Tag Archives: From the President’s Desk

April 2024—When Tip O’Neill, former speaker of the U.S. House of Representatives, said many years ago that all politics is local, he was talking about how elections, legislation, and all of politics affect people where they live. I believe the concept applies just as much to pathology advocacy. When it comes to the issues we care about for our profession and for our patients, our efforts in advocacy, lobbying, educating, and persuading all need to happen at the local level just as much as at the national level.

March 2024—During the 12 years I spent as director of a pathology residency program, one thing I worried about was how to better prepare our residents for their first roles as attending pathologists or laboratory directors. For many pathologists, the transition from always having someone looking over their shoulder to being on their own is very challenging.

February 2024—Even before the pandemic, burnout had become a major issue in medicine. Today, the effects of too much stress, staff shortages, and increasing demands have become so widespread in health care that they cannot and should not be ignored.  

January 2024—I was planning to write about a much more pleasant topic this month, but instead I’ll use this column to address something that’s gnawing at all of us now: the prospect of FDA regulation of laboratory-developed tests.

December 2023—About five years ago, when I was serving in my first term on the CAP Board of Governors, I attended a House of Delegates meeting where we had a candidate forum with several people on stage competing for just a few Board slots. Of the half-dozen or so people, only one or two were women and none was a minority. That’s when one delegate stood up and, with a single question, altered the course of our entire organization: “When will the CAP have candidates for higher office who look like the CAP membership?”

November 2023—For 100 years, pathologists have been called “the doctor’s doctor.” We have traditionally done our work in the background, interacting mostly with other physicians and not visible to or known by patients.

October 2023—In my long career, I’ve met a lot of pathologists. The military pathologist. The private practice pathologist who drives 75 miles each way to serve patients at a small rural hospital. The academic pathologist frantically writing a research grant proposal after a full day of clinical service. The lab director struggling to keep up with a rapidly growing specimen volume.

September 2023—In the past two years, I’ve written a lot in this column about leadership and why pathologists make natural health care leaders. Effective leaders emerge from a process of continual self-correction in those who constantly seek out new ideas and hone their leadership skills.

August 2023—The benefit of the doubt: a risk worth taking in health care? Many of us work in practices, hospitals, or departments that are short-staffed. In the aftermath of the pandemic, it is harder now than ever to find qualified people, from pathologists to clinical laboratory scientists to phlebotomists. Those of us who still work in laboratories are feeling the stress of carrying an extraordinary load.

July 2023—About a year ago, I used this column to talk about the CAP’s efforts to prioritize innovation and to create more pathways for staff and members to help keep us on the cutting edge. I know “innovation” can seem like a meaningless buzzword that organizations throw around without putting anything substantial behind it, so I wanted to come back to the topic and show that we really are taking it seriously at the CAP.

June 2023—I embarked this year on my first international travel as president of the CAP. Due to limitations from the pandemic, I haven’t been able to do as much of this as some of my predecessors, but happily this year we seem to be finally coming out of the worst of it.  

May 2023—The spring of 2003 was not an easy time for me. I was taking care of my kids, a four-year-old and an infant, while going through a divorce. I had just started a new job and felt all the stress associated with that. The upheaval in my life sometimes felt overwhelming.  

April 2023—Here is a scenario for you: Your hospital administration team identifies a strategic need and establishes a new service line, perhaps in cardiology or women’s health. They speak with the relevant surgeons and specialists, gathering expert perspectives about this new service line. But only after everything else has been put in place does anyone consider how laboratory medicine will play a role. Sound familiar?  

March 2023—If you’ve read my prior columns, you know I am a strong advocate for pathologists stepping into leadership roles both within and outside the clinical laboratory. Our training gives us unique advantages as we serve in executive positions in health care, where our holistic view of medicine allows us to engage substantively on a broad range of issues. But what does that look like in the real world? I took on my first role as a hospital’s chief medical officer nearly two years ago and in some cases I’ve been surprised by how my day-to-day responsibilities differ from what I expected. Some of those surprises have been pleasant and some have not.  

  March 2023—Whether you watched Quincy, M.E., like I did as a kid, or something more recent like CSI, many of us encountered pathology for the first time through a TV show. Watching Jack Klugman’s weekly adventures as the L.A. county medical examiner, Dr. Quincy, certainly had me intrigued about the specialty of pathology. While most of us work in clinical or anatomic pathology instead of subspecializing in forensic pathology, it’s the forensics field—and how it’s portrayed in TV and movies—that gives most of the general public the only insight into pathology they get in their daily lives. When people outside the medical field hear about a pathologist, they typically picture someone performing an autopsy and trying to figure out the mystery behind a person’s demise.

January 2023—When I was newly elected into my officer role at the CAP in 2019, I had the opportunity to join a meeting of a committee under the umbrella of the Council on Accreditation. This was a committee whose work I knew little about but which I quickly grew to appreciate. In this committee I saw an extreme focus on operational processes and quality management structures. They wanted to prevent errors, not just fix them. This focus on process was different from the focus on blame that we often see in medicine. As I listened to Gaurav Sharma, MD, lead the CAP 15189 Committee, I knew I was among folks dedicated to pushing for ever-better care and quality for our patients and our laboratories.

December 2022—Many of us were raised on alluring stories of the good old days in medicine, when physicians enjoyed long-term, respectful relationships with their patients. I grew up hearing from my father, an obstetrician/gynecologist, and my mother, a nurse, about their frustrating transition from this to a modern reality in which these relationships were strained by a seemingly impenetrable health care bureaucracy. Like so many pathologists, I have felt intimidated by such behemoths as the CMS, the FDA, and insurance companies, as well as smaller monoliths like the C-suites or dean’s office at health systems and medical schools where I have practiced. But what I have realized by working with the CAP is that dealing with these entities can be more manageable when we create positive and productive relationships with the people who work in them.

November 2022—Like me, many of you can remember when you first thought about specializing in pathology, a decision that for a lot of us was made difficult by the notion of “disappearing” from the scene—working behind the scenes and in relative obscurity. As a specialty we are not as self-explanatory as surgery or pediatrics; indeed it can be exhausting for all concerned to explain, even to our fellow physicians, what we do. And so we often find ourselves somewhere between disregarded and misunderstood. Despite this, there is no other specialty with comparable impact. We are aware each time we sign a pathology report that a cascade of usually predictable consequences will ensue, and that upon this work the types of treatment, expectations for response, and tenor of conversations will depend. We know each time we validate a new test, review quality metrics, or accept a specimen for testing that subsequent laboratory results will be accepted as credible and acted upon. In short, while pathologists are not always visible, there can be no doubt that pathologists are palpable.

October 2022—When I was in pathology training back in the ’90s, physicians carried around an index card for each patient, with all of the information we needed to know about them easily covered in that small space. Today, the practice of medicine—and specifically the practice of pathology—looks very different in the era of big data. Of course, we still have to fill our traditional roles: making the correct diagnosis for individual patients and ensuring the integrity of laboratory results. But increasingly large data sets inform the diagnosis in individual cases and, at the same time, individual cases become data points in large data sets that inform the health of populations. Beginning in the 2000s with the value-based care movement and accelerating with the rise of high-parameter tests, we find ourselves having to be data scientists as much as physicians. We are being asked to incorporate data-heavy tests and pipelines, some of which require clinical decision support algorithms that demand a certain fluency with more sophisticated software. We find ourselves in the new position of considering population health in addition to patient health, an element that can involve predictive analytics and data mining.

September 2022—Like so many pathologists, I have been keeping a close eye on the VALID Act, which would create a new framework for FDA oversight of laboratory-developed tests (LDTs). As I write this, the VALID Act has been voted out of a Senate committee and now awaits further action by the full Senate. I have heard from some pathologists and laboratorians who are concerned about this legislation and about the CAP position on it since the Senate HELP Committee released a draft on May 17, 2022. If you have not followed this bill and the issues of LDT oversight, allow me to offer some context. Regulatory oversight of LDTs has been in active discussion since 2008 when the FDA intervened with a national reference laboratory that was selling a test that had been developed at a prestigious university to identify high-risk women who might have ovarian cancer. Patient advocacy groups had raised a concern because several women had undergone unnecessary prophylactic bilateral oophorectomy based on this LDT. In response, the FDA expressed concern about the public harm, and the reference laboratory pulled the test from the market.

August 2022—The CAP has been advocating for an increase in residency slots that would help give more young physicians the opportunity to embrace careers in pathology. We support the Resident Physician Shortage Reduction Act, bipartisan legislation that is working its way through both chambers of Congress. It would add 14,000 Medicare-supported residency slots over the course of seven years and help ensure an open pipeline for pathologists. Between pandemic burnout and the retirement cliff resulting from an aging population of physicians, we are facing a shortage of all physicians, pathologists included. The CAP projects that the number of pathologists will shrink in the coming years. Unfortunately, when there are not enough pathologists to lead clinical laboratory teams, it creates a gap that has to be filled somehow. Many of us have already seen health care gaps being filled by people with less extensive and intensive training.

July 2022—The CAP has been looking to identify areas where pathologists can help overcome institutional bias in medicine. As you may have seen, the CAP recently issued a statement supporting a new position from the American Medical Association that calls for a change to the FDA’s policy about blood donations from men who have sex with men. The current rule, established in early 2020 in response to a drastic blood shortage associated with pandemic lockdowns, prohibits blood donations from gay or bisexual men who have engaged in sexual activity in the prior three months. Previously, only gay or bisexual men who abstained from sex for a full year were eligible to donate blood. Many of you remember as I do the societal rejection of HIV-positive patients that occurred in the late ’80s. I was in medical school at this time, working at the county hospital in Kansas City, Mo. A lack of access to health care elsewhere was only one form of rejection to which our HIV-positive patients were subjected.

June 2022—You’re probably familiar with the expression “jack of all trades, master of none.” While that sounds disparaging, it’s actually taken out of context. The original quote in its entirety is, “A jack of all trades is a master of none, but oftentimes better than a master of one.” It was intended as a compliment for someone who had good, broad knowledge. The widespread misinterpretation of that quote supports a common idea that no individual can be really good at a lot of different things. But pathologists challenge that concept every day. While many of us subspecialize, we are able to fall back on our broad training when circumstances require it. Such may be the case when encountering pathologic findings that indicate a disorder not commonly found in our area of expertise, or findings that indicate a systemic illness. Many of us find that we have to be experts on different things on different days and in different parts of our career.

May 2022—In the 1990s, as immunohistochemistry was first adopted in clinical laboratories, there was palpable fear among many pathologists who believed our expertise would no longer have a role in health care. The prevailing sentiment at the time was, “If the brown stain lights up, you know it’s cancer, and they won’t need pathologists anymore.” Of course, nothing could have been further from the truth. Having IHC capabilities meant there was more information that we had to process. It enabled us to extract more information from a tissue sample and to do more for our patients, but it also required more of us in terms of test selection, test interpretation, and communicating what it all meant to our fellow clinicians. More recently, next-generation sequencing has given us more, not less, to do; far from replacing us, such innovations require more of us to realize their full potential. These additions have not necessarily made our lives easier, but they have absolutely made what we can offer our patients richer and more precise.

What you’ll get from the Leadership Summit
April 2022—The end of this month marks the start of one of my favorite CAP events: the Pathologists Leadership Summit. If you’re not familiar with it or haven’t signed up to attend, I’d like to give you a sense of why it’s so important. Back in the early 2000s, I attended what was known as CAP Advocacy School. At that point in my career, I had seen many physicians who felt discouraged, frustrated, and helpless about the state of physician payments and government health care regulations, and I understood those feelings. Advocacy School offered a solution. What struck me about this program was the message that we were not powerless. Through this meeting, the CAP taught me that my government representatives would be interested in what I had to say as an expert physician. I was partnered with Richard Hausner, MD, a seasoned pathologist advocate.

Strengthen your state societies
March 2022—If you’re reading this column, you’re likely a member of the CAP. But are you also a member of your state pathology society? Too many pathologists think that joining the CAP is enough. The truth is, the CAP can have a greater impact—and pathologists can be more effective physician advocates for their patients—when partnering with robust state pathology societies. State societies are essential because so many of the policies and regulations governing our work as pathologists are enacted at the state level. Balance billing rules, scope of practice issues, and insurance regulations are often decided by each state. So many issues about how we are licensed, how we practice, and how we get paid are regulated at the state level.

The time for courage
February 2022—We pathologists tend to share traits common among physicians: We are often type A overachievers, driven by perfectionism, our own unrealistic expectations, and a deep fear of failure. Normally, these characteristics help us to achieve our goals, in life and in caring for patients. But these are not normal times. In the COVID-19 pandemic, it is almost impossible to feel like we’re doing a good job. Like so many of you, I am working significantly long­er hours than usual. At the end of each day I am often left with a sense of despondency that there’s not enough time to get everything done, or to do it all as well as I would like.To get through this crisis, we have to let go of our perfectionism and embrace doing what we can. We need to accept that if we’re doing what we can, it’s enough. Even if our individual efforts seem inadequate in dealing with this pandemic nightmare, the collective effort is adequate. Each day in my hospital I feel like I’m taking a bath in COVID-19. But I go home, rest up, and do it again the next day.

The CAP for the next generation January 2022—Happy New Year! Most of us start each year with resolutions, fresh budgets, or perhaps yearlong plans. This is often the time we think about the future and the choices we need to make now to achieve those long-term goals. In that spirit, I’ve been thinking about how important it is for the CAP to continually engage with and mentor the newest members of our pathology community. Residents and early-career pathologists bring vibrant energy to our ranks, and many of them will eventually contribute to the leadership of the CAP. While we always value the experience and wisdom of our more seasoned fellows, it is essential that we also make space to train up-and-coming leaders.

December 2021—When I became a pathologist more than 20 years ago, I never imagined I would have the opportunity to serve as chief medical officer at a hospital. But I can see from my new position how a background in pathology has prepared me for hospital leadership. In fact, the very traits that led us to become pathologists are the ones that make so many of us natural leaders. We are nimble thinkers who can simultaneously appreciate the big picture and the tiny details. Likewise, we can think concurrently about population health and individual patients. Our ability to see and understand these perspectives so clearly is a huge advantage. Because our specialty touches many different aspects of medicine, we are comfortable interacting with all segments of the health care system—from operative services and radiology to the emergency department, medical wards, and ambulatory setting.

November 2021—In the past two years we have seen the lethal effect of a lack of trust in science. As physicians, pathologists, and fellows of the College of American Pathologists, our duty now as always is to prevent harm, the threat of which comes from mistrust and misinformation. It has always been our role to be revealers of truth, keepers of truth, and producers of clear, reliable information. Our profession and the entire CAP are based on the idea that there is a single truth that can be found through a laboratory value—a truth about a patient’s pathophysiology at a moment in time. This belief that there exist objective truths in medicine is fundamental. In fact, if the laboratory were not a reliable source of truthful information, then pathologists would have a much diminished role, if any at all, to play in clinical medicine. With the truth, pathologists are incredibly important. Without it, much less so. The founders of the CAP understood that.

September 2021—As my term as president of the College of American Pathologists comes to a close, I am both honored and humbled to have been selected by my peers for this position. Over the past two years our organization was presented with the greatest challenge we have ever faced. Because of our phenomenal members and staff, we have accomplished great things even though we worked under the most adverse conditions. We, yet again, backed a horse named CAP. It broke out of the gate well and had to weave through traffic on a bad track, but we are ahead. We made the right bet and I am so, so lucky to have been chosen to be the jockey for this race. Looking back, the COVID-19 pandemic presented our community with relatively sudden and profound changes resulting in a tremendous number of challenges. It has dominated our lives. We should be proud of our accomplishments. We have not only put out many fires and sewn up deep wounds, but we have also set up the College and our fellows for continued success so that we will be able to keep serving our patients well.

August 2021—No doubt about it, in-person meetings are coming back. I went from a record-long stretch at home because of the pandemic to attending events all over the country. I hasten to add that my entire family is fully vaccinated, and we were so at our first opportunity. As I write this in July, I just returned from an in-person professional development meeting, and I am reminded that virtual meetings are nowhere near as effective as face-to-face meetings. That’s why I am pleased that CAP21 will be a hybrid meeting this year. It’s a step back to normal and will allow people to engage in the way that’s most comfortable for them as the COVID-19 pandemic continues in our country. It feels good to have the opportunity to come back together. I think one of the many reasons our country is so divided now is that we have been separated from each other for so long. At a recent CAP meeting I attended, there was a disagreement during one particular session. After it ended, everyone involved got together face to face, talked through the issue, and came to a good resolution.

July 2021—It has been a long time since the American public has been so terribly divided by politics. So many topics seem polarizing in our country right now. As pathologists, we should not allow these forces to fragment us. I fear that if we are not careful, we could find our community pulled apart, and that would be detrimental to those we should most protect—our patients. I’ve been thinking a lot lately about the phrase, “United we stand, divided we fall.” It is well worn but still meaningful. It’s the official motto of the Commonwealth of Kentucky, where I was born. Within the CAP and each state’s pathology society—in my view, the two groups every pathologist should belong to—it is imperative that we stick to the topics that unite us to keep our organizations strong and inclusive. We are all pathologists or soon-to-be pathologists, and we are all physicians. We are united on measures that allow us to better serve our patients and protect our practices. We should not be divided by politics, and there is no room for that in the CAP or state-level pathology societies. I am not saying that we should not individually be politically active or work peacefully in other politically active groups.

June 2021—Several CAP fellows have reached out to me recently about a topic many find controversial: whether pathologists should unionize. Some of this interest stems from concerns about employment models and how pathologists are treated in various situations. Some of it comes from concerns that pathologists are not being compensated appropriately for the risks and responsibilities they bear daily. The COVID-19 pandemic has also fueled increased interest in unionizing among many types of health care workers. According to the U.S. Bureau of Labor Statistics, people who work in health care and social assistance are a little less likely to belong to unions than people in other fields. In 2020, 7.1 percent of workers employed in health care and social assistance were members of unions, compared with 10.8 percent for people in all industries. But the pandemic has led to an uptick in unionizing interest for many in the health care field, from nurses and respiratory therapists to many other providers as well as physicians. My great-grandfather was instrumental in bringing the United Mine Workers of America to the coal mines in Appalachia at a time when that was one of the most dangerous jobs in the country. Many miners were paid by the number of tons of coal they dug. The more they dug, the higher the pay.

May 2021—Since the $1.9 trillion American Rescue Plan was signed into law in March, pathologists have been both excited and confused about its ramifications for our community. I’ve heard from many of my colleagues who expect more money to flow to their labs, and that may not necessarily be the case. The lab I run has not seen this new funding directly. Congress has made significant investments to support diagnostic testing in this bill and others enacted over the past year. The CAP is grateful for the support and recognizes that if we don’t receive funds directly, we will find funds flowing indirectly to our laboratories in one form or another. For example, Congress has ensured the necessary tests for COVID-19 that our laboratories run will be covered. This includes the tests for the uninsured. The CAP was instrumental in achieving big wins for us in this bill —but there were also places where we didn’t win. I’d like to review some of the most important elements to help all CAP members understand what to expect for your laboratories.

April 2021—“Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” I thought of this Winston Churchill quote when I, along with many others, received my first COVID-19 vaccine in December. Unfortunately, this country would go on to experience a second peak. My counterparts in other countries remind me of their third peak. Still, we are well along in the end of the beginning. By the time this column reaches you in mid-April, COVID-19 metrics will have changed, and I believe will be better. This is being written in early March and positive indicators are abundant. Testing availability has increased substantially. In the U.S., reported new daily infections have fallen significantly from their peak in January, while more than 10 percent of the public is now fully vaccinated against the virus.

February 2021—In late December, the U.S. Congress passed a COVID-19 relief bill that included two key items for pathologists—measures that the CAP pushed hard to achieve on our behalf. The document is more than 5,000 pages and addresses a large number of subjects, including thoroughbred horses. Here, I’d like to offer a brief analysis of the elements that affect our profession.

January 2021—Please join me in a collective sigh of relief: 2020 is finally over. I am glad that awful year is behind us at last and sincerely hope that 2021 will be kinder and gentler to us all. From my perspective, 2021 is already off to a better start because it gives us a reason to celebrate. In 1946, 140 board-certified pathologists gathered in Chicago on Dec. 12 and 13 and formed the College of American Pathologists. This year is our 75th anniversary.

December 2020—As we reach the end of December, I am taking a look back at this year and wondering: How long was 2020 anyway? My calendar says 12 months, but if you’re like me, 2020 seems like it has already had about 24 in it and I’m still counting. I’ve even taken to using “2020” as an expletive. When I think of the key themes of the past year, most are quite negative. The pandemic, virtual meetings, and extremely challenging legislation just to name a few. In the spirit of hoping the worst is behind us—and to remind ourselves how much we worked to make the best of a bad situation—let’s take a quick tour of the major difficulties we faced in 2020.

November 2020—Despite the circumstances that forced us to shift to a virtual event for our annual meeting this year—and my sincere hope we will never have to do so again—I couldn’t be more proud of how everyone in the CAP worked hard to adapt to the COVID-19 pandemic and ensure the best experience possible for all of our pathologists. As I write this, the annual meeting has just concluded. While every conference we hold requires tremendous effort, this was a different event, a different horse race. The work and persistence that went into making our virtual meeting a success were extraordinary.

October 2020—Many CAP TODAY readers know about my fondness for horse racing, so it will come as no surprise that I thoroughly enjoyed the belated running of the Kentucky Derby last month. I even made a few dollars from a small bet, which may be the only positive financial news I get in a year marked by COVID-19 and the threat of impending reimbursement cuts.

July 2020—It is with profound sadness that I write about the passing of a dear friend. Gene Herbek, MD, served as president of the CAP from 2013 to 2015, and many CAP TODAY readers will remember his informative column in these pages. For details about his life and accomplishments, please read his obituary in this issue (page 12). I’d like to spend this column focused on how he shaped the CAP, and what an honor it was to have known him.

June 2020—Like so many CAP TODAY readers, I have been spending the vast majority of my time working on COVID-19. In Georgia we have the dubious distinction of having a county with one of the highest per capita death rates due to COVID-19 in the country—at least as of early May when I wrote this. Things are moving so fast with this pandemic that by the time you read this, much will have changed.

May 2020—The most pressing topic in pathology today is the COVID-19 pandemic. Because this column must be written a few weeks before it is printed and delivered to readers, anything I write in April will be out of date by the time you see it. Numbers will be wrong, and comments on testing methodology will be obsolete. Instead, I’ll focus on the bigger picture. As we watch the world’s response to the pandemic, I am proud to be a physician and a pathologist. I am honored to work with phenomenal laboratory personnel, and this is by no means unique to me. Across the medical community, we have seen people come together for a shared mission in ways we have never experienced before. The demands on our laboratories are tremendous, and we are rising to the challenges of producing tests and directing therapies under conditions we have not seen before.

April 2020—It is important for pathologists to understand just how much influence the federal government has on our practice of medicine. In last month’s column, I discussed ways in which the government dictates how and whether we are paid for our services. This month I’ll address the role of the federal government in determining where and how we practice. You probably already know that pathology labs are among the most highly regulated areas within health care, subject to regulations from multiple agencies.

March 2020—It is important to understand that we—those of us who work in the U.S.—are all essentially independent contractors for the federal government. Pathologists who work directly for a federal agency or the Department of Defense are the only exception. The federal government has enormous influence on funding and reimbursement in health care. Including direct and indirect spending, about 50 cents of each health care dollar comes from Washington.

February 2020—Regular readers of CAP TODAY know I believe that it is extremely important for CAP members to become politically active. The upcoming Pathologists Leadership Summit, which will take place May 2–5 in Washington, DC, will give you the opportunity to do so. If you haven’t registered already, I encourage you to consider attending this special event. The Pathologists Leadership Summit is new for the CAP. It is replacing our annual policy meeting focused on government advocacy.

January 2020—Recently I attended and spoke at a meeting of the Georgia Association of Pathology. That might not sound like a big deal, but it was. This was an important occasion for me and my colleagues in Georgia because our state society had been dormant for the past decade. Thanks to the efforts of five CAP fellows and the CAP itself, we are back in Georgia.

December 2019—This time of year, it’s easy to find ourselves caught up in holiday planning and the challenges of managing a busy team’s hectic vacation schedule. But it is also the appropriate time to look ahead to the coming year and think about the opportunities as well as the challenges we should expect. Here’s what I can say for sure about next year and the years after that: The importance of pathologists and the laboratories that we direct will increase. Already, the majority of diagnoses and therapies are greatly influenced, if not outright dictated, by pathologists and our laboratories.

November 2019—There is a saying about Washington that applies to our state capitals as well: If you are not at the table, you are on the table. I want to spend this column considering some of the ways in which the CAP helps its members get off the plate and pick up a fork. In other words, to become engaged politically.

October 2019—I have two goals as a pathologist, and I suspect that my colleagues share them. First, I want to be the best physician—the best pathologist—so I can give the best possible care to my patients. Second, I want to get paid fairly for the service I provide. Being the best pathologist comes with a number of requirements: staying up to date on the latest information and protocols, practicing in a quality lab, and working with great pathologists.

September 2019—The CAP will sponsor next May the Pathologists Leadership Summit in Washington, DC. This is not just another meeting where you’ll learn to deal with changes happening around you that feel as if they are out of your control. No. This is a radical reinvention of a meeting where members will come together to achieve something specific—and move pathology forward.

August 2019—I am always interested in learning what is new in CAP laboratory improvement. My first inspection was some 40 years ago and our work in that realm has grown faster and gone further than I could have imagined back then.The CAP accredited its first laboratory in 1964 and published the first checklist several years later. I’m told that when Dennis B. Dorsey, MD (a then-future CAP president), submitted the first draft at 10 pages, his fellow LAP commissioners asked that he try to make it shorter.

June 2019—I wasn’t one of those kids who always knew they wanted to be a doctor. Science was a powerful draw, which might have suggested medical school if my sister hadn’t gotten there first. But she did, so I majored in chemistry at Vanderbilt. As an undergraduate with little money, I hoped to fast-track, so I found a summer job anesthetizing laboratory rats in the middle of the night and removing their kidneys. The work supported a group studying the renin-angiotensin system. They thought I had a knack for surgery, which prompted a reassessment of my chemistry major and eventually led to an application to medical school. Life makes choices for us sometimes, and I was lucky that way.

May 2019—The CAP Center for Pathology and Laboratory Quality for Evidence-Based Guidelines has partnered or collaborated with more than 20 societies to produce 15 published laboratory practice guidelines—with 10 more underway. The Center is one of the best things we do and one of the things we do best.One thing about the CAP: We make no small plans. It was that way when we decided to inspect and then accredit laboratories. It was that way when we decided to hold an independent annual meeting. And it was that way when the CAP Center had its first official guidelines published in Archives of Pathology & Laboratory Medicine.

April 2019—As Dr. Seuss famously wrote, “It is fun to have fun, but you have to know how.” CAP Council on Education chair Jennifer Hunt, MD, MEd, agrees. Learning styles evolve as we mature, she says; grownups are not just tall children. We know what we want to do and are drawn to knowledge we can use. Most pathologists are born educators; we can’t help ourselves. We like to think about how we learn. I think that’s why the CAP Learning team does such an outstanding job—they know what to ask, how to listen, and when to act. Participant evaluations are scrutinized and what we learn from them is applied quickly.

March 2019—We launched the CAP member services and support strategy two years ago, setting out to figure out which benefits were most valued by the greatest number of members, identify places where we could find better ways to direct or maintain them, and see where we could be falling short. To keep everyone connected and everything on track, we created a coordinating group whose members had access to a fine staff and thoughtfully curated findings from years of member surveys and market research. Our own surveys showed how the interests and needs of our members overlapped. The market provided context.

February 2019—In last month’s column, we talked about practice engagement as an umbrella term for laboratory medical direction and practice management that builds strong relationships within and beyond the laboratory. The CAP Practice Management Committee has been taking the lead on this, but it cuts across multiple domains; the conundrum, as always, is the complexity of what we do. Practice management tools designed for other settings cannot meet our needs because we must address economy, efficiency, effectiveness, and collegiality concerns specific to pathology. But then, affinity for complexity is how we landed here in the first place, so that plays to our strengths.

January 2019—Excellence in the laboratory can have a powerful impact on the culture of our institutions because we come into contact with so many and so much. Mostly, we just need to do complex things extremely well and make it look easy. In other words, practice pathology. The more than 50 pathologists and numerous laboratory professionals in my group practice, Delta Pathology, serve nearly 100 institutions across Louisiana and Mississippi.

December 2018—The CAP Curriculum Committee chaired by Sarah M. Bean, MD, follows a competency-based model to build an annual meeting program that is practical, prescient, and diverse. The committee is balanced demographically, experientially, and scientifically. Whatever the topic, there is someone who can speak to it.

November 2018—Last month, we talked about how the CAP Laboratory Accreditation Program employs mentorship and perspective to move our specialty forward. I’d like to talk this month about how we apply those tools in our advocacy program.

October 2018—I grew up in the CAP as a volunteer in the Laboratory Accreditation Program. It’s a good place to dive in. Many of us do what I did—work our way through many volunteer opportunities over 30 years or more because each was so interesting. There are an amazing number of ways a person can approach challenges in a laboratory; more amazing is how many of the approaches will work. Partly that’s because the learning cuts both ways—I’ve learned as much when we were inspecting another laboratory as when my laboratory was being inspected.

September 2018—CAP leadership presents a gamut of responsibilities, including the enforcement of policies adopted to protect members and staff. What I am about to discuss is relevant to all organizations and work settings. As you read on, I hope you will reflect on how tolerance for inappropriate behavior could have an impact on your own workplace and what steps you can take to protect yourself, your colleagues, and by extension your patients.

August 2018—This year, I made a point of noticing just how much goes on during the AMA Annual Meeting so I could tell you about it. There are 600 delegates now and an equal number of alternates. More special sections give us more ways to engage, and we do. It’s challenging, enjoyable, and exhausting at once.

July 2018—CAP members know that laboratory quality improvement and accreditation drive much of what we do. Nobody can know everything about the science underlying our specialty because pathology embraces a vast body of knowledge that is always changing …

June 2018—Nobody has an annual meeting like ours. Nobody. And CAP18 will be no exception. The CAP18 educational program features 85 courses presented by 128 outstanding faculty. A quick scan of the program reveals 42 new learning opportunities and another 38 returning by popular demand.

May 2018—As a professional society, we want to know what our members need so we can provide services and programs to help them excel. We know that pathology practices are diverse because they have to be—science is never static. We also know that practice settings vary widely. In short, CAP members’ interests and concerns are uncommonly diverse because our field is uncommonly diverse.

April 2018—The National Institute on Drug Abuse estimates that 100 million Americans suffer from chronic pain. The majority of drug overdose deaths involve an opioid, and nearly half of drug overdoses caused by opioids involve prescription drugs.

March 2018—I was just out of training and still getting my bearings when I learned that the new partner in our group was expected to manage CAP Laboratory Accreditation Program inspections. Today I think that is a good idea, but back then I was nervous. I had done several CAP inspections as a resident. But did I know enough to get a laboratory through one?

Last month we talked about the eighth edition of the American Joint Committee on Cancer staging manual, which was launched Jan. 1. CAP experts had undertaken a full-court press to harmonize our cancer protocols with the new edition.

January 2018—For me, friendships formed and lessons learned have more than compensated for the effort invested over the years on CAP committees, but make no mistake: When we meet, what we’re doing is work. The professional engagement is enjoyable, but a person can get tired toward the end of a two-day meeting, not to mention homework in the evenings.

December 2017—Most of us look forward to the holidays. We are excited about renewing old connections or making new ones, getting together with family and friends, having special meals, attending comforting services, gathering together to exchange gifts or just talk. We look forward to the comforts of predictability. The corny Dad jokes that must be retold. Family stories, those true and nearly true, are relived together and, for the younger members of the family, may be heard for the first time. Familiar, treasured television shows are seen for the umpteenth time. Beautiful lights, shows, pageants, and parades dazzle all, young and old.

November 2017—My sister Jean had a Chatty Cathy doll; you pulled a cord in the back of her neck and she would say one of a handful of things (“Would you like some tea?”). Chatty Cathy was Jean’s favorite for a while, supplanting her much-loved Raggedy Ann. The coup lasted just long enough to make it plain that the new kid on the block didn’t have much to say for herself. She was kind of stiff and controlling, really. Raggedy Ann was a much better listener. Making up stories with her was a lot more fun.

October 2017—I understand that you’re reading this several weeks after CAP17, after I’ve been sworn in, after we’ve returned home thinking about friendships renewed, controversies debated, new tools encountered up close. Although I write this before the meeting, I know how I will feel by the time you read it: grateful and glad to be a member of this organization.

September 2017—Academic Pathology recently published the results of a two-year project by the CAP Graduate Medical Education Committee to build a framework for teaching specific entrustable professional activities (EPAs) in pathology. Their scheme structures a competency-based approach to training mapped to the ACGME Milestones for pathology resident evaluation. Competency-based curricula are well suited to impart the breadth and depth of necessary fundamental knowledge to future pathologists.

August 2017—Nearly two years ago, I mentioned that I wanted to start a conversation about how we as pathologists and the CAP as our professional society must evolve in order to meet our emerging needs as individuals and as a specialty. Now, as my time in the perch is coming to a close, I’d like to explore what we have come to realize—and sometimes reinforced—about building and maintaining a complex infrastructure that reflects and serves our core purposes.

July 2017—Once upon a time, “breaking news” referred to critical information on the order of an assassination or act of war. Over time, its use came to embrace emergencies and disasters. Now, it seems that anything more curious than “man bites dog” qualifies.

June 2017—We typically define “normal” or “true” from the perspective of our local communities and social circles. This reliance on the familiar can compromise communication effectiveness when we don’t appropriately consider the audience. And as the exchange of information continues to accelerate, the impact on what constitutes an authoritative assessment evolves similarly. Sometimes we don’t stop to think.

May 2017—When we were growing up, my sisters would often ask, “Is it soup yet?” mimicking a popular TV commercial. The catch phrase caught on with the kids as a way to express eagerness for anything, lunch related or not. Another commercial popular back then showed an inverted ketchup bottle slowly yielding its contents to the force of gravity while Carly Simon belted out “Anticipation.” Part of me always wanted to tell my friends that because ketchup was thixotropic, a good shake would help the ketchup flow faster. I never did, probably because that wasn’t how the cool kids talked and partly because it seemed necessary to wait for the ketchup to plop.

April 2017—Our ubiquitous access to (and increasing reliance on) search engines such as Google, Siri, Cortana, and others has resurfaced much of the intellectual landscape. The historical “Guardians of the Truth” no longer sit comfortably in ivory towers waxing poetic while issuing definitive determinations of “fact.” Today, when we want to know something, we reach for our phones. The answers, devoid of context and authoritative citations, seem to be so simple there.

March 2017—Students of history tell us that a durable paradigm shift most often involves a long gestation, typically under the radar and recognized by a precious few. What they frequently fail to tell us is that the vast majority of prognosticators often turn out to be both flat-out wrong and invisible when the “future” arrives. Either way, however, the prevailing narrative points to uncertainty in the greater health care environment.

February 2017—One of my mentors, Richard E. Horowitz, MD, is thoughtful, perceptive, persuasive, and calmly persistent. He is a pathologist to the core, the physician inseparable from the scientist. When he wants to know something, he asks—and there’s plenty he wants to know. He is an emeritus professor of pathology with a long string of leadership credits, so he knows where to look for answers to deep questions. And his seemingly irrepressible inclination to mentor younger pathologists nurtures pragmatic leaders who can move our specialty forward.

January 2017—In February 2002, with Americans still reeling from the Sept. 11 attacks, many were preoccupied with rumors suggesting that the Iraqi dictator had acquired weapons of mass destruction and intended to supply them to terrorists.

December 2016—I gave a talk for the CAP16 House of Delegates in September that opened with a three-minute video showing how perspective can change along a continuum of distance. The clip depicts a logarithmic journey across space from a grassy field in downtown Chicago to the farthest reaches of outer space, then retraces and extends its path to the deepest interior (“inner space”?) of human cells. That would be mesmerizing even without the stirring—almost danceable—orchestral accompaniment. The overall effect is visually stunning and intellectually provocative. I have watched the video a number of times. It never fails to remind me that where we stand and how we focus our attention really do shape what we see and how we see it.

November 2016—This month’s column marks the midpoint of my term as CAP president. I have tried in the past year to write about topics that would foster discussion around certain underlying themes—most often communication, collaboration, and flexibility.

October 2016—I had been looking forward to Cancer Biomarkers Conference II at Houston Methodist Hospital, even though early September wasn’t the best time to travel. Work was busy and CAP16 was only two weeks away. During the weekend meeting, I rediscovered the value of stepping back from business as usual. The program was fast-paced and stimulating, and I learned a lot. Even the nonpathologists I met clearly appreciated what I shared about how much pathologists do to facilitate the adoption of these new diagnostic tools.

September 2016—Radiolab is a radio show and podcast about (mostly) scientific curiosities co-hosted by a perpetually interested guy who majored in music. You might describe it as a talk show for science geeks. These are people who know how to ask the right questions and put the answers in context. A recent installment (“Colors”) questions whether color is a concrete characteristic of the physical world or simply a mental overlay we apply to our perception. Early on, you learn that a young Isaac Newton pursued the mechanism of color perception by piercing his own eye with a knife. I was hooked.

August 2016—Most of us have heard the laboratory described as a black box where specimens are exchanged for information and diagnoses. This tells me that we work beside some highly skilled people who don’t know what we do and that the knowledge gap makes them uncomfortable enough to joke about it. This incomplete understanding of what takes place within the laboratory has meaningful consequences in multiple contexts.

July 2016—I love to read and I like to watch a good baseball game. Sometimes I can actually use one to enhance the other. No, this is not leading to a discussion on Bull Durham and how life is defined by baseball or Field of Dreams and the logic of build it and they will come.

June 2016—Even though I had a good idea of what would be in the CAP16 program, my heart raced when the final curriculum arrived. Perhaps because of my role as CAP president, I found myself taking a slightly different perspective than in the past and thinking about just how ambitious an undertaking it is. A program this complex involves serious choreography. Those who construct it must be thoughtful, forward-looking, and sensitive to many compelling needs and interests competing for limited time and space. It’s a big job.

May 2016—I received a number of letters about last December’s column on the late Oliver Sacks, MD, who wrote with great insight about his experience with a tumor-induced scotoma. One of the most moving came from a seasoned medical professional who had survived traumatic brain injury.

April 2016—In late January, I represented the CAP at MEDLAB, the medical laboratory conference and exhibition held each year in Dubai, United Arab Emirates. MEDLAB was held in conjunction with Arab Health, a multidisciplinary conference attended by more than 130,000 people from 163 countries. I was asked to present six separate talks in Dubai; the one on precision medicine in pathology drew more than 1,200 attendees.

March 2016—Changes in how our government operates are not always evident from day to day, but patterns emerge over time. It is clear we are moving inexorably toward a value-based system of care. New terminology, initialisms, and performance metrics have entered the lexicon.

February 2016—As a pathologist, reference laboratory medical director, and academic department chair, my day-to-day activities center upon administration, transfusion medicine and apheresis services, and teaching. Every time I turn to my clinical responsibilities, I am reminded of why I do everything else—and why I won’t give them up.

January 2016—Pathology is becoming more vital, complex, variable, integrated, and interactive. Once upon a time, we trained to enter practice. Today, we must train to be continually trained. Our ability to stay current with science and explain its potential is a critical variable in the quality of care our patients receive. As a department chair and laboratory medical director, I encourage each member of our group to embrace a coordinated approach.

December 2015—I have long admired Oliver Sacks, MD, the neurologist and best-selling author who died in August of metastatic melanoma at the age of 82. Many knew him through The Man Who Mistook His Wife for a Hat, although I first became aware of him through Uncle Tungsten.

November 2015—While distance learning has its place, nothing beats personal experience. Travel takes time and time is money, but cost is primarily a short-term metric. Sometimes you just have to get up and go. Our annual meeting is great fun. There’s nothing like spending a few days with 1,300 pathologists in one hotel.

October 2015—As I mulled over the best way to begin my first column, two classes I had taken long ago came to mind. The first was part of an intensive undergraduate philosophy program at Stanford in 1978. The second, on organizational behavior, was part of a master’s program in health care management at Harvard 20 years later. In each case, I expected little more than a series of fuzzy discussions. Instead, the components I thought would be the lightest were the deepest.

August 2015—The CAP Foundation See, Test & Treat program is one of the best things we do. I like that it is patient centric and volunteer driven. I like that it is multidisciplinary, collaborative, and community based. I like that it is quietly disrupting how underserved populations experience the health care system and how we relate to our clinical partners. And I like knowing that something that does so much good for everyone it touches is pathologist led—which means we are forever examining, growing, and improving it as only we can do.

July 2015—Responsibilities as medical director for transfusion and coagulation services at Nebraska Methodist Hospital in Omaha occupy about 15 percent of my time. We have an excellent staff, the work is satisfying, and I enjoy the patient contact. In 2007, we became one of what are now three hospitals in Nebraska with recognized blood conservation programs and one of about 150 nationally that accommodate patients who refuse or restrict blood use for personal or religious reasons. Many of these patients travel a significant distance to reach us.

June 2015—More than 11,000 dead of Ebola virus disease in Africa; measles recurring in the United States after a 15-year hiatus; 40 million poultry dead from bird flu or culled in the hope of containing it. The world gets smaller, the agents stay strong, the zoonotic threats multiply. Anticipating and managing such challenges is an important part of laboratory leadership.

May 2015—Pathologists in every practice setting are part of a vital community of learners who collaborate, through the College, to maintain their capabilities and nourish those of their colleagues.

April 2015—Before I could become your president, my partners had to agree to cover for me. I would be away a lot and it would be more work for everyone. We talked about it, weighed the impact on our practice, considered what it would mean for them, and came to a consensus. I would be the person whose picture appeared on this page. They would have a decisive role in making it possible.

March 2015—Turning points emerge in retrospect, but I’m ready to put a red pushpin at December 2013 on the evolutionary timeline for pathology graduate medical education. Twenty-four pathology education organizations came together that month for a workforce summit sponsored by the CAP, the American Society for Clinical Pathology, the Association of Pathology Chairs, and the United States and Canadian Academy of Pathology that would refine consensus on how to best shape the future of our specialty.

February 2015—Increasingly sophisticated laboratory-developed tests have populated the testing landscape rapidly in recent years, and the CAP has worked with government agencies and private stakeholders to address effective oversight. The Food and Drug Administration has issued draft guidance describing its thinking about that oversight.

January 2015—Ebola virus disease had taken 6,900 lives in West Africa and exactly one in the United States as of Dec. 18, 2014. The World Health Organization in August had declared the West African crisis to be a public health emergency of international concern. Yet EVD received little attention in the U.S. until a patient who had traveled from Liberia was diagnosed at Texas Presbyterian Hospital in Dallas on Sept. 30 and died eight days later.

December 2014—At this time of year, when we are inclined to reminisce, I often recall holiday travel with small children. I mention this to explain my headline—an existential question also relevant to our work at the CAP. When those around the table begin to debate a point (say, for example, during a CAP Board of Governors meeting), I sometimes recall voices. I suspect that’s true for many of us.

November 2014—We do what we do because we know it’s important, we find it engaging, and we like to keep things interesting. We are committed to our work and precise by nature. So we spend hours with one patient’s specimens. We build systems-based safety nets to protect quality. We investigate, verify, document. We juggle a bit of everything and work with everyone. No wonder no one knows what we do.

October 2014—Laboratory medicine is a human endeavor with zero tolerance for error. “Human endeavor” and “zero error” make for an awkward pairing, but those are the rules and they’re good ones. So we create systems to protect quality, sustain excellence, and provide education. We are vigilant. CAP quality assurance programs are instruments of that vigilance and of our member-driven commitment to patient safety.

September 2014—Even as a newly minted pathologist, I knew that the CAP Surveys were critical tools to ensure patient safety and test validity. Still, I didn’t give them much thought. There was already a lot to learn; something already so well established just wasn’t on my radar. But over time and with experience, I learned that our Surveys program of proficiency testing, which had its roots in a demonstrated need for interlaboratory comparison 60 years ago, had evolved organically into an engine of scientific advancement in our specialty.

August 2014—It was my good fortune to be introduced to practice by a group of pathologists with a tradition of robust professional engagement. In residency or shortly thereafter, all of us joined the CAP, our state pathology society, state medical society, and the AMA because we were brought to understand it was the right thing to do. Explicitly and by example, mentors and partners have taught me a lot.

July 2014—I recently attended my first meeting as a member of the American Society of Clinical Oncology. I joined ASCO because I’ve been so impressed with the members I’ve met and the way they contribute to our work. I learned a lot and enjoyed the company, which means that I plan to attend their meetings whenever I can and hope many of you will do the same.

June 2014—The Food and Drug Administration on April 24 approved use of the Cobas HPV test manufactured by Roche Molecular Systems as a primary standalone screen for cervical cancer in women 25 years and older. There was a lot of chatter in the general interest press about cervical cytology, not all of it well informed.

May 2014—The CAP annual meeting is the place to find top-drawer educational opportunities, network with peers, and become a more effective advocate for your practice and your specialty. I’m intent on persuading you to come.

April 2014—Soon CAP members will receive the online Practice Characteristics Survey, designed to provide evidence of the value we contribute to health care and the many ways we serve our patients. This is the ninth time since 1994 that we have conducted this survey, which informs our policy, advocacy, and planning for member services. If every CAP member makes a commitment to complete and return the survey, the results will greatly refine and enlighten our work to serve, promote, and represent your best interests. But every is the key word. Each member has a role in building a robust response rate that will give our findings the depth and level of credibility that inform and educate.

March 2014—Implementation of meaningful use and related federal regulations has spurred widespread adoption of the electronic health record, and that’s a game-changer. Every one of us will need to have competence in clinical informatics, to varying degrees.

February 2014—I wrote in recent columns about CAP Surveys, laboratory accreditation, and other laboratory improvement programs. These are core activities tied to some of our most important goals—timely, efficient, patient-centered, cost-effective care that yields optimal outcomes.

January 2014—The landscape for physician payment is changing and all of medicine is feeling a persistent downward pressure on reimbursement, so this month’s column is a reality check and a call to arms. The reality check piece is that we’re not just talking about the shift from volume to value, the growing influence of coordinated care, or a new approach to Medicare physician payment updates.

December 2013—Some nonpathologists attribute our ability to negotiate the cutting edge of science and medicine to the tools we use. I’m not saying that tools aren’t important, but we know better. Our ability to navigate today’s volatile waters is the product of an affinity for quality and an inclination for systems-based thinking. First we get it right. Then we get it out.

Paul A. Raslavicus, MD October 2002—It is an axiom that painful transition is a prerequisite for meaningful change. This is true of organizational change as well as of life passages. It is also true of social and economic movements. Changes occurring now in the culture of our health care system suggest that the issue of medical liability is in this ...

November 2013—PT for the passionate and the savvy I believe that most pathologists and laboratory professionals enjoy refining systems and processes to further promote quality practices in their laboratories. We may not think about discipline and precision when somebody mentions passion, but passion is what those inclinations represent. While passionate pathology can manifest in a host of ways, this month I’d like to talk about how it drives excellence in CAP Surveys or proficiency testing (PT) programs.

October 2013—This is my first column, and it’s only good manners to introduce myself.

September 2013—Cross-country runners train for terrain and endurance. Downhill routes require biomechanical adaptations because the runners must anticipate and adjust for sudden rocks in the road or lack of traction. While there is time to plan around threats on an uphill route, threats to safety or stability in a downhill race may manifest too late for avoidance strategies. Agility matters.

August 2013—Many people don’t know what we pathologists do. This is concerning, especially when some of the same people are responsible for determining levels and allocation of funding for graduate medical education, keeping our training programs open, or encouraging careers in pathology. I hope this column ignites a sense of urgency around funding for pathology training and recruiting a strong workforce, for without both our patients will suffer an indefensible loss.

July 2013—The CAP Residents Forum, a voice for pathology residents and an effective agent of change, will celebrate its 25th anniversary at CAP ’13. Forty-two residents attended the first CAP Residents Forum in October 1988. Last year, 218 delegates from 116 training programs came to the meeting, a remarkable fivefold increase.

June 2013—My father and his brother were teenagers when they found steerage on a ship to the United States in 1910. They arrived with neither English nor assets but with a firm belief that this democracy would provide opportunity. My father completed high school, college, and medical school under difficult circumstances; the long effort gave shape to his hopes. He became a physician who loved his work. We absorbed by osmosis the satisfactions of a life devoted to thoroughly unreasonable goals. I still believe what we learned then: In this country, effort that is intentional and persistent will be respected and rewarded.

May 2013—Eric Topol, MD, director of the Scripps Translational Science Institute, chief academic officer for Scripps Health, and editor-in-chief of Medscape, will present at the CAP ’13 Spotlight Reception in October. We (CAP CEO Charles Roussel; Nazneen Aziz, PhD, director of molecular medicine and staff lead for the CAP Next Generation Sequencing Working Group; and I) invited Dr. Topol to speak after we met with him to talk about our interest in genomic medicine and the steps we have taken—through the Transformation Program Office, CAP Learning, and the Laboratory Accreditation Program—to spearhead efforts to fully integrate cutting-edge genomics into pathology practice.

April 2013—Our 11th CAP annual meeting will open Oct. 13 in Orlando with a scientific plenary tied to this year’s “dig deeper” track (13 courses) in endocrine pathology. Three renowned experts will present “Metabolic Syndrome: Can the Controversy Become Pathology’s Opportunity?” and launch four days of outstanding education and networking.

March 2013—Regular readers know that the CAP has spent the past several years exploring how we can ensure a bright future for pathology. The future, of course, as my adult children would quip, is “ours, but also ours to lose.”

February 2013—A National Football League playoff game was on the ceiling monitor in the airport lounge where I was trying to work on this column, and the announcer was talking about how well they were moving the ball. My first reaction was that he sounded awfully excited for a guy with only one ball to move. Maybe he should come to work at the CAP and see what real excitement is.

January 2013—CAP secretary-treasurer Paul Valenstein, MD, remarked that pathologists’ varied reactions to our new eBook, New Paths…New Choices: Pathology in an Era of Advancing Science and Disruptive Health Economics, reminded him of “Rashomon.”