CAPcast from the College of American Pathologists: Recent Episodes
College of American Pathologists
The College of American Pathologists' CAPcasts feature interviews with leading pathologists on current issues impacting pathology and laboratory medicine.
The College of American Pathologists is the leading organization of board-certified pathologists, serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine.
CAPcasts are now available on cap.org and the MyCAP app: https://www.cap.org/member-resources/podcastsDownload MyCAP for iOS and Android:https://apps.apple.com/us/app/mycap-cap-member-app/id1575620028https://play.google.com/store/apps/details?id=org.cap.member.appYou can also subscribe on the following podcast platforms:Apple Podcasts: https://podcasts.apple.com/us/podcast/capcasts/id1279391140Amazon Music: https://music.amazon.com/podcasts/161134c5-94fd-460e-87ef-18cc27f8003c/capcasts
World Cancer Day is recognized around the world on February 4th to raise awareness of and encourage the prevention, detection, and treatment of cancer. To commemorate World Cancer Day, Gladell Paner, MD, FCAP, chatted with M.E. de Baca, MD, FCAP, and Gail Vance, MD, FCAP, about how the CAP is addressing barriers to health equity through the Cancer Protocols, Council on Informatics and Pathology Innovation, and the CAP Foundation Global Pathology Committee.Learn more about the CAP Foundation: https://foundation.cap.org/CAP Foundation 2023 Webinar Series: https://brnw.ch/CAPF2023Webinars
This month we'll look at a prior authorization rule that could pave the way for legislation to reduce burdens on clinicians, a grant awarded to the CAP to improve healthcare communication, action on Medicare cuts, and more. We'll also sit down with Anna Tart, MD, FCAP, to talk about why the CAP no longer supports 'excited delirium' as an official cause of death.
Jason Scapa, MD, FCAP, Chair of the Digital Content Committee talks with Andrew Bellizzi, MD, FCAP, Past Chair of the Immunohistochemistry (IHC) Committee and current IHC Committee Member Gregory Bean, MD, PhD, FCAP, about the latest update to HER2 Breast Cancer Testing Guidelines. Issued in June 2023, the CAP and the American Society of Clinical Oncology (ASCO) have reaffirmed the 2018 "HER2 Breast Testing Guideline Focused Update" in response to the results of the 2022 DESTINY-Breast04 trial.CAP HER2 Guideline: https://www.cap.org/protocols-and-guidelines/cap-guidelines/current-cap-guidelines/recommendations-for-human-epidermal-growth-factor-2-testing-in-breast-cancer
This month we’ll take a look at efforts to mitigate recent Medicare cuts, digital and cybersecurity news in the health care sector, and more.
So you have a job offer. Now what? If you're a senior trainee or new-in-practice pathologist navigating contract negotiation for the first time, this episode is for you.Jennifer Woo, MD, FCAP, and Esther Yoon, MD, FCAP, from the New-in-Practice Committee chat with Practice Management Committee members Moira Larsen, MD, MBA, FCAP, and Cedric Bailey, DO, FCAP, about their contract negotiation advice and experiences. This episode is a collaboration between the New-in-Practice and Practice Management Committees and is one of two episodes on job searching tips.
Biobanking of human biospecimens has a long history. In the last two decades, several best practices have been developed, resulting in better-quality specimens. Jim Vaught, PhD, Editor Emeritus of the Biopreservation and Biobanking journal, joins the podcast to talk about the new era we are entering where new markets and technologies will result in new approaches to collecting, processing, and storing samples.Learn more about the CAP's Biorepository Accreditation Program: https://www.cap.org/laboratory-improvement/accreditation/biorepository-accreditation-program
Joseph Sirintrapun, MD, FCAP, and Dibson Gondim, MD, FCAP discuss implementing digital pathology at UofL Health. Dr. Gondim shares the challenges and easy wins that the University of Lousiville experienced during the process and how artificial intelligence will continue to impact digital pathology in the next 5 to 10 years. This episode is part of a series of conversations featuring institutions at varying degrees of digital pathology implementation.For more information about digital pathology, visit the Digital and Computational Pathology Committee resource center: https://www.cap.org/member-resources/councils-committees/digital-pathology-topic-center
This month we'll review the 2024 Final Medicare Physician Fee Schedule and what it means to you as well as a grant for the CAP's work to promote effective communication in health care. We will also sit down with Dr. Mark Synovec to discuss what happened at the most recent AMA meeting and what it means going forward.
In this CAPcast, Mary Edgerton, MD, FCAP, talks with experts in the field of cancer research, diagnosis, and treatment: Lara Harik, MD, FCAP; Stephen Edge, MD, FACS, FASCO; Donna Gress, RHIT, CTR; Veronica Klepeis, MD, PhD, FCAP; and Eric Daley, MS, PA (ASCP).The group discusses how the CAP’s Cancer Protocols are created and used, the difference between Cancer Protocols and electronic Cancer Protocols, and the future of synoptic reporting.More information about the CAP Cancer Protocols: https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocols. For questions, please email us at CancerProtocols@cap.org.
Interviewing for your first job as a pathologist might seem intimidating. But this is an opportunity to not only showcase your abilities but to find out if the position and practice setting are a good fit for you and your career goals.Neha Varshney MD, FCAP, FASCP, from the New-in-Practice Committee, chats with Practice Management Committee members Karim Sirgi MD, MBA, and Jeremy S Ditelberg MD, FCAP, about their job interview advice and experiences. This episode is a collaboration between the New-in-Practice and Practice Management Committees and is one of two episodes on job searching tips.
In this special CAPcast episode, CAP Foundation President Eva M. Wojcik, MD, FCAP, talks with CAP Foundation board member Sara Herbek, Esq, and CAP Board member Diana Cardona, MD, FCAP. They share their personal connections to the CAP Foundation and discuss advocating for your own personal health and the work the Foundation is doing for pathologists and patients.Learn more about and donate to the CAP Foundation: https://foundation.cap.org/
As leaders in the medical laboratory, pathologists are important gatekeepers to the highest value use of ancillary testing techniques for patient samples. So, how can a pathologist prepare for questions on molecular tests before they come? In this episode, Jennifer Yoest, MD, FCAP, author of the new Clinical Pathology Improvement Program case Choosing a Molecular Test: Techniques Decoded, shares her thoughts.Register for the case: https://education.cap.org/content/2023-cpip-k-case-11-molecular-%E2%80%93-choosing-molecular-test-techniques-decoded
The liquid biopsy has rapidly emerged as a method to minimize the amount of tissue needed for testing, making it a less invasive and safer alternative to more traditional procedures. As it continues to evolve, liquid biopsies offer exciting new options in the practice of pathology. In this episode, Maria Arcila, MD, FCAP, and JinJuan Yao, MD, FCAP, discuss the development of this new diagnostic tool.CAP Precision Medicine Resource Center: https://www.cap.org/member-resources/precision-medicineCAP and AMP recommendations on validation of cell-free DNA assays: https://www.jmdjournal.org/article/S1525-1578%2823%2900219-2/fulltext
We sat down with the newly inaugurated CAP President Dr. Donald Karcher to discuss the CAP's legislative priorities and how advocacy by CAP members can advance the profession.
In this CAPcast, Mary Edgerton, MD, FCAP, talks with experts in pancreatic cancer research, diagnosis, treatment, and patient advocacy: Paula Kim, co-founder of Pancreatic Cancer Action Network (PanCAN); Ariban Maitra, MD, FCAP, Nilo Azad, MD; Ralph Hruban, MD; and, Fatima Zelada-Arenas, Senior Director of Research and Education at PanCAN.More information about the CAP Cancer Protocols: https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocols. For questions, please email us at CancerProtocols@cap.org.For more information about PanCAN, visit https://pancan.org/.
This month we’ll be looking at the excellence of the CAP’s proficiency testing, add-on services responsible for Medicare cuts, excited Delerium and more. We'll also sit down with Matthew Foster MD, FCAP to go over what CAP members advocated for, how it was received in Congress and how members can get involved in the future.
This episode features a conversation with Oksana Volod, MD, FCAP, editor and co-author of the new book, Whole Blood Viscoelastic Assays in Clinical Diagnosis: An Illustrated Case-Based Guide. A comprehensive resource on viscoelastic testing for pathologists, clinical laboratory scientists, and other health care professionals, the book addresses hemostasis, physiology, conventional assays for its assessment and their advantages and disadvantages, and therapeutic agents used in patient management.Link to purchase: https://estore.cap.org/OA_HTML/xxCAPibeCCtpItmDspRte.jsp?section=10044&item=840358&sitex=10020%3A22372%3AUS&ebsprd=WJncyDZVZ6m4qcbiT9v8wUATre&ebsprd_pses=ZG071176E1693C695511D97E6D9DA8E80D42444F9B903B3D8BAEBAF82F68EE18E4992B0C09AC3887DBBF2969DE58D1A84D762ED3554A3608AE
Joseph Sirintrapun, MD, FCAP, and Diana Cardona, MD, MBA, FCAP, discuss implementing digital pathology at Duke Health. Dr. Cardona shares the challenges and easy wins Duke Health has experienced so far in the process and where she sees digital pathology heading in the next 5 to 10 years. This episode is part of a series of conversations featuring institutions at varying degrees of digital pathology implementation.For more information about digital pathology, visit the Digital and Computational Pathology Committee resource center: https://www.cap.org/member-resources/councils-committees/digital-pathology-topic-center
Artificial intelligence, also known as AI, is streamlining processes within health care, particularly related to diagnosing and managing patient care. In this interview with Becker’s Healthcare, M.E. (Doc) de Baca, chair of the College of American Pathologists’ Council on Informatics and Pathology Innovation, discusses the complexities of integrating AI into patient care, considering the practical, ethical and collaborative aspects that need to be addressed for effective implementation and improved patient care.
October has been recognized as Breast Cancer Awareness Month for nearly four decades. In this CAPcast, Mary Edgerton, MD, PhD, FCAP talks with Regina Barzilay, PhD, Ross Simpson, MD, FCAP, Timothy Law, MD, and Patient Advocate Rebecca Seago-Coyle. The group discussed what’s on the horizon for breast cancer research, how it will impact patient outcomes, and the role of pathology data in these efforts.More information about the CAP Cancer Protocols: https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocols. For questions, please email us at CancerProtocols@cap.org.
The digital transformation of pathology is underway, and laboratories increasingly need equipment and software that enables the use of innovative diagnostic tools such as machine learning/artificial intelligence. To implement any of these diagnostic tools, laboratory leadership must take several pre-analytic considerations into account. Matthew Hanna, MD, FCAP, authored a new case on this topic for the Informatics Essentials for Pathologists Program. In this episode, he shares insights on the prerequisites necessary for a successful digital pathology system implementation.Link to the case: https://education.cap.org/content/2023-icbe-b-pre-analytic-best-practices-successful-digital-pathology-implementation-0
This month we’ll discuss efforts to improve Medicare payments for pathologists, advocacy wins with UnitedHealthcare, name changes for cytotechnologist. We also sat down with Pam Wright, Senior Director for Economic and Regulatory Affairs at the CAP, to discuss this year's Practice Expense Survey and go in depth on what the survey is, why it’s important and how it’s results can help pathology practices.
Artificial intelligence is an exciting technology impacting the practice of pathology. When applied to the area of precision medicine, especially to treat oncologic disease, even more frontiers open for providing better patient care. This episode, a joint effort between the CAP’s Personalized Health Care Committee and its Digital and Computational Pathology Committee, features Dr. Marilyn Bui and Dr. Eric Walk discussing machine learning developments and the future of AI in precision medicine. Visit the CAP’s Precision Medicine Resource Center for more resources, including Dr. Walk’s article on the use of machine learning to predict patient outcomes and the best course of treatment: https://www.cap.org/member-resources/precision-medicine
Srividya Sathiyamoorthy, MD, MS, FCAP, shares her personal journey to wellness after dealing with years of musculoskeletal pain and offers advice to other pathologists about the importance of seeking help and advocating for yourself. Dr. Sathiyamoorthy is also a member of the CAP's Wellness Project team, which will be hosting a Wellness Lounge at the upcoming CAP23 Annual Meeting. Stop by to get a preview of a Heartfulness Meditation and upper body workout session, geared specifically towards pathologists.
CAP's Biorepository Committee member Nalin Leelatian, MD, PhD, joins the podcast to talk about neuro biorepositories and how the CAP's Biorepository Accreditation Program (BAP) improves the quality and consistency of biobanks.For more information about BAP, visit https://www.cap.org/laboratory-improvement/accreditation/biorepository-accreditation-program
September is Childhood Cancer Awareness Month. In this CAPcast, Mary Edgerton, MD sits down with pediatric cancer experts to talk about their work as it relates to the updated Pediatric Cancer Protocols released in September 2023.
More information about the CAP Cancer Protocols: https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocols. For questions, please email us at CancerProtocols@cap.org.
This month we’ll examine advocacy to prioritize Medicare payment reform in Congress, efforts to strengthen enforcements of payment decisions under the No surprises act, the critical research done by the CAP to study pandemic-era laboratory supply shortages, and more. We'll also speak with Dr. Glenn Ramsey of Northwestern medicine about the importance sickle cell disease awareness and the fight to ensure adequate treatment and care for all those impacted with the condition.
Retirement may be years away, but it's never too early to start planning and saving. Abdul Abid, MD, a member of the New-in-Practice Committee talks with Brian Truscott, a certified financial planner and wealth management advisor who shared his tips on retirement plans, debt repayment, and investment considerations for early career pathologists.
We asked three real-life forensic pathologists to watch “Autopsy Turvy,” an episode of the TV show “Psych” (season 6, episode 14) and fact-check the truth from the fiction. Featuring Michelle Aurelius, MD, FCAP, Anna Tart, MD, FCAP, and Natasha Grandhi, MD, FCAP, of the CAP’s Forensic Pathology Committee, this is the second installment in a series of CAPcasts where pathologists react to how forensic scientists are portrayed in TV and film.
August is Appendix Cancer Awareness Month. In this CAPcast, Mary Edgerton, MD sits down with Katie Hagen, MD to talk about appendiceal carcinomas and how the Cancer Protocols support patient care and treatment when it comes to GI tumors.
More information about the CAP Cancer Protocols: https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocols. For questions, please email us at CancerProtocols@cap.org.
In the practice of clinical medicine and clinical pathology, novel technologies often disrupt existing paradigms in diagnostic medicine to improve patient care through more timely and accurate lab results. In his new book, Disruptive Technologies in Clinical Medicine, author Frederick Kiechle, MD, PhD, FCAP, discusses some of these technologies and their impact in practice. This CAPcast with Dr. Kiechle gives listeners a preview of what’s covered in the book, which is out now and available for purchase on the CAP’s estore via the link below.
https://estore.cap.org/OA_HTML/xxCAPibeCCtpItmDspRte.jsp?section=10045&item=840356&sitex=10020:22372:US.
This month we’ll look at Senate efforts to strengthen laboratories for future pandemics, the potential burdens of post-market surveillance in AI software, and new digital pathology CPT codes developed by the CAP. Later, we’ll hear some highlights from the proposed 2024 Medicare physician fee schedule.
July is Sarcoma and Bone Cancer Awareness Month. Sarcomas are rare cancers in which malignant cells form in the bones or soft tissues.
In this CAPcast, Mary Edgerton, MD sits down with Julie Fanburg-Smith, MD to talk about bone and soft tissue tumors and how the Cancer Protocols support patient care and treatment.
Dr. Edgerton is the chair of the Pathology Electronic Reporting Committee and Dr. Fanburg-Smith is a member of the Cancer Committee.
More information about the CAP Cancer Protocols: https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocols. For questions, please email us at CancerProtocols@cap.org.
The Cancer Protocols help ensure that all pathology reports contain the necessary data elements for optimal patient care. Cancer registries also depend on the protocols for accurate standardized data collection.
Lara Harik, MD, FCAP, a pathologist at Emory University Hospital talks with Peggy Adamo and Andrea Sipin-Baliwas to continue the conversation about cancer registries. Peggy is a public health analyst for the NCI SEER program and Andrea is the director of registry operations for the Los Angeles Cancer Surveillance Program. Listen to part one here: https://soundcloud.com/pathologists/understanding-cancer-registries
More information about the CAP Cancer Protocols: https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocols. For questions, please email us at CancerProtocols@cap.org.
In June 2023 the American Medical Association held its annual meeting in Chicago. Physicians across the nation gathered to discuss issues regarding their specialty and the field of medicine as a whole. We sat down with Joe Sanfrancesco, MD, FCAP, to recap some of the highlights from the event.
Platelet refractoriness can be life threatening for thrombocytopenic patients. Penn State Health pathologist Melissa George, DO, FCAP, and pediatrician Sarah Kesterson, MD, authored the new Clinical Pathology Improvement Program course on this topic. In this CAPcast, they discuss how narrowing the differential diagnosis for poor platelet transfusion response is critical to guide appropriate management and product selection.
To purchase this case, please visit the CAP's estore: https://estore.cap.org/OA_HTML/xxCAPibeCCtpItmDspRte.jsp?section=10139&item=848356&sitex=10020:22372:US
Pop culture's fascination with forensic science is fueled by TV shows and movies like "CSI," "Law & Order," etc. They offer the general public front-row access to otherwise off-limits crime scenes, autopsies, and trials. The entertainment value and popularity of these shows are undeniable, but their accuracy is up for debate.
We asked three real-life forensic pathologists to watch an episode of the ABC show “Body of Proof” and fact-check the truth from the fiction. Members of the CAP's Forensic Pathology Committee, Michelle Aurelius, MD, FCAP, Jonathan Eisenstat, MD, FCAP, and Natasha Grandhi, MD, FCAP, joined us for the first in a series of CAPcasts where pathologists react to how forensic scientists are portrayed in TV and film.
This month, we’ll review some of the highlights from the annual AMA meeting in Chicago, look at why the CAP is opposing a name change for cytotechnologists, and more.
Joseph Sirintrapun, MD, FCAP and Jochen Lennerz, MD, PhD, FCAP discuss implementing digital pathology at Massachusetts General Hospital and the creation of the Pathology Innovation Collaborative Community (PIcc). Dr. Lennerz shares the challenges and easy wins Massachusetts General experienced during the process, where he sees digital pathology heading in the next 5 to 10 years, and the importance of regulatory science. This episode is part of a series of conversations featuring institutions at varying degrees of digital pathology implementation.
For more information about PIcc, visit: https://pathologyinnovationcc.org/
For more information about digital pathology, visit the Digital and Computational Pathology Committee resource center: https://www.cap.org/member-resources/councils-committees/digital-pathology-topic-center
Joseph Sirintrapun, MD, FCAP and Sam Terese, president and CEO of Alverno Laboratories, talk about the implementation of digital pathology in an integrated laboratory network. Sam shares the challenges and easy wins Alverno experienced during the process and where he sees digital pathology heading in the next 5 to 10 years. This episode is the second in a series of conversations featuring institutions at varying degrees of digital pathology implementation.
For more information about digital pathology, visit the Digital and Computational Pathology Committee resource center: https://www.cap.org/member-resources/councils-committees/digital-pathology-topic-center
This month, we’ll talk about the CAP’s communication with CMS on surprise billing, efforts to pin Medicare pay to the inflation index and more.
Joseph Sirintrapun, MD, FCAP, and Matthew Hanna, MD, FCAP talk about the implementation of digital pathology at their institution, Memorial Sloan Kettering Cancer Center. They talk about the challenges and easy wins they experienced during the process and where they see digital pathology heading in the next 5 to 10 years. This episode is the first in a series of conversations featuring institutions at varying degrees of digital pathology implementation. For more information about digital pathology, visit the Digital and Computational Pathology Committee resource center: https://www.cap.org/member-resources/councils-committees/digital-pathology-topic-center
The Cancer Protocols help ensure that all pathology reports contain the necessary data elements for optimal patient care. Cancer registries also depend on the protocols for accurate standardized data collection.Lara Harik, MD, FCAP, a pathologist at Emory University Hospital sits down with Mildred Jones, Certified Tumor Registrar and liaison for the National Cancer Registrars Association for the CAP Cancer Committee to talk about the basics of cancer registries.More information about the CAP Cancer Protocols: https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocolsFor questions, please email us at CancerProtocols@cap.org.
This month, we’ll look at the FDA’s newest proposal on blood donations, as well as plans from the CMS to improve hospital equity. Later we will be sitting down with Dr. Victoria Jones and Dr. Eric Loo of Dartmouth Health to talk with them about their experience at this years’ Pathologist Leadership summit.
The EAC is largely responsible for health care policy that affects the coverage, payment, and overall value of pathology services. In this podcast, Jonathan Myles, MD, FCAP, chair of the Council on Government and Professional Affairs spoke with three leaders of the EAC: Ronald McLawhon, MD, PhD, FCAP, who chairs the EAC; Theresa Emory, MD, FCAP, Vice Chair of the EAC, and Jan Nowak, MD, FCAP. They each discussed a wide range of issues and different policies that allow pathologists to be paid, as well as the payment challenges pathologists face in the future.
Just released, the new Color Atlas of Flow Cytometry offers a full range of hematolymphoid disease cases, highlighting disease categories and disease entities that may be difficult to diagnose in clinical practice. The new book can benefit students, medical technologists, and practicing pathologists, explains lead author, David Dorfman, MD, PhD, FCAP in this CAPcast interview.To purchase this book, please visit CAP's estore: https://estore.cap.org/OA_HTML/xxCAPibeCCtpItmDspRte.jsp?section=10044&item=747354&sitex=10020:22372:US
This month we’ll examine the White House Budget Proposal and what it means for the pathology workforce and pandemic preparedness, why the CAP and other organizations are calling for Congress to pass an inflation-based fix to Medicare payments, and more. We'll also will sit down with CAP President Emily E. Volk, MD, FCAP, to discuss her recent meeting with the Congressional Black Caucus, including key takeaways from her conversation and how the CAP can engage with policy to create a more equitable.
As Women's History Month 2023 wraps up, we're joined on this CAPcast by CAP President Emily Volk, MD, FCAP, and Lacey Durham, MD (@PathDoctorMD on TikTok). Dr. Volk and Dr. Durham talk about a variety of topics, including gender diversity in pathology, positive changes in health equity, and early career advice for women.
The AMA, CAP, state pathology societies, and state medical societies promote the interests and well-being of pathologists. In this CAPcast, Susan Strate, MD, FCAP, and Tiffani Milless, MD, FCAP, share reasons why pathologists should get involved in advocacy at both the state and federal levels. Their discussion serves as a preview to the Finding Your Place in Organized Medicine course, taking place at the 2023 Pathologists Leadership Summit. For more information, visit pathologistsleadershipsummit.org/.
Why Mitigating Risk of Cuts on Capitol Hill is so Important This Year by College of American Pathologists
Over the course of her nearly 30 years with the CAP, Mary Kennedy has played a pivotal role on the SNOMED team and in the development of the cancer protocols. In this CAPcast for Women’s History Month, Mary talks about her career at the CAP, her experiences in the field of pathology informatics, and the opportunities she sees for pathologists in informatics and artificial intelligence going forward.
This month we meet with PathPAC Chair Dr. Kalisha Hill who will update CAP members on the "Back the PAC" competition for the House of Delegates. We will also review advocacy developments during the month of February: congressional efforts to address Medicare cuts, the Centers for Medicare & Medicaid Services hits pause on the independent dispute resolution process, and the CAP's advocacy regarding coverage for special stains.
Eric Glassy, MD, FCAP, has just released a new volume of his popular Color Atlas of Hematology, which delves into the morphology, physiology, and pathophysiology of bone marrow. Like the first volume, this publication offers not only the morphology but vital statistics, illustrations, discussions, and photomicrographs, as Dr. Glassy explains in this CAPcast interview.To purchase this book, please visit CAP's estore: https://estore.cap.org/OA_HTML/xxCAPibeCCtpItmDspRte.jsp?section=10044&item=747355&sitex=10020:22372:US
Peter McCaffery, MD, FCAP and M. E. de Baca, MD, FCAP discuss the AI and Readiness course they are leading at the 2023 Pathologists Leadership Summit. They share some of the potential benefits, limitations, and implications of AI's growth in pathology testing. For more information, visit pathologistsleadershipsummit.org/.
Participating in a council or committee is a great way to be a part of our CAP community. Jessica Bentz, MD, FCAP, Muhammad Mahmood, MD, FCAP, and Kamran Mirza, MD, PhD, FCAP share their experiences being on a CAP committee, how they balance their personal and professional responsibilities, and their advice to anyone considering joining a committee. The application for 2024 Committee Appointments closes on April 28, 2023. To learn more and apply visit https://www.cap.org/member-resources/councils-committees/committee-application-process
This month we’ll cover the updates from the FDA in regards to breakpoints as well as some of the latest COVID news. We'll also sit down with Dr. Joe Saad to discuss Federal policy changes Pathologists need to know about in 2023.
Moira Larsen, MD, MBA, FCAP and Ethan Larsen, PhD discuss the Human Factors Engineering (HF) course they are leading at the 2023 Pathologists Leadership Summit. They explain how HF methods streamline processes, despite resource limitations, allowing laboratory practices to “Do More with Less.” For more information, visit https://pathologistsleadershipsummit.org/.
This month we’ll look at updates for Good Faith Estimate requirements, developments on MIPS, as well as important legislative priorities that were in the year-end legislation passed by Congress.
This month we’ll look at remote work practices following the end of the emergency declaration, the finalization of the Medicare Physician Fee Schedule, MACRA improvement recommendations, and more.
In this CAPCast members of the New in Practice committee, Yasmeen Butt, MD, Neha Varshney, MD, and Jaclyn Rudzinski, MD, share tips to help early career pathologist prepare to conduct laboratory inspections
Lead pathology at the state and national level as a member of the CAP House of Delegates. Self-nominations are open through Jan. 13, 2023, for the 2023-26 term. Elections take place next Spring. Learn more from HOD Speaker Sang Wu, MD, FCAP, talking with New Hampshire Delegation Chair, Candice Black, DO, FCAP.
This month we’ll highlight a grant awarded to the CAP to improve diagnostic excellence, key issues from this years’ advocacy town hall at the CAP’s annual meeting, and we’ll speak with Dr. Thomas Wheeler about findings from this years’ Practice Characteristics Survey.
CAP Foundation President Eva Wojcik, MD, FCAP, and Executive Director Maya Ogden talk all things Foundation: its goal to expand health equity in the US and globally, its pathology-focused grants and awards, and its pathologist-led free cancer screening program, See, Test & Treat. Listen and consider donating to support the Foundation this giving season at foundationdonation.cap.org.
Marisa Saint Martin, MD, FCAP and Michael Cohen, MD, FCAP, co-chairs of the Council on Membership and Professional Development Wellness Project Team discuss member needs as related to wellness and burnout. For more information visit https://www.cap.org/member-resources/articles/wellness-resources-for-pathologists
In this CAPCast, Dr. Megan Kressin and Dr. Leilani Valdes chair of the Council on Membership and Professional Development discuss the work of the professionalism and ethics project team and what it means to be a FCAP.
This month we’ll look at updates regarding Clinical Laboratory Labor Pricing, the introduction of a bill to support Medicare providers, the dismissal of a federal surprise billing case, and more.
In this episode of the College of American Pathologist's CAPCast, Dr. Lisa Stempak, chair of the CAP's Continuous Compliance Committee explains the updates to Proficiency Testing requirements for laboratories performing predictive marker testing using IHC.
Hear from Florida Society of Pathologist president Qihui Jim Zhai, M.D, FCAP and president-elect, Marilyn Bui, M.D, FCAP about how the Florida Society of Pathologists created one community for all practice types. Chakshu Gupta, M.D, FCAP, president of the Missouri Society of Pathologists, moderates this discussion and provides practical tips on how to engage academic pathologists in your state.
Dr. Matthew Hiemenz and Dr. Damon Olson discuss molecular testing practices for sarcomas to help differentiate between types
This month we’ll review the proposed 2023 Medicare Payment Regulations released by the CMS, the technical reporting changes made to CLIA proficiency testing regulations, as well as the declaration of Monkeypox as a global health emergency and a public health emergency in the United States. We will also be joined by Theresa Emory, MD, FCAP to talk about good faith estimate requirements as they relate to surprise medical bills.
With so much structural change happening in the world right now, it’s easy to be uncertain and weary. It also means adapting to broaden the scope of individuals who have historically been left behind by the innovations and advances of modern medicine. In this sense, Heather McGhee’s book, The Sum of Us: What racism costs everyone and how we can prosper together, addresses what it means make sure health care includes everyone.
We spoke about how structural inequities have held back advances in the medical system, why racism still impacts systems like health care today, and what professionals in the medical field can do to find success while reducing disparities and improving equity in care.
This month we’ll look at updates on the VALID Act, examine the CDC announcement for Monkeypox specimen guidelines, and review the decision by the CMS to retain diagnostic codes for next generation sequencing. We'll also be joined by Dr. Mark Synovec to recap the American Medical Association’s annual meeting and what the CAP-led delegation advocated for during the event.
This month we’ll be focusing on the VALID Act and its impact on laboratory developed tests. We sat down with CAP President Dr. Emily Volk to get some background on the legislation and what to expect moving forward.
Pathologists are responsible for developing safe and efficient blood selection policies for routine and emergency bleeding situations, in a variety of clinical scenarios and in different practice settings, explains Monica Pagano, MD, FCAP, in this CAPcast interview. Dr. Pagano is Medical Director, Transfusion Service Laboratory at the University of Washington Medical Center and led the development of a Clinical Pathology Improvement Program case-based course on this topic (https://capatholo.gy/3wglhvN).
This month we recognize National Minority health month, look at the request for additional COVID funding, learn about new efforts in pandemic preparedness, and review highlights from this year’s pathologists leadership summit with Vaishali Pansare, MD, FCAP.
We spoke with Jonathan Myles, MD, FCAP, Chair of the Council on Government and Professional Affairs. to get a preview of what to expect at this years' Pathologists Leadership Summit.
April is Head and Neck Cancer Awareness month. The National Cancer Institute estimates that head and neck cancers comprise 4% of cancers diagnosed each year. In 2021, more than 65,000 people impacted by newly diagnosed head and neck cancers. These cancers are diagnosed more often in women and also more often among people over age 50.
CAP Cancer Protocols play an important role in disease management, ensuring that all pathology reports contain necessary data elements to improve patient care. The CAP has nine protocols for head and neck related cancers (https://capatholo.gy/2OkNDkZ), as Raja Seethala, MD, FCAP, explains in this CAPcast episode. Dr. Seethala is Director of the Head and Neck/Endocrine Pathology Center of Excellence at the University of Pittsburgh Medical Center. Dr. Seethala is also a member of the CAP Cancer Committee and Biomarker Committee serving as a subject matter expert on cancers of the head and neck.
It's one thing to talk about the advocacy pathologists engage in, but it's another to get started in that advocacy, especially in a time where getting in contact with elected officals can be more difficult than ever. Bekra Yorke, MD, FCAP, Houston Methodist Hospital Pathology invited three residents: Chiraag Gangahar, MD, FCAP, Ashley Holloman, MD, and Lukas Cara, MD, to participate in their first virtual fly in. We sat down with the four of them to discuss their experience and how other pathologists can work with the CAP to get involved in effective advocacy.
If you are a pathology resident (or a CAP fellow teaching residents), and would like to experience teachable moments like this, make sure you register for the Pathologists Leadership Summit which culminates with the CAP’s Hill Day on May 3. This year’s Hill Day is taking place virtually, so you can participate alongside colleagues, from the convenience of your home or office.
The financial lifeblood of a pathology group relies on the efficiency of its billing operation. Assessing whether to insource or outsource a practice’s billing operations is the focus of this CAPcast episode, which features a recording of a Practice Management Committee Roundtable Discussion moderated by Committee Chair Karim Sirgi, MBA, MD, FCAP. In this discussion, Dr. Sirgi talks to two pathologists--A. Joe Saad, MD, FCAP, who is Chairman of Pathology at Methodist Health System in Dallas, Texas and Sang Wu, MD, FCAP, Medical Director of North Dallas Pathology Services, as well as pathology practice advisory Al Harrison Sirmon. (This discussion was originally in June 2021.)
For more Practice Management resources, please visit the Practice Management section of CAP.org: https://www.cap.org/member-resources/practice-management.
This month we’ll look at recent efforts to strengthen the national blood supply, the passing of an omnibus bill by Congress, and the latest updates about the PREVENT Pandemics Act. We will also sit down with the Chair of the CAP’s Federal and State Affairs Committee, Dr. David Gang, to talk about the CAP’s legislative asks for this year’s Hill Day and what participants can do to prepare.
Integration of external laboratory test results without careful review could lead to significant patient safety issues, particularly as we move towards ever increasing usages of clinical decision support. These interoperability issues preclude artificial intelligence (AI) from reaching its potential, and instead introduce new risks pathologists need to be cognizant of, explains Monica de Baca, MD, FCAP. in this CAPcast interview. Dr. de Baca is moderating a panel discussion on this topic at the Pathologists Leadership Summit, which will be held virtually and in person in Washington, DC from April 30-May 3.
The title of this panel discussion is "Towards Laboratory Data Democratization and Artificial Intelligence: Underlying Standards and What Pathologists Need to Know" and will be held on Sunday May 1, from 3:00-4:00 pm EST. For more information, please visit pathologistsleadershipsummit.org.
March is Colorectal Cancer Awareness Month. In 2022, the American Cancer Society’s Cancer Statistics Center, estimates that more than 150,000 patients will be diagnosed with colorectal cancer in the United States, with more than 52,000 dying of the disease.
Early detection through prevention and screening is proven to dramatically reduce fatalities from this cancer. The CAP Cancer Protocols help ensure that all pathology reports contain necessary data elements to improve patient care. In this CAPcast discussion, pathologists Lawrence Burgart, MD, FCAP, and William Chopp, MD, FCAP, members of the CAP Cancer Committee are joined by Manish Sharma, MD, an oncologist based in Grand Rapids, Michigan and the Associated Director of Clinical Research at START Midwest, to discuss the role that CAP cancer protocols have in diagnosing and treating patients with colorectal cancer.
For more information on CAP Cancer Protocols, please visit https://capatholo.gy/2OkNDkZ.
In this CAPcast, New in Practice Committee members Drs. Alan Brown and Jaclyn Rudzinski discuss common financial challenges and issues for fellows and new attendings, including common pathology practice structures as well as the importance of balancing debts and savings.
This episode is adapted from a New-in-Practice Committee Roundtable discussion originally recorded on Nov. 12, 2021. For more information on resources from the CAP New-in-Practice Committee, please visit CAP.org: https://www.cap.org/member-resources/new-in-practice.
Few pathologists receive training on laboratory IT issues, or how to manage a new installation. In this CAPcast, John Sinard, MD, FCAP, discusses the educational case he has developed to teach planning tools related to successfully implementing histology tracking software. Dr. Sinard founded the Pathology Informatics Program at the Yale School of Medicine.
This month we’ll look at the Biden administration’s relaunch of its cancer moonshot initiative, addressing social determinants of health, and more. We'll also be speaking with the CAP’s Vice Chair for the Council on Government and Professional Affairs, Dr. Joe Saad. He will provide us with updates surrounding lawsuits and the No Surprises Act.
The topic of workload distribution, whether linked to a pathologist's "productivity" and compensation or simply considered as a part of group dynamics and harmony, is often treated as a taboo subject or completely ignored by the leadership and individual pathologists alike. In this CAPcast, Moira Larsen, MD, MBA, FCAP, and Karim Sirgi, MD, MBA, FCAP, will discuss how to determine workload distribution while navigating the associated group dynamics. Dr. Larsen is currently the Physician Executive Director of MedStar Medical Group Pathology, which is part of MedStar Health, an integrated care delivery network in Washington DC and Maryland. Dr. Sirgi owns and manages Sirgi Consulting LLC, which offers expertise to medical groups in various aspects of practice management and leadership.
Drs. Sirgi and Larsen will be leading a course on this topic at the Pathologists Leadership Summit (https://www.pathologistsleadershipsummit.org/), which will be held virtually and in-person in Washington, DC on April 30 through May 3.
Feedback is a key component of learning in any field of medicine and no less so in pathology. Giving feedback can be difficult because there is little training for it and many teachers fear emotional responses from learners. In this CAPcast, Nicole Riddle, MD, FCAP, discusses how to most effectively provide and receive feedback and the importance of SMART goals.
Dr. Riddle will be leading a course on this topic at the Pathologists Leadership Summit, which will be held April 30-May 3 in Washington, DC. Learn more & register: https://www.pathologistsleadershipsummit.org/.
In 2022, CMS raised the number of points large practices need to score to avoid a MIPS penalty. Using the measures in the CAP’s registry is now the only way large practices can get enough points to meet the MIPS performance score threshold. Quality Payment Programs are here to stay, and pathologists are going to be continually subjected to evolving value-based payment programs. Eligible pathologists should consider MIPS participation as a strategy to help protect revenues as well as a strategy to demonstrate their value. A low MIPS score may affect your ability to recruit pathologists, promote your practice, or even you—if and when you move jobs and your score follows you.
Trichomoniasis is the most common, non-viral, sexually transmitted infection. Pathologists providing laboratory testing for this infection should understand the advantages and disadvantages of the commercially available, FDA approved/cleared methods, explains Mayo Clinic pathologist Bobbi Pritt, MD, FCAP, in this CAPcast. Dr. Pritt led the development of the Clinical Pathology Improvement Program offerings on this topic (capatholo.gy/3x9XUCy).
As the COVID-19 pandemic continues, perinatal deaths remain an important question, particularly because the mechanism of death remains unclear. A new study just published in the Archives of Pathology & Laboratory Medicine (https://capatholo.gy/3JfXHTu) found that pathology abnormalities composing SARS-CoV-2 placentitis cause widespread and severe placental destruction that can result in still births. To the best that researchers could determine, all of the mothers in this study were unvaccinated.
In this CAPcast, David Schwartz, MD, FCAP, lead author of the study, discusses the research and what conclusions pathologists and the public should take away from these findings, as well as the important epidemiological role that pathologists and the Archives of Pathology & Laboratory Medicine (archivesofpathology.org) have had in global outbreaks--from AIDS and Zika to COVID.
This month we’ll look at testing supply shortages caused by the Omicron variant, new dispute guidelines in the No Surprises Act, and more. Later, we will be speaking with the CAP’s Vice Chair on the Economic Affairs Committee, Dr. Ronald McLawhon, about the recent updates to clinical consultation codes for pathology.
Pathologists play an important role in assisting biorepositories in obtaining and setting standards for quality samples for research. In this CAPcast, Dr. Rebecca Obeng discusses the range of services and resources that biorepositories can provide researchers as well as the benefits and value of accreditation for biorepositories. Dr. Obeng is a pathologist at Northwestern Medicine and the CEO of the Sub-Saharan Africa Healthcare Initiative, a non- profit organization working to improve pathology services in Africa.
For more information on the CAP's Biorepository Accreditation Program, visit https://www.cap.org/laboratory-improvement/accreditation/biorepository-accreditation-program.
The laboratory director has a legal obligation to follow-up with all recalls that impact any test components or blood components used in the laboratory. While blood bankers are already on high alert for all blood component recalls, the impact from a medical device recall can be just as serious as a blood component recall. Per the CAP laboratory general checklist (GEN.20340), the laboratory manages notifications from vendors of defects or issues with reagents, supplies, instruments, equipment, or software that may affect patient care/client services. For example, there was a recent recall on waived blood lead testing lot numbers. The recall was classified as level I because use of the impacted lot numbers might have led to falsely low lead results.
In this CAPcast, Matthew Krasowski, MD, FCAP, Chair of the CAP Toxicology Committee, discusses the laboratory’s role in medical device recall, such as this recent incident, and how both CAP accredited laboratories and inspectors should respond to recalls.
Insufficient health plan networks and surprise medical bills have had a substantial impact on patients through the years. The No Surprises Act of 2020 aimed to address surprise bills by taking patients out of medical billing disputes between physicians and insurance companies. In part, the law set up an independent dispute resolution, or IDR, process that was supposed to be fair and impartial. However, the regulations implementing the law now favor insurance companies. The CAP is advocating to make the IDR process truly independent and fair to all participants. We spoke with Dr. Theresa Emory, chair of the CAP’s Payment Policy Subcommittee, to learn more.
February 4 is World Cancer Day, an international initiative focused on raising awareness of the importance of preventing, detecting, and treating cancer. World Cancer Day is led by the Union for International Cancer Control to support the goals of the World Cancer Declaration. This year, the focus is on Closing the Gap. In this CAPcast interview, CAP President Emily Volk, MD, FCAP, talks with Joseph Khoury, MD, FCAP, who is chair of the CAP’s Cancer Committee and Mary Edgerton, MD, PhD, FCAP, Chair of the CAP’s Pathology Electronic Reporting Committee about how the CAP and pathologists are working to improve access to quality care.
For more information on CAP Protocols, please visit the Protocols & Guidelines section of CAP.org: https://www.cap.org/protocols-and-guidelines.
Evolving molecular technologies and genomic knowledge has significantly changed the diagnosis and management of T-cell malignancies. More and more clinical laboratories have adopted next generation sequencing platforms to assess clonality and to identify diagnostic and predictive biomarkers. However, current standard testing practices to diagnose T-cell lymphomas use clonality assessment by fragment analysis. This approach has low sensitivity and low specificity, among other limitations, explains Jinjuan Yao, MD, FCAP, a pathologist at Memorial Sloan Kettering Cancer Center and a member of the CAP Personalized Health Care Committee. Dr. Yao has written an article (“The Updates of Molecular Testing in T-Cell Malignancies", https://capatholo.gy/3tOznDY) about how using next generation sequencing techniques allows more accurate initial diagnosis, as well as high sensitivity for detecting minimal residual disease and therefore improving post treatment outcomes, as she’ll explain in this CAPcast interview.
What are some common challenges that pathologists face when they are transitioning from training to practice? This CAPcast features a panel discussion recorded during the 2021 Fall Residents Forum meeting, when Abdul Abid, MD, vice chair of the Resident Forum moderated a discussion on this topic with three pathologists who are early in their careers—Elizabeth Rinehart, MD, FCAP; Marcos Lepe, MD, FCAP; and Juanita Evans, MD, FCAP. The panelists share their insights about how they are navigating the early stages of their pathology careers.
For more information about the CAP Residents Forum, please visit CAP.org and click on the Residents section located under the Member Resources tab.
This month we’ll look at a lawsuit involving the implementation of the No Surprises Act, the efforts of Congress to mitigate Medicare cuts, and more. We'll also be speaking with Michael Giuliani, Senior Director of Legislation and Political Action, about the status of the Build Back Better act and other legislative priorities Pathologists should look out for.
Document review is a critical component of any laboratory accreditation inspection. Driven by the need to innovate due to the ongoing pandemic, the CAP now offers laboratories a choice on whether they want to share documents in advance of their inspection whether it be in person or virtual. In this CAPcast, Adrienne Malta, the CAP’s Director of Inspection Services will describe options for laboratories to share documents in advance of an inspection. Adrienne also provides insight into how her team of Inspection Assignment Specialists help the inspection team and laboratory navigate the laboratory’s preference for document review during the inspection.
For the latest information on CAP accreditation, please visit the Laboratory Improvement section of CAP.org: http://www.cap.org/laboratory-improvement.
Medical errors happen to all pathologists, and every pathologist wants to make sure that they never happen. Indeed, there are whole books on identifying and correcting errors that should be part of every lab's quality management plan and CAP accreditation is there to help pathologists prevent, catch, and correct errors. However what is often missed is the worry, mental effort and stress that pathologists who are new in practice feel regarding mistakes when they first started their careers.
In this CAPcast, Drs. Richard Owings, Juanita Evans, and Yasmeen Butt discuss medical errors--how to confront and move on from them, as well as how to avoid them. Drs. Owings, Evans, and Butt are all members of the CAP's New in Practice Committee.
Additional resources for pathologists who are early in their career are available on the New-in-Practice section of CAP.org: capatholo.gy/3btuncz.
There’s a gap in the instructional texts for surgical pathology, such that residents preparing for pathology board exams or even practicing pathologists who need a refresher/reference texts lack sufficient information. In this CAPcast, Daniel Mais, MD, FCAP, discusses his recently published book, Surgical Pathology Review, which is focused on addressing these gaps.
Visit the CAP's estore to purchase the book: https://capatholo.gy/3bLFLks.
One of the challenging aspects of transitioning from a pathologist in training to one who is new in practice is how to organize your workday. In this CAPcast, Yasmeen Butt, MD, FCAP, and Neha Varshney, MD, FCAP, discuss this topic from both a private practice and an academic practice perspective.
For more resources for pathologists early in their careers, visit the New in Practice section under the Member Resources tab on CAP.org (https://capatholo.gy/3btuncz).
It's one thing to talk about the advocacy pathologists engage in, but it's another to get started in that advocacy, especially in a time where getting in contact with elected officals can be more difficult than ever. Bekra Yorke, MD, FCAP, Houston Methodist Hospital Pathology invited three residents: Chiraag Gangahar, MD, FCAP, Ashley Holloman, MD, and Lukas Cara, MD, to participate in their first virtual fly in. We sat down with the four of them to discuss their experience and how other pathologists can work with the CAP to get involved in effective advocacy.
If you are a pathology resident (or a CAP fellow teaching residents), and would like to experience teachable moments like this, make sure you register for the Pathologists Leadership Summit which culminates with the CAP’s Hill Day on May 3. This year’s Hill Day is taking place virtually, so you can participate alongside colleagues, from the convenience of your home or office.
In this recap, we review the final Medicare fee schedule regulations, updates from Cigna, and more.
Distinguishing between type 1 and type 2 diabetes is critical, because delayed diagnosis of type 1 diabetes is associated with 20% or more risk of diabetic ketoacidosis, a major cause of death in children. Differentiating between type 1 and type 2 diabetes is also extremely important for choice of appropriate therapy. While the clinical presentation of a patient may not allow an unambiguous discrimination between type 1 and type 2 diabetes, the presence of one or more islet autoantibodies can support the diagnosis of type 1 diabetes, according to William Winter, MD, FCAP, the director of the UF Health Pathology Laboratories' Endocrinology Unit. Because islet autoantibodies can also predict the development of type 1 diabetes, once safe and effective therapies are available to prevent this disease, islet autoantibody testing will become routine in medical practice, as Dr. Winter explains in this CAPcast. Dr. Winter led the development of a Clinical Pathology Improvement Program or CPIP course on this topic.
The CAP’s Accreditation Services is launching its Online Deficiency Response on December 20. This will impact the way the CAP’s accreditation customers send the necessary documentation for any deficiencies cited during their inspection. In this CAPcast, Amy Daniels, the CAP’s Technical Director of Accreditation Services, describes the new process for responding to deficiencies and how it impacts laboratories during the transition to the new process.
For more information on this new CAP Accreditation Services Online Deficiency Response, please visit the Accreditation section of CAP.org (https://www.cap.org/laboratory-improvement/accreditation).
In the latest episode in our series commemorating the CAP's 75th Anniversary, we talk with past presidents Thomas Sodeman, MD, FCAP, and Bruce Williams, MD, FCAP, about discovering and nurturing the next generation of pathologist leaders. Dr. Sodeman was president from 2005 to 2007 and Dr. Williams was president from 2017-2019. Dr. Sodeman appointed Dr. Williams to one of his first leadership roles in the CAP.
Precision oncology in the treatment of solid tumors is a rapidly growing field which involves testing for molecular biomarkers. Molecular biomarkers can be used to confirm a diagnosis, provide prognostic information, and select targeted therapies. Pathologists need a working knowledge of these biomarkers and assays used for their evaluation to optimize patient care, explains Jennifer Yoest, MD, FCAP, a pathologist at UH Cleveland Medical Center, in this CAPcast.
Dr. Yoest, who led the development of a Clinical Pathology Improvement Program course on this topic (https://capatholo.gy/3187OsM), will also discuss how this knowledge will also help pathologists triage specimens and prioritize testing in situations where limited tissue is available, which is also known as tissue stewardship.
During this years' annual CAP meeting, Dr. Emily Volk was formally inagurated. We sat down with our new president to discuss the clinical goals and advocacy priorities she has for the CAP during her tenure.
Amylase testing has long been used as a diagnostic tool for pancreatitis, despite amylase levels not being a definitive indicator of pancreatitis. Lipase offers a more useful diagnostic result, as its readings are a better indicator of inflammation of the pancreas, according to James Nichols, PhD, a member of the CAP Quality Practices Committee. Ordering a combination of amylase and lipase is a common practice, but the combination does not increase the sensitivity over a single test. Likewise, serial testing of lipase does not offer better monitoring or treatment. As part of the CAP Test Ordering Program, a new module (https://capatholo.gy/3Du78fr) provides information and resources for the pathologist to address unnecessary testing volumes in the laboratory while still providing effective patient care, as Dr. Nichols explains in this CAPcast.
Leading a laboratory involves both technical knowledge and softer skills: technical knowledge of testing and accreditation is needed along with the ability to manage people, perform risk assessment, and deal with finances and budgeting. Many pathologists leave training with the required technical knowledge but sometimes lack training and confidence in the “softer” skills. The CAP’s Laboratory Medical Direction course is led by experienced laboratory directors who can help correct gaps in your knowledge and improve your ability to function as a lab director. In this CAPcast, leading pathologists Elizabeth Wagar, MD, FCAP, and Richard Scanlan, MD, FCAP, discuss the benefits of attending the course, which will be held March 31-April 1, 2022 in Chicago: capatholo.gy/2mVcxrh.
Cancer immunotherapy has revolutionized oncology through dramatically increased survival rates, even in late-stage disease. Some biomarkers are already covered in what has become routine testing in many laboratories, affording pathologists an opportunity to play a central role in developing and implementing these biomarkers in ways to improve patient care, explains Eric Walk, MD, FCAP, Chief Medical & Scientific Officer and Senior VP of Medical & Scientific Affairs with Roche Diagnostics, in this CAPcast.
Dr. Walk recently wrote an article on this topic, which is posted on CAP.org under the Precision Medicine Resource Center: https://capatholo.gy/345u6dd.
For this episode we have a conversation with Dr. Richard Eisner to discuss the CAP’s Virtual fly-in to Capitol Hill that he participated in to urge members of Congress to mitigate future cuts to Medicare. As well as Cigna PC of CP updates, news from capitol hill, and more.
Yasmeen Butt, MD, FCAP, talks to her Mayo Clinic pathologist colleague Theresa Kinard, MD, FCAP, about why she decided to focus her pathology career in transfusion medicine, as well as the challenges and opportunities that she encounters in this area of laboratory medicine.
Emily Green, MD, FCAP leads a discussion about pathologist-patient consultations with Favia Dubyk, MD, FCAP and Lija Joseph, MD, FCAP. Both are pathologists with unique practices where they interact directly with patients around their pathology results.
The CAP continues to introduce innovative inspection models to ensure safety for our inspectors and laboratories while working around evolving travel restrictions related to COVID-19. In this CAPcast episode, Frank Sharkey, MD, FCAP, joins us again to discuss how to plan and conduct advanced document review for both in-person and virtual inspections, as well as some other modifications to the inspection processes. Dr. Sharkey has completed both in person and virtual inspections with advanced document review for domestic and international laboratories.
For more information, please visit the Inspector Tools & Training section of CAP.org: https://capatholo.gy/3G5x178.
Welcome to our latest episode of our CAPcast 75th Anniversary series where we ask past presidents to provide a glimpse behind the curtain of leadership and share their insights on leading the profession and a major organization like the CAP.
This episode’s discussion features Richard Friedberg, MD, PhD, FCAP, and Bruce Williams, MD, FCAP. Serving back-to-back terms, Dr. Friedberg was president from 2015 to 2017 and Dr. Williams was president from 2017 to 2019.
CAP members can download a PDF of a book commemorating the CAP's 75th anniversary on the CAP's estore (capatholo.gy/3DEf6m9), as well as on CAP.org, where a historical timeline is featured highlighting seminal events in the CAP's history (capatholo.gy/2YEBtsj).
Pathologists and laboratory staff in various practice settings have experienced severe challenges and stresses secondary to the COVID-19 pandemic. This CAPcast features an audio recording of a virtual roundtable discussion about pathologist wellness and resilience in the face of burnout, which was hosted by the CAP’s Practice Management Committee earlier in 2021. Moderated by Dr. Karim Sirgi, panelists include Dr. Gina Ann Drobena, who is a pathologist at the University of Arkansas for Medical Sciences and Dr. Judy Melinek, CEO of Pathology Expert.
In this CAPcast Roundtable, leading pathologists provide a primer on digital pathology and discuss what pathology residents need to know about the burgeoning field of digital pathology. CAP Digital Content Committee members Drs. Nicole Riddle and Ziad El-Zaatari facilitate this discussion with Drs. Eric Glassy and Kamran Mirza, both of whom have an interest and expertise in digital pathology.
For more on digital pathology, please visit the CAP's Digital Pathology Topic Center: https://capatholo.gy/3Fls0ac. And if you are a pathology resident, the CAP has numerous resources to support you during your training: https://www.cap.org/member-resources/residents.
This latest episode of the special CAPcast series celebrating the CAP's 75th Anniversary features a discussion with past-Presidents Stephen Bauer, MD, FCAP, and Stanley Robboy, MD, FCAP. Serving back-to-back terms, Dr. Bauer was president from 2009 to 2011 and Dr. Robboy was president from 2011 to 2013. This period in the CAP's history focused on how the organization needed to transform to meet the evolving needs of members.
CAP members can download a PDF of a book commemorating the CAP's 75th anniversary on the CAP's estore (https://capatholo.gy/3DEf6m9), as well as on CAP.org, where a historical timeline is featured highlighting seminal events in the CAP's history (https://capatholo.gy/2YEBtsj).
In this CAPcast we’ll have a conversation with Kathryn Knight, MD, FCAP about the CAP’s annual meeting and the advocacy town hall she moderated.
Other stories include FDA network of experts admission, updates on CAP advocacy in regards to the reconcilliation bill in Congress and more.
This latest episode in the CAPcast series commemorating the CAP's 75th Anniversary features Paul Bachner, MD, FCAP, who served as president from 1999-2001 and Bruce Williams, MD, FCAP, who served as president from 2017-2019. During Dr. Williams’ term, the Board approved an update of the CAP’s history for its 75th anniversary as the last book was published in 1996 for the CAP’s 50th anniversary. Dr. Williams asked Dr. Bachner to author the book and he graciously agreed.
CAP members can download a PDF of a book commemorating the CAP's 75th anniversary on the CAP's estore (https://capatholo.gy/3DEf6m9), as well as on CAP.org, where a historical timeline is featured highlighting seminal events in the CAP's history (https://capatholo.gy/2YEBtsj).
Few residents receive training in informatics, but almost every laboratory faces informatics challenges. These include installing new software or a new instrument, maintaining privacy, protecting laboratory data security, and more. This fall, the CAP is introducing a new Informatics Case-Based Education (ICBE) program (https://capatholo.gy/3m3lSuz), which is designed to help pathologists get ready to succeed in their careers by providing relevant, practical education on informatics topics they commonly encounter. In this CAPcast interview, Mandy O’Leary, MD, FCAP, a member of the CAP Informatics Committee, explains the value that this program brings to pathologists. Dr. O’Leary worked to develop this new program with Dr. John Sinard, its key architect.
Welcome to the latest episode in this CAPcast special series celebrating the CAP's 75th anniversary. This episode features Drs. Patrick Godbey and Emily Volk. Serving back-to-back terms, Dr. Godbey has been president from 2019 to 2021 and Dr. Volk assumes office this year in 2021. Drs. Godbey and Volk discuss what it’s been like to lead the profession during this historic time during the COVID-19 pandemic.
CAP members can download a PDF of a book commemorating the CAP's 75th anniversary on the CAP's estore (https://capatholo.gy/3DEf6m9), as well as on CAP.org, where a historical timeline is featured highlighting seminal events in the CAP's history (https://capatholo.gy/2YEBtsj).
The incidence of genetic mutations increases with age. Age-related mutations in hematopoietic stem cells in the absence of a hematologic malignancy is termed clonal hematopoiesis, or CH. While CH took the hematology field by storm several years ago, there is increased awareness of the identification of CH not just underlying hematologic neoplasms, but in the background of solid tumors as well, explains Dr. Annette Kim in this CAPcast. Dr. Kim, who is a member of the CAP’s Personalized Healthcare Committee, wrote an article on this topic that was recently posted to the Precision Medicine section of CAP.org (https://capatholo.gy/3A9L8ow).
In this inaugural CAP Advoacy Recap for the month of August we will review the CAP's opposition to a recent VA initiative, take a look at the 3.5 trillion dollar infratructure bill in congress, and we'll sit down with Dr. Jonathan Myles, chair of the Council on Government and Professional Affairs, to discuss what pathologists need to know about the proposed 2022 Medicare Physician Fee Schedule.
This first episode of the CAPCast series celebrating our 75th anniversary features Drs. Paul Bachner and Paul Raslavicus. Serving back-to-back terms, Dr. Bachner was president from 1999 to 2001 and Dr. Raslavicus was president from 2001 to 2003.
Throughout this discussion, Drs. Bachner and Raslavicus discuss seminal aspects of their presidency, including navigating their leadership transition during 9/11 and the focus on bioterrorism following the terrorist attacks. Dr. Bachner will also discuss how the CAP’s educational focus shifted under his leadership and Dr. Raslavicus will discuss why he’s so passionate about advocacy, and both will offer advice to not only incoming and future CAP leaders, but also pathologists who are early in their careers.
CAP members can download a PDF of a book commemorating the CAP's 75th anniversary on the CAP's estore (https://capatholo.gy/3DEf6m9), as well as on CAP.org, where a historical timeline is featured highlighting seminal events in the CAP's history (https://capatholo.gy/2YEBtsj).
Forty-two percent of physicians reported feeling burned out last year, according to Medscape's 2021 Physician Burnout Report published earlier this year. And not surprisingly, COVID 19 appears to have increased levels of physician burnout. While 69% of physicians said they were somewhat or very happy in 2020 before the pandemic started, this figure fell to 49 percent during the pandemic, according to that same Medscape survey.
Like most physicians, many pathologists find it challenging to balance professional and personal responsibilities. While this balance can be particularly difficult for pathologists early in their careers, there are some methods to improve efficiencies both at home and at work, as Yasmeen Butt, MD, FCAP, and Jaclyn Rudzinski, MD, FCAP discuss in this CAPcast episode.
Value-based payment models continue to evolve to include considerations for quality of care, cost, and population health through a set of evidence-based metrics. As this shift continues, pathologists are challenged to find quantitative ways to demonstrate their value in newer payment structures. In this CAPcast, we’ll be joined again by Diana Cardona MD, FCAP who will be teaching a course at CAP 21 on how Pathologists can demonstrate their impact on overall quality and cost through various quality measures to maximize reimbursement in these programs.
It’s September, Ovarian Cancer Awareness Month. It’s also a good opportunity to highlight the important role that Cancer Protocols play in patient care. The CAP Cancer Protocols help ensure that all pathology reports contain necessary data elements to improve patient care. By requiring those specific data elements, synoptic reporting ensures more accurate reports that communicate findings in a clear, standardized format to clinician colleagues, researchers, and other users of the data, explain Barbara Crothers, MD, FCAP, and Uma Krishnamurti, MD, FCAP, in this CAPcast interview. In this episode, both pathologists will discuss how these Cancer Reporting Protocols benefit thousands of CAP member pathologists and other medical professionals by ensuring complete, uniform reporting of malignant tumors.
Gene-editing technologies have been at the forefront of innovation in precision medicine as investigators look for novel ways to treat otherwise refractory inherited diseases, infectious diseases, and cancer. As these technologies are adopted, pathologists will need to consider implications on laboratory medicine and clinical practice, as it is likely to fall to them to identify the mutations to be corrected, to monitor for proper insertion and expression post-infusion, to develop positive controls, and to detect any potentially harmful off-target edits, explain CAP21 instructors Wayne Grody, MD, FCAP, and Alison Cushman-Vokoun, MD, FCAP, in this CAPcast interview.
For more information on CAP21, which will be held as a hybrid event Sept. 25-28, please visit www.capannualmeeting.org. Be sure to follow #cap21 on social media for event updates.
Advances in therapies for lung adenocarcinoma have arisen from advances in biomarker testing. The biomarker testing landscape is evolving quickly, as is its impact on patient care, and pathologists need to keep up current on the field, explains Jeff Chang, MD, FCAP, in this CAPcast interview. Dr. Chang recently wrote an article on this topic for the Precision Medicine section of CAP.org (https://capatholo.gy/3jQmPVS). Dr. Chang is a member of the CAP’s Personalized Healthcare Committee, as well as the Associate Editor of the Archives of Pathology & Laboratory Medicine.
Like many live events in 2021, the CAP’s Multidisciplinary Breast Pathology (MBP) Advanced Learning Series will be a virtual event (capatholo.gy/3zgIFaW). Taking place over the week of Oct. 25-Oct.31, the curriculum, led by faculty and live expert panels, consists of five pre-recorded lectures in advance of the Virtual Workshop live sessions. The event, which qualifies for 18.5 CME credits, is designed for pathologists with intermediate or higher skill level in breast pathology, as one of the course instructors, Dr. Bradley Turner explains further in this CAPcast interview. Dr. Turner is an Associate Professor of Pathology and Laboratory Medicine at University of Rochester Medical Center in New York.
The three functions of grossing, staging, and reporting are fundamental to the practice of surgical pathology; yet no surgical pathology text has ever discussed these three functions in an integrated manner. A new book entitled Grossing, Staging, and Reporting–An Integrated Manual of Modern Surgical Pathology (https://capatholo.gy/3CDPciq) promotes a standardized approach for practicing pathologists, pathologists-in-training, and pathologist assistants who handle specimens, explains the author Jim Zhai, MD, FCAP, in this CAPcast episode.
Between 2014 and 2018, microbial contamination of blood products was the third leading cause of transfusion-related fatality. Platelets are more likely than other blood products to become contaminated because they are stored at room temperature. In 2019, the FDA updated requirements for bacterial mitigation strategies, which will result in significant changes to how platelets are manufactured, explains Alexis Peedin, MD, FCAP, in this CAPcast interview. Dr. Peedin led the development of a CAP Clinical Pathology Improvement Program course on this topic (https://capatholo.gy/3wHYMwC).
In a recent panel discussion, CAP Speaker of the House of Delegates Kathryn Knight, MD, FCAP; CAP President Patrick Godbey, MD, FCAP; and Council on Government and Professional Affairs Chair Jonathan Myles, MD, FCAP, talked about the implications of patients who postponed their care because of the pandemic, the potential issues laboratories could face as they return to seek treatment, and what roles pathologists will have in patient care as we move past the pandemic.
Common questions arise in the daily practice of surgical pathologists who sign out medical liver, explain Maryam K. Pezhouh, MD, FCAP, and Meredith E. Pittman, MD, FCAP, in the CAPcast. Drs. Pezhouh and Pittman will be teaching a course on this topic at CAP21, which will be held Sept. 25-28 (www.capannualmeeting.org). Using case-based presentations, the faculty will facilitate discussion on a range of common but difficult topics in medical liver biopsy.
Burnout adversely affects pathologists’ quality of life and their ability to practice high quality patient care. It can lead to medical errors and increased malpractice risk, professional turnover, and significant morbidity as well as mortality, as Marisa Saint Martin, MD, FCAP, explains in this CAPcast.
Dr. Saint Martin will be one of the leaders of a CAP21 course on this topic; the course is entitled, “When the Fire is Gone: Strategies to Reignite Your Resiliency.” For more information on CAP21, which will be held Sept. 25-28, please visit capannualmeeting.org. And be sure to follow #cap21 on social media for event updates and news.
Transitioning from training to new in practice is a very tough phase for many pathologists. Identifying critical skills needed for success and developing them during training can help to ease the move into practice, explains Juanita Evans, MD, FCAP and Lauren King, MD, FCAP in this CAPcast. Drs. Evans and King will be leading a course on this topic at CAP21, which will be held Sept. 25-28 both virtually and in-person in Chicago. Be sure to follow #cap21 on social media for event updates; learn more and register meeting: https://www.capannualmeeting.org/.
Introducing low titer O whole blood or LTOWB into blood bank inventory can introduce challenges, including the logistics of maintaining and optimizing inventory and fulfilling regulatory requirements. That said, LTOWB can serve to improve massive transfusion workflow and potentially improve patient outcomes in patients undergoing massive transfusion, explain Julie Katz Karp, MD, FCAP, and Julie Cruz, MD, FCAP, in this CAPcast. Drs. Karp and Cruz are teaching a course on LTOWB at CAP21, which will be held Sept. 25-28: www.capannualmeeting.org.
Diagnosing soft tissue tumors can be a significant challenge, even to the experienced surgical pathologist. In recent years, the diagnostic options available to diagnose soft tissue tumors have expanded dramatically, following the discovery of molecular alterations that underlie the pathogenesis of soft tissue tumors, explains Jason Hornick, MD, FCAP, in this CAPcast.
Dr. Hornick will be teaching a CAP21 course on this topic entitled, “Limited Biopsies of Soft Tissue Tumors: A Pattern-Based Approach to Diagnosis.” For more information on CAP21, which will be held Sept. 25-28 both in-person in Chicago and virtually, please visit capannualmeeting.org and follow #cap21 for updates via social media.
The numbers speak for themselves. Women represent more than 80% of the workforce but less than 20% of leadership in healthcare. Sadly, the number of women in leadership has not changed significantly in the last two decades, explains Dr. Jennifer Hunt, who will be teaching a CAP21 course entitled, “Reversing the Gender Leadership Gap: Taking Action to Create Meaningful Change.”
Dr. Hunt currently serves as Chair of Pathology, Immunology and Laboratory Medicine at the University of Florida and has held numerous other professional leadership roles. She has recently released her first book, “Unlocking Your Authentic Self” which has helped thousands of female professionals achieve self-confidence and conquer the impostor syndrome.
CAP21 will be taking place Sept. 25-28; for more information, please visit www.capannualmeeting.org.
The Inaugural Pathologists Leadership Summit took place during the unprecedented circumstances of a global pandemic and for the first this year’s CAP Hill Day was completely virtual. This setting provided some unique challenges, as well as some unexpected benefits. We spoke with Amanda C. Herrmann, MD, FCAP, who recently received the CAP Foundation Development Leadership Award and participated in the CAP’s hill day for the first time. She shared what she took away from the experience and how it can be used in future advocacy as the world slowly gets back together again.
It is never too early or too late to plan the direction of your career and consider your professional legacy. This includes finding meaning and value in your work and relating them to physician engagement and burnout, explains Sarah Bean, MD, FCAP, who is teaching a course on this topic at CAP21, “Setting Career Direction: Using Personal Leadership to Ignite the Flame and Keep It Going.” CAP21 will be held Sept. 25-28, for more information, please visit capannualmeeting.org and follow #cap21 on social media.
The incidence of cyberattacks on health care systems is increasing both in the United States and internationally. It has been said that it isn’t a matter of if an institution will be affected by a cyber attack, it is really a matter of when. It is important that pathologists understand the impact of a cyberattack and recognize how to implement operational and risk-mitigation processes in response to an extensive, long-lasting IT system outage, explains Andrew Goodwin, MD, FCAP, who will be teaching a course on this topic at CAP21, which will be held Sept. 25-28 (https://www.capannualmeeting.org/). Dr. Goodwin is a pathologist and Division Chief of coagulation at the University of Vermont Medical Center in Burlington.
In this CAPcast, Digital Content Committee Chair Michael Misialek, MD, FCAP, leads a discussion about ongoing professional practice evaluation (OPPE) and focused professional practice evaluation (FPPE). The discussion features three fellow CAP members: Brian Le, MD, FCAP, a pathologist with Novant Health in Charlotte, North Carolina; Moira Larsen, MD, FCAP, an Executive Director of MedStar Medical Group Pathology in the Baltimore/Washington DC region, and Erin Rubin, MD, FCAP, a pathologist and professor of pathology at the University of Colorado Anschutz Medical Campus.
More information is available in this resource, "Making Sense of OPPE and FPPE": https://capatholo.gy/3fI6MIE. For more information about practice issues impacting pathologists, please visit the Practice Management section of CAP.org: https://www.cap.org/member-resources/practice-management.
While there is a diversity of laboratory information systems available, there is no one system used by bio-banks. Furthermore, there is an increased utilization of digital whole-slide scanning technology in converting slides made from biobanking into digital whole slide images.
In this CAPcast, Duke Medical Center pathology resident Dr. Richard Davis interviews leading pathology informatics expert Dr. Raj Dash about biobanking and its integration with various LIS technologies. Dr. Dash is also at Duke Medical Center.
For more information about biobanking, please visit the Biorepository Accreditation Program section on CAP.org: https://capatholo.gy/3rzSPkg.
As science learns more about the SARS-CoV-2 antibody and related patient testing, the CAP continues to evolve their programs to support laboratory testing, as Drs. Susan Fink and Danyel Tacker explain in this CAPcast.
Susan Fink, MD, PhD, FCAP, is an Assistant Professor of Laboratory Medicine and Pathology at the University of Washington in Seattle. She is also the Assistant Director of the University of Washington Medical Center Clinical Immunology Laboratory.
Danyel H. Tacker, PhD,(ABCC), is an Associate Clinical Professor of Pathology at West Virginia University. Danyel serves as section director of the Chemistry and Clinical Mass Spectrometry Laboratories, and the CLIA Laboratory Director of Blood-Gas Laboratories, at the WVU Hospital; she is also CLIA Laboratory Director of the Fairmont Medical Center Hospital Laboratory.
Visit the COVID-19 page on the CAP’s web site for the latest news and resources, including those for proficiency testing customers and CAP-accredited laboratories (https://capatholo.gy/38HjAZh). The COVID-19 page offers useful links to helpful tools and resources to clarify rules of compliance as you implement COVID-19 testing in your laboratory. You can order the SARS-CoV-2 Serology PT program today. The program code is COVS.
In this CAPcast, we’ll speak with Diane Cardona, MD, FCAP, Chair of the Quality and Clinical Data Registry Affairs Committee, about why eligible pathologists should consider MIPS participation as a strategy to help protect revenues as well as a strategy to demonstrate their value instead of seeking a COVID exemption.
In this CAPcast we are joined by Joe Saad, MD, FCAP, vice chair of the Council on Government and Professional Affairs, and Walter Klein, MD, FCAP, who has participated in virtual lobbying meetings with his members of Congress and has attended previous CAP Hill Days. They will get into greater detail and give pathologists tips on how to conduct a virtual meeting with a senator or representative in Congress.
Absolute Eosinophilia: A Practical Approach is the latest activity from the CAP’s Clinical Pathology Improvement Program, also known as CPIP (https://capatholo.gy/3aIYr4K). This activity describes a pragmatic approach for the workup of eosinophilia, including the appropriate application of molecular genetic studies, explains on of the CPIP case authors, Vandita Johari, MD, FCAP, in this CAPcast interview.
Implementing the CAP Cancer Protocols can help to ensure the completeness of pathology reports and higher-quality pathology evaluation. Further, using the Cancer Protocols (https://www.cap.org/protocols-and-guidelines)can help to ensure pathologists are practicing consistent with current best-practices. In this CAPcast episode, Yale Pathology’s Dhanpat Jain, MD, FCAP, discusses how cancer protocols benefits his practice, particularly the protocol that guides the diagnosis of esophagus related cancers.
Trichomoniasis is the most common, non-viral, sexually transmitted infection. Pathologists providing laboratory testing for this infection should understand the advantages and disadvantages of the commercially available, FDA approved/cleared methods, explains Mayo Clinic pathologist Bobbi Pritt, MD, FCAP, in this CAPcast. Dr. Pritt led the development of the Clinical Pathology Improvement Program offerings on this topic (https://capatholo.gy/3x9XUCy).
Following the release of the White House’s National Strategy for the COVID-19 Response and Pandemic Preparedness, the CAP responded to the Biden Administration by outlining pathologists’ priorities as government officials work to implement the strategy. The CAP’s Advocacy efforts have included several touchpoints with the Administration and Congress. In this CAPcast, Jonathan Myles, MD, FCAP, will discuss the CAP’s actions this year to influence the government’s response to the pandemic.
More than one year into the pandemic, leading pathologists discuss the challenges of managing the impact of COVID-19 on multiple public health fronts, including health disparities in which “preventable differences in the burden of disease ... are experienced by socially disadvantaged populations,” according to the CDC, and what that means in terms of testing and disease diagnosis and treatment.
This CAPcast interview features the audio recording of a recent CAP Zoom media briefing, "The Rapidly Changing COVID-19 Testing Landscape: Vaccines, Variants, and Health Disparities." The moderator is Kisha A. Mitchell Richards, MD, FCAP, Director of Pathology and Laboratory, Greenwich Hospital; expert panelists are CAP President Patrick Godbey, MD, FCAP; Kalisha Hill, MD, MBA, FCAP, FASCP, Governor, CAP; Regional Chief Medical Officer, Amita Health St. Joseph Medical Center and St. Mary's Hospital Kankakee; Medical Director, Pathology and Laboratory Services, Amita Health St. Mary's Hospital Kankakee; and Carey Z. August, MD, FCAP, President, Board of Directors, CAP Foundation; Chairman of Pathology and Medical Director of Laboratories, Advocate Illinois Masonic Medical Center.
How can CAP members effectively advocate for their specialty when they cannot currently speak to their members of Congress in person? Or perhaps they are hesitant to speak to Congressional members due to a perceived lack of knowledge on advocacy issues. Fortunately, plenty of CAP members have participated in virtual meetings with members of Congress, and their legislative staff, and can provide some insight. In this CAPcast, Rasleen Saluja, MD, a pathologist in Chicago, Illinois, discusses her experience advocating virtually with her Congressional representatives. Dr. Saluja is currently the Blood Banking and Transfusion Medicine Fellow at Northwestern University and after graduation, she will join the pathologists at Carle Foundation Hospital in Champaign, Illinois.
For more information on the CAP’s Advocacy efforts, please visit the Advocacy section of CAP.org and be sure to follow CAP Advocacy on Twitter at @CAPDCAdvocacy. And for more information about the Pathologists Leadership Summit, which will be held virtually May 1-4, 2021, please visit https://www.pathologistsleadershipsummit.org/.
The legislative attention span has never been more difficult to catch and carry—particularly in the current virtual environment. The most effective approach to reach lawmakers to advocate effectively for the pathology specialty is two pronged—the first is to create a one-minute elevator pitch and secondly, polish your virtual speaking skills, according to leading communications experts and media trainers Teri Goudie and Caylen Bufalino, who will be leading two courses on these topics on May 2 at the Pathologists Leadership Summit (https://www.pathologistsleadershipsummit.org/), which will be held virtually and is free for CAP members.
Cancer immunotherapy has revolutionized oncology through dramatically increased survival rates, even in late-stage disease. Some biomarkers are already covered in what has become routine testing in many laboratories, affording pathologists an opportunity to play a central role in developing and implementing these biomarkers in ways to improve patient care, explains Eric Walk, MD, FCAP, Chief Medical & Scientific Officer and Senior VP of Medical & Scientific Affairs with Roche Diagnostics, in this CAPcast.
Dr. Walk recently wrote an article on this topic, which is posted on CAP.org under the Precision Medicine Resource Center: https://capatholo.gy/345u6dd.
Throughout the COVID pandemic, the CAP has worked to introduce innovative hybrid and virtual inspection models to ensure safety for our inspectors and laboratories while working around evolving travel restrictions. During this podcast, Francis Sharkey, MD, FCAP, one of the pioneers of this new model, will discuss how he refined his inspection process and how the tools that he developed overlap with what the CAP provides. Dr. Sharkey, who is with UT Health in San Antonio, Texas, has completed both hybrid and virtual inspections for domestic and international laboratories.
To stay up-to-date with the latest information on the CAP’s inspection models during the pandemic, go to cap.org and search “Inspector Tools and Training”.
The CAP’s Accuracy-Based programs use genuine human specimens that exhibit essentially no matrix effects. Such samples can be used to compare different methods to each other and to reference methods. In so doing, pathologists and laboratory professionals can assess whether the method used in their laboratories is accurate, not just that your performance matches your peer group. In this CAPcast, Gary Horowitz, MD, FCAP, Chair of the CAP’s Accuracy-Based Programs Committee, explains why it’s important to incorporate accuracy-based testing into your quality process.
For more information about the CAP’s Accuracy-Based programs, please visit https://capatholo.gy/3qtcJMF.
State pathology societies strengthen the profession and bolster pathology’s influence on advocacy issues at the state and federal levels. When working with elected officials, we know that the number of members in an organization and the viability of the organization affects its ability to guide policy and impact decisions, explains Matthew Foster, MD, FCAP, vice-chair of the CAP’s Federal and State Affairs Committee and immediate past president of the Virginia Society for Pathology, in this CAPcast interview. Dr. Foster will be leading a session on state advocacy at the Pathologists Leadership Summit, which will be held virtually May 1-4, 2021.
There's a lot of hype surrounding artificial intelligence (or AI) and pathology. Indeed, many pathologists are afraid that AI or machine learning will replace them. But there’s no evidence to suggest that pathologists will be replaced by the robots just yet, explains Matthew Hanna, MD, FCAP in this CAPcast interview. Dr. Hanna will be leading a session on this topic at the Pathologists Leadership Summit, which will be held virtually May 1-4, 2021.
The current state of health care is mandating consolidation and integration of practices and laboratories. The scope and rapid pace of these changes, particularly amidst the COVID pandemic, is unsettling and disruptive to staff and can lead to unusually large numbers of resignations. It’s unlikely this will slow down in the near future, and therefore, it’s important for pathologists who will lead and be part of these changes to be cognizant of the impact of change and how they might mitigate and facilitate the process, explains Moira Larsen, MD, FCAP, in this CAPcast. Dr. Larsen will be leading a session on navigating change at the Pathologists Leadership Summit, which will be held virtually May 1-4, 2021.
Surveys have shown hesitancy among African Americans to take the COVID vaccine, much to the concern of physician and public health experts, who emphasize the perils posed by immunizations gaps in certain populations to overall public health. But it’s important to understand this hesitancy, explains Valerie Fitzhugh, MD, FCAP, who is Associate Professor and Chair of Pathology at both the Rutgers New Jersey Medical School and the Rutgers Robert Wood Johnson Medical School.
Submitting quantitative PT results manually can be time consuming, can drain laboratory resources, and is subject to human error. CAP customers can now simplify this process by using direct transmission. In this CAPcast interview, Tim Aukerman, Corporate Quality Assessment Manager at Quest Diagnostics, discusses his experience with directly transmitting PT results to the CAP via the Data Innovations Instrument Manager. Tim has oversight of quality initiatives—including PT—across Quest Diagnostics and led the switch to using direct transmission across more than 100 Quest regional and rapid response labs.
In this CAPcast interview, Tim Aukerman, Corporate Quality Assessment Manager at Quest Diagnostics, discusses his experience with direct transmission of PT results. Tim has oversight of quality initiatives including PT across Quest and has overseen the implementation and use of direct transmission across multiple Quest Labs.
There are several methods for workup of urinary tract infections or UTIs and utilizing the appropriate test(s) on the appropriate patients can allow for prompt and appropriate treatment and symptom relief, as well as reduce unnecessary testing and unnecessary treatment with antimicrobials, explains Dr. Stacy Beal, in this CAPcast. Dr. Beal, a pathologist at UF Health in Gainesville, Florida and member of the CAP's Quality Practices Committee, has helped to develop a new CAP testing module focused on UTIs, which can now be found on CAP.org: https://capatholo.gy/38dpl3L.
Pathologists have long been at the forefront of biobanking practices, assuring that biospecimens from patients are properly collected and processed for diagnostic procedures. During the ongoing COVID-19 pandemic, pathologists and laboratory technicians have had to develop and implement new biosafety procedures to protect themselves and patients and they are also often involved in research into new therapies, explains Dr. Jim Vaught, editor-in-chief of the journal Biopreservation and Biobanking. In this CAPcast, Dr. Vaught discusses the special challenges involved in developing protocols to work with biospecimens collected from patients during an infectious disease emergency, as well as the role that biobanks play in the development of COVID vaccines and therapies.
More resources related to biobanking and biorepositories can be found on CAP.org under the Biorepository Accreditation Program: https://capatholo.gy/3rzSPkg.
About 85% of board-certified pathologists are reporting that the COVID-19 pandemic has negatively impacted their practices, according to a recent CAP survey: https://capatholo.gy/2HmFTLZ.
In this CAPcast interview, Dr. Thomas Wheeler discusses the survey’s findings, which confirm the pandemic’s ongoing adverse effects on pathologists as the United States has relied on COVID-19 testing throughout this national crisis. Dr. Wheeler is chair of the CAP’s Policy Roundtable Steering Committee.
As more antigen testing methods become available in the market, the laboratory remains at the center of testing and ensuring accurate results for optimal patient care. Introducing a new antigen proficiency testing program for SARS-CoV-2 virus to complement existing programs for molecular and serology PT, the CAP now offers laboratories a complete suite of PT and quality improvement programs for all COVID-19-related testing.
In this CAPcast, Dr. Daniel Rhoads, Section Head of Microbiology at the Cleveland Clinic and member of the CAP’s Microbiology Committee, speaks with us about antigen testing for SARS-CoV-2 and the new proficiency testing program that the CAP offers its customers.
You can order the new antigen proficiency testing program today at CAP.org: https://capatholo.gy/2FBbSal. The program code is COVAG. For more information about specifications of and enrollment in the CAP’s COVID-19-related proficiency testing programs for antigen, molecular, or serology testing, please visit the COVID-19 page on the CAP’s web site for the latest information and resources, including those for proficiency testing. The CAP’s COVID-19 web page offers links to helpful tools and resources to help you clarify rules and compliance as you implement testing in your laboratory.
Classification of endometrial tumors based strictly on morphology can be challenging due to overlapping histologic features and often requires the assistance of ancillary testing. Recently proposed algorithms, such as the ProMisE Proactive Molecular Risk Classifier for Endometrial Cancer, coupled with TCGA data, aim to further subclassify endometrial carcinomas into prognostically significant groups based on molecular genetics, explains Dr. Laura Tafe in this CAPcast interview. Dr. Tafe will be joining Dr. Jessica Dillon to teach a course on this topic at CAP20 this year, which will be held virtually on Oct. 10-14.
CAP20 will be held virtually this year from Oct. 10-14 (www.capannualmeeting.org/). Follow #cap20virtual on social for the latest on the event.
In the current pandemic, the microbiology laboratory plays a central role in testing. To meet the demand for SARS-CoV-2 molecular testing, many laboratories have expanded testing capacity by adding multiple molecular instruments. However, this has left laboratories with questions regarding proficiency testing (PT) requirements for these additional instruments, as two CAP members, Dr. Bobbi Pritt and Dr. Lauren Pearson, explain in this CAPcast interview. Dr. Pritt is the Chair of the Clinical Microbiology Laboratory and a Professor of Laboratory Medicine and Pathology at Mayo Clinic in Rochester, Minnesota. She currently serves as chair of the CAP Microbiology Committee. Dr. Pearson is Assistant Professor of Pathology at the University of Utah and Laboratory Director of University of Utah Health Sciences Center Clinical Laboratories. She serves as chair of the CAP Instrumentation Committee.
If your laboratory could benefit from the Quality Cross Check program discussed in this interview, more information is available on the CAP web site. Go to cap.org and click on the “SHOP” link in the upper right corner to visit our online store. The program code is COV2Q. Interested participants can enroll for 2020 participation; the shipping date will be October 26. For 2021 enrollment, interested laboratories can add this program to their 2021 PT order renewal. For description: https://capatholo.gy/2FBbSal.
Many pathologists in training have gathered debt and are managing life on salaries that are going to adjust significantly as they exit training and move into practice. However, pathologists, like all doctors, need to be prepared to handle their finances as they train and exit into their jobs whether it’s to pay off debt or plan for retirement or both, explains Dr. James Dahle in this CAPcast interview. Dr. Dahle, an emergency room physician, is the author of the book, “The White Coat Investor: A Doctor's Guide To Personal Finance And Investing,” as well as The White Coat Investor podcast and blog. He will be speaking at this year’s Fall Residents Forum Meeting on Oct. 10, which will be held virtually this year.
With the dramatic rise in demand for COVID-19 testing, laboratories have implemented a variety of testing methods, among them polymerase chain reaction (PCR) tests. Regularly published research findings seem to question the validity or efficacy of many of the testing methods – and PCR is no different, as Dr. Sophia Yohe explains in this CAPcast interview. Dr. Yohe, director of the University of Minnesota Medical School’s Molecular Diagnostics Laboratory, addressed many questions about diagnostic PCR testing for SARS-CoV-2, the virus that causes COVID-19, in an article recently posted on the Precision Medicine Resource Center on CAP.org (https://capatholo.gy/32U3XwO).
When pathologists train they are often monitored every step of the way, and don’t have the opportunity to sign out cases on their own. It’s nerve-wracking to sign out your first cases, explains Dr. Buu Duong in this CAPcast interview. Some common questions that go through the minds of new in practice pathologists can include when to ask for help, when to get review, how many questions are too many questions, and do you look like you don’t have a clue about what you’re doing? In this interview, Dr. Duong will discuss what pathologists need to know during this important transition, and important tips to gain confidence when you first start out in practice.
More resources on navigating challenges during the early stages of your pathology career are available in the New-in-Practice section on CAP.org: https://capatholo.gy/3btuncz.
By mid-2020 in New York, the state had more than 425,000 confirmed cases of corona virus and 23,500 residents dead from the virus. Most of these cases occurred early on as the disease spread rampantly throughout New York City and other parts of the state. Amidst all this trauma, the autopsies from these early COVID patients revealed significant findings, explained Mt Sinai pathologist Mary Fowkes, MD, FCAP, in this CAPcast before her sudden death in November 2020.
In this interview, Dr. Fowkes discussed what’s been gleaned from these autopsies, as well as how she and her colleagues responded during those early months of the pandemic. Dr. Fowkes, who was a member of CAP's Board of Governors and also the president of the New York State Society of Pathologists at the time of her death, added her perspective on the role of her state pathology society during the pandemic.
For more on the pandemic and pathologists, visit the COVID-19 information pages on CAP.org. And to learn more about state pathology societies, go to https://capatholo.gy/2YVI4fs.
Soft tissue pathology is ubiquitous to any subspecialty. Recognizing some of the most common soft tissue lesions, as well as what immunohistochemical studies to order to decipher which lineage from which it arises can be challenging, explains Dr. Nicole Riddle, who will be teaching a course on this topic with Dr. Jerad Gardner at CAP20, entitled Soft Tissue Pathology Is Fun…Really! A Crash Course for General Pathologists, on Weds., Oct. 14 at 9am-11am CT. CAP20 will be held virtually this year from Oct. 10-14 (https://www.capannualmeeting.org/). Follow #cap20virtual on social for the latest on the event.
Clinical decision support systems are IT-based tools that compile patient- and context-specific data, presenting this to providers at the point-of-care and clinical decision making. These systems are an excellent means for pathologists to influence laboratory test-ordering practices and to foster appropriate test use. However, the optimal methods to design, implement and maintain CDSS are not well-known, representing an important gap in knowledge, explains Dr. Amanda Blouin in this CAPcast interview.
Dr. Blouin, a pathologist at Memorial Sloan Kettering in New York City, will be teaching a course on this topic with Dr. Ronald Jackups at CAP20, which will be held virtually this year from Oct. 10-14. For more information about CAP20, visit www.capannualmeeting.org and follow #cap20virtual on social media.
This year’s CAP20 virtual event will feature a book club discussion on Bad Blood: Secrets and Lies in a Silicon Valley Startup, John Carreyrou’s award-winning account of the rise and fall of the lab testing company Theranos and its controversial founder, Elizabeth Holmes. Dr. Paul Valenstein will facilitate the discussion.
In this CAPcast interview, Dr. Valenstein discusses the book in terms of the impact of innovation in the laboratory market space and lessons to be drawn from Ms. Holmes and the trajectory of Theranos. For more information on this year's CAP20 virtual event, visit www.capannualmeeting.org and follow #cap20virtual on social media.
Laboratories must report cumulative antimicrobial sensitivity information to the medical staff at least annually under accreditation requirements from both the CAP and the Joint Commission. Despite requirements to do this at the institutional level, there is no national reporting or convenient way for the institution to monitor trends or compare rates recorded by other laboratories, explains Dr. Ron Schifman in this CAPcast interview.
The CAP is introducing a new Quality Management Tools program to help participating laboratories enhance the value of their cumulative antimicrobial susceptibility report. Dr. Schifman is currently emeritus Professor of Pathology at the University of Arizona and a member of the CAP Quality Practices Committee. He is one of the architects of this new quality management program involving antimicrobial susceptibility.
Careful morphologic review of blood smears is a crucial first step in the diagnostic workup of an abnormal WBC differential, explains Dr. Olga Pozdnyakova in this CAPcast interview. Dr. Pozdnyakova, along with Dr. Kyle Bradley, will be teaching a course on this topic at CAP20, which will be held virtually Oct. 10-14. For more information and to register: https://www.capannualmeeting.org.
Patients with cirrhosis are frequently transfused with platelets and plasma, yet the optimal role of these blood products may be poorly understood by ordering providers. It is important for pathologists to evaluate the available evidence supporting or refuting the use of these blood products in this population and be able to have conversations with gastroenterology colleagues about optimizing the transfusion plans for their mutual patients, explains Dr. Alexis Peedin in this CAPcast interview. Dr. Peedin led the development of a Clinical Pathology Improvement Program—also known as CPIP—on this topic (https://capatholo.gy/3hIpY7g).
Recent U.S. physician workforce counts have understated by about 40% the number of actively practicing pathologists, CAP members outline in an article published recently in the Journal of the American Medical Association Network Open (“Re-evaluation of the US Pathologist Workforce Strength": https://capatholo.gy/3eBugLM).
In this CAPcast interview, two CAP member leaders—past president Stanley Robboy and Governor Dr. Donald Karcher—provide background on the misevaluation, its impact, and future policy implications of their new research.
In a laboratory setting with fast-paced changes and heavy demands on staff, day-to-day communication across departments is challenging, yet paramount to resource sharing and real-time problem solving. To improve communication across departments, the laboratory at Seattle Children’s Hospital has been using daily huddles for several years, explains Dr. Joe Rutledge in this CAPcast. Daily huddles have been valuable during the COVID-19 pandemic, according to Dr. Rutledge, ensuring efficient communication among the laboratory staff and across the Seattle Children’s enterprise. Until his recent retirement, Dr. Rutledge was a pediatric pathologist at Seattle Children’s Hospital.
Pathologists need to be aware of upcoming Medicare cuts due to changes to evaluation and management payment and coding, which were finalized in November 2019, explains Dr. Jonathan Myles in this CAPcast.
In this interview, Dr. Myles will provide an overview of the current state of the efforts to prevent Medicare cuts to pathologists due to changes to evaluation and management (E/M) payment and coding, which take effect in January 2021. Dr. Myles is a member of the CAP Board of Governors and serves as the chair of the Council on Government and Professional Affairs.
For more information on this issue, please visit Advocacy's Payments for Pathology Services section of CAP.org: https://capatholo.gy/2Yc16xP.
In early 2020, the CAP introduced its first Autopsy Protocol for Adult Decedents, explains Dr. Jody Hooper, Director of Autopsy Service at Johns Hopkins Hospital and Associate Professor of Pathology, in this CAPcast. Dr. Hooper was the chair of the CAP’s Autopsy Committee until recently and was instrumental in creating this protocol.
The protocol is available on CAP.org: https://capatholo.gy/2zvUS2A.
As we move into the next phase of the pandemic, laboratories are ramping up efforts to implement SARS-CoV-2 antibody testing to identify individuals who may have been infected with SARS-CoV-2 in the past.
In this CAPcast, Dr. Daniel Rhoads, Section Head of Microbiology at the Cleveland Clinic and Dr. Elitza Theel, Director of Infectious Disease Serology from Mayo Clinic explain the clinical use of antibody testing for SARS-CoV-2 and describe the work of the CAP’s Microbiology and Diagnostic Immunology and Flow Cytometry Committees to develop the new proficiency testing program SARS-CoV-2 Serology (COVS).
The new SARS-CoV-2 Serology PT program is available today (https://capatholo.gy/3d9u4DR). The program code is COVS, and the first shipment is scheduled for June 22, 2020. Visit the COVID-19 page (https://www.cap.org/covid-19) on the CAP’s web site for the latest news and resources, including those for proficiency testing customers and CAP-accredited laboratories. The COVID-19 page offers useful links to helpful tools and resources to clarify rules of compliance as you implement COVID-19 testing in your laboratory.
One investigational treatment being explored for COVID-19 is the use of convalescent plasma or CCP collected from individuals who have recovered from COVID-19. CCP that contains antibodies to severe acute respiratory syndrome coronavirus 2 or SARS-CoV-2 (the virus that causes COVID-19) is being studied for administration to patients with COVID-19. Use of convalescent plasma has been studied in outbreaks of other respiratory infections, including the 2003 SARS-CoV-1 epidemic, the 2009-2010 H1N1 influenza virus pandemic, and the 2012 MERS-CoV epidemic.
Although promising, CCP has not yet been shown to be safe and effective as a treatment for COVID-19, explains Dr. Glen Ramsey, Medical Director of the Blood Bank at Northwestern Memorial Hospital in Chicago and Chair of the CAP Transfusion, Apheresis, and Cellular Therapy Committee. In this CAPcast, Dr. Ramsey provides a basic primer on CCP, as well as explains why it’s important to study the safety and efficacy of COVID-19 convalescent plasma in clinical trials and the blood bank’s role in providing CCP.
Visit CAP.org's COVID-19 site for more updates related to pathologists and laboratory medicine: www.cap.org/covid-19.
Most biorepositories have not traditionally paid attention to the financial aspects of their operations, which has led to problems in the long-term sustainability of some academic, government and commercial biobanking operations, explains Dr. Jim Vaught, editor-in-chief of the journal Biopreservation and Biobanking, in this CAPcast. Dr. Vaught has studied the challenges involved in the economics and sustainability over the past 10 years and has published several papers on these topics. In this CAPcast, Dr. Vaught will discuss why all biorepository directors need to understand the costs of setting up and operating their facilities and how to develop a business strategy.
For more resources related to biobanking and biorepositories, including the CAP’s Biorepository Accreditation Program, please visit CAP.org and search for biorepository.
Emergency assistance programs recently enacted by Congress have created more than $350 billion in financial aid for small businesses during the COVID-19 national emergency and economic downturn. Many of these programs for small businesses, which are defined as those with 500 or fewer employees, are applicable to pathologists and their laboratories. The CAP is urging its members to consider applying for these programs as revenues for services typically billed by pathologists have decreased in recent weeks.
In this CAPcast, Dr. Jonathan Myles, who chairs the CAP’s Council on Government and Professional Affairs, explains how this program can help pathologists keep their practices solvent until the pandemic and national emergency are over.
For more information on government assistance programs applicable to pathology practices, go to the COVID-19 section of CAP.org (https://capatholo.gy/38HjAZh). If you have additional questions about small business assistance or want to provide us with your feedback, email the CAP at smallbusiness@cap.org.
In the wake of the outbreak of COVID-19, clinical laboratories have shown an unwavering commitment to the patients they serve by ramping up efforts to deploy COVID-19 testing. The CAP is committed to supporting your efforts and is happy to announce COV2, a new proficiency testing (PT) program for the detection of SARS-CoV-2 by nucleic acid amplification testing. The new PT program’s material is non-infectious and targets gene regions N, E, RdRp, ORF1a, and S.
In this CAPcast, Dr. Bobbi Pritt, Director of the Clinical Parasitology Laboratory and Co-Director of Vector-borne Diseases Laboratory Services at Mayo Clinic, discusses what pathologists and laboratories need to know about COV2. Dr. Pritt is also the chairperson of the CAP’s Microbiology Committee, who was instrumental in designing the recently launched proficiency testing program for SARS-CoV-2, the novel coronavirus.
To learn more and order COV2, visit CAP.org: https://capatholo.gy/34FmvRO.
As U.S. laboratories expand their testing capabilities, many pathologists are eager to share lessons learned from their own experiences. In this CAPcast interview, Dr. Richard Scanlan discusses his experiences bringing COVID-19 testing online at his institution, including some lessons learned. Dr. Scanlan is the medical director of the Oregon Health and Sciences University Hospital laboratory in Portland.
For updated information for pathologists and laboratories from the CAP, visit https://capatholo.gy/38HjAZh.
Seattle experienced the COVID-19 pandemic’s first wave in the United States. UW Medicine’s Geoffrey Baird, MD, PhD, acting chair of Laboratory Medicine was at the forefront, confronting significant challenges related to diagnosing patients with this virus. In this CAPcast, Dr. Baird discusses lessons learned from testing and personnel challenges when ramping up testing capacity. In addition, Dr. Suzanne Dintzis, Associate Professor of Pathology at UW School of Medicine and current president of the Washington State Society of Pathologists, weighs in on UW’s current autopsy protocols.
Visit CAP.org for the latest CAP information on COVID-19: https://capatholo.gy/38HjAZh.
Patients treated with opioids for noncancer chronic pain are known to exhibit aberrant drug behaviors. The urine drug screen or UDS complements behavior monitoring as an objective means to assess patient compliance. UDS results can impact decisions related to a patient’s treatment, including discontinuation of opioid therapy or removal of the patient from the treatment program, explains Barbarajean Magnani, MD, PhD, FCAP, in this CAPcast interview.
Dr. Magnani, a renowned expert in toxicology, helped developed a Clinical Pathology Improvement Program or CPIP course on this topic (https://capatholo.gy/3cz90XA).
Technology continues to move at a fast pace, and many tools are available to streamline practice. However, the busy pathologist may not have time to seek out and keep pace with all the latest developments and technologies, explains Raul S. Gonzalez, MD, FCAP, in this CAPcast interview. Dr. Gonzalez is one of the instructors of a CAP20 course on this topic.
Register and learn more about CAP20, which will be held virtually this year on Oct. 10-14, please visit www.capannualmeeting.org. Follow #cap20virtual on social media for updates on this event.
Fluid samples are one of the most commonly-encountered samples in cytopathology, and may show a range of benign, inflammatory, and neoplastic disease processes. A structured approach to these samples is important, according to Xiaoyin "Sara" Jiang, MD, FCAP, who will be teaching a course on this topic at CAP20, which will be held virtually this year on Oct. 10-14. In this CAPcast, Dr. Jiang discusses efforts to standardize cytology reporting and how pathologists can enhance their ability to recognize key cytologic features of inflammatory and malignant processes.
For more information on this virtual event, please visit www.capannualmeeting.org and follow #cap20virtual for the latest updates.
Drug testing is critical to patient care, whether it’s for compliance to prescribed medications, identification of drugs in the immediate overdose setting, or exposure to toxins that may cause long term deleterious effects, such as lead. But there’s an important resources to help pathologists address these challenges--the second edition of Clinical Toxicology Testing: A Guide for Laboratory Professionals (https://capatholo.gy/2IfWvlJ). This edition features expanded sections on testing in the clinical setting, methodologies, and more user-friendly information on specific analytes, as renowned pathologist and co-author Barbarajean Magnani, MD, PhD, FCAP, explains in this CAPcast interview.
The novel coronavirus, 2019-nCoV or COVID-19, is rooted in Wuhan, China but has since arrived in the United States, stoking fears of a global pandemic. In this CAPcast interview, Dr. Michael Mina, Associate Medical Director of Clinical Microbiology and Molecular Virology at Brigham and Women’s Hospital’s Department of Pathology in Boston, discusses the current outlook of the virus and what pathologists need to know about their role in diagnosis and treating patients suspected to have contracted this virus.
For updated information on the coronavirus or COVID-19, please visit CAP.org (https://www.cap.org/) or CDC.gov (https://www.cdc.gov/coronavirus/2019-ncov/index.html).
Determining obsolescence for clinical tests in each setting requires discussion between laboratory staff and clinicians, influenced by reimbursement determinations, explains Dr. Robert Dufour in this CAPcast. Dr. Dufour led the development of a Clinical Pathology Improvement Program (CPIP) course on this topic (https://capatholo.gy/39Alig1).
The advent of new molecularly targeted treatment strategies for patients with advanced colorectal cancer places anatomic and molecular pathologists as key players in the delivery of care for this large patient population. Specifically, advanced colorectal cancer encompasses patients presenting with Stage IV cancer, or those who experience a cancer recurrence, explains Dr. Joseph Willis in a new CAP.org article (https://capatholo.gy/37Pdt5A), "Testing of Specimens From Patients With Advanced Colorectal Carcinoma."
Dr. Willis is Vice Chair for Pathology Translational Research and a GI pathologist at Case Western Reserve University and University Hospitals Cleveland Medical Center in Ohio. In this role, Dr. Willis has pursued better understanding of pathogenesis and prediction of outcomes of patients with GI cancers. He also currently serves on the Personalized Healthcare Committee of the CAP. This committee curates the Precision Medicine section of CAP.org (https://capatholo.gy/37R8WiX). Visit this page to access articles and presentations on precision medicine topics, such as PD-L1 or the use of liquid biopsies.
Surprise billing continues to be a priority for Congress in Washington, DC. In this CAPcast, Dr. David Gang and Dr. Matthew Foster--two leaders with the CAP’s Federal and State Affairs Committee--discuss their recent trips to Capitol Hill to meet with their legislators on surprise billing. Also interviewed is Michael Hurlbut, CAP Assistant Director, Legislation & Political Action, who will provide a recap of the legislative process to fix surprise billing and where it may go in 2020.
For more information, please go to the Advocacy section of CAP.org: https://www.cap.org/advocacy. From there, you can sign up for upcoming meetings and learn more about how you can participate in our lobbying programs. Also, be sure to register for the Pathologists Leadership Summit, which will be held May 2-5 in Washington, DC (https://www.pathologistsleadershipsummit.org). Advocacy will be a central theme of this meeting, and CAP members will have the opportunity to meet with their lawmakers on Capitol Hill.
The Atlas of Fundamental Infectious Diseases Histopathology: A Guide for Daily Practice contains real-world, practical information on commonly encountered infectious diseases for all levels of pathologists, from trainees to attendings. In this CAPcast, editor Dr. Bobbi Pritt discusses how the book is designed to be a valuable resource for pathologists, including using algorithms to help study patterns of inflammation for clues to the presence and potential types of organisms.
For more information and to purchase the book, please visit https://capatholo.gy/2svyYsK.
By the end of 2019, the CDC had reported over 2,000 hospitalizations and over 60 confirmed deaths due to vaping associated lung injury. While research into the pathology of vaping-associated lung injury is in its early phases, Dr. Brandon Larsen and his pathology colleagues at the Mayo Clinic published research in the New England Journal of Medicine in early October (https://www.nejm.org/doi/full/10.1056/NEJMc1913069) finding that lung injuries from vaping most likely are caused by direct toxicity or tissue damage from noxious chemical fumes. In addition, Dr. Larsen and his colleagues published subsequent correspondence in this same publication cautioning clinicians against performing lipid stains on bronchial fluid or lung tissue from adult patients (https://www.nejm.org/doi/full/10.1056/NEJMc1914980). In this CAPcast interview, Dr. Larsen discusses what CAP members need to know about the pathology of vaping-associated lung injury.
Adding ultrasound fine needle aspiration or USFNA to your practice’s diagnostic menu can provide a more thorough sampling of a palpable nodule than when using manually-directed sampling. The CAP’s USFNA Advanced Practical Pathology program provides hands-on training to allow pathologists to add a new dimension to their practice, as Dr. Susan Rollins explains in this CAPcast. The course will be held April 4-5, 2020, in Chicago (https://capatholo.gy/2T9cPv2).
Blood gas laboratories, like all laboratories operating under CLIA, need to ensure that they have qualified personnel in the CLIA defined roles. Many respiratory therapists only have an associates degree so they are not qualified to fulfill the technical consultant role as defined by CLIA because it requires a four year degree. Recently the CAP observed that CMS is citing blood gas labs for not having appropriate personnel during their validation inspections, as Dr. Earle Collum outlines in this CAPcast interview.
For more information, visit please visit Accreditation Resources on CAP.org (https://capatholo.gy/2tLQzN6) or call CAP Technical Specialists at 800-323-4040.
Pathologists have been at the forefront of efforts to understand why vaping causes severe lung illness in some individuals, and the nature of the injury that is caused by vaping. In this CAPcast interview, Dr. Timothy Allen, Chair of Pathology at the University of Mississippi Medical Center, discusses what pathologists currently know about the impact of vaping on lungs.
The CAP strongly opposes vaping, particularly among children, teens, and young adults who have never smoked. While the CAP acknowledges that vaping may have a role in smoking cessation, we stress the need for improved medical research to inform vaping-related U.S. Food and Drug Administration (FDA) regulations or guidance. More information on the CAP's statement on vaping can be found on CAP.org: https://capatholo.gy/2QavwMZ.
The Color Atlas of Mycology (https://capatholo.gy/2FrMobZ) is an up-to-date resource designed to assist pathologists and medical technologists in the laboratory identification of fungi using the most recent taxonomic classifications. In addition, because the book includes more than 15 years of proficiency testing data, it helps pathologists and laboratory professionals better identify medically-important fungi by addressing confusion points identified by analysis of errors in proficiency testing over more than 15 years, as one of the book’s authors, Dr. Gordon Love, explains in this CAPcast interview.
Leading a laboratory involves both technical knowledge and softer skills: technical knowledge of testing and accreditation is needed along with the ability to manage people, perform risk assessment, and deal with finances and budgeting. Many pathologists leave training with the required technical knowledge but sometimes lack training and confidence in the “softer” skills. The CAP’s Laboratory Medical Direction course is led by experienced laboratory directors who can help correct gaps in your knowledge and improve your ability to function as a lab director. In this CAPcast, leading pathologists Dr. Elizabeth Wagar and Dr. Richard Scanlan discuss the benefits of attending the course, which will be held April 30-May 1 in Chicago: https://capatholo.gy/2mVcxrh.
While many hospitals don’t frequently activate massive transfusion protocols (or MTPs), these events may be stressful and confusing for laboratory personnel. And because of the low frequency of MTP activation without designated trauma centers, there may be confusion as to the appropriate laboratory protocol, explains Dr. Alexis Peedin in this CAPcast. Dr. Peedin helped lead the development of a Clinical Laboratory Improvement Program (or CPIP) course on this topic: https://capatholo.gy/2LfNkDI.
The CAP Policy Roundtable conducts the Practice Characteristics Survey (https://capatholo.gy/2KTjqoK) every other year to gather data that pathologists can use to understand how their practice compares to others, and how pathologists are dealing with current health care trends and the changing business environment. The CAP also uses the data gathered to set advocacy priorities and understand market pressures and environmental changes that affect the practicing pathologist.
In this CAPcast, Dr. Michael Cohen, Chair of the CAP Policy Roundtable, discusses the some of the key take-aways from the 2019 edition of this survey.
The laboratory and pathologist play an essential role in the diagnosis of hemophagocytic lymphohistiocytosis or HLH. The pathologist’s morphologic diagnosis as well as direction to appropriate additional testing are truly essential for patient care, explains Dr. Megan Nakashima in this CAPcast. Dr. Nakashima also helped developed a course on this topic as part of the CAP’s Clinical Laboratory Improvement Program, or CPIP: https://capatholo.gy/31JGonR.
In recent years, biobanking has become increasingly vital to furthering the promise of precision medicine. However, academic, government and commercial biobanking operations have also come under increased pressure to balance their budgets and plan for long-term sustainability in the face of budget shortfalls and increased competition for limited research funding. As one of the primary medical specialties engaged in biobanking, pathologists face these challenges in their institutions, explains Dr. Jim Vaught, editor-in-chief of the journal Biopreservation and Biobanking (https://capatholo.gy/2nOY6Yx), in this CAPcast. Dr. Vaught has studied the challenges involved in the economics and sustainability over the past 10 years and has published several papers on these topics.
Learn more about the CAP's Biorepository Program: https://capatholo.gy/2LveVSV.
Protein electrophoresis is commonly ordered for patients with suspected or known plasma cell disorders. Pathologists may sometimes be unsure of the sequence in which tests should be ordered when evaluating for a plasma cell neoplasm, and it’s important to understand the utility and the limitations of each test, and its unique role in arriving at an accurate conclusion.
In this CAPcast, Dr. Diana Desai provides an overview of protein electrophoresis and some challenges that pathologists should be aware of when ordering these tests. Dr. Desai developed a course on this topic as part of the CAP’s Clinical Laboratory Improvement Program, or CPIP (https://capatholo.gy/32LNx80).
Acute promyelocytic leukemia (APL) with PML-RARA is a true clinical emergency. Due to the rapid onset of this disease and rapid deterioration of the patient, it is important for pathologists to quickly and accurately identify APL, explains Dr. Juli-Anne Gardner in this CAPcast. Dr. Gardner developed a Clinicial Pathology Improvement Program or CPIP course on this topic (https://capatholo.gy/2Zw1tku).
MAHA is a nonimmune condition characterized by hemolytic anemia either due to abnormalities in the microvasculature or to intravascular devices that lead to fragmentation of the red blood cells. When MAHA is combined with thrombocytopenia, it is referred to as thrombotic microangiopathy (TMA). Pathologists may get requisitions for peripheral blood smear review that say “rule out MAHA”, explains hematopathologist Dr. Vandita Johari.
While these may appear like a simple question, these patients tend to be complex and have multiple comorbid conditions and a clear understanding of the laboratory findings and approach to differential diagnosis of this condition is required to provide an appropriate answer. Dr. Johari lead the development of a case-based course on this topic as part of the CAP’s Clinical Pathology Improvement Program—or CPIP (https://capatholo.gy/2zdW1rR).
This year’s CAP annual meeting features 25 new courses and a diverse portfolio of programs that are central to daily practice. As chair of the CAP Curriculum Committee, Dr. Sarah Bean leads a multi-disciplinary group of pathologists through the rigorous process of reviewing and selecting the educational courses presented at the annual meeting. In this CAPcast, Dr. Bean discusses the key offerings of CAP19, which will be held Sept. 21-25 in Orlando, Florida. Register now for CAP19: https://capatholo.gy/2Vzqkm9.
Dr. Husain Sattar, a well-known pathology educator to medical students, provides insights as to what a pathologist does, his story on why he chose the specialty of pathology, and advice he would give to medical students interested in exploring pathology.
Statistical quality control or QC is a fundamental part of clinical laboratory practice; it assures that methods are performing at their usual level. Laboratories can make two main types of errors in selecting QC rules: too tight or too loose and both have ramifications, explains CAP inspector Dr. Robert Dufour in this CAPcast. If control limits are set too tight, time and money will be spent evaluating results that are already acceptable for patient care needs. However, use of too loose control limits will prevent them from detecting changes in method performance that may lead to suboptimal patient care and PT failures, explains Dr. Dufour, who also led the development of a CME course (https://capatholo.gy/2YXzY2M) on this topic as part of the CAP’s Clinical Laboratory Improvement Program or CPIP.
The CAP’s annual meeting, CAP19, is about knowledge, relationships and expertise. Held Sept. 21-25, CAP19 courses are designed to help you learn today and apply tomorrow when you return to your institution, particularly if you are a pathology resident, explains Dr. Adam Booth, Chair of the CAP Resident Forum Executive Committee. In this CAPcast, Dr. Booth outlines the key benefits at CAP19 for residents, including educational courses and the Residents Forum which kicks off with a reception the night of Sept. 20, followed the full meeting on Sept. 21.
Register now for both events: www.capannualmeeting.org.
Whether a pathologist has future aspirations or feels panic stricken with new responsibilities, those who are managing a practice will need to understand payment models, budgeting concepts, practice operations, and cost structures to maximize income, explains pathologist Dr. Andrea Volk, a graduate of the CAP's Practice Management Fundamentals Workshop, which will be taking place August 17-18 (https://capatholo.gy/2Y18EVU).
In this CAPcast, Dr. Volk discusses the business skills critical to running a practice and why it’s so important for pathologists to have a solid understanding of the financials related to operating a successful practice.
Biorepositories are responsible for maintaining specimen integrity over long periods of time. Ensuring that specimens are stored at temperatures appropriate for their intended use is a critical component to ensuring their quality. While storage units are typically equipped with primary and secondary temperature monitoring probes, these probes often only provide a temperature sampling of one small region within the storage unit. However, variables within the storage unit that impact airflow or the effectiveness of insulation can adversely affect the uniformity of temperature, creating ‘silent’ warm spots that can compromise specimens within.
In this CAPcast, Dr. Erik Zmuda, will share his experience from serving as a Technical Director in the Biospecimen Core Resource at Nationwide Children’s Hospital in Columbus, Ohio, by discussing why it’s important for laboratories to develop a method for evaluating temperature uniformity within biorepository storage units and how pathologists and laboratorians can confront the complex task of assembling the tools and methods for running a freezer mapping program on their own.
More information on biorepositories, including the CAP's Biorepository Accreditation Program (BAP), is available on CAP.org: https://capatholo.gy/2LveVSV.
Many parasites are considered “tropical diseases” so depending upon where you are in the world, you may not have a chance to diagnose parasitic infections with any degree of frequency. But maintaining ongoing competency in making an accurate diagnosis of a parasitic infection can therefore be challenging, explains UK Medicine pathologist Dr. Julie Ribes in this CAPcast. Dr. Ribes will be leading a CAP19 course on this topic entitled, “Case-Based Identification of Parasites in Tissues and Cytologic Specimens: on Sept. 21 in Orlando, Florida. For more information and to register for the meeting, visit www.capannualmeeting.org.
Not only is Dr. Barbarajean Magnani a world-renowned pathologist specializing in toxicology, she is also a novelist. And just in time for the summer reading season, Dr. Magnani has released her second book featuring the brilliant—yet complex—physician Dr. Lily Robinson, who has an encyclopedic knowledge of all toxins and poisons, as well as a penchant for stilettos. In this new book, entitled The Queen of All Poisons (https://capatholo.gy/2Jwc60G), the U.S. Government approaches Dr. Robinson to rid the world of threats to our nation, including a terrorist threatening New York City. Meanwhile, Dr. Robinson quickly realizes the Russians have already released a deadly toxin in a surprisingly innocuous medium.
In this CAPcast, Dr. Magnani discusses her book, the inspiration behind her eponymous character or Dr. Lily Robinson, and why she’s decided to pursue another career as a novelist. Dr. Magnani is donating a portion of the book's proceeds to the CAP Foundation's See, Test & Treat program, a pathologist-led initiative that delivers free cervical and breast cancer screening to vulnerable women in the United States (https://capatholo.gy/2RG0Ous).
Pathologists could lose, or gain, $2.1 billion over seven years in Medicare’s new quality payment programs. This represents the difference between pathologists gaining the full possible Medicare payment bonuses or receiving the payment penalties. Pathologists need to understand Medicare’s merit-based incentive payment system (MIPS) program as it relates to reducing the burden of participating, understanding and maximizing scoring, and seeking measures and improvement activities with maximum scoring and bonus point potential, explain Drs. Emily Volk and Diana Cardona in this CAPcast. Drs. Volk and Cardona are leading a CAP19 session on Monday, September 23 at 9:30am. Register now for CAP19: www.capannualmeeting.org.
Highly sensitive next-generation sequencing-based assays have driven a rapid expansion of gene-disease associations for a diverse group of segmental overgrowth syndromes. In this CAPcast, Dr. Jonathan Heusel, a pathologist at the Washington University School of Medicine in St. Louis, discusses the medical director’s role in selecting both the appropriate assays and the reference laboratories to ensure high diagnostic yield. Dr. Heusel lead the development of a case-based course on this topic as part of the CAP’s Clinical Pathology Improvement Program—or CPIP: https://capatholo.gy/2xGJxbd.
Pathologists frequently evaluate peripheral blood smears for lymphocytosis or the presence of abnormal lymphoid cells. In this CAPcast, Dr. Kyle Bradley discusses benign and malignant lymphoproliferative disorders, which is the topic of a course he is teaching at CAP19, which will be held Sept. 21-25 in Orlando, Florida. Learn more and register for CAP19: www.capannualmeeting.org.
Pathologists can help improve patient care by staying up to date on the most recent recommendations on genomic testing for solid tumors, which can be a challenge since this information changes frequently. In this CAPcast, Drs. Leilani Valdes and Sophia Yohe discuss some of the key changes in genomic testing for oncology specimens, as well as how changing cancer treatment paradigms are changing the role of the pathologist. Drs. Valdes and Yohe will be teaching a CAP19 course entitled, “Molecular Genomic Oncology for the Practicing Surgical Pathologist” on Sept. 23. For more information and to register for CAP19, visit www.capannualmeeting.org.
Practice Management skills such as budgeting, cost forecasting, and understanding payment models are not concepts taught in medical school. But pathologists need to develop and master these skills in order to advance their careers and manage a pathology department or practice, according to Dr. Robert L. Breckenridge, the Southwest Regional Medical Director for Quest Diagnostics. Dr. Breckenridge is also a member of the CAP’s Practice Management Committee, whose members are sponsoring an upcoming Practice Management Workshop (https://capatholo.gy/2W3Jmkf) on August 17 - 18, 2019.
In this CAPcast, Dr. Breckenridge will discuss why it’s important for pathologists to develop business acumen along with their diagnostic expertise, and what business skills need to be developed for career advancement.
Supporting the platelet transfusion needs of refractory patients is very resource intensive. These patients present numerous challenges for all clinical providers, including pathologists, because they typically have multiple comorbidities, are receiving multiple medications, and given the low platelet count, are at risk for bleeding. Because of the suboptimal response to platelets, these patients typically receive more transfusions compared to non-refractory patients, according to Dr. Monica Pagano, Medical Director of the Transfusion Service Laboratory at UW Medical Center in Seattle, in this CAPcast. Dr. Pagano lead the development of a case-based course on this topic as part of the CAP’s Clinical Pathology Improvement Program—or CPIP (https://capatholo.gy/2X6gb0b).
Evolving regulatory guidance, changing reimbursement rules, staffing shortages and other concerns are creating more challenges for laboratory leaders.
The latest edition of the Laboratory Administration for Pathologists (https://capatholo.gy/2F1uLzT) provides laboratory managers with practical knowledge to identify situations which could lead to sanctions as well as strategies to improve their laboratory. Understanding and responding to changes in regulation can help to improve patient safety, ensure laboratory viability and reduce risk of sanctions or loss of accreditation, explains leading pathologist and co-author of this second edition, Dr. Elizabeth Wagar in this CAPcast.
Practicing pathologists continue to be vexed by issues that are related to payment for the services that they provide. However, better understanding the payment structure will enable pathologists to examine their own practices and adapt to reimbursement changes. In this CAPcast, Dr. Jonathan Myles, a member of the CAP Board of Governors and an expert on pathology reimbursement policies, discusses the fundamental processes associated with payment for services under Physician Fee Schedule Medicare Part B as well payment associated with the Clinical Laboratory Fee Schedule, both topics which he will discuss during a course he will be leading with Dr. Marc Synovec at CAP19 in Orlando, Florida: www.capannualmeeting.org.
Since pathologists have oversight responsibility for testing, they should be involved in the pre-analytic and post-analytic phases of testing, as well as optimizing the analytic phase, to deliver the highest quality of care to our patients. In addition, pathologists are often leaders in the hospital and healthcare setting, where the cost of care delivery is scrutinized. Pathologists are in a unique position to recommend the appropriate testing algorithms that optimize patient care and decreases waste, both of which in turn saves healthcare dollars, according to Cleveland Clinic pathologist Dr. Gary Procop, who will be teaching a course on this topic at on Sept. 21 at CAP19 in Orlando, Florida. Register now: www.capannualmeeting.org.
Genitourinary (GU) neoplasia is a continuously evolving diagnostic area and GU cases are among some of the most common diagnoses in today’s practice. In this CAPcast, Dr. Donna Hansel will discuss recent guideline changes and advancements in this pathology specialty.
Dr. Hansel will be one of the faculty members teaching a day-long course on GU pathology at CAP19 in Orlando, Florida. Her co-faculty members include Drs. Mahul B. Amin; John C. Cheville, Peter A. Humphrey, Anil Parwani, and Debra L. Zynger. For more information and to register for CAP19, please visit capannualmeeting.org.
Pathology practices are entering a new value-based payment era and the ability to successfully demonstrate contributions to the quality of care provided will likely have a significant impact on their ability to positively impact their own reimbursement in the Merit-based Incentive Payment System, also known as MIPS. The Centers for Medicare & Medicaid Services (CMS) has finalized several changes to the program for 2019, which is year 3 of MIPS.
In this CAPcast, Dr. Emily Volk, vice chair of the CAP’s Council on Government and Professional Affairs and chair of the CAP Qualified Clinical Data Registry Ad Hoc Committee, discusses what pathologists need to know and do for 2019 in order to be successful in year 3 of the program. For more information on MIPS, please visit the Advocacy section of CAP.org: https://capatholo.gy/2KhOIpR.
Thyroid nodules are a common source of diagnostic difficulties for practicing pathologists. The correct diagnosis of these nodules is often difficult given some of the controversies associated with their interpretation and evolving criteria for diagnosis.
In this CAPcast, Dr. Saul Suster discusses controversial areas in thyroid nodule interpretation and recent changes in terminology for papillary carcinoma. Dr. Suster will be teaching a course on this topic on Saturday, Sept. 21 at CAP19 in Orlando, Florida. For more information and to register for CAP19, visit www.capannualmeeting.org.
Advances in minimally invasive thoracic sampling techniques allow pathologists and laboratories to perform multiple ancillary studies on small biopsy and cytology specimens. But with small specimens, ensuring optimum diagnostic yield and judicious triaging of these limited volume samples to perform an ever-growing list of ancillary studies is a challenge, according to Dr. Sinchita Roy-Chowdhuri.
In this CAPcast, Dr. Roy-Chowdhuri, discusses the new CAP guideline, Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies, which provides recommendations for pathologists and proceduralists to optimize testing outcomes for patients with suspected thoracic abnormalities. Dr. Roy-Chowdhuri will be teaching a course on this new guideline at CAP19, which will be held Sept. 21-25 in Orlando, Florida (www.capannualmeeting.org).
Endometrial biopsy is amongst the most frequent specimens evaluated by pathologists. But difficulties in interpretation of findings and the presence of common morphologic mimics, including metaplastic and reactive changes, may lead to misdiagnosis, with important consequences for patient management.
In this CAPcast, Dr. Ricardo Lastra discusses the common pitfalls in diagnosis as well as classification of endometrial precursor lesions and neoplasia, as well as the rare diagnoses that may be present in endometrial biopsy specimens. Dr. Lastra will be teaching a CAP19 course on this topic with Dr. Mamta Gupta on Monday, Sept. 21 in Orlando, Florida.
Colorectal carcinoma remains the most common gastrointestinal malignancy and a common cause of morbidity and mortality. Pathologists are seeing considerable change in the diagnosis, testing, and reporting of colorectal carcinoma. In this CAPcast, Dr. Raul S. Gonzalez will discuss three common areas of concern related to stains, deposits and buds as well as the recent publication of the International Tumor Budding Consensus Conference proceedings is likely to lead to a further increase in applying tumor budding in routine practice.
Dr. Gonzalez will be teaching a course on this topic at CAP19, which will be held Sept. 21-25 in Orlando, Florida. For more information on CAP19, please visit www.capannualmeeting.org.
Colon biopsies, especially polyps, are the bread and butter of many pathologists and issues surrounding these specimens are not uncommon. In this CAPcast, Dr. Lysandra Voltaggio discusses issues and challenging diagnoses as it pertains to colon polyps. Dr. Voltaggio is teaching a course on this topic at CAP19; learn more and register at www.capannualmeeting.org.
Registration is now open for the CAP’s annual meeting, CAP19, which will be held Sept. 21-25 in Orlando, Florida. In this CAPcast interview, Dr. Jennifer Hunt, Chair of Pathology and Laboratory Medicine at the University of Arkansas for Medical Sciences, discusses the rich career and educational opportunities at this annual event. Learn more and register for #cap19ORL: https://www.capannualmeeting.org/.
Immunotherapy targeting the PD-1/PD-L1 pathway represents a new therapeutic paradigm and a promising treatment option for advanced non-small-cell lung cancers, melanoma, and more recently, gastric and gastroesophageal carcinomas. As the role of PD-L1 IHC testing in the diagnostic work-up of solid tumors continues to expand, practicing pathologists are playing an increasingly larger role in test selection and integration of these molecular data into their reports, according to Dr. Larissa Furtado, who is teaching a course PD-L1 testing at CAP19 (www.capannualmeeting.org).
In this CAPcast, Dr. Furtado provides an overview of PD-L1 testing, as well as how pathologists can confront the challenges related to implementing PD-L1 IHC testing into their laboratories.
Because pathologists confront informatics problems on a regular basis, it’s critical for them to effectively diagnose and treat common informatics problems in partnership with other clinical providers, hospital/client leadership, IT staff, and laboratory staff.
In this CAPcast, Dr. John Sinard discusses common process and technology-based informatics issues and how pathologists can develop clinical diagnostic informatics acumen to deal with these issues. Dr. Sinard will be teaching a course on this topic at CAP19, along with his co-faculty Dr. Alexis Carter and Dr. Myra Wilkerson. For more information and to register for CAP19, visit www.capannualmeeting.org.
Pathology systems such as digital microscopy, laboratory instruments, middleware, LIS, and EHR are starting to incorporate components based on machine learning and artificial intelligence. However, pathologists are poorly equipped to verify the quality of performance of the various digital pathology and other laboratory systems other than by using documents provided by the system vendors, according to Dr. Matthew Hanna, who is teaching a CAP19 course on navigating the implementation challenges of systems incorporating machine learning and artificial intelligence (learn more about CAP19: https://capatholo.gy/2Vzqkm9).
In this CAPcast interview, Dr. Hanna discusses these challenges and how pathologists can avoid problems using best practices in performance assessment from initial deployment through ongoing maintenance of quality.
The paradigm for prostate cancer treatment is evolving. While there is an increasing desire to manage low-risk cancers without aggressive treatment, there is also a need to identify high-risk cancers and treat appropriately.
In this CAPcast interview, Dr. Sean Williamson, a surgical pathologist from the Henry Ford Health System, discusses the diagnostic challenges of evaluating prostate biopsies, the significance of neuroendocrine differentiation in prostate cancer, and recent consensus guidelines and classification schemes. Dr. Williamson and Dr. Giovanna Giannico will be teaching a course on this topic at CAP19, which will be held Sept. 21-25 in Orlando, Florida: https://capatholo.gy/2Vzqkm9.
Soft tissue pathology—it can be a challenging area of specialty for many general pathologists. In this CAPcast, Dr. Jerad Gardner discusses the common pitfalls and benign mimics that pathologists are most likely to encounter, as well as how to navigate the many ancillary tests available for soft tissue lesions. Dr. Gardner will be teaching a course on this topic at CAP19, which will be held Sept. 21-25 in Orlando, Florida: https://capatholo.gy/2Vzqkm9.
Maximizing patient safety and reducing diagnostic errors is rooted in a quality management approach. The manual Quality Management in Anatomic Pathology (https://capatholo.gy/2UNJ9lk) provides pathologists and laboratory directors with the tools necessary to implement a comprehensive quality program, with an emphasis on regulatory compliance and cross-references to the CAP Laboratory Accreditation Program checklists and CLIA. In this CAPcast, one of the book’s co-authors, Dr. Gene Siegal, discusses the challenges related to quality, the common causes of error, and the key elements of a comprehensive quality program.
Clear, concise communication is required in all pathology practices with many constituencies, such as colleagues, clinicians, staff, nurses, administrators, and patients. But effective communication with all these audiences may be difficult. In addition, conventional modalities such as meetings, conference calls, written communications, and emails may have limited effect or may be used inappropriately and newer communication platforms, such as social media, may be unfamiliar to many pathologists.
In this CAPcast interview, Dr. Timothy Allen discusses better modes of communication as well as pitfalls in written, verbal, and visual interactions. Dr. Allen will be teaching a course on this subject in September at CAP19. Learn more about CAP19: https://capatholo.gy/2Vzqkm9.
Injuries to patients or laboratory staff due to unsafe conditions can result in unwanted publicity, adverse accreditation decisions, and damage to the pathologist’s professional reputation. Pathologists who recognize and correct unsafe conditions are less likely to be involved in related court proceedings, according to Dr. Richard Scanlan, who will be teaching a course on this topic later this year entitled, “Don’t Be THAT Lab,” at CAP19 which will be held Sept. 21-25 in Orlando, Florida. In this CAPcast interview, Dr. Scanlan discusses some of the challenges related to managing a laboratory and how laboratory directors can mitigate risks.
Throughout his pathology training, Dr. Richard Owings thought that finding a job would be the hardest part of transitioning from a trainee to new-in-practice pathologist. But after signing a contract with his current employer, he soon realized he had a lengthy punch list to complete before he started his new job. Dr. Owings outlines some of the challenges during this transition period in a recent blog on CAP.org entitled, “You’ve Signed Your Contract as a New-in-Practice Pathologist: Now What?”: https://capatholo.gy/2I96OdZ. In this CAPcast interview, he shares his perspective and advice on ensuring a smooth training to practice transition.
According to Dr. Nicole Riddle’s recent article on CAP.org, whether you’re starting a new job or vying for a raise or promotion, you should always be negotiating. Research has shown that that only about 20% of people always negotiate their salaries while up to 40% never do. Dr. Riddle’s article on this topic, titled “Working Hard for the Money: The Importance of Salary Negotiation,” is now posted on CAP.org: https://capatholo.gy/2AY3fkP.
In this CAPcast interview, Dr. Riddle provides advice on how and why to negotiate your salary—as well as other employment benefits. Negotiating may be scary, but as Dr. Riddle explains, it’s much worse not doing it.
If you are a new-in-practice pathologist in your first job, it’s important to prove yourself early in your career, because a good impression sets you up for success down the road, according to Dr. Joshua Hanson, who recently wrote a blog on this topic, which is now posted on CAP.org: https://capatholo.gy/2B2wl2Q.
In this CAPcast interview, Dr. Hanson, who is an attending surgical pathologist at the University of New Mexico in Albuquerque, shares some tips on how to prove yourself during your first year on the job.
Morphologic examination by light microscopy remains an integral part of initial histopathologic assessment for hematolymphoid neoplasms; however, a variety of laboratory techniques are now being used to optimize diagnostic information in the appropriate clinical context. For diagnosing myeloid disorders and acute myeloid leukemia, one approach is to utilize an next gen sequencing panel and DNA-based cytogenomic microarray, according to Dr. Pranil Chandra, Chief Medical Officer of Genomic and Clinical Pathology with PathGroup. In this CAPcast, Dr. Chandra discusses why his laboratory, in conjunction with pathologist and oncologist colleagues, developed this technology and how they’ve implemented it into clinical practice.
Dr. Chandra currently serves on the Personalized Healthcare Committee of the College of American Pathologists, and he’s written a short article now posted on CAP.org (https://capatholo.gy/2RO4h96) outlining the reasoning his team used to make this panel their standard of care.
Because pathologists are integral to patient care, they can contribute significantly to preventing and reducing medical error. Understanding causes of patient safety errors is the first step in developing and implementing programs to reduce their occurrence, according to Dr. Deborah Sesok-Pizzini, editor of the book, Patient Safety in Anatomic & Clinical Pathology Laboratories (https://capatholo.gy/2AVzvW5). In this CAPcast interview, Dr. Sesok-Pizzini discusses the cognitive and human errors that can compromise patient safety and how pathologists can create a culture of safety, including designing and implementing effective training programs.
Light-sheet microscopy is a significant advance for pathologists, because it allows them to not only examine tissue in minutes rather than days, but also to view it in three dimensions instead of two. This will ultimately lead to improved clinical care, according to Dr. Nicholas Reder, a pathologist at the University of Washington Seattle, who specializes in developing this technology.
In this CAPcast interview, Dr. Reder discusses the benefits of light sheet microscopy and its significance in the future of pathology.
For more information on emerging microscopy technologies, visit the In Vivo Microscopy Topic Center on cap.org. To get there, go to cap.org and search for “IVM Topic Center”.
CAP Press has released a new resource guide, The Color Atlas of Mycology: An Illustrated Field Guide Based on Proficiency Testing, which is intended to maintain and extend skills in this age of increasing fungal infections whether from HIV, burns, or profound immunosuppression from organ transplant or drug treatment. In this CAPcast interview, one of the co-authors, Dr. Gordon Love, will discuss how this new resource will assist pathologists and medical technologists in the laboratory identification of fungi using the most recent taxonomic classifications. To purchase the book, please visit the CAP's estore: https://capatholo.gy/2yiLWcW.
The transition from pathology residency and/or fellowship training to junior attending status is often a source of great anxiety on the part of both new-in-practice pathologists and those who hire them. In this CAPcast, former CAP President Dr. Gene Herbek discusses some of the challenges faced by new-in-practice pathologists, as well as their pathologist employers, and offers some tips on how both groups can navigate this transition period. Dr. Herbek will be a speaking at a panel of this topic at CAP18, which will be held Oct. 20-24 in Chicago. For more information and to register for CAP18, visit www.capannualmeeting.org.
Physician burnout is on the rise. According to a 2015 Medscape survey, 45% of female pathologists and 33% of male pathologists show rates of burnout. Pathology, like other medical specialties, requires psychological wherewithal and perseverance and burnout, therefore, can compromise a pathologist’s ability to carry out his or her work effectively, according to Dr. Timothy Bono, a psychologist from Washington University in St. Louis. Dr. Bono will be one of the speakers at the upcoming CAP18 Scientific Plenary, where he will discuss physician burnout. In this CAPcast, he will discuss drivers and impact of physician burnout and how pathologists can confront burnout. To register for CAP18, held Oct. 20-24 in Chicago, visit www.capannualmeeting.org.
Female physicians report higher burnout rates compared to their male colleagues—48% versus 38%—according to a Medscape survey on physician burnout and depression released earlier this year. While female physicians may be reluctant to draw attention to gender-related differences, they do face different challenges than male physicians, explained Dr. Gina Drobena in a recent article in CAP Today on this topic: https://capatholo.gy/2pnTiH2.
In this CAPcast interview, Dr. Drobena, who is the chief of pathology for the clinical laboratory at Arkansas Children’s Hospital in Little Rock, discusses how physician burnout impacts female pathologists and ways to confront and cope with these challenges.
The real value of the laboratory accreditation process is the opportunity it provides for the highest level of professional validation, by peers, for the work that a director and their staff contribute to patient care, according to Dr. Gregory Gagnon. But challenging inspections are not uncommon, and there are approaches to confronting difficulties during inspections, as he will explain in this CAPcast interview. In fact, Dr. Gagnon will lead a course on this topic at CAP18, which will be held Oct. 20-24 in Chicago. For more information on CAP18, please visit www.capannualmeeting.org.
In 2017, the CAP collaborated with the American Society of Hematology (ASH) to publish a clinical practice guideline for the workup of acute leukemia. In this CAPcast, Dr. Daniel Arber, a hematopathologist with the University of Chicago Department of Pathology, discusses the reason for the new guideline and how pathologists can work with their fellow clinicians to implement the new guideline to improve diagnosis, treatment, and outcomes for acute leukemia patients.
For more information on the CAP-ASH guideline, “Initial Diagnostic Workup of Acute Leukemia,” please visit CAP.org and the Archives of Pathology & Laboratory Medicine: https://capatholo.gy/2CDmvY8.
Not only is Dr. Kevin Pho a board-certified internal medicine physician, he is also a pioneer in the presence of physicians on social media, a topic he details in a book that he co-authored entitled, “Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices.”
Dr. Pho is the CAP18 spotlight speaker, and in this CAPcast interview, he discusses how pathologists can make a profound difference through social media. He will be speaking on Sunday, October 21 at 5:45pm at CAP18 in Chicago. For more information and to register for CAP18, please visit capannualmeeting.org.
When a breast cancer patient wanted to actually see her cancer cells—what she called the dragon she was slaying, she turned to Dr. Lija Joseph, a pathologist at Lowell General Hospital in Lowell, Massachusetts. Since March of last year, Dr. Joseph has opened her laboratory to over 30 patients, allowing them to view their tissue under a microscope.
In this CAPcast interview, Dr. Joseph shares her experience with patients and how it has impacted her practice as a pathologist. She will also share her story on Inspiration Stage at CAP18 in Chicago on Tuesday, Oct. 23, along with Drs. Crystal Moore and Barbarajean Magnani. For more information and to register for CAP18, please visit www.capannualmeeting.org.
Learning how to communicate effectively is a critical skill for pathologists, particularly those who are new in practice. Patients and clinicians rely on the pathologist’s ability to communicate— be it a pathology report, an email, at a tumor conference, a medical staff meeting or through the various types of social media. Indeed, a solid communication strategy will elevate your professional standing and more importantly, lead to better patient care, according to Dr. Eric Glassy, who is leading a CAP18 session on this topic with Dr. Timothy Allen and Dr. Paul Bachner.
In this CAPcast, Dr. Glassy will elaborate on the importance of becoming a good communicator and what CAP18 attendees can expect in this course. For more information on CAP18, which will be held Oct. 20-24 in Chicago, please visit www.capannualmeeting.org.
CAP18, the CAP’s annual meeting, offers a diverse portfolio of programs that are central to daily practice. The meeting, which will be held Oct. 20-24 in Chicago (www.capannualmeeting.org), enables participants to increase their breadth and depth of knowledge on “bread and butter topics” as well as gain insight into advances in pathology. In this interview, Dr. Eli Morey, chair of the CAP’s Residents Forum, discusses how the meeting can benefit residents.
Unprofessional behaviors may occur at any level in any organization and can compromise workplace morale as well as patient care. In fact, unprofessional or unethical behaviors are among the most common reasons for disciplinary action taken by licensing boards and professional organizations.
In this CAPcast interview, Dr. Suzanne Powell discusses some common examples of unprofessional behavior, some approaches to responding to such behavior, and how to navigate sensitive issues of discrimination and privacy. Dr. Powell is Vice Chair of pathology at Houston Methodist, as well as Education Director of the AP/CP Residency Program. Dr. Powell will be joined by Dr. Ronald Domen in teaching a CAP18 course entitled “Vignettes in Ethics and Professionalism: A Case-Based Discussion” on Tuesday, Oct. 23 at from 3:30pm-5:30pm. To register for CAP18, please visit www.capannualmeeting.org.
What does a leading pathologist get out of the CAP annual meeting? In this CAPcast, Dr. Jennifer Hunt, Chair of Pathology and Laboratory Medicine at the University of Arkansas for Medical Sciences, discusses why she is attending CAP18, and what keeps her coming back to this annual meeting year after year. CAP18 will be held Oct. 20-24 in Chicago. To register for CAP18, please visit www.capannualmeeting.org.
Soft tissue pathology is uncommon in most settings. Many benign things look malignant and vice versa, sometimes presenting significant challenges for the general pathologist. But having a basic understanding of soft tissue pathology will aid in proper diagnosis and understanding when a consult is warranted, explains Dr. Nicole Riddle in this CAPcast interview. Dr. Riddle will be teaching a course on this topic at CAP18 held Oct. 20-24 in Chicago; learn more and register at www.capannualmeeting.org.
Twitter use by physicians, especially pathologists, continues to rapidly grow. Twitter provides an easy-to-use communications platform for rapid education, news, and networking that helps busy pathologists stay engaged and informed without taking up much time. Many pathologists see the benefits of joining Twitter but are unsure about how to get started, according to Dr. Jerad Gardner, who is leading a session on this topic at CAP18. In this CAPcast, Dr. Gardner discusses why Twitter is a powerful tool for pathologists, his experience on Twitter helping patients and colleagues, as well as how to confront some common challenges when getting started on this social media platform. For more information and to register for CAP18, please visit http://www.capannualmeeting.org.
Pathologists have not traditionally discussed cases directly with patients, nor have pathologists traditionally sat with patients and examined the patients' cases. But in today’s molecular era there is a growing need for pathologists to directly discuss with patients their diseases.
In this CAPcast, Dr. Timothy Allen will discuss the real-time anatomic pathology diagnostic management team conference, a new concept in which the pathologist joins clinical and radiologic colleagues in real time, using HIPAA-compliant Skype technology, to discuss with a patient (and possibly also the patient's family) the patient's disease process including diagnosis, current treatment, and future management. Dr. Allen will be teaming with Dr. Harpreet Talwar to teach a course on this topic at CAP18, which will be held Oct. 20-24 in Chicago. To register for CAP18, please visit www.capannualmeeting.org.
New laboratory directors are rarely prepared for regulatory and accreditation issues that face them. Even very seasoned pathologists and laboratory directors struggle to keep up with new regulatory requirements that pose high risk. In this CAPcast, Dr. Christina M. Wojewoda, a pathologist at the University of Vermont Medical Center in Burlington, discusses these issues and shares her perspective on what new medical directors need to know about regulatory, accreditation, and compliance issues. Dr. Wojewoda is teaching a course on this topic at CAP18, which will be held Oct. 20-24 in Chicago. To register for CAP18, please visit www.capannualmeeting.org.
Social media is an important education tool for pathologists. Communicating through social media channels like Twitter and Facebook can help pathologists educate patients about diagnostic medicine. But pathologists can also learn from each other via social media, according to pathologist Dr. Kamran Mirza. Dr. Mirza is an assistant professor in the departments of pathology & laboratory medicine and medical education and serves as medical director of molecular pathology at Loyola University Health System in Chicago, as well as a graduate of the CAP’s Engaged Leadership Academy (https://capatholo.gy/2N8sTaQ). In this CAPcast, he discusses how pathologists can best leverage social media as an education tool—both to teach others as well as learn from others.
In the laboratory setting, feedback (or the lack thereof) extends beyond self-improvement and ultimately impacts patient care. In this CAPcast, Duke Health pathologist Dr. Sara Jiang discusses how to give and receive feedback effectively. Dr. Jiang and her Duke Pathology colleague Dr. Sarah Bean will once again teach their popular course, “Can You Hear Me Now?: Giving and Receiving Feedback Effectively” at CAP18 in October. More information on CAP18 can we found online at capannualmeeting.org.
Both networking and publishing are important for academic pathologists to succeed, according to Dr. Roseann Wu, a staff pathologist and assistant professor of clinical pathology & laboratory medicine at the University of Pennsylvania Health System and Perelman School of Medicine in Philadelphia. In this CAPcast, Dr. Wu discusses why networking and publishing are so vital and how membership in the CAP can benefit academic pathologists. Dr. Wu’s recently wrote a blog on the issue, "CAP Membership for the Academic Pathologist," now posted on CAP.org: https://capatholo.gy/2AqanZA.
Effective laboratory management not only benefits the staff, but improves patient safety and patient care. However, many laboratory directors grapple with serious issues related to budget constraints as well as responding effectively to demanding clinician colleagues, according to Dr. Paul Bachner, a professor and immediate past chairman of the University of Kentucky College of Medicine’s Department of Pathology and Laboratory Medicine. Dr. Bachner will be teaching a course on this topic at CAP18, which will be held Oct. 20-24 in Chicago: www.capannualmeeting.org.
Discussing the subject of an autopsy can be a very difficult process for both the bereaved family member being asked and for the health care professional making the request. In this CAPcast, Dr. Harold Sanchez, a member of the CAP's Autopsy Committee, and Dr. Tom Smith, an oncologist and the Director of Palliative Care at Johns Hopkins Medicine in Baltimore, discuss the consent process for the performance of a hospital autopsy as well as advice on how to best navigate the process with family members.
In this CAPcast, Dr. Diana Cardona discusses what pathologists need to know about the Medicare Access and CHIP Reauthorization Act of 2015, also known as MACRA. Dr. Cardona, the Medical Director of the Surgical Pathology and Immunopathology Laboratories at Duke University Medical Center, is teaching a course on this topic with Dr. Stephen Black-Schaffer at CAP18 in Chicago, which will be held Oct. 20-24: www.capannualmeeting.org.
Many pathologists struggle with diagnostic questions surrounding cervical adenocarcinoma. In this CAPcast, Drs. Christina Kong and Teri Longacre, both pathologists with Stanford Healthcare in California, discuss the diagnostic challenges related to cervical adenocarcinoma, criteria for distinguishing reactive changes, as well as explaining the Silva classification system and how it applies to invasive adenocarcinomas. Drs. Kong and Longacre will be teaching a course on this topic at CAP18 which will be held Oct. 20-24 in Chicago: capannualmeeting.org.
This year’s CAP annual meeting features 25 new courses, creating a diverse portfolio of programs central to every pathologist’s daily practice.
In this CAPcast, Duke University pathologist Dr. Sarah Bean discusses how attending CAP18, held in Chicago, Oct. 20-24, can benefit pathologists. Dr. Bean is the Chair of the CAP Curriculum Committee.
For more information on CAP18, visit http://www.capannualmeeting.org.
It’s never too early for pathologists to devote time to develop their leadership skills, according to Dr. Adam L. Booth, the Chief Pathology Resident at University of Texas Medical Branch in Galveston. He is also a delegate to the AMA, a member of the CAP Digital Content Committee, and a member of the CAP Residents Forum. In this CAPcast, Dr. Booth shares tips for pursuing professional development as a new-in-practice pathologist. Dr. Booth is also a graduate of the CAP's Engaged Leadership Academy. Applications are currently being accepted for the 2018 ELA: https://capatholo.gy/2IYNUl9.
While the clinical use of analytical tests to assess genomic variants in circulating tumor DNA is increasing, there is insufficient evidence of clinical utility and validity for the majority of ctDNA assays in advanced cancer. Recently, representatives from the CAP and the American Society of Clinical Oncology analyzed the current literature on this diagnostic method also known as liquid biopsy. These findings were published in a recent issue of the Archives of Pathology & Laboratory Medicine (https://capatholo.gy/2oMWMD8).
In this CAPcast, one of the CAP members on the panel, Dr. Neal Lindeman, discusses the outcome of the review and what pathologists need to know about the findings. Dr. Lindeman is an Associate Professor of Pathology at Harvard Medical School and the Director of the Molecular Diagnostics Laboratory at Brigham & Women’s Hospital in Boston.
Pathologists need to be knowledgeable and keep pace with the recent advances in cytological classifications to modify the way specimens are processed, reviewed, reported, and managed. Two new cytological classifications, the Paris System for urinary cytology and the Milan System for salivary gland cytology have changed and will continue to change the practice of these challenging sites.
In this CAPcast, Dr. Jeffrey F. Krane, chief of the head and neck pathology service at Brigham and Womens Hospital in Boston, and Dr. Eva Wojcik, Chair of Pathology at Loyola University Medical Center in Chicago, discuss what pathologists need to know about these two new classification systems. Drs. Krane and Wojcik will be teaching a course on this topic at CAP18 which will be held Oct. 20-24 in Chicago. Learn more about CAP18 (#cap18chi): http://www.capannualmeeting.org/.
Subspecialty signout is becoming increasingly common in surgical pathology. In this CAPcast, Dr. Christa Whitney-Miller, Director of Surgical Pathology at the University of Rochester Medical Center in New York, talks about what’s driving this change as well as the benefits and drawbacks. Dr. Whitney-Miller will be teaching a course on this topic at CAP18, which will be held Oct. 20-24 in Chicago. To learn more about CAP18, visit www.capannualmeeting.org.
Technical and investigative advances have greatly expanded pathologists’ knowledge in the field of hematology. To help pathologists and laboratorians keep up with these changes, the CAP Press has just released the second edition of the Color Atlas of Hematology, an expanded version of the first with new content focusing on peripheral blood pathology. In this CAPcast, senior editor Dr. Eric Glassy and co-editor Dr. Katherine Galagan discuss this edition’s new content and how pathologists and laboratorians can best implement this vast resource of information into their practice. Learn more about the book: https://capatholo.gy/2rqUzOx.
Hemostasis/thrombosis is one of the most complex area of laboratory practice. While the impact of preanalytical variables on coagulation testing is well known, it can be difficult to control.
In this CAPcast, Dr. Kristi Smock, a pathologist and Medical Director at ARUP Hemostasis/Thrombosis Laboratory in Salt Lake City, Utah, discusses some of the best practices to ensure quality in the preanalytic phase of coagulation testing as well as identifying coagulation tests subject to requirements for calibration and AMR verification. Dr. Smock will be teaching a course on this topic at CAP18 which will be held Oct. 20-24 in Chicago. Learn more about CAP18: http://www.capannualmeeting.org/.
Many pathologists are not only members of CAP, but also other specialty medical organizations as well as the American Medical Association. In this CAPcast, Dr. Jason Scapa, the UCLA Department of Pathology & Laboratory Medicine’s Chief Resident and Secretary of the CAP Residents Forum Executive Committee, interviews two CAP members, Dr. Nicole Riddle and Dr. Sang Wu, about why and how they are active in pathology and organized medical associations. Dr. Riddle, a pathologist at Tampa General Hospital in Florida, is currently on the CAP House of Delegates Steering Committee and the current Delegate to the HOD for USCAP and Member-at-Large of the Young Pathologists Section Governing Council at the AMA. Dr. Wu is a pathologist with Texas Health Presbyterian Hospitals in Denton and Dallas, and is active with the college, serving as the Chair for the CAP Practice Management Committee, Member at-Large for the CAP House of Delegates Steering Committee, and member of the PathPAC Board.
In this CAPcast, Dr. Donald Karcher will discuss how the current political climate is impacting key advocacy issues for pathologists. Dr. Karcher is a Chair of the Pathology Department at George Washington University Hospital in Washington, DC, as well as the Chair of the CAP’s Council on Government and Professional Affairs. He is also a member of the CAP Board of Governors.
Improving blood product utilization not only impacts patient outcomes, it can also yield significant cost savings. In this CAP Case Example, Geisinger Health System’s Medical Director for Transfusion Medicine, Dr. Amanda Haynes, explains how she spearheaded a blood product utilization improvement program that resulted in more than $1 million in savings in 2015. Read more about Geisinger's initiative in this CAP Case Example: https://capatholo.gy/2HmlXVm.
In this CAPcast, Dr. Matt Anderson discusses his work on new methods to sequence the genes encoding human leukocyte antigens, better known as “HLA.” Dr. Anderson is Vice President and Medical Director at the BloodCenter of Wisconsin, an Associate Investigator at the Blood Research Institute, and an Assistant Professor of Pathology at the Medical College of Wisconsin. He also currently serves on the Personalized Healthcare Committee of the CAP, and he’s written a short article summarizing some of his work on HLA genes that is posted in the Precision Medicine Resource Center on the CAP web site, http://capatholo.gy/2FIHjh7.
Legislation to increase transparency and accountability in Medicare’s Local Coverage Determinations is currently pending before Congress. The legislation, which is championed by the CAP and pathologists around the country, continues to gain momentum in both the House and Senate with the total of 44 representatives and 15 senators currently sponsoring the bill.
Reforms are necessary to ensure that independent, medical and scientific evidence is not used selectively when developing Local Coverage Determinations, which are also known as LCDs. The CAP helps ensure that all pathologists are appropriately reimbursed for medically reasonable and necessary services provided to Medicare patients.
In this CAPcast, Dr. Gail Vance will discuss this LCD issue, as well as why and how she is advocating for pathologists.
An international consortium of cytopathologists, surgical pathologists, and urologists known as the Paris System Working Group has published a standardized system for urine cytology reporting. This new system was conceived at the 18th International Congress of Cytology in Paris in May 2013. In this CAPcast, consortium member Dr. Daniel Kurtycz and co-editor of the atlas discusses what pathologists need to know about this new reporting system, known as the Paris System.
At the annual Policy Meeting, government leaders and policy experts discuss how major policy and regulatory challenges impact pathologists. In addition, CAP members meet with their representatives and senators in Congress. In this CAPcast interview, Dr. Jared Abbott discusses what he gets out of attending the meeting each year and his experience engaging in advocacy. The 2018 Policy Meeting will be held April 30-May 2 in Washington, DC, learn more: http://capatholo.gy/2si9z4T.
It’s critical for pathologists to maintain their clinical pathology expertise, according to Dr. Jon Heusel, Director of Clinical and Translational Genomics and Chief Medical Officer of Genomics and Pathology Services at Washington University School of Medicine in St. Louis. In this CAPcast interview, Dr. Heusel will talk about why maintaining expertise in clinical pathology is so important, and how a program from the CAP can help ALL pathologists do just that.
HistoQIP is a quality assurance program for histopathology, jointly sponsored by the National Society for Histotechnology and the College of American Pathologists. The primary focus of this program is to improve the quality of histologic preparations routinely performed in the histology laboratory through education.
In this CAPcast from the College of American Pathologists, pathologist Dr. Matthew Carr of Western Michigan Pathology Associates and ASCP certified histotechnologist Sue Lewis discuss how the program works and how it can help pathologists, laboratory managers and their staff members improve the quality of their histology laboratory operations. For more information, visit https://nsh.org/content/all-about-histoqip.
Because medical training is lacking in financial education, new pathologists are often at a loss when diagnosing their financial health. But the burden of student debt, modest resident salaries, and the societal pressures of ‘‘physician wealth’’ can lead to financial despair, depression, and burnout during training, writes Dr. Anne Mills in an editorial recently published on the Archives of Pathology & Laboratory Medicine website. In this CAPcast, Dr. Mills, a pathologist at the University of Virginia, discusses the challenges many young pathologists face in understanding their financial situation and some steps they can take toward financial stability.
The incidence of HPV-related head and neck carcinomas is rising in the United States, with the greatest increase among middle-aged white men. In fact, more than 95% of oral cancers are squamous cell carcinomas, a type that is most closely linked to high-risk HPV. The urgent need to understand HPV's impact on head and neck cancer patients is driving the need for a new evidence-based clinical practice guideline just released by the College of American Pathologists (CAP) and available in early online release from the Archives of Pathology & Laboratory Medicine (http://capatholo.gy/2AUcwbG). In this CAPcast, Dr. William C. Faquin, a pathologist from Massachusetts General Hospital, discusses the significance of these guidelines and how clinicians and pathologists can best implement them. Visit CAP.org for more resources on how pathologists can implement these guidelines: http://capatholo.gy/2BMfPoX.
Many—if not most—pathologists come out of training with little or no confidence in their knowledge about blood banking and transfusion medicine. That’s where Dr. Joe Chaffin—also known as the Blood Bank Guy—comes in. Through his Blood Bank Guy podcasts and videos, Dr. Chaffin is focused on educating pathology residents, practicing pathologists, and laboratorians on the basics and common misconceptions about transfusion medicine, as he explains in the CAPcast.
Pathologists can make a solid case for introducing an emerging technology into their laboratory—even one without a reimbursement code—by creating a business plan, according to Dr. Wendy Wells, the chair of pathology and laboratory medicine at Dartmouth-Hitchcock Health System in Lebanon, New Hampshire. Dr. Wells spoke about creating such a business plan for ex vivo microscopy earlier this year at CAP17. In this CAPcast interview, Dr. Wells will discuss this emerging technology and the important components of a business plan, including establishing financial justification for a technology that is not yet reimbursable. For more on emerging technologies such as in vivo and ex vivo microscopy, visit the CAP IVM Topic Center: http://capatholo.gy/2zDnJzY.
Nearly 40% of physicians say that fragmented or missing information on pathology reports is a barrier to accurately diagnose and characterize cancer. To improve the consistency and reliability of cancer reporting, the CAP and mTuitive have developed the Electronic Forms and Reporting Module, or eFRM for short. In this CAPcast interview, Dr. Jason Pettus, a pathologist with Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, discusses his experience with eFRM and cancer reporting.
One of the new frontiers in pathology, in vivo microscopy(IVM) offers new roles and opportunities for pathologists, specifically those who are still in training and those early in their career. In this CAPcast, Dr. Hany Osman, who is currently the first IVM fellow at Massachusetts General Hospital in Boston, will discuss why IVM is so full of potential for young pathologists. He will also discuss a project that he is working on, an IVM Atlas. For more information, visit the CAP IVM Topic Center: http://capatholo.gy/2lzvyRx.
The CAP’s recently launched Test Ordering Program offers tools and self-assessment modules to assist pathologists in understanding and improving test utilization, so that the pathologist, in collaboration with clinician colleagues, can improve the value and effectiveness of the wider health care organization.
In this CAPcast from the College of American Pathologists, Dr. Ronald Schifman, a pathologist with the Veterans Health Administration, discusses the wide-ranging benefits of this program, which is free to CAP members. Dr. Schifman also shares his experience with improving test utilization at the VA and how these improvements impacted patient care. For more on the CAP's Test Ordering Program, visit http://capatholo.gy/test-ordering-program.
Physician wellness and burnout is the new epidemic in health. By some estimates, 30% to 68% of physicians are experiencing symptoms of burnout, and it exceeds any other professional group. The ramifications of burnout include a 1 in 4 probability of the physician leaving their work situation in the ensuing three years, not to mention the risk of intemperate drug use or suicide, explained Stanford physician and best-selling author Dr. Abraham Verghese at the recent CAP17 meeting in the Washington, DC, area, where he was the meeting’s Spotlight Speaker.
In this CAPcast interview, Dr. Verghese delves deeper into what’s driving physician burnout, the impact, and what, if anything, can be done to reverse burnout.
Benign conditions that masquerade as malignancies, and tumors that are prone to be mistaken for other types of cutaneous malignancies are often challenging to new in practice pathologists. In this CAPcast, Dr. Aleodor Andea, Director of the University of Michigan’s Dermatopathology Molecular Diagnostics Laboratory, will discuss some of the most common causes of misdiagnosis in dermatopathology and what steps pathologists can take to avoid misdiagnosis. Dr. Andea will be teaching a course on this topic next week on Wednesday, Oct. 11 at CAP17 in the Washington, DC region.
The daily challenges of clinical laboratory oversight are mushrooming. Keeping abreast of changes in technology, new and innovative clinical programs for patient care, and new attendant clinical guidelines, compounded by a shifting regulatory landscape, contribute to these challenges. In this CAPcast, pathologist Dr. Robert Dufour will discuss some of these challenges and how some innovative programs and best practices can help pathologists better manage their laboratories. Dr. Dufour is teaching a course on this topic on Monday, Oct. 9 at the CAP17 meeting in the Washington, DC area.
The CAP’s Graduate Medical Education Committee recently published recommendations for Entrustable Professional Activities—or EPAs—for pathology in the journal Academic Pathology (http://capatholo.gy/2xvOXqJ).
In this CAPcast from the College of American Pathologists, committee vice-chair Dr. Cindy McCloskey from the University of Oklahoma College of Medicine discusses how and why these recommendations came about and how they can be another means to determine proficiency and evaluate educational outcomes in the workplace and training environment.
The 2017 CAP Checklist Edition has just been released, and it contains several updates to the Individualized Quality Control Plans—also known as IQCP—required for CAP Accredited Labs.
In this CAPcast, CAP Checklist Committee Chair Dr. William West discusses the key changes that CAP accredited laboratories need to know about to implement these updates.
For more information, please visit the IQCP Resources Page on CAP.org: http://capatholo.gy/2xv0l6l!.
The CAP recently released 52 cancer protocols for reporting pathologic features in the treatment of cancer patients, also known as the CAP Cancer Protocols. These revised protocols now incorporate changes to tumor stage classification from the American Joint Committee on Cancer 8th Edition Cancer Staging Manual.
In this CAPcast, Dr. Thomas Baker, chair of the CAP Cancer Committee, discusses these updates. Dr. Baker will also be teaching a course on this topic, along with Dr. Mahul Amin, on Oct. 9 at CAP17 at the Gaylord National, near Washington, DC. Registration is now open for CAP17:http://www.thepathologistsmeeting.org.
The healthcare payment landscape is changing fast and the financial impacts for physicians could be enormous. In this CAPcast, Dr. Diana Cardona will discuss the primary issues related to Medicare’s quality program and physician fee schedule that will impact pathologists. Dr. Cardona is the Medical Director of the Surgical Pathology and Immunopathology Laboratories at Duke University Medical Center.
If you are attending CAP17 in the Washington, DC, region, be sure to register for Dr. Diana Cardona’s session entitled, Medicare’s New Quality Payment Program and the Physician Fee Schedule—You Can Run But You Can’t Hide, on Monday, Oct. 9 from 2-4pm. She will be joined by other CAP advocacy leaders in teaching this course, Drs. Stephen Black-Schaffer, Patrick Godbey, and Jonathan L. Myles. Registration is now open online at thepathologistsmeeting.org.
CAP17 (www.thepathologistsmeeting.org) puts storytelling front and center at the Inspiration Stage. On Tuesday, October 10th at 5:30, three compelling storytellers will step onto the Inspiration Stage to share their personal journey toward being the change they want to see in the society, in medicine, and in innovation.
In this CAPcast, one of the storytellers, Dr. Susan Rollins, discusses the event and the importance of storytelling for pathologists and patients.
When it comes to liver pathology, many practicing pathologists find non-neoplastic liver biopsy interpretation challenging, as well as how to optimize the use of ancillary testing modalities, like special stains to analyze liver biopsies. In this CAPcast, Dr. Robert M. Najarian discusses this and other challenges related to liver pathology as well as share suggestions to improve communication between practicing pathologists and liver specialists. Dr. Najarian, a pathologist at Boston’s Beth Israel Deaconess Medical Center, will be teaching a course on this topic on Oct. 8 at CAP17 in the Washington, DC area. Register now for CAP17:http://www.thepathologistsmeeting.org/.
Twitter use by physicians, especially pathologists, continues to grow. Twitter provides an easy-to-use communications platform for rapid education, news, and networking that helps busy pathologists stay engaged and informed without taking up much time. Many pathologists see the benefits of joining Twitter but are unsure about how to get started.
In this CAPcast, Drs. Sara Jiang and Jerad Gardner discuss why pathologists should embrace Twitter and how this social media tool has benefited their careers. Drs. Jiang and Gardner will be leading a CAP 17 workshop on this topic, entitled: CAP Foundation Keitges Program on Medical Ethics: Get Tweeting: A Hands-On Interactive Twitter Primer for Pathologists on Monday, Oct 9.
And if you are already active on social media and want to further hone your skills, don’t miss Dr. Jiang and Dr. Gardner’s Roundtable Lunch Discussions at CAP 17. On Sunday, Oct. 8 at 12pm, Dr. Gardner will be leading, “Lessons From a Social Media Pro: Harnessing the Full Power of Twitter and Facebook for Career Development.” And then on Monday, Oct. 9 at 12pm, Dr. Jiang will be leading another lunchtime discussion entitled, “Twitter Beyond the Basics: Analytics, Journal Clubs, and Optimizing Your Efficiency.” Registration for all of these CAP17 events is now open online at http://www.thepathologistsmeeting.org or by clicking on the CAP17 link on http://www.cap.org.
ISO 15189 is an international quality standard for medical laboratories. One of the best practices addressed in this standard is risk management. In this CAPcast from the College of American Pathologists, Dr. Frank Schneider, chair of CAP’s 15189 Committee, discusses ISO 15189 and risk management. Dr. Schneider, a pathologist at Emory University Hospital in Atlanta, Georgia, is also the co-author of a chapter on this topic in the new book, Quality Management in Anatomic Pathology, out now from CAP Press: http://capatholo.gy/2tnSsi1. The CAP 15189 program has issued a Risk Management Guideline that provides additional detail about the ISO 15189 requirements for risk management: http://capatholo.gy/2vjbeo4.
Drug overdoses are now the leading cause of death among Americans under 50. In Milwaukee County, opioid-related deaths are now one-third of the autopsy workload, outnumbering motor vehicle-related and homicide deaths combined, explains Chief Medical Examiner Dr. Brian Peterson. In this CAPcast, Dr. Peterson discusses the factors fueling the rise of the opioid epidemic, how it’s overwhelming the nation’s forensic pathologists and even threatening their laboratory’s accreditation in some cases. Dr. Peterson, who is also the president of the National Association of Medical Examiners will also share his thoughts on what needs to be done to counteract this strain, given this epidemic is showing no signs of reversing course.
In vivo microscopy (IVM) is a key emerging field in the practice of pathology, representing a new role and opportunity for pathologists. Specifically, pathologists will be called on to partner with other physicians in clinical decision making and delivering patient care, according to Dr. Nicholas P Reder, a current clinical research fellow and co-chief resident at the University of Washington Medical Center’s Department of Pathology. In this CAPcast, Dr. Reder will discuss why IVM should be of interest to residents.
Dr. Benjamin Witt discusses the recent reclassification of what had been termed encapsulated (or non-invasive) follicular variant of papillary thyroid carcinoma as a result of a landmark April 2016 article in JAMA Oncology: http://capatholo.gy/2rNnZWn.
In this CAPcast interview, Dr. Miriam Post, a member of CAP’s Graduate Medical Education Committee, discusses findings from a recent survey published earlier this year in the Archives of Pathology & Laboratory Medicine (http://capatholo.gy/2qVz6zd). She speaks about the survey's findings on attributes employers seek in applicants for entry level pathologist positions as well as why networking is so important when looking for a job.
Feedback in the laboratory provides pathologists with an opportunity to ensure improvement when necessary, to reinforce the positive, and to ensure that standards are met in a low stakes environment, translating to improved clinical outcomes, explains CAP member Dr. Sarah Bean in this CAPcast interview. In this interview, Dr. Bean discusses the importance of feedback and how to give and receive effective feedback. Dr. Bean will be leading a course on this topic at CAP17 on October 8th, along with Dr. Sara Jiang. Learn more about CAP17: http://capatholo.gy/2q9qphF.
ISO 15189, an international quality standard for medical laboratories, has the potential to improve the quality of anatomic pathology services, explains Dr. Frank Schneider, a pathologist with Kaiser Permanente in Northern California who chairs the CAP’s ISO 15189 Committee. Dr. Schneider is the co-author of a chapter on this topic in the new book, Quality Management in Anatomic Pathology, out now from CAP Press. For more information on ISO 15189, read this CAP FAQ document: http://capatholo.gy/2qx96Gi.
The FDA has issued Emergency Use Authorization for several diagnostic tests for Zika to assist in the public health response. In this CAPcast, Dr. Benjamin Pinsky, Stanford University Medical Center’s Director of the Clinical Virology Laboratory, discusses the types of testing available as well as the new Vector Bourne Disease Survey from the CAP, which is designed to provide an extra measure of quality assurance for laboratories performing molecular Zika testing.
A new book, The Healing Art of Pathology, brings together essays and artwork about pathology from the perspectives of doctors, patients, and family members. In this CAPcast, the book’s editors, Dr Marilyn Bui and Dr. Katherine Galagan, discuss how the book came about and its message about celebrating the courage of patients, the compassion of physicians, and the strength of the human spirit.
Ever since Dustin Bennett was a toddler, he had trouble keeping his balance, and as he grew older, he experienced rigid, jerking spasms that would appear and disappear. He also developed learning disabilities. Linda Bennett, who is Dustin’s adoptive mother, took him to several doctors to try to find the cause of his movement problems. But after years of tests, medications, and hospital stays, there was no clear diagnosis.
Then a physician suggested that Dustin, now 23, visit the Mayo Clinic’s campus in Jacksonville, Florida. There, specialists, including Dr. Zignew Zolek, recommended that Dustin undergo whole exome sequencing, using Dustin’s blood samples as well as his biological parents and sister. The testing lead to a diagnosis—episodic ataxia type 1, a rare condition. Dustin’s case was recently profiled in the Mayo Clinic Proceedings in a paper authored by Dr. Zolek.
In this CAPcast, Linda discusses her experience with this genome sequencing, from a caregiver’s perspective, and the impact that the test results have had on Dustin’s life as well as on Linda and the rest of Dustin’s family.
Pathologist Dr. Carol Harris has been leading efforts to diagnose and care for HIV patients in Ethiopia since 2002 as director of Einstein College of Medicine's Institute of Global HIV Medicine. In 2012, she turned her attention to cancer, given the growing number of Ethiopians who are living with and dying from cancer. "As the major infectious diseases...come under control...one of the burgeoning epidemics are non-communicable diseases," explains Dr. Harris in this CAPcast interview. "Of course, cancer is one of these. It will become a prodigious healthcare burden and a source of horrific suffering for Ethiopians."
The quality of both a patient's biospecimen and the biorepository where it is stored is vital--or the patient can suffer harm, explains Dr. James Robb, who as a consulting pathologist, helped develop the National Cancer Institute’s Community Cancer Center Program (NCCCP)and the Cancer Human Biobank (caHUB). In this CAPcast, Dr. Robb outlines what is being done to ensure quality biospecimens and biorepositories.
When Kimberly Jewett was first diagnosed with breast cancer at 31, she not only confronted the complexities of treatment decisions, but also managing the transfer of her pathology reports among various doctors and hospitals. In this CAPcast, two-time breast cancer survivor Kimberly Jewett talks about how pathologists can be important advocates for breast cancer patients.