will be backing every test performed at the lab. So don’t take the job for pennies, and be sure you have or arrange for insurance coverage.

Should you take a lab director position?

You probably have a good idea at this point if a lab director position may be a fit for your background and your lifestyle. For those still on the fence, consider a few pros and cons from my own point of view.

Pros:

  • Supplemental income without much added stress
  • Schedule flexibility
  • Interesting work for science-minded and research-loving types
  • Additional professional experience for your resume

Cons:

  • In some cases, you may need to be regularly available by phone
  • Requires professional risk (i.e. your medical license)

Finally, here’s a pro or a con depending on what you like:  this job requires a lot of paperwork, organization, and following protocols. If you love being organized and following rules, it’s probably great for you. But if you’re unorganized and hate filling out forms, it might not add much value to your life.

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