President’s Desk Column

Our intangible assets-priceless

January 2004
Mary E. Kass, MD

There are a lot of ways to approach long-range planning. My favorite is to consult the various constituencies and see what people think. So two years ago, when the Strategic Planning Committee I chaired met for the first time, one of the first things we talked about was where we needed input and how we would get it.

"Strategic planning" may sound like a ponderous undertaking, but ours was not. We were 15 pathologists and four or more CAP staff members who met quarterly, usually two days at a stretch. Some committee members were selected for their expertise, others because I respected their experience and could count on them to disagree with me once in a while.

Guest experts were invited to many of our meetings. Depending on the topic, we might host a half-dozen pathologists with knowledge of molecular diagnostics, continuing medical education, informatics, finance, or practice management. We asked our experts to tell us about their vision for pathology in the next five years. What will our members need to know to see that patients get the best care and that clinicians have optimal information and support? What programs should we develop? What materials should we provide? They did not hesitate to speculate.

To ensure balance on the committee and among our consultants, we sought out people at different points in their professional lives (from residency, early practice, mid-career, and near retirement). We included people who had different roles in a variety of settings (pathologists and administrators from large and small laboratories, community hospitals, and laboratory systems). And we invited people from councils, committees, and other groups within the College, such as the Laboratory Accreditation Program, the Archives of Pathology & Laboratory Medicine, and SNOMED. The confluence of opinions and points of view was enormously helpful. Our group worked hard, enjoyed lively discussion, and did an excellent job.

In strategic planning, the idea is to keep the process consultative and iterative by seeking new input to build on what has been done before. Previous strategic planning committees had given us an excellent foundation, but the greater environment had changed. We needed to anticipate cost and revenue shifts related to SNOMED, Laboratory Accreditation, and Surveys, for example, and for this we turned to those within the College with direct knowledge. They told us what they thought about pursuing international markets for SNOMED, about competition in the laboratory accreditation industry, and about new Surveys opportunities in molecular diagnostics.

Much planning is about numbers, and numbers are important, but the picture they paint is a flat one that fails to reflect the intangibles at the heart of successful enterprise. Our accountants can place a dollar value on information technology equipment as property subject to depreciation, but that number tells us nothing about the value of the data maintained in those computers for research and education. We do not yet know what applications will be found for the information mined from thousands of Surveys and accreditation site visits and housed in those computers. We can’t calculate the multiplier effect of a superb IT staff. As they say in those ubiquitous advertisements promoting the convenience of credit cards, at the CAP, our intangible assets are "priceless."

We’d also be hard-pressed to project the ultimate yield of the College’s 2002 decision to make a significant investment in cutting-edge educational programming for pathologists. Under our new education plan, we have brought in highly skilled professionals to design learning opportunities that will be accessible, flexible, and useful to our members. Our curriculum will integrate technology and practical techniques supporting both day-to-day practice and American Board of Pathology requirements to maintain certification.

For example, molecular pathology has emerged as an extremely important area with tremendous clinical potential. It is critical that our members assume a central role in leadership and stewardship of molecular diagnostics and other emerging technologies. One of our primary responsibilities is to keep our members on the cutting edge in that field and to support its continued development.

The Strategic Planning Committee spent two days on molecular pathology, working with scientists, medical educators, and our government affairs staff in Washington. We met with Debra Leonard, MD, PhD, who serves on a 13-member Department of Health and Human Services committee that advises the HHS secretary on the clinical, ethical, legal, and social implications of genetic testing and other technologies. Dr. Leonard, a member of the CAP Molecular Pathology Committee, was nominated for the position by the College. It’s good to know that a pathologist of Dr. Leonard’s caliber is available to policymakers in Washington.

In advocating for pathologists, patients, and the public, our mantra is quality. Certain professional requirements must be protected. These include the right to complete our work in a timely fashion but without undue haste; institutional pressures to "produce" more "output" must be resisted. They include the right to fair compensation. And they include the right to pursue our responsibility to the many intangibles in laboratory medicine that translate to quality in patient care. We must work harder to educate payers and administrators who don’t appreciate the real cost of failing to pay for these services.

Of 13 core goals in the strategic plan, eight relate to ways that the College will continue to serve its customers. The most important customers, of course, are CAP members, whose interests direct our energies and whose needs shape our goals. What would a newcomer learn about the College from reading our strategic plan? That we work to foster excellence in the practice of pathology and laboratory medicine. That we seek to represent the interests of patients, pathologists, and the public. And that we pursue these goals with a certain ferocity, emboldened by the emerging preeminence of our science and empowered by its extraordinary clinical potential.

Dr. Kass welcomes communication from members. Send your letters to her at president@cap.org