[Histonet] Aetna and In-Office Lab Accreditation

Pratt, Caroline Caroline.Pratt <@t> uphs.upenn.edu
Tue Apr 10 08:47:33 CDT 2012


There are pros and cons to both business structures.  I love the
information I get on histonet, but why does everything have to turn into
an argument?  Can't we just respect each other's opinions? 

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Kim
Donadio
Sent: Monday, April 09, 2012 5:58 PM
To: Daniel Schneider
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation

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
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 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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>> 
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