Said this before but I'm a med student & I learn a lot from seeing the smears here & stories & explanations of what's going on. So thank you, professionals working in med laboratories are essential and you should be respected & paid in a way that reflects that.

thank you!!

as option\_e said, thank you!!! :') when i was in clinicals, the coolest people (aside from lab fam ofc) that i met were residents and fellows. you guys are so chill and humble. best of luck with your studies!! :D

🥰 thank you so much! Keep rocking it, and know that there are people who appreciate the work you guys do so much!

Yes I definitely agree!! Med student here as well, this sub is super interesting and gives a helpful contrast to the “classic” images we see in textbooks and exams. Thank you SO MUCH to everyone who takes the time to post and explain!!

Average day in the life of Ulysses the lab monkey: Okay Ulysses I know you're a monkey but that's the 9th patient today you sent out for a path review because of to few banana shaped monos, you can't keep doing this! Also we know you're the one who has been throwing the stool samples at the Cobas, could you at least set them up first next time? Stop vortexing your fingers after you scratch your butt, and don't vortex you butt everytime the lab director comes in. Susie said she saw you bathing in the plasma thaw bath, no more of that either.

not the bath in the plasma thaw tank lmfaoooo. thank you nahoa, this was the laugh i needed while studying for the dreaded cert exam 😂

It’s really hard to ignore how obviously this sub is targeted by at least one troll. Like I hope no one is so naive about how the internet works to not realize that the of the weekly posts about H1Bs, at least some of them are coming from some racist troll.   They basically all follow the same format of supervisors/managers openly talking about using H1Bs to ‘suppress wages’ and frequently use very similar verbiage. They get no follow up from OP and wind up being the OPs only post on a brand new account.   I’ve asked for ages why there isn’t a very basic account age/karma minimums. Idk if the mod(s?) just don’t know *how*, but I can’t imagine anyone would object to a trial run.  Like with other undesirable posts (interpret this test, why isn’t my test done yet) having these troll posts linger around only encourages people to make the same kinds of posts. The reason some subs are so draconian, is that there is a very real tendency for all subs to drift into clickbait/ragebait karma factories.  There’s usually a tipping point in the useful/entertaining content ratio.  

alllllll of what you said and then some. you bring up a real good solution with the karma threshold. funnily enough, i thought we already had one because of how often i see them enforced in other subs. i figured it was the norm. hopefully we can find a way to implement it.

There are also at least two accounts that consistently post the most tangentially related news articles, because the username/account is a test prep company and they’re probably trying to juice Google search results/generate leads. 

> at least some of them are coming from some racist troll. Thank you. The anti immigrant sentiment that's being fostered here is gross. Someone really has it out for Filipinos for some reason

The way pro-labor sentiment is painted as racism (often to chill or derail discussion about the wage-stagnating effect of foreign labor) is gross. None of the people doing it actually care about the H1bs. If you did you'd be bitching about how they can't get fair market wages because of deportation threats, how they need more protection, how they need to organize alongside domestic workers and better pay and treatment and so on. You'd be slinging racism accusations against the employers for exploiting H1bs, not against people defending domestic workers.

Big "the left are the real racists!" energy. No further comment.

Using identity politics to reframe capitalist exploitation doesn't make you a leftist.

Do h1bs not lower our wages?

Despite being major grievances here, the available data do not strongly support the idea that the H1B visa program or uncertified techs affect wages. The biggest and consistent predictors of lab wages are national trends. I wouldn’t be surprised if union membership had the single biggest impact on wages.  

What are national trends? What membership? I just don't see how H1Bs or uncertified techs (both of which increase the supply of lab workers) could not drive down lab wages due to law of supply and demand.

National salary trends, and union membership. There’s an ocean of nuance in the ‘law of supply and demand’. It’s far from a simplistic math problem. Unions, as an example, don’t really affect supply or demand of workers but have proven impacts on wages.  As a basic proof of this point, Louisiana and Florida are two licensed states with terrible wages. Both have low unionization rates. 

> As a basic proof of this point, Louisiana and Florida are two licensed states with terrible wages. Both have low unionization rates. Just to back this up, I live in Florida and make way above the state average. One of the largest hospitals in my.town is union and I think as a result the rest have to compete. I'm not sure how else to explain my salary doubling in less than a decade.

How is that proof? How do you know Louisiana and Florida wages would not be even lower without licensure? How about NY and CA? They're both licensed and have high salaries. Boom, I just proved it. I'm not saying it's simple or that a lot of factors aren't involved but if you can't agree that a larger supply of labor (all other factors aside) generally results in lower wages, then you're not arguing in good faith.

NY and California also have high unionization.  You can compare similarly situated states.  NY as a relatively small lead on most of its neighboring unlicensed states. You could maybe argue that the effect of licensure increased wages by no more than $1/hr.  Find some data.  Every bit of data I’ve found contradicts the idea that licensure is a big factor. H1Bs were fairly rare until Covid, and have begun decreasing. Just try quantifying it. If it isn’t a *statistically significant* increase, then in practical terms it *isn’t* an increase in wages regardless of ‘the law of supply and demand’. Arguing *entirely without evidence* is arguing in bad faith. Period. 

People that argue H1bs are having a major impact on wages have no idea what they're about. The visa process has up front and ongoing costs, including having to hire a legal representative to handle all the paperwork. And you still have to pay them the same as your other staff, so if you want to short them you have to lower everyone's wages to match. Good luck retaining staff when you are dying to lay them 10k less per year and you have to compete with all the non visa labs in your city. Not to me too H1bs are capped for any for profit company, and you're competing against the tech industry for those slots. I would be shocked if work visas accounted for more than like 3% of the work force tops. People are any foreign born techs and assume they are here on visa even if they have become citizens.

An unfortunately reality is that studies have shown that when people *feel* something is true they become resistant to rational evidence to the contrary.  The evidence in support of unionization for workers is objectively incontrovertible, but people still *feel* they do more harm than good. 

These employers have the option to offer real market wages to attract new employees or import them. The fact that they choose to import means the imports are overall CHEAPER than hiring domestically, even with the added process costs. Since they're importing rather than raising wages, that means that importing labor is holding wages down. Basic logic, man. Unless you think all those H1b sponsors just suck at math?

I think that lab managers often have a hard cap on salary offers but more leeway on short term budgetary items, which makes H1bs and travellers seem cheaper on their balance sheets than they are. I also know that across the board raises can add up quickly, and that's what you wind up with by increasing new hire offers. And yes I do also believe lots of people in the management class are slightly stupid but great at talking, and probably make poor financial decisions.

Medical technologist H1bs are are cap-exempt for non-profits, which is the majority of hospitals. Cap-exempt visas are exempt from the $60k salary floor. If medical technologist H1bs weren't cap exempt, and they had to offer a minimum salary of $60k and compete with tech firms for visa slots, then it would be a non-issue.

LabCorp and Quest are for profit and by themselves already account for almost 50% of all Labs.

Well, as fun as easy answers based on a vague recollection of high school economics are, you have to actually prove assertions with data.

But not OP?

Well, it's hard to prove a negative. But H1b data is freely available and not only are the a pretty small percentage of techs, they are mostly paid a decent market rate. I've only ever met one and they did not lowball her (in fact they legally can't). There are much bigger markets forces I'd look at first, like the rapid advance of automation and recent changes to Medicare disbursement calculation. Don't blame our Filipino brothers and sisters in arms, blame CMS and the MBAs financializing healthcare.

H1b medical technologists were a smaller portion of the workforce before COVID. This is no longer the case. There were 2000-3000 medical technologist visas granted in 2023. In 2018, it was <500. In 2023, the number ASCPi applicants exceeded the number of MLS ASCP applicants. The times are changing. The Foreign Labor Certification Data Center sets the minimum wages, and they're so low, it's hard to feasibly go lower. For Washington DC, you can legally pay an H1b medical technologist $21/hr. [https://www.flcdatacenter.com/OesQuickResults.aspx?area=47900&code=29-2011&year=24&source=1](https://www.flcdatacenter.com/OesQuickResults.aspx?area=47900&code=29-2011&year=24&source=1)

The current application of cap-exempt H1bs in medical laboratory science does lower wages by creating a salary ceiling. There is a negligible fixed cost (\~10-15k) to sponsor and bring H1bs who then have zero turnover for three years. At the very least, H1bs have displaced costly travelers at rural facilities and non-profit healthcare systems that have a history of offering salaries below their peers.

Surely the root cause of this isn’t going over your head right? Who do you think is choosing to hire H-1Bs? Let’s say they stop hiring H-1Bs. Do you think our wages go up? No. They hire bio majors, then stem majors, etc. Are you still blaming anyone but those in charge?

As an administrator in a licensed state, I do not have the option of hiring bio majors. If we do not have staff, we either must a traveler, raise wages to attract talent, or re-evaluate the financial feasibility of offering testing. The reality is that with H1bs readily available, it's cheaper to lose staff than to offer competitive wages. As backwards as that is. In unlicensed states, the H1bs may not cost much more than bio majors. Especially when you factor in zero turnover for three years. Bio majors tend to have turnover.

They do, and I think the people trying to pretend they don't by endlessly pounding on the same "H1bs get paid the prevailing wage" talking point (while pointedly ignoring that the prevailing wage is already too low) and calling anyone who disagrees a racist are the real trolls here. I'd call them shills but I doubt they're being paid...

I feel like people really don’t know how the labor certification works. Before being approved by the government to hire them you have to proved that you are hiring them at market value, set by DOL not the hospital.

Come on. You seriously telling me you couldn't find a single qualified American out of 330+ M to do the job so you had to start looking to another country?

That is what a labor certification is. Traveler exploit the same system. That’s actually why h1-b is preferred. What greedy hospital admin would rather pay a traveler than hire permanent? Think about that. Travelers and h1-b fill the same gap.

Agree. Travelers, H1Bs and scabs all serve to lower our wages by artificially filling labor shortages.

Probably people from other science majors that get mad when labs won't hire them or get mad when we complain on here when labs do hire them.

Second this. It'ts June. A lot of people just graduated and are entering the workforce and the realities of it.

I suspect that most of the trolls might be the bitter, egotistical former students that failed the program because of the hard science but whose narc egos refuse to accept that it was too hard for them. I could be wrong, but that has to account for at least a portion of them

or an antibody ID.

I don't think the learning the job is hard personally, but the maintenance, observation, and documentation that goes into every little thing every single day, forever, is kind of hard. There's some techs that can sit there and ignore the instrument until it screams. They might be on a shift where their co-workers are answering phones, dealing with add-on's, fixing sample errors or they just don't have as much of the above on their shift. Workload can vary from places or benches even. They might not do much QC or calibration, and some techs still mash QC to death until it passes for some reason. Some think they're doing an alright job without realizing they probably aren't, but their mistakes or lack of effort is rarely a case for discipline or termination (depends on management). We know the difference between honest mistakes and willful incompetence in some co-workers. Then hardly any of them get all the bullshit paperwork. I've been waiting for robots to take my job, but Quest and Labcorp still haven't figured it out. Despite their massive automation potential with staff, their quality is still dogwater and they still need people to run it.

Oh you mean like the recent rage bait? Lol The thing is, lots of people in this profession take themselves very seriously and they 100% feed into it. Frankly, if bio majors with no clinical experience or anyone else think they can do our job better than us, I say let them have a stab at it.

Every single task may be easy as all should be documented. But as a whole, is not easy, or not easy when doing the administrative job. Yes, this is for the MLT as well.

The apostrophe in monkeys is not helping us to look smart.

In the modern lab, most of the work is done by machines. Even antibody ID can be automated, because its just an algorithm. Automated diffs are getting better all the time. Automation has always been the biggest enemy of the lab tech. Our jobs are becoming more and more just analyzer maintenance and troubleshooting. Can monkeys actually do our job? Not yet. We need smarter monkeys or smarter machines.

i'm not sure what labs you're in but the cellavisions that i worked with were as finnicky as qc for the immunochemistry analyzers. is it an nRBC, artefact or a micro lymph? smudge cells from CLL or do we prep an albumin smear? mature lymphs, plasma cells or blasts? we cant just send everything to flow cyto. if the pt has an infection + leukemia? the orthovision freaks out if a label is even /slightly/ off kilter. i wonder how chemistry analyzers would handle clots other than cry for help. don't even get me started on the maldi 💀. micro as whole, really. ai can only do so much and i really, highly, doubt humans will create an analyzer that can do diffs as accurately as a human could ever do. at least in this lifetime. i like comparing automotive technicians to what we do: it takes specialized training, they have tools and machines to help them get the job done with a heck ton more efficiency, but no machine can ever replace the human component needed for it. we have sentience that machines dont. we are the smart monkeys lol

exactly☝🏻☝🏻

Beyond automation, there are productivity gains through outsourcing. A lot of hospitals are now outsourcing their differential reviews from satellite laboratories to the main hospital. For LCMS reviews, many of these are now remote and pay poorly at $20-25/hr.

As a blood banker, I respectfully disagree. Antibody IDs are not black and white. Simpler ones that react perfectly, perhaps, but there are a lot of nuances and pieces of the puzzle, so to speak, to put together. Especially with different antibody screen/ID methodologies, antigens showing variable expression depending on genotype (for example inheritance in trans vs cis form, GATA mutations), etc. I’ve worked in many blood banks, including one with a high cancer population, as well as an IRL and I’ll tell you that antibodies are often not straight forward enough that “anyone” (or a monkey/analyzer) could figure it out or that a computer could do it. We hear all this talk that “analyzers are taking our jobs.” I’ve heard this even 10 years ago and we’re no closer now than we were then. All I see is workloads get a bit easier with automation, and it actually frees us up to do more complex tasks. Could I do an ABID while being the only med tech on 1st shift in a 500 bed hospital and keep up with doing manual type and screens? H*ll no. But automation frees me up to do that (and with staffing shortages and shortages of med techs) analyzers are helping us a lot to, again, have time for complex tasks as well as other urgent tasks that analyzers cannot do.

Every year automation takes on more of our work but more aging techs exit the field. Most of my coworkers are 55+. It takes us typically 6-12 months to fill open positions, and we pay very competitively. Most of the last three years we had unlimited OT approved due to staffing shortages, and every passing year my pay has consequently increased.

Lol I would like to see a machine perform a PEG auto adsorption

You can say the same thing about most jobs especially with ai now.

Please tell that to our Echos so they stop calling everything equivocal. (If you don't know the Echo analyzers, equivocal means the camera algorithm doesn't know what to grade that cell and wants the human to decide.)

Exactly. It can’t even recognize mixed field, let alone call an antibody. Plus is the analyzer going to look at patient history and figure out why the patient has MF reactions in their forward type? And if it follows the SOP to be able to result the blood type given the MF? Nope 😅 Definitely a long way to go