Educational Objectives:
1) Understand the challenges associated with equal distribution of work to pathologists with subspecilization and/or expertise in different fields
2) Recognize the problems associated with calculating workload based on raw numbers such as specimen count, CPT codes, or RVUs
3) Appreciate the importance of utilizing a “weighted/adjusted” models for assessing and distributing workload to pathologists


Successful management of a pathology laboratory requires good knowledge of allocation of resources and distribution of work. There has been increasing pressure on laboratories to embrace sub-specialization among pathologists, in the face of increasing specimen complexity and detailed information needed for clinical management. It has been difficult, however, for laboratories to implement a fair system of work distribution among pathologists with different specialties. Many institutions have utilized raw data such as slide and case count, or billing data such as CPT and RVUs, to equalize the workload. These methods, however, have been shown to be extremely inaccurate in assessing true effort associated with individual cases, and have particularly underestimated cytology workload. In this session, two pathologists will present distinctly different approaches to work distribution, which have been successfully implemented in their perspective academic and private practices. These include the application of an adjusted, RVU-based system for assigning service work credit, and a "tray-weighted" calculation that takes into account the number of slides, and pathologist’s assessed difficulty and time to evaluate individual cases. With proper weighting to reflect the complexity and value of each case, a variety of specimens (including, surgical pathology, cytology, autopsies, consults, etc.) can be distributed fairly among different subspecialties.