[Histonet] Aetna and In-Office Lab Accreditation

Tue Apr 10 09:16:24 CDT 2012

Because some things are worth arguing about or fighting for?
That there are two sides to a conflict doesn't imply that the sides are
equally right.

It's well documented that clinicians who own their own pathology labs, and
profit from the processing and reading of their biopsies, generate
significantly more biopsies.  Is that good for the patient?

Incentives matter.

Separating the biopsy grabbing from the biopsy processing/reading is one
small way to remove an incentive to abuse the patient and the taxpayer.

On Tue, Apr 10, 2012 at 8:47 AM, Pratt, Caroline <
Caroline.Pratt <@t> uphs.upenn.edu> wrote:

> 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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