[Histonet] Unregistered HT

Wed Sep 11 10:54:03 CDT 2013

This discussion comes up every year and, of course is never resolved to our satisfaction because histotechs  really have only a little say in it. 

Personally I think labs are better off with certified techs. Uncertified techs should start as lab assistants and earn their certification before getting a histotech title.  The histotech title should be for someone who at least starts as a general histotech who can do the gamut of histology work - embedding, cutting, H&E, specials and IHC/ISH. From that base they can branch out or specialize. It would be a dream to require formal schooling, as with med techs, but there are so few schools that it is just impractical. A certification is a baseline that shows a person who is OJT has learned the minimum required to understand histotechnology.

However, because we don't report out any results on our own authority there is no impetus for a pathologist or institution to make the position more than it is: a technical position that does do require fancy work, but in the end "only" provides the materials for someone else to use for interpretation, decisions and reporting. We don't even pick the sample, the test or even determine how to do the test - that is all determined by the Technical Director of the lab, usually a board certified pathologist. Our primary job is to provide good quality materials so they can do their job well. That does involved a lot of knowledge, organization and skill, but it is not at the level of making actual patient care decisions. 

Pathologists Assistants get a  bit more "respect" because they are required to make judgment decisions on how to sample a particular case. Even then, that sampling is strictly detailed in procedures developed by pathologists. 

The most we could ask for is licensing that requires certain qualifications to be a histotech. However, that has some drawbacks as well, namely the restriction of the profession to licensed people, and so is a barrier to entry. Would it lead to pay raises? Does anyone have studies showing pay before and after licesure requirements?  It is questionable whether it enhances the quality of the lab since most histotechs are OJT anyway, and simple licensure may not increase actual quality of work by an individual. (does anyone know of any studies that look at quality in states with and without licensing?).

The CLIA requirements at least set a baseline for education, if not actual certification. Asking pathologists to support universal certification and/or licensure is problematic - many independent labs won't support that because, as in licensure, it decreases the pool and increases costs (ie, pay). Since the pathologist is the person deemed responsible for quality and lab results, setting the bar higher is only in the interests of the technologists, not the pathologist. Now, some enlightened pathologists understand that better-educated and better-trained techs are good for the overall.

So in the end the histotech community, along with a few enlightened pathologists have to lobby for anything they want. But what is that? Increased pay? More say in lab operations?

My experience is that you can rise as high as you want if you take opportunities that come up. But that may mean either spending many years in one place slowly moving up, or moving around to take other opportunities. It will depend on the individual. In either case using your time in the lab to learn whatever there is to learn, even in other departments, or on various committees, pays off in the long run. And that includes management. The last thing you should do is limit yourself to a job description someone gives you. Take that as the base line, not the limit.  

Tim Morken
Supervisor, Electron Microscopy/Neuromuscular Special Studies
Department of Pathology
UC San Francisco Medical Center

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Horn, Hazel V
Sent: Wednesday, September 11, 2013 6:30 AM
To: 'Weems, Joyce K.'; 'Jennifer MacDonald'; Marcum, Pamela A
Cc: histonet <@t> lists.utsouthwestern.edu; histonet-bounces <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Unregistered HT

Histology does not get the respect or the recognition because histologists do not report results.  All of the complex testing we do is overlooked because the pathologists report the results.   CLIA standards are based on result reporting.   The CAP has looked the other way for years because pathologists would hire unregistered techs.  If pathologists would demand only registered techs half our battle would be won. 

Hazel Horn
Supervisor of Histology/Autopsy/Transcription Anatomic Pathology Arkansas Children's Hospital
1 Children's Way | Slot 820| Little Rock, AR 72202
501.364.4240 direct | 501.364.1241 fax
hornhv <@t> archildrens.org
archildrens.org

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Weems, Joyce K.
Sent: Wednesday, September 11, 2013 8:08 AM
To: 'Jennifer MacDonald'; Marcum, Pamela A
Cc: histonet <@t> lists.utsouthwestern.edu; histonet-bounces <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Unregistered HT

And the reason so many have been fighting for this for years. If a lab were looking for a Medical Technologist there would be no question.

Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
joyce.weems <@t> emoryhealthcare.org

www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342

This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s).  It may contain information that is privileged and confidential.  Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email.

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Jennifer MacDonald
Sent: Tuesday, September 10, 2013 7:32 PM
To: Marcum, Pamela A
Cc: histonet <@t> lists.utsouthwestern.edu; histonet-bounces <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Unregistered HT

As long as we do not need certification, licensure and minium education requirements we will not be recognized as Laboratory Professionals.

From:   "Marcum, Pamela A" <PAMarcum <@t> uams.edu>
To:     "'joelle weaver'" <joelleweaver <@t> hotmail.com>, "'Emily Sours'"
<talulahgosh <@t> gmail.com>, "histonet <@t> lists.utsouthwestern.edu"
<histonet <@t> lists.utsouthwestern.edu>
Date:   09/10/2013 01:12 PM
Subject:        RE: [Histonet] Unregistered HT
Sent by:        histonet-bounces <@t> lists.utsouthwestern.edu

I agree we have huge gray areas and not all histology schools are as good as they could be for what we are facing in Histology.  I keep harping on the fact that until we are recognized as Laboratory Professionals we will stay in this limbo.  The rules determining complex testing should be revisited to what is done in Histology Laboratories today and not what we did 30 or more years ago.  The Clinical Laboratory is now so automated it is hard to find anyone in most areas who can even remember doing any manual testing.  The Micro lab is the closest to being as manual as areas of Histology.

I am in a small market and finding a registered Histologist is harder for us.  I would love to have 8 to choose from and interview.

Pam Marcum

From: joelle weaver [mailto:joelleweaver <@t> hotmail.com]
Sent: Tuesday, September 10, 2013 2:59 PM
To: Marcum, Pamela A; 'Emily Sours'; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Unregistered HT

 Well I am  mostly clinical...but I think that organizations can set standards outside and beyond what CAP,CLIA etc stipulate. For the position I have now, I had to submit all my transcripts from high school up through masters in addition to  proof of my ASCP certification, IHC qualification, continuing education, and professional association activity. There is a lot of gray area out there. They seem to have not had trouble getting applicants though ( and I know this varies by market), there were over 8 candidates for an HT opening, which I thought was a pretty good turn out.

Joelle Weaver MAOM, HTL (ASCP) QIHC

> From: PAMarcum <@t> uams.edu
> To: talulahgosh <@t> gmail.com; joelleweaver <@t> hotmail.com
> CC: histonet <@t> lists.utsouthwestern.edu
> Subject: RE: [Histonet] Unregistered HT
> Date: Tue, 10 Sep 2013 13:53:26 +0000
>
> Research is a different area and not controlled by CAP, CLIA and other
hospital licensing or accreditation organizations. We are bound by the rules of these organizations and while I agree with you to a point. We do need minimums for training and registration by recognized licensing bodies when patient tissue is being processed for histological examination. I am sure no one thinks of this often however; there are medical legal issues with insurance we have that do not apply for research. It is also clear that registration does not mean we don't have registered people who are not as good as they should be for excellent patient care.
>
> I have worked in research and while I would not ever say the hiring of
non-registered people is a problem for research. It is often a specialty area that requires knowing more than routine Histology. I have done plastics in research that could not ever be used in routine Histology due to the time factors and in some cases limited use with staining applications, especially IHC for some procedures. Many other areas in research require more specialized training than would be used in a routine area. I would also add some really great techs are in many phases of research. I know MT who work in Histology and are not registered as the MT BS, overrides the HT requirement for many institutions.
>
> Many factors must be considered for both research and routine 
> Histology
that cover far more than just hiring registered people in certain areas of the laboratory.
>
> Pam Marcum
>
>
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu<
mailto:histonet-bounces <@t> lists.utsouthwestern.edu> [ mailto:histonet-bounces <@t> lists.utsouthwestern.edu]<mailto:[
mailto:histonet-bounces <@t> lists.utsouthwestern.edu]> On Behalf Of Emily Sours
> Sent: Tuesday, September 10, 2013 8:20 AM
> To: joelle weaver
> Cc: histonet <@t> lists.utsouthwestern.edu<
mailto:histonet <@t> lists.utsouthwestern.edu>
> Subject: Re: [Histonet] Unregistered HT
>
> Do employers consider lab techs to be proficient enough? I've been 
> doing
ISH and immuno for 13 years, but I'm not certified as I do research. Maybe there aren't a lot of lab techs out there? Just wondering since you might be missing someone awesome by hiring only certified people.
>
> "By bitching and bitching and bitching, they could exhaust the drama 
> of
their own horror stories. Grow bored. Only then could they accept a new story for their lives. Move forward."
>
> -Chuck Palahniuk, "Haunted"
>
>
> On Mon, Sep 9, 2013 at 6:49 PM, joelle weaver 
> <joelleweaver <@t> hotmail.com<
mailto:joelleweaver <@t> hotmail.com>>wrote:
>
> > All I have is a "histology assistant" description I put together. It 
> > is mostly clerical, instrument up keep and other duties. My employer 
> > does not hire uncertified techs- due to CLIA license, grossing, FISH 
> > & molecular duties ( high complexity). I hope to be a clinical site 
> > eventually, and then they will have to complete their certification 
> > within one year -if they are hired on.
> > If you think that will help, I can send it on.
> >
> >
> >
> >
> > Joelle Weaver MAOM, HTL (ASCP) QIHC
> >
> > > Date: Mon, 9 Sep 2013 15:39:12 -0500
> > > From: delsuec <@t> gmail.com<mailto:delsuec <@t> gmail.com>
> > > To: histonet <@t> lists.utsouthwestern.edu<
mailto:histonet <@t> lists.utsouthwestern.edu>
> > > Subject: [Histonet] Unregistered HT
> > >
> > > Hi all,
> > >
> > > I'm wondering if anyone can share a job description for an 
> > > unregistered
> > HT
> > > position. I also need to know if unregistered HT's are allowed to 
> > > cut frozen sections. I know there is a limit to what they can do, 
> > > especially where IHC and special staining are concerned, but I 
> > > really don't know
> > about
> > > frozens, since it's a lot like regular microtomy, except for the 
> > > H&E staining of the slide. I also understand that facilities might 
> > > have different descriptions, but what I'm really looking for is 
> > > what CAP
> > allows
> > > them to do.
> > >
> > > Thanks for your help,
> > >
> > > Deloris Carter, HT(ASCP)
> > > SMMC
> > > Shawnee, KS
> > > _______________________________________________
> > > Histonet mailing list
> > > Histonet <@t> lists.utsouthwestern.edu<
mailto:Histonet <@t> lists.utsouthwestern.edu>
> > > http://lists.utsouthwestern.edu/mailman/listinfo/histonet
> >
> > _______________________________________________
> > Histonet mailing list
> > Histonet <@t> lists.utsouthwestern.edu<
mailto:Histonet <@t> lists.utsouthwestern.edu>
> > http://lists.utsouthwestern.edu/mailman/listinfo/histonet
> >
> _______________________________________________
> Histonet mailing list
> Histonet <@t> lists.utsouthwestern.edu<
mailto:Histonet <@t> lists.utsouthwestern.edu>
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet
>
> ----------------------------------------------------------------------
> Confidentiality Notice: This e-mail message, including any 
> attachments,
is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet

_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet

________________________________

This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited.

If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments).

_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet

******************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************
The information contained in this message may be privileged and confidential and protected from disclosure. If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by replying to the message and deleting it from your computer.
Thank you.

_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet