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Number 1 2007 |
Contents: 32nd ASM Companion Club Meetings Faces from last year’s meeting An important message from Fred Silva, Executive Vice President of USCAP The Role of Pathologists’ Assistants in Anatomic Pathology How PA’s (Pathologist Assistants) help Pathologists International Society for Biological and Environmental Repositories (ISBER) Congratulations: Gold Medals to the Division and Robin Cooke
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Message from the President
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The 2007 meeting has the now well established normal format.
There are Can we improve the meeting? John Pedersen |
| 32nd ASM |
9:00-10:45 PAEDIATRICS – Room 102 NEUROPATHOLOGY - Room 105 11:15 – 1:00 LUNG - Room 102 LYMPHOMA - Room 104 2:00 – 3:45 DERMATOPATHOLOGY – Room 105 BREAST – Room 104 RENAL – Room 102 5:15 – 7:00 ORELL FNA - Room 102 UROLOGY – Room 105 GREY-GREEN – Room 104
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An important message from Fred Silva, Executive Vice President of USCAP We just returned from the largest meeting of physician-pathologists in history, ever, anywhere: Approximately 3500 physician-pathologists were in attendance last week (March 24-30, 2007) at our Annual Meeting in San Diego. 1.) All of the 24 Companion Societies and 17 evening Specialty Conference Educational Materials are now up on the USCAP Website: www.uscap.org for free (right hand side--USCAP Bulletin: 2007 Annual Meeting) 2.) All of the IAP Centennial Congress/Montreal Educational Materials are also up, including the three Plenary Lectures (“100th IAP Congress”) 3.) Take a look at our “eAcademy”: “Sample APECS Case”. It is a great case. 4.) In addition to the USCAP scientific abstracts presented at our Annual Meeting last week, many of the abstracts in toto can be viewed “View Posters Online” You are invited to attend the next Meeting of the USCAP
in Denver, Colorado, Mar 1-7, 2008. |
| Faces from last year’s meeting |
Bruce Latham and Bastiann de Boer
Nathan Apps, David White, Catherine Francis, Hans Leung, Troy O’Callaghan
Jane Dahlstrom (ACT) and Mary Miller ( NZ)
Jenny Clayton, Alastair Murray, Jessica Ng, Justine Gearry, Pat Renait, Nicole Smith, Martin Whitehead (Christchurch, NZ)
Frances Petry, Leonard Wu, Peter Chow
David Ellis (SA) and Sujartha Fernando (NSW)
Min Ru Qin, Liqing Zhuang, Lisa Wang. (Hunter Pathology)
Andrew Ryan, Phillip Moss Alan Pham, John Pedersen (Melb)
Chris Shi, Esther Myint, Hui Yin
Glen Francis and Roger Guard (Qld)
Suzanne Danieletto, Wiesia Wielebinski, Eva Fong (Syd)
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The Role of Pathologists’
Assistants in |
Tom Reilly The advent of managed healthcare delivery and the resultant cost pressures coupled with a drop in the number of physicians opting for pathology residencies, in the United States and across the world have contributed to increased utilization of non-physician healthcare providers (Pathologists’ Assistants) in the anatomic pathology department. In the United States there are currently seven official university-based pathologists’ assistant training programs. Six are Masters programs and one is an undergraduate program. All are accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS), ensuring uniformity in curricula for all programs. The American Association of Pathologists’ Assistants (AAPA) is the professional organization of the pathologists’ assistant profession in the United States, and counts among its members pathologists’ assistants from Canada, Australia, New Zealand and Denmark as well as from the United States. Pathologists’ assistants work in a variety of settings, primarily in university medical centers, community hospitals, government medical centers such as the Veterans Administration Hospital System, private reference laboratories, and, to a significantly lesser degree, in medical examiner offices. The utilization of pathologists’ assistants provides significant workload relief for the pathologist and facilitates the practice of medicine in an economically sound fashion. The two primary areas of expertise of the pathologists’ assistant in anatomic pathology are the gross examination, dissection, description and processing of human tissue from the operating room Suite, various clinics and outside physician offices (surgical pathology); and the postmortem examination/prosection of human remains (autopsy pathology). In surgical pathology the trained pathologists’ assistant, under
the supervision and direction of a qualified pathologist is capable of
dealing with all aspects of specimen processing i.e. accession, examination,
gross description, dissection, tissue sampling and processing. They work
closely with the pathologists as well as surgeons, radiologists, and various
other staff to ensure appropriate patient care. In autopsy pathology the trained pathologists’ assistant, under the supervision and direction of a qualified pathologist is trained to research the patient chart, summarize the patient’s clinical history and consult with the attending pathologist to formulate a “game plan” for conducting the postmortem examination. They then may ascertain the legal viability of the autopsy permit and prosect the case, i.e. eviscerate, examine and dissect the organs, dictate final gross autopsy findings, submit appropriate tissues for microscopic evaluation and assist the pathologists in the preparation of the preliminary anatomic diagnosis. In short, as healthcare reform, increasing regulation regarding quality of care and administrative responsibilities are added to the pathologists’ workload, the utilization of pathologists’ assistants in anatomic pathology provides significant cost effective workload relief for pathologists. Tom Reilly, American Association of Pathologists’ Assistants
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| How PA’s (Pathologist Assistants) help Pathologists |
If we reflect for a moment, we realize that from the beginning of our involvement in health care, we have worked in teams. As medical students, we worked in teams that included nurses, nurses’ aids, fellow-students, house officers and attending physicians. As pathologists, we work in teams that include histotechnologists, cytotechnologists, laboratory technologists, clerical personnel, fellow pathologists and physicians responsible for direct patient care. We have never performed alone. What Dr. Eugene Stead did in the 1960’s was to add another, unique team member, the physician assistant. The physician assistant was designed to be a professional whose training and experience was intermediate between that of nurses and physicians. Stead recognized that on the one hand there were many talented persons who could provide effective care when supervised by fully trained physicians, and on the other that such people could be trained more quickly and cheaply than physicians. Shortly afterwards, Dr. Thomas Kinney introduced an analogous concept of a PA in anatomic pathology, that is, a professional that is between a histotechnologist and a pathologist, and Duke University began its Bachelor of Health Sciences program to train these PA’s in 1972. Today, our Duke program graduates 6 PA’s each year. These are wonderful, energetic young people who already hold a bachelor’s degree. Here they then do one year of formal education alongside our Duke medical students followed by a second year of practical training supervised by pathologists and our PA faculty. At the end of the second year they receive a Masters of Health Science degree from Duke and a certificate of completion of training. Then they sit for the national examination given by the American Society of Clinical Pathologists, and in the US they are quickly hired by many eager pathology practices. In practice, working with a PA is like having extra pairs of hands and eyes. PA’s share much of our knowledge and all of our motivation to achieve accurate, efficient diagnoses in anatomic pathology. They free pathologists from many of the details of gross analysis, and they do careful, thoroughly documented dissections. Yet, pathologists need not abandon the gross analysis. What many of us do is to oversee the work the PA is doing. For example, to observe key findings, we quickly review cases with complicated dissections at the beginning, at the end or during the dissection. In this way our gross analysis becomes more efficient, and this leaves us more time to perform microscopic analyses as well as to integrate ever increasing technologies like FISH, immunohistochemistry, cytogenetics and flow cytometry into the final diagnosis. Because of their stature and knowledge, PA’s often assume supervisory roles over other laboratory personnel. Thus, for all these reasons, PA’s make the teams in anatomic pathology more sophisticated as well as efficient. Dr. Robin Vollmer |
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International Society for Biological and Environmental Repositories (ISBER) Conference at the Furama River Front Hotel, Singapore This is an international organisation formed to establish
centres for banking human tissues for future research. This will be their
first meeting in the Asia Pacific Region. |
Congratulations Gold Medals to the Division and Robin Cooke |
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