CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
I would like to highlight this month two innovative pathologists who can pivot with the best of them. To my way of thinking, there is no better way to demonstrate the satisfactions of a transformational practice than to let our members speak for themselves.
Susan D. Rollins, MD, who opened the Outpatient Cytopathology Center in Johnson City, Tenn., in 1991, is among three CAP members who were founding faculty for the CAP Ultrasound-Guided Fine-Needle Aspiration advanced practical pathology program. She and her partner, Janet F. Stastny, DO, conduct some 2,400 FNAs annually. When possible, Dr. Rollins and Dr. Stastny share preliminary findings with their patients, inviting them to view their slides through a two-headed microscope in their offices (yes, patients are keenly interested in their findings and learning about them from their pathologist). Dr. Rollins attributes the great satisfaction she takes in her work to a series of mentors, including John Abele, MD, of Sacramento, Calif., who had one of the first outpatient cytopathology practices. When she was a resident, Dr. Rollins called out of the blue to ask if she could visit his practice. It was Dr. Abele, she says, who insisted that despite a 3.5-year waiting list, she should further her studies by training under Torsten Lowhagen, MD, at Karolinska Hospital in Stockholm, Sweden. Dr. Lowhagen taught her to be what he called a clinical cytopathologist, enjoying patient contact and integrating in her reports what she learned from the history and physical examination so that her diagnoses “were not made in a vacuum.”
Elizabeth A. Wagar, MD, professor and chair of the Department of Pathology and Laboratory Medicine, Division of Pathology and Laboratory Medicine, MD Anderson Cancer Center, sees herself as a problem solver. “I walk around a lot,” she told me. “These are people who are very sick. I like to talk with patients and make sure we’re doing a good job taking care of them. I give them my card and discuss what works for them.” Dr. Wagar rounds at least monthly in phlebotomy (125 phlebotomists perform as many as 1,000 draws daily). She takes care of her surgeons, too, by finding a way to shorten turnaround times while providing complete results rapidly so that patients needn’t have unnecessary waits for their procedures. Her Human Leukocyte Antigen (HLA) laboratory recently instituted a new form of integrated reporting of all blood units for stem cell transplantation coming from inside or outside the laboratory. Rather than attempt integrated reporting for the entire laboratory, she says, they took a “small bite” that motivates everyone more effectively than big projects that don’t work. The department has found that as a result of Dr. Wagar’s involvement in patient care, the transfusion medicine and HLA teams work more closely with the stem cell transplantation group; the clinicians even ask them to order the relevant tests. Her whole group is now being complimented for its patient care efforts.
Stories like these always encourage me. I hope you will share their ideas, and your own, with colleagues in other specialties, members of your laboratory staff, and me. This kind of thinking is one of the best ways to move the ball.
Dr. Robboy welcomes communication from CAP members. Send your letters to him at president@cap.org.