Back to the question at hand,

You will need to engage the pathologists to provide information as to the 
correct way to embed the skin specimens. If you have a dermatopathologist in 
your practice, that person will need to provide the information about how 
he/she dissects it, what he/she wants, and why. I have attended a continuing 
education lecture locally by a dermatopathologist and he showed H&E slides of 
incomplete and improperly embedded skin samples. He could not render a proper 
diagnosis due to this histologist's inability to give him the correct view of 
the samples. How would you feel if that was your biopsy and someone embedded it 
with complete disregard?

I would like to think that mistakes happen due to a misunderstanding and 
nothing more sinister. There was a time back in the day that we each had a 
grossing room rotation and watched how the pathologists did their grossing. I 
suspect in these busy labs and busy times, that happens less and less.

Having the paper trail of the process and/or quality improvement can hopefully 
demonstrate competency. But the expectation alone can not provide that. The key 
is education. Teach us how it needs to be done correctly. Show us the results 
of our work. Have it evaluated and give constructive feedback. Everybody wins 
in this scenario.

Teri Johnson, HT(ASCP)QIHC
Head, Histology and Electron Microscopy
Stowers Institute for Medical Research
Kansas City, MO


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