[Histonet] Re: Quality assurance program for pathologists

Bob Richmond rsrichmond <@t> gmail.com
Sat Jan 7 12:40:26 CST 2012

Diana McCaig (where?) asks: "Is anyone willing to share with me their
quality assurance/management
program for pathologists?"

Glad to know you're in charge of pathologists. (Also glad I'm nearly
73 years old, though not yet retired.)

I've worked in a few programs that did a 10% review of cases. If you
go this route, don't choose the cases at random, but ask the
pathologists to designate the cases as they do the day's work -
they'll catch a lot more problems that way. I've worked in a single
practice that did 100% second-pathologist review (before the case was
released), and I thought that was excessive.

Pathologists should be encouraged to document their internal
consultations - I mean when you pass a slide to the guy at the next
microscope and ask him "from the ear of a 70 year old man - do you
think there's enough here to call this a basal cell carcinoma?" Such
cases should be documented in a comment - I say "Dr. John Doe has seen
this material and concurs." Such cases are legitimately considered
part of a 10% review policy. I've worked in one large and highly
competent practice that documented internal consultation very
meticulously, and one of their QA guidelines was that 2.8% of their
cases document internal consultation.

Bob Richmond
Samurai Pathologist
Knoxville TN

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