Who will run America's public health labs? : educating future laboratory directors
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Who will run America's public health labs? : educating future laboratory directors

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      As the current generation of public health laboratory directors (PHLDs) nears retirement age, it is increasingly important to train and effectively transition new professionals into these vital positions. A key component of this impending changeover will be to determine the knowledge, skills, and experience necessary for the success of PHLDs in the 21st century. The educational foundation for PHLDs in the last century encompassed studies in public health practice, research methodology, epidemiology, classic sciences, and medicine. New PHLDs will need to expand this foundation to include expertise in areas such as management, public policy, leadership, and strategic planning. Further, new PHLDs must meet the requirements of the Clinical Laboratory Improvement Amendments of 1988 (CLIA 1988), which requires PHLDs to have a PhD or an MD and at least two years of experience. CLIA also mandates that PHLDs participate in board certification programs offered by several associations.

      In addition to these increased legal and managerial requirements, the field of public health in general has witnessed major structural and institutional changes over the last five decades. Dubbed "the new public health," the profession has been challenged to assess current and foreseeable trends, such as changing information technology and a new emphasis on public policy development, that will continue to redefine public health in the future. The dynamics of change within public health and within public health laboratories are inescapable, and are further compounded by the complex economic pressures resulting from health care reform and managed care. For example, as laboratory testing is integrated with other diagnostic services, such as imaging and electrodiagnostics, the entire laboratory paradigm must change from one with an automated core laboratory with point-of-service rapid response and outlying satellite laboratories to one comprising a consolidated diagnostic center.1 Public health professionals must face these challenges head on by acquiring the knowledge and skills necessary to succeed in this new environment.

      The goal of our study is to determine, in the face of current and evolving regulations and health care systems, what attributes the future pool of PHLDs should have. That is, what will define the "ideal" laboratory director and how will those defining characteristics be attained? Our findings are intended to guide recommendations for a program of continuing education or certification aimed at producing PHLDs that possess an effective blend of management and leadership skills, policy awareness, and public health and science expertise.

      Development of this report was supported under the APHL/CDC Cooperative Agreement #U60CCU303019, coordinated by the Division of Laboratory Systems, Public Health Practice Program Office, CDC.

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