“The Doctors’ Doctor”: Saving Lives with Medical Laboratory Scientists

Of all the data that physicians use for diagnosis, about 70 percent comes not from doctors themselves, but from the work of medical laboratory scientists and others in healthcare who provide diagnostic data. Few people at Texas State are as qualified to talk about their experience in the medical lab as two Bobcats with a total of six TXST degrees between them. 

The chair of the Clinical Laboratory Science program (CLS) at Texas State is Dr. Rodney E. Rohde, who is also a professor within the program. (The academic program here is known as CLS; graduates go on to take a certification exam in medical laboratory science, or MLS, in order to work as medical laboratory scientists. CLS and MLS refer to the same field.)

Medical lab professionals play a different role in healthcare than physicians; both are vital. Rohde uses the idea of an airport ground crew to describe how physicians and pilots are the visible face of their industry, supported by others who aren’t as public-facing: “You never see the mechanic at the airport, but I bet you hope there’s a qualified one taking care of that plane you are about to board.”

Lindsey Coulter Estetter stands outside a CDC building
Lindsey Coulter Estetter works at the Centers for Disease Control and Prevention, studying emerging infectious diseases.

“They’re all amazing,” says Rohde of CLS students. He goes on: “Lindsey has a special talent.”

Lindsey Coulter Estetter, like Rohde, is a three-time Texas State graduate. Her interest in science began in high school. “My school district offered cosmetology classes,” she recalls. “I quickly realized I couldn’t do hair to save my life, but I was really interested in learning the health regulations and the types of infections that could be caught in a salon. So, microbiology became my focus.”

Estetter earned her bachelor’s degree in microbiology in 2010; she stayed at Texas State for a master’s in biology. That was when she met Rohde.

As a member of Estetter’s thesis committee, Rohde spoke with her about her research and plans for the future. When he learned that she dreamed of working at the Centers for Disease Control and Prevention (CDC), he told her about a prestigious program: the Association of Public Health Laboratories Emerging Infectious Disease Fellowship. Rohde was familiar with this opportunity because prior to his academic career, he had spent two terms as a CDC Visiting Scientist through his work with the Texas Department of State Health Services. Rohde knew that a CLS degree would help Estetter compete for the fellowship and hopefully get to the CDC. So Estetter took on her third degree.

In the CLS program, students acquire the skills they’ll need to perform medical testing, analysis and interpretation — the steps that happen behind the scenes in settings such as hospital labs, blood banks, reference laboratories and public health departments. 

Even the best doctor cannot look at a patient and determine which particular strain of bacteria is causing an infection. And it is typically very rare, Rohde explains, for a physician to sit in a lab and perform something like blood types and screens for themselves; that kind of lab work is a different skillset from the training that physicians receive in medical school in order to provide direct care. This is where medical lab professionals come in.

Estetter works in the CDC’s Infectious Diseases Pathology Branch, where her team is on the front line of disease identification and research. She analyzes tissue in order to better detect and understand emerging disease agents like the Zika virus.

Medical lab scientists master four key areas: clinical microbiology, clinical chemistry, hematology (blood-borne diseases) and immunohematology (the screening and matching necessary for blood banking). Dr. Rohde says, “Our students basically have to major in those four critical areas, as well as understand quality control and assurance, clinical research methods and more.” Their training covers parasitology, immunology, molecular diagnostics, laboratory management and much more. With this knowledge, they provide expertise on the best type of tests to run for any given patient and then perform the lab-based work of the test itself. They identify the bacterial or viral agent and whether it has any drug resistance, thus narrowing in on the best kind of medication to throw at it. By specifying appropriate, targeted tests, medical lab professionals save hospitals millions of dollars. More importantly, they save lives by providing accurate diagnoses and guiding effective treatments.

Dr. Rodney E. Rohde sits in a lab surrounded by lab equipment
Dr. Rodney E. Rohde spent a decade as a public health practitioner before serving as the chair of Texas State's Clinical Laboratory Science program.

“We’re the doctors’ doctor,” says Rohde, in that medical lab professionals are equipped with a vast toolbox of information that lets physicians know what they’re dealing with.

As Estetter’s medical lab education wrapped up, it was time for her to apply for the CDC fellowship. Rohde knew that through her master’s degree, Estetter had a strong foundation in research. Together, they hoped that combining this research experience with her new CLS training would make Estetter competitive in the fellowship application cycle.

It worked. Out of 325 applicants from across the country, Estetter was one of just six people to receive the fellowship in 2014, and was the first student from Texas State to be part of the program. “We were doing cartwheels,” Rohde remembers.

Today, Estetter works in the CDC’s Infectious Diseases Pathology Branch, where her team is on the front line of disease identification and research. She analyzes tissue in order to better detect and understand emerging disease agents like the Zika virus.

abstract image of green lines and shapes with blue circles among them
Medical lab scientists analyze samples like this Zika virus, shown under a microscope and digitally colorized. Photo credit: Cynthia Goldsmith, Public Health Image Library, CDC.

“Our branch specializes in identifying infectious diseases in tissues, not a specific infectious agent, which gives me the opportunity to test for different organisms and viruses and try to improve our methods with new technologies,” Estetter says. Her work is a little different each day, revolving around extracting genetic material from samples, testing for infectious agents using molecular techniques, sequencing, and analyzing and interpreting results.

Although Estetter doesn’t interact with patients directly, she plays a significant role in people’s lives. “The work we do in our branch helps to identify and track outbreaks,” she explains, “as well as to identify unknown causes of death, which not only helps track infectious agents, but also gives closure to family members that don’t know why their loved one died.”

Back at Texas State, Rohde is clearly proud of Estetter and the work she did to arrive at the CDC. Rohde’s own journey was not as straightforward. After getting a bachelor’s in microbiology and a master’s in biology with a focus on viruses, he started looking for work in medical labs. “I was quickly told, ‘You can’t work here,’” Rohde remembers. “Um, I have two degrees…” Unknown to him at the time, he needed an MLS credential in order to do the type of work he was drawn to. He was able to get there eventually and has had a thoroughly successful career. But he wants to make sure that young people are aware of the CLS degree and the MLS profession early in their education, so that they can avoid his initial backtracking.

When introducing people to medical laboratory science, Rohde describes how the field can be a great fit for those whose STEM interests run toward the health sciences, especially if they want to make an impact without a high level of direct patient care. (Most MLS professionals spend their time at the laboratory bench rather than the bedside.) Those armed with a passion for lab work and investigation do well in the field. “If you love detective work, getting to the answer, you might look at us,” Rohde urges. And indeed that’s what Estetter does every day at the CDC, where she is part of a global investigation into ever-changing ecosystems of disease. 

While Estetter’s achievement in securing the CDC fellowship was outstanding, her success is not unique. Texas State’s CLS alumni have a 100 percent employment rate just one month after graduation. “I always tell my students: ‘You stand out,’” says Rohde. “They have a unique set of skills, not only in theory but in practice.” The CLS degree is a direct route to critical healthcare jobs — like Estetter’s, on the cutting edge of infectious disease research and prevention — using skills that are in high demand across the country. As public health professionals, blood bank directors, toxicologists, diagnostic equipment specialists, lab regulators, core researchers and more, medical lab scientists impact people’s lives every day. ⭑