By Bonnie Rubin, Associate Director, State Hygienic Laboratory at the University of Iowa
I trained as a clinical laboratory scientist, or medical technologist as it was called when I graduated back in the day. I thought it would be neat to work in a zoo laboratory but my application to the St. Louis Zoo did not even warrant a phone interview. So, I found my first job in a private reference laboratory where the majority of samples were received via the United States postal system. You can imagine what the summer heat did to the white cells in blood sent for complete blood counts and differentials (exploded them!) and to the bacteria in the employee urine samples (exploded them too!). Since I didn’t think the quality of the laboratory was quite up to par, I left after working there for three months to work in a clinical laboratory in a brand new hospital. The laboratory oversight and management was actually outsourced to a (another) large private reference laboratory 100 miles away, BUT the quality requirements were what I had been trained to expect. Believe it or not, I became the manager of the laboratory after 3 months – by default, I think. However, after one year, it was time to move out of my hometown and get a life of my own.
I accepted a position at the University of Iowa Hospitals and Clinics in Clinical Chemistry in the Department of Pathology and my career in laboratory medicine truly started. I worked as a bench tech for several years. There, I had the opportunity to become the supervisor and creator of the Critical Care Laboratory concept and operations; worked part-time and got my master’s degrees in the dual-program for healthcare administration and business administration; did an internship in pathology; and then was hired to be the executive administrator of the clinical and anatomic laboratories, pathology education and research labs (over 500 FTEs). During that time, I was tagged to lead a reorganization effort for the entire clinical and anatomic laboratory operations to make us more agile and flexible in responding to healthcare changes – this was during the Clinton Administration. We reduced laboratory units from 32 to six sections, and the number of supervisors from 24 to six. Needless to say, this was a major undertaking. During the month prior to full implementation, I was on maternity leave with our second son. I was very busy.
A few years after the reorganization, I was approached by a former colleague to apply for a general manager position at a start-up genomic discovery and biorepository company in Cambridge, Massachusetts. This was to be an “offer I couldn’t refuse.” So, we moved to Tewksbury, Massachusetts and I discovered what it was like to spend two hours driving twenty miles to work. Although we were only in MA for two years, the experience I gained in the private sector and the personal experiences that I and my family had while there were priceless – we have never regretted that decision.
We moved back to Iowa City in 2002, which is when public health and my career intersected. The State Hygienic Laboratory was advertising for a terrorism response coordinator and I was looking for a new adventure. Fortunately for me, the interview committee (which included Dr. Mary Gilchrist and Dr. Michael Pentella) offered me the opportunity to develop a robust emergency response program and ultimately provide me with many national, state and local opportunities as a public health professional. As response coordinator, I got to meet a LOT of new friends and colleagues in disciplines I NEVER would have if I had stayed in clinical or private laboratories. I have to admit I was intimidated when I first met the commander and staff of our 71st Civil Support Team. Having them to my house for burgers and beer, made our partnership even more solid and dependable.
Since 2009, I have been the Associate Director for Administrative Services. I oversee the non-analytical areas of the laboratory (finance, central accessioning, education and training, quality assurance, supply chain management, facilities and security). This phase of my career has definitely been exciting and sometimes daunting. Business theory indicates (Harvard Business Review, one of my favorite journals) that hospitals tend to be 10 years behind for-profit technology and processes. I believe public health is about 20 years behind, with the primary cause being lack of cash to build and maintain our business infrastructures. It has been quite the journey to identify, justify and implement new financial software, budgeting systems, test costing calculations and introducing staff to the concepts of process improvement in our customer delivery systems. Yes, quality assurance and control is not just for technical laboratory staff to use to improve what we do. The challenge, long hours and frustrations have been worth it. Our laboratory has a long way to go, but we are definitely on the right track and moving forward.
Being in public health has allowed me to become the best leader I can be. I have had the opportunity to work with national healthcare leaders, statewide leaders, and some of the best intellects in public and environmental science – opportunities I NEVER would have had in any other job. I am involved in policy making, new organizational models and processes – making a difference not only in my own Iowan community but also in the whole world of public and environmental health. I get to work outside the laboratory, recently being President of the Iowa Public Health Association, involved in the state’s STEM initiative, being a member of the Iowa Environmental Health Association and of course, being actively involved with the Association of Public Health Laboratories.
This series of fortunate events led me to where I am now at the State Hygienic Laboratory at the University of Iowa – and I wouldn’t change a thing.