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Determining numbers and types of personnel to staff clinical laboratories is important to employers and educators. At 5-year intervals over the last 25 years, employment patterns among laboratory personnel have been examined in the 5 county Minneapolis-St. Paul (Twin Cities) area that includes 2.2 million persons, almost 50% of Minnesota's population. The 1995 survey was distributed to laboratory administrators of 28 major laboratories. All (100%) responded with information regarding personnel numbers and types. Data from 1995 were compared to that from 1970, 1980, and 1990. In 1970 there were 30 hospitals in the Twin Cities area with over 10,000 hospital beds; there were also 2 blood banks and 4 clinic laboratories. Altogether approximately 1300 laboratorians were employed. In 1980 there were still 10,000 hospital beds among 29 hospitals. However there were 8 other major employers of clinical laboratory personnel, including blood banks, clinics, and a reference laboratory. Between 1970 to 1980, the number of laboratory personnel almost doubled to 2500. The impact of managed care together with the Prospective Payment System, a government initiative of 1983, profoundly affected health care institutions and their personnel. By 1990 hospital mergers and closures reduced the number of Twin Cities hospitals to 20 with a total of 7500 beds. There were 11 blood banks, clinics, reference labs, and HMOs, including 3 reference (independent) laboratories. Laboratory employees increased slightly to 2600. By 1995, hospitals were reduced to 18 and hospital beds to fewer than 7000. The number of all personnel in the 28 laboratories surveyed rose to 2900. Between 1980 and 1995, 10 major hospitals closed or were converted to a different type of facility. Four hospitals merged to form 2 consolidated hospitals. Only 2 small suburban hospitals were built. However, despite the decrease in hospitals, laboratory personnel numbers increased after 1980, due largely to the emergence of 3 independent laboratories, as well as a result of an increase in overall testing volume. Seventy-five percent of the 28 administrators surveyed reported more laboratory testing in 1995 than in 1990. The number of laboratory personnel in the Minneapolis-St. Paul area has more than doubled in the past 25 years, despite the closure of 1/3 of the Twin Cities hospitals and efforts by the government to reduce laboratory testing. One reason for the expanded employment of laboratories and greater testing volume is the expansion of the laboratory itself--into new diagnostic technologies, as well as into new laboratory sites.