[Histonet] Dermatopathology question....

[Michael LaFriniere]

It has been my experience that most Dermatologists have had sufficient
training to read histological sections, however, this does place
liability issues on their practice, and this is why many dermatologist
choose to have a pathologist (preferably a dermatopathologist) read
their patients' specimens.   In this part of the country, I am noticing
that approx 50% of dermatologists are reading their own cases, and
sending difficult cases, i.e., cancers, melanoma's or any melanocytic
lesions to a dermatopathologist. The dermatologist can charge the
pathology professional fee for performing the histological professional
component. 
 
 
 
 
Michael R. LaFriniere
Executive Director
Cytology Services of Maryland (CSM)
301-206-2555 ext 27
301-206-2595 fax
michael.lafriniere <@t> csmlab.com 


>>> On 9/27/2007 at 1:27 PM, in message
<46FBA1980200003C0001B662 <@t> gwia.alegent.org>, "Janice Mahoney"
<jmahoney <@t> alegent.org> wrote:
I find this topic very interesting.  I used to think that only
pathologists could read slides.  I'm no expert either but I do know
that
most dermatologists read their own slides and send anything that is
not
straight forward on to a cetified pathologist.  
I'm going to have to look up the CLIA requirements and educate myself.
I agree with Vinnie, I'd rather have a Pathologist diagnosing my
slides.
Jan
Omah

>>> "Della Speranza, Vinnie" <dellav <@t> musc.edu> 09/27/2007 8:34 AM >>>
Kim, I can't speak to this with authority but it occurs to me that
should the dermatology practice ever be sued by a patient who believes
his case was mishandled in someway, I imagine the attorney's would
have
a field day with a physician who is not board certified reading out
cases. If the individual is proficient, why isn't he/she boarded?

Secondly, I would worry that billing out medicare patients would
create
potential problems with CMS if the case was read out by someone who is
not boarded. I can't quote you chapter and verse of CMS regulations
but
it is impossible for me to believe that CMS is cool with paying
physicians who charge for services when they aren't board certified in
the specialty they are billing for.

The whole issue speaks to who is and is not "qualified" to read out
tissues and I would think one who is not board certified is not
qualified in the eyes of just about everyone.

Vinnie Della Speranza
Manager for Anatomic Pathology Services
165 Ashley Avenue  Suite 309
Charleston, South Carolina 29425
Tel: (843) 792-6353
Fax: (843) 792-8974

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu 
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Kim
Tournear
Sent: Thursday, September 27, 2007 8:57 AM
To: Histonet
Subject: [Histonet] Dermatopathology question....

Hi everyone,
  I work in a busy dermatology office.  We process our own histology
and
do Mohs.  We have 5 dermatologists and 3 P.A.'s. 1 of our
dermatologists
is a Board Certified Dermatopathologist.  My question is:
   
  Since we have a Dermatopathologist in house, can a dermatologist,
who
is fluent in reading slides, (but not a certified as a
dermatopathologist), read slides for another dermatologist (to help
keep
up)? Are there any legalities that I should be aware of?
   
  Any help would be greatly appreciated.....thanks in advance....


Kim Tournear, HT (ASCP), QIHC ( ASCP)
  Specialists in Dermatology
  Histology/Mohs Supervisor
  Tucson, AZ
  


       
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