CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
December 2021—There are success stories. There are overnight success stories. And then there are things that just seem to happen overnight—minus the success. In the midst of chronic discontent over the use of a race coefficient in equations for estimating glomerular filtration rate, one San Francisco hospital sought to make a change. The hope was to help end disparities in health care, such as lower kidney transplantation rates in Black people with chronic kidney disease. The change at Zuckerberg San Francisco General Hospital was pushed by what Neil Powe, MD, MPH, MBA, calls “a very small group of faculty and trainees lobbying the lab, unbeknownst to others.” The lab reported two values, using the eGFR equation with and without the race coefficient, but assigned “high muscle mass” and “low muscle mass” to the two values as a way to step around the troubling race component. Dr. Powe, the hospital’s chief of medicine, doesn’t mince words when he considers how the change was made. “And it stereotyped ethnic groups even more,” he says.
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