|November 13, 2010|
|12:00 pm - 1:45 pm||Panel Luncheon Seminar #1
Papanicolaou Society of Cytopathology
Pathologist Workload Distribution in the Era of Subspecialization: What is the Best Indicator for Determining Fair Allocation of Surgical and Cytologic Specimens?
Tarik M. Elsheikh, M.D.
W. Stephen Black-Schaffer, M.D.
S. Nicholas Agoff, M.D.
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.
|12:00 pm - 1:45 pm||Panel Luncheon Seminar #2
Advances in Pulmonary Cytology
Christine N. Booth, M.D.
Jennifer A. Brainard, M.D.
1) Apply a systematic approach to diagnostic challenges in pulmonary cytology encountered in daily practice
2) Define morphologic criteria and discuss the differential diagnoses of pulmonary cytology cases
3) Identify the applications and limitations of special techniques and molecular markers relevant to pulmonary cytopathology
4) Understand the clinical significance of pulmonary cytopathologic diagnoses
Lung carcinoma is the leading cause of cancer mortality for both genders in the United States and throughout the world. Cytologic techniques are usually part of the initial workup of patients with suspected pulmonary malignancy and are commonly used for both diagnosis and staging. On-site assessment of specimen adequacy together with cytomorphologic features and use of ancillary techniques including immunostaining profiles and flow cytometry make this possible in most cases. Additionally, in the past, a cytologic diagnosis of small cell carcinoma versus non-small cell carcinoma was sufficent to appropriately direct patient management. However, with recent advances in molecular medicine and the clinical use of selective EGFR tyrosine kinase inhibitors, it has become increasingly important to specifically classify non-small cell carcinomas in cytologic preparations. Immunostaining patterns are quite useful in this regard. The course faculty will use a case-based approach to illustrate diagnostically challenging pulmonary neoplasms in which a combination of morphology and ancillary testing was used to make a definitive interpretation. Distinguishing specific subtypes of non-small cell carcinoma and the role of EGFR testing will be emphasized.