[Histonet] Aetna and In-Office Lab Accreditation

[Kim Donadio]

To suggest that any physician who goes into private practice and has their own lab is any more of a money hound than any other physician at a hospital would also be disingenuous . And of course this is about money.  It's about one group of people trying to get another group of people out of the lab business because they want that money. It's also about the government squeezing insurance companies into these more stringent regulations. Now I'm not against more stringent regulations but I do find it offensive of how they are going about it. The little guy will take the hits on this one. I guess what they want is a bunch of walmart like labs. Private practices serve a patient care cause just as hospital labs do. They all make a diagnosis.  They all deserve to be paid. 

My 2 cents

Sent from my iPhone

On Apr 9, 2012, at 4:47 PM, Daniel Schneider <dlschneider <@t> gmail.com> wrote:

> This is all about the money. The rest is rationalization.
> 
> The reason a group of non-pathologist physicians opens an in-house
> pathology lab and hires an employee pathologist is first and foremost
> to harvest profit from pathology reimbursement. Be a fly on the wall in the
> partners' meetings and you would know that's what they are talking about.
> 
> To suggest otherwise is disingenuous.
> 
> And the implication that the generalist anatomic pathologist is unqualified
> to be signing out skins, prostates, GI's and whatever is reprehensible.
> This is not cardiac bypass surgery, and AP pathologists *are* trained to do
> all of the above. I eagerly defer to subspecialty expert consultants as
> needed, but most of the time they're not needed.
> 
> Hospital labs that see few, if any skins, prostates, GI's, are only in that
> pickle because of the cherrypicking they've already been subjected to.
> 
> *"in-office AP labs are an emerging frontier of employment for histologists
> and pathologists.  In an era of high unemployment, another source of
> employment for our professions is "a good thing.""*
> 
> Really? The jobs follow the specimens. Given the same number of specimens,
> there's the same number of jobs, more or less, just under different
> circumstances and in different locations   Unless you're suggesting that
> in-office labs will generate increased specimens, and thus increased jobs
> though overutilization, i.e. excessive numbers of unnecessary biopsies and
> abuse of the patient and the taxpayer.  In which case I have to say there's
> a grain of truth. And the truth hurts.  And it's not " a good thing."
> 
> None of this should be taken as criticism of histotechs and pathologists
> who find themselves working in an in-office lab. I know there's bills to
> pay, families to take care of, and god knows it's hard for a pathologist to
> find a job these days with the numbers our residency programs keep churning
> out (but that's another rant...).
> 
> Dan Schneider, MD
> Amarillo, TX
> 
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> 
> On Mon, Apr 9, 2012 at 12:52 PM, <jdcochran <@t> aol.com> wrote:
> 
>> 
>> Histonetters:
>> 
>> In-office AP labs provide a valuable service to the practices they serve
>> by facilitating 1) better communication between pathologists and ordering
>> clinicians, 2) quality metrics that are practice-specific, and 3) high
>> volume, sub-specialization for both histotechnologists and pathologists.
>> In other words, the more of one type of histopathology a lab does (e.g.,
>> skin, prostate, GI), the better it gets.  Most people would not think of
>> having their cardiac bypass surgery done at a community hospital doing
>> 50/year; you want to go where more than 500/year are done.  In
>> histopathology, the kinds of volume you want are in the thousands for each
>> tissue type.  Many hospital labs do little skin or prostate histology
>> anymore.  Many sub-specialty in-office AP labs may do thousands of cases of
>> one tissue type every year.
>> 
>> Aside from that, in-office AP labs are an emerging frontier of employment
>> for histologists and pathologists.  In an era of high unemployment, another
>> source of employment for our professions is "a good thing."
>> 
>> This requirement by an insurer for accreditation will help to validate
>> these in-office AP labs' commitment to quality and put them on the level
>> with their hospital counterparts.
>> 
>> John D. Cochran, MD, FCAP
>> 
>> 
>> 
>> 
>> 
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