Patrick Godbey, MD
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.
Dr. Godbey
The CAP’s founding took place during challenging times. Pathologists were justifiably not satisfied with their status in the house of medicine. They felt, correctly so, that neither their financial compensation nor their prestige were what they should be. After all, pathology had just been affirmed to be the practice of medicine by the AMA in 1943. It should be remembered that third-party payers, including Blue Cross and Blue Shield, became a significant factor just before and during World War II and it was often their practice to pay hospitals and not pathologists for our work.
Those problems were pointed out to other national and local organizations with less than acceptable results. Pathologists were frustrated. The need for a separate, different organization was recognized, and a grassroots movement began. The resulting organization would be formed on its own by dedicated pathologists and not by any existing organization. Frank W. Hartman, MD, was one of the leaders. He was extremely instrumental in getting that first meeting together in Chicago and would be the first president of this new society, the College of American Pathologists.
Many of the earliest decisions made by the newly formed CAP continue to influence how we operate today. Some of the first committees established covered clinical laboratory standards and the evaluation of hospital laboratories. Early in its existence the CAP became dedicated to the quality of laboratory practice. Today, the CAP writes the laboratory accreditation standards that promote and ensure quality laboratory practice around the world. It is essential that these standards are written by pathologists, for pathologists, because only we have a deep understanding of what lab quality is and how to make it happen at every level.
When I tell people I work in a really good lab, I’m not boasting. I know I work in a good lab because the CAP tells me I do. My lab has to meet the same standards as laboratories anywhere in the world, from the best-funded academic medical centers to the smallest private practices. My lab undergoes regular inspections thanks to the CAP. I can compare my test scores to those of other labs through the CAP proficiency testing program. Our labs are better because of the CAP, and that results in better patient care.
Throughout its history, the CAP has been a 501(c)(6) organization rather than any other type of nonprofit. This was and still is different. It reflects one of the basic reasons we were formed and exist, to be the organization that truly can advocate for pathologists and our patients. This designation allows the CAP to lobby for pathologists, and it is the reason the CAP has become the most active and most successful advocate for pathologists on the planet.
We see the results of that today in many ways. The CAP looked after us when COVID-19 hit, making sure we were in line to receive benefit from government stimulus packages. We can sign out remotely, thank you CAP. I think it is important to remember that the CAP grants more CME hours than any other pathology organization, ensuring that members have plenty of opportunity to meet their continuing education requirements. We would not be compensated the way we are without the CAP; it is the only pathology organization to have a seat at the table in the committee that makes value recommendations to the Centers for Medicare and Medicaid Services. Every time I get a check from Medicare, I have benefited from the CAP’s commitment to pathologists.
From its inception, the CAP has been composed of physicians. So it is only fitting that our members and the information coming from the labs we direct now influence the majority of decisions about how health care dollars are spent. Our laboratories are more important than ever to patient care. We can examine tissue in ways we’ve never been able to do before. New assays and novel technologies, run in quality labs, have made us better diagnosticians. Patients are the ultimate beneficiaries, which is the way it should be.
As the importance of pathologists and the laboratories we direct grows, so does the importance of the CAP and its commitment to laboratory quality, education, and advocacy. We owe a great deal to the pathologists who came before us, especially to that special group of 140 pathologists who had the foresight and dedication to their practice, their patients, and our profession to found the CAP. We will celebrate these pathologists and our history in an upcoming book written by Paul Bachner, MD, and managing editor James Crumley, along with CAP staff Mary Katherine Krause, Nancy Johnson, Drew Davis, Opel Aguila, and Clemmie Lozano. I truly believe that every pathologist in this country is a better physician because of the CAP. We have much to be proud of as we celebrate this milestone.
Dr. Godbey welcomes communication from CAP members. Write to him at president@cap.org.