[Histonet] Non-Pathologist Grossing (Amy Self)

[Bob Richmond]

Vikki Baker (or Amy self) - where? - asks:


> >>We recently had an incident which led us to review our policy on frozen
> section QA. In your institution does the same pathologist who did the
> frozen section read the permanent [paraffin] sections?  Also if they do
> then who is the pathologist responsible for doing the QA?
>
 Last, does any facility with less than 450 beds have their
pathologists specialized?<<

This is a very serious question that should be decided by pathologists.
It's a pretty basic principle in pathology practice that whenever possible
(and it often isn't possible) a case should be the responsibility of a
single pathologist from start to finish. A pathologist is a physician, not
a technician (though this is news to a lot of people), and is not
interchangeable in the care of a single patient.

The most common problem here is the case with multiple frozen sections done
on margins of resection. Often the initial record of where various sections
came from is unclear, and only the responsible pathologist can straighten
the record out in the final sign-out.

As to the second question, most younger pathologists practicing general
pathology have subspecialty qualifications. In any pathology group, cases
in a pathologist's subspecialty will often be seen by that subspecialist.

Finally, "paraffin sections", not "permanent sections". At the age of 81,
I'm just old enough to remember the old "wet knife" frozen section
technique, that resulted in sections set loosely on the slide, and not
easily preserved. During the 1960s the cryostat replaced the old method.
Correctly prepared frozen section slides are quite as permanent as the
subsequent paraffin sections.

Bob Richmond
Samurai Pathologist
Maryville TN

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