By Patrick Lynch, CBET, CCE, CHTM, CPHIMS, FACCE
Lately, I’ve been hearing a lot about succession planning. I know it is a problem: who is going to take over when the directors, managers, and other leaders retire (as many of them are)? But a more important question looms ahead: Where are the technicians who actually repair the equipment going to be found—and what kinds of skills will they need?
With many of the private, for-profit biomedical schools closing their biomed training programs, there will surely be a shortage of graduates within just a few years. This shortage may not display itself too much with the entry-level technicians, as electronics technicians and people with diplomas instead of associate degrees can perform many of the basic tasks.
But when more advanced skills are needed—for radiology equipment, for example— these minimally trained people may not be equipped with enough fundamental knowledge to address more technically demanding challenges of advanced technology.
We have many established colleges that turn out very capable biomedical graduates every year, but even these graduates are not always employable. Many of them are retraining into their second careers and are middle-aged, with families and mortgages. Entering a new career field, at entry-level wages, may not be feasible for those who don’t want to relocate their entire family and give up a home with a very low mortgage.
Seeking Qualified Personnel
Recently, I was informed that a nearby community college is considering starting a biomedical program. I may be asked to help write the curriculum. Here is my dilemma: Should the course of study be written to enable people to get into the job market as quickly as possible and rapidly become productive, entry-level BMETs? After all, many of them, due to streamlined training, may never progress beyond BMET 2 or 3 rankings.
Or, do we make it a rigorous program and prepare all graduates to pass the certification exam upon graduation? This might give us a higher dropout rate or cause the duration of the program to be lengthened a little. But the graduates would be higher-performing initially and should have more career growth in their futures.
At any rate, there are lots of potential problems for healthcare as our pool of trained, experienced technicians and engineers will soon diminish. This is especially true with imaging engineers, a profession that has consistently faced shortages. To start with, it is rare to find people with the right skills to become an imaging engineer. Even further, once the correct person is identified, it is an expensive proposition to train him or her since service schools cost exponentially more than most biomed schools.
Moreover, the information learned at school is not as readily converted into experience and mature skill for the imaging engineer, compared to the BMET. Imaging systems are bigger, more complex, physically more intimidating, much more dangerous, and the learning curve to become proficient is much longer.
In fact, it may take a couple of years to become an expert on a particular imaging system. Additionally, there are many different imaging systems in a hospital, each requiring a school and a special set of access codes, service procedures, and often operating using entirely different principles, such as ultrasound, radiation, magnetism, radioactive elements, and more. Learning—and remembering—all of them may seem like a herculean task.
Replacing a retiring imaging engineer is not an easy job or a task to be taken lightly. It should be planned years in advance. Ideally, there should be maximized job overlap, where the new and the old employee have ample time to transfer knowledge and skills before the retire date. This is easiest when the replacement is being promoted from within the hospital, and the two can work together to ease the transition.
Nevertheless, all too often, the replacement is an outside hire. In these cases, hospital administration rarely sees the benefits of job overlap. Administration will not allow the new employee to begin work until the retiring employee is gone, so there is no opportunity for the transfer of information or for the retiring employee to train the new one. Personally, I view this as shortsighted and contrary to the best interests of the hospital.
Making a Plan—and Sticking to It
Far too often, a replacement is not going to be found, so the hospital is forced to return to a service contract for the maintenance of the equipment that the retiring employee was maintaining. In my opinion, this is almost always a bad thing. The original manufacturer will use this as an opportunity to “teach the hospital a lesson” and make sure the facility never tries self-maintenance ever again.
Here is how they do it: Several manufacturers will make the statement that they cannot take over responsibility for the proper operation of the equipment as long as there are any third party-provided parts in the unit. This includes x-ray tubes, circuit boards, review stations, disk drives, and—in the case of endoscopes—bending rubbers, articulation components, and any other internal pieces.
So in order to begin providing service on the device that the manufacturer was asked to service, the company must first “bring it back to its original specs,” which is poorly disguised code for “replacing all parts that were not bought from the manufacturer at current list price for both parts and labor.” Now, the manufacturer can begin providing full equipment maintenance.
The costs of this “return to original condition” is staggering and is meant to accomplish two things: First, make a ton of money for the company. And, secondly, teach the hospital that no matter how good and successful its in-house program is, this will become a regular cost whenever it needs to reach out to the original manufacturer for regular service.
The only way to avoid these issues with manufacturers is to have a good succession plan, and make sure that when you start an in-house HTM program—be it general biomed, imaging, anesthesia, laboratory, or anything else—you have the commitment to keep it going through all sorts of adversity. This includes the impending shortage of technical staff. Get planning. The shortage is just around the corner.
Patrick Lynch, CBET, CCE, CHTM, CPHIMS, FACCE, is a biomedical manager with 40 years’ experience. For more information, contact chief editor Keri Forsythe-Stephens at [email protected].