Similar diagnostic delays due to clinical laboratory staff shortages are reported in other nations as well

Critical pathology shortages are causing lengthy delays for clinical laboratory test results in New Zealand, according to a report that states some patients are waiting over a month for a melanoma diagnosis. This situation puts the lives of cancer patients at risk in the island nation. 

The Melanoma Network of New Zealand (MelNet) is working to reduce the number of people who develop the disease and help melanoma patients receive a fast diagnosis and proper treatment and care.

However, plastic surgeon and MelNet Chair Gary Duncan, MBChB, FRACS, told Radio New Zealand (RNZ) that when patients return to their doctors for test results, those results often have not come back from the medical laboratory. Therefore, the physician cannot discuss any issues with the patient, which causes them to make another appointment for a later date or receive a melanoma diagnosis over the telephone, RNZ reported.

Dermatologist Louise Reiche, MBChB, FRACS, told RNZ that slow pathology services are unfair to patients. Such delays could result in the spreading of the melanoma to other parts of the body and require major surgery under anesthetic.

“Not only will they suffer an extensive surgical procedure, but it could also shorten their life,” she said.

“We’ve got shortages across the board, and it only seems to be getting worse,” said Trishe Leong, MB.BS (hons) Medicine, FRCPA Anatomical Pathology (above), President of the Royal College of Pathologists of Australasia (RCPA). She added that “there was also a backlog of pathological examinations of placentas, which are used to detect genetic conditions and shed light on complex births,” The Sydney Morning Herald reported. Clinical laboratories in several countries worldwide are experiencing similar delays in reporting critical test results to physicians and their patients. (Photo copyright: RCPA.)

Pathology Labs Cannot Meet Demand for Testing

The Royal College of Pathologists recommends that 80% of specimen results should be returned to clinicians within five days. General practitioner Jeremy Hay, MD, of the Upper Hutt Skin Clinic told RNZ that he has never seen a melanoma report returned from the laboratory he utilizes within the suggested five-day time span. He stated that his local pathology lab simply cannot meet the demand for the vast number of samples waiting to be tested.

“I have visited the lab, and you can see even in the corridors stacks of unreported slides sitting outside the pathologist’s rooms, and there are more inside their rooms,” he said. “They need more staff and that’s quite obvious.”

Hay added that, because of the delays, he typically does not start with a small biopsy of a suspicious-looking piece of skin. Instead, he just cuts the entire area out and sends it to the lab for testing to expedite the diagnosis process.

Lab Loses Accreditation Due to Delays

Long delays caused one lab—Auckland’s Community Anatomic Pathology Service (APS)—to lose its accreditation for the lab’s skin testing department. According to RNZ, some patients had to wait up to eight weeks to learn whether they had melanoma.

An article published by medical/science specialty recruiting firm Odyssey, states that the deficiency at APS was due to several factors, including:

• Population growth.
• An increase in private medical practices.
• The underestimation of the costs required to run the lab.
• An overestimation of potential savings.
• A shortage of qualified pathologists, specifically in the fields of anatomical, chemical, and forensic pathology.

The article also states that pathologists are now listed on Immigration New Zealand’s list of shortage skills in the country. That designation means that foreign candidates who have the skills, and who are offered jobs in the country, can immediately apply for permanent residency. 

Three Week Wait for Cancer Diagnoses in Australia

According to the World Cancer Research Fund International (WCRF), New Zealand has the second highest rate of melanoma in the world. The number one spot is held by Australia. 

Other countries are experiencing long wait times for cancer diagnoses as well. According to The Sydney Morning Herald, some individuals are waiting up to three weeks to receive a cancer diagnosis due to a shortage of pathologists.

“It could be the cancer you didn’t suspect,” said Trishe Leong, MB.BS (hons) Medicine, FRCPA Anatomical Pathology, President of the Royal College of Pathologists of Australasia. “There’s always the chance of something unexpected showing up in a biopsy, and if that is not tended to as soon as possible it can have an impact on patient care.”

This is not the first time Dark Daily has reported on clinical laboratory staff shortages around the world causing huge test result delays.

In “Irish Cancer Society Report Shows Patients May Wait Two Years or More for Genetic Cancer Test Results,” we covered research conducted at the University of College Cork (UCC) which revealed that genetic services have been “starved of investment and resources” in the Emerald Isle, leaving healthcare workers involved in cancer genetics and follow-on services “completely overstretched.”   

And in “In Canada, Shortage of Medical Laboratory Technologists and Radiology Technicians Continues to Delay Care,” we reported how varies combinations of facility, physician, and other healthcare professional shortages are generating regular headlines about patient wait times in the UK, Canada, New Zealand, and Australia, particularly for elective procedures that may be six months to a year or more.

In those countries, and around the world, healthcare experts say the solution is expanding training opportunities to solve the shortage of clinical laboratory scientists, medical laboratory and imaging technologists, doctors, nurses, and other medical professionals, and increasing funding for modernizing hospital facilities and clinics.

But in countries with government-run healthcare, that solution is problematic at best.

—JP Schlingman

Related Information:

Eight-week Wait for Skin Cancer Test Results Risking Lives – Doctors

Private Healthcare Pushing Auckland Labs to the Brink

Factors Increasing Demand for Pathology Services in Auckland NZ

‘The Cancer You Didn’t Suspect’: Medical Test Delays Could Be Endangering Patients

Irish Cancer Society Report Shows Patients May Wait Two Years or More for Genetic Cancer Test Results