President’s Desk Column

Be seen and be heard

February 2005
Mary E. Kass, MD

When the CAP Strategic Planning Committee met in mid-January, we invited an expert to talk about challenges hospitals face in the marketplace and strategies they employ to remain viable. I was glad to hear him predict that investment in that investment in technology would continue to be an important marketing strategy for hospitals. So much of what we can contribute requires new technologies—everthing from molecular genetics to SNOMED.

I know that many pathologists are concerned that certain new technologies might eliminate some of our traditional responsibilities and might eliminate some of our traditional responsibilities and might compromise the quality of test results. Technological changes in the laboratory will present difficulties for those who have not prepared for them, but fortunately it is not too late to prepare. Tomorrow might be too late, but today is soon enough.

Yale president Alfred Whitney Griswold once said the only sure weapon against bad ideas is better ideas. He was right about that, but the best ideas in the world won’t go anyplace if you aren’t in a position to get them on the table. When people are thinking about changes that can compromise the quality of laboratory services, you need to participate in the conversation. Become a part of the group so you can present concerns and suggest alternatives.

Constraints and opportunities in the marketplace drive top-down decisions, but administrators will consult people they know and trust, which is why it is so important to be an active member of the hospital medical staff. Those who make decisions that affect out laboratories may depend to a degree on data and other objective information, but that’s just the scaffolding. Facts inform decisions, but strategies are softer. They come from visceral impressions about what will work and who can be trusted. These are the subtler messages that emerge in dialogue among peers.

Many people on your hospital medical staff may think you are the person in the basement who provides information about blood and tissue samples. Your colleagues might be surprised to learn how much you know about molecular diagnostics. Certainly, your floor nurses would be glad to hear you are available to train their staff in proper procedures for point-of-care testing. I’m sure your administrators would welcome the news that you had monitored the use of reference laboratories and identified tests that could be kept in-house to save the hospital money.

The overarching strategy for career advancement in hospital pathology is to create partnerships. Demonstrate your value to the hospital by being seen, being heard, and taking on more responsibilities. Get to know a lot more people and teach each of them to see you as a resource, a willing contributor, and a physician who is always available for consultation.

If you would like to be considered an irreplaceable member of the hospital team, start today to tend to the details and hidden opportunities. For example:

• Accuracy and efficiency are essential, but don’t neglect the smaller courtesies. If your report will relate an important and unexpected diagnosis, don’t send it through the hospitals email; call the treating physician. Volunteer to share the news with the patient at the bedside.
• Most hospitals have programs to improve the experience of inpatients, and a well-run laboratory is an important part of that. Is your staff trained to handle every request as if it came from a member of their own family? Train your staff to make every test a stat test. Stay late if you must, but ensure a consistent and quick turnaround.
• Volunteer for the physician recruitment committee, and once you’re there, look for ways the laboratory can be promoted as an asset. If the goal is to bring in the members of a large physician group, offer to visit their practice and evaluate the feasibility of setting up a satellite laboratory in their building.
• Consider new ways to communicate directly with patients. Why not provide a patient-oriented write-up, why not invite patients to contact you directly with follow-up questions?
• Is your hospital investigating online patient access to laboratory test results? If not, suggest it and volunteer to help set up the program. As you work on the software, make sure to include links for patients to contact the laboratory staff directly. Do what you can to make it easier for patients to contact the laboratory staff directly. Do what you can to make it easier for patients and their treating physicians to consult with you.
• Laboratory management of point-of-care testing should be tight and on site. Ask your colleagues to allow their staff to participate in training for point-of-care testing. Once they’ve signed on to that concept, volunteer to conduct the training, manage the proficiency testing, conduct the competency assessments, and verify their quality control procedures.

These are just a few examples of options available for professional growth in the hospital setting. Pathology is at a crossroads, yes. We are standing at a place where many new challenges intersect. We can pursue those challenges or not. Those who do not may become bystanders, watching the profession move forward as they become obsolete. For those who step forward, however, I firmly believe the sky is the limit.