[Histonet] Who can perform Histology Duties

Mon Jan 14 06:26:00 CST 2008

Odd that there should be only one comment on my post, because I thought
it (the subject rather than my post) was an interesting one. It's
impossible to judge just what gets people interested.
Anyway, back at the ranch, you are right that there is a range of
appearances, but that range is only of significance in breast and
prostate, of the things we see commonly, and it would certainly be true
that "normal" has very fuzzy edges in these organs.
However, for the rest, there is no significant range.
Large bowel biopsies actually gives rise to problems too, as they are
almost always abnormal, but only mildly so, and unfortunately, not
showing any features by which one can make a diagnosis. I usually report
these as no significant abnormality, or similar, but sometimes I just
call them normal, as it really makes no practical difference. As these
patients have bowel problems, usually diarrhoea, and many have had some
sort of bowel prep., it is no surprise that the appearance should not be
"normal" in the sense of ideal.

It's all a matter of how you look at things, and in US in particular,
how well you like to cover your ass.

Terry

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Esther
Peters
Sent: 13 January 2008 22:22
To: Marshall Terry Dr, Consultant Histopathologist
Cc: histonet <@t> lists.utsouthwestern.edu; Terri Braud; Kemlo Rogerson
Subject: Re: [Histonet] Who can perform Histology Duties

Terry,

Enjoyed your comments.  Training, continuing education, and especially
knowing when you should refer to someone else are key in any profession!

Regarding "norma,l" the pathologists are not using "some sort of mealy
mouthed evasion" but they know that there is a "range" of normalcy when
identifying the condition of cells and tissues, because of individual
variation, age, reproductive status, nutritional status, etc.  Just
think of the wide range in values for what are considered "nondiseased" 
levels of various blood parameters.  I once corresponded with a
professor of histology, who told me he only knew "normal" and didn't
know anything about pathology.  But if you don't understand structural
changes indicating diseases, are you sure you can recognize "normal"?

Esther Peters, Ph.D.
George Mason University

Marshall Terry Dr, Consultant Histopathologist wrote:
>  "Proper training can allow Histotech's to report normal, ....."
>
> There was a bizarre discussion on the histopathology discussion group 
> recently, around reporting tissue as "normal".
> An amazing number of pathologists never used the word, but preferred 
> some sort of mealy mouthed evasion.
> Within normal limits, no definite lesion seen ... That sort of thing.
> Indeed one very competent pathologist claimed he could not recognise 
> normal!
>
> Terry
>
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Kemlo 
> Rogerson
> Sent: 10 January 2008 16:08
> To: Terri Braud; histonet <@t> lists.utsouthwestern.edu
> Subject: RE: [Histonet] Who can perform Histology Duties
>
> Please save your flames.  The scenerio of a Non-Histotech embedding, 
> cutting, and staining my surgical tissue does not thrill me, but that 
> was not her question.  Maybe the reality of the answer is why many 
> Histology Labs have always been considered the evil red-headed 
> stepchildren of the Lab.
> Terri
>
> I think you are correct in that as long as someone is properly 
> trained, the training is revisited regularly and there is adequate 
> supervision and the professional groups are in agreement Non-BMS 
> (Non-Histotech) Staff can do many jobs in Histology and maybe Non 
> Medical Staff (BMS) can carry out some interpretation. I would have no

> issues with a Non-Histotech (Non-BMS) doing as you say with proper 
> supervision by a HPC registered supervisor.
>
> But where does it end? Do you need a medical degree to identify vas, 
> appendix or gall bladder? You need the training to know when you have 
> reached the limits of your knowledge and when to refer to someone 
> better able to report a disease and I concede that is probably a 
> Medic. Proper training can allow Histotech's to report normal, maybe 
> non-normal requires medical insight, what do you think?
>
>  
> Kemlo Rogerson        
> Pathology Manager
> DD   01934 647057 or extension 3311
> Mob 07749 754194; Pager 07659 597107;
> Don't be afraid to take a big step when one is indicated. You can't 
> cross a chasm in two small jumps. --Buckminster Fuller
>
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