Re: [Histonet] Aetna and In-Office Lab Accreditation
Money is at the root of all finicial decisions, in-house labs and hospitals. There are many over utilization of resources within the health care field. Many gallbladder surgerious are performed unneccesarly by general surgeous who's practice are within hospitals walls. Tonsilectomy. etc. How are those specimens not self reffered to the hospitals AP lab. David you made the comment about specialities staying with there specialty and not branching out. A dermatopathologist specializes in derm specimens so why is it so far fetched that he would read derm specimens from all sources, hospitals or in-house labs. My in-house lab has a higher turn around rate, lower overhead, and cuts courier fees out. We also do a service to our patients by allowing them one stop shopping. We can service all there needs and they do not have to have multiple appointments at different facilities. This cuts down on their copay and billing from multiple doctors. Also, it would cost more for a person to have Mohs surgery in a hospital setting. As we all know cost are higher at a hospital because they have higher overhead. The hospital is self reffering when they let a surgery center or group be affiliated with them. The surgery center was allowed to join the hospital so the hospital could reep the revenue generated and process their specimens. Either way, we are all joined by a common form of employment, and one facility is not better than another. My field provides jobs and creates revenue just like yours. Insurance company are going to make changes to try and make revenue during this change into OBAMA CARE. Remeber we are not the enemy they are. Who are they to dictate how my company runs. Insurance companies have to much power and the decisions they force us to make do not always provide the best patient care. And that is the ultimate goal for any provider, to give best patient care right? This is just another hurdle we all must jump through in these comming changes. I vote we stick together and try our best to protect all our jobs. Wasnt that long ago that each of us we trying to get pay increases and bring the importance of our jobs to the fore front of pathology. The financial squeeze of the helath care system is going to be felt by all. Histology, pathology, radiology, cytology, we all must do our best to role with the punches and ensure quality care and our incomes, as well as our field, reguardless of location. Nicole Tatum, HT ASCP Thank you for that. How are things at Hartford Hospital? One of my favorite places, rotated there many years ago. Very impressive facility! Is Dr. Ricci still there? On Mon, Apr 9, 2012 at 4:43 PM, Richard Cartun rcar...@harthosp.org wrote: This was released today. Richard Statline Special Alert: New Evidence Links Self-Referral Labs to Increased Utilization, Lower Cancer Detection Rates Study co-funded by CAP Appears in April 2012 Issue of Health Affairs April 9Self-referring urologists billed Medicare for nearly 75% more anatomic pathology (AP) specimens compared to non self-referring physicians, according to a study published today in a leading health care policy journal. Furthermore, the study found no increase in cancer detection for the patients of self-referring physicians-in fact, the detection rate was 14% lower than that of non self-referring physicians. These findings, from an independent study co-funded by the CAP, provide the first clear evidence that self-referral of anatomic pathology services leads to increased utilization, higher Medicare spending, and lower rates of cancer detection. The study, led by renowned Georgetown University health care economist Jean Mitchell, PhD, will appear in the April 2012 issue of Health Affairs and is now available on the journals website. Daniel Schneider dlschnei...@gmail.com 4/9/2012 4:47 PM This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires an employee pathologist is first and foremost to harvest profit from pathology reimbursement. Be a fly on the wall in the partners' meetings and you would know that's what they are talking about. To suggest otherwise is disingenuous. And the implication that the generalist anatomic pathologist is unqualified to be signing out skins, prostates, GI's and whatever is reprehensible. This is not cardiac bypass surgery, and AP pathologists *are* trained to do all of the above. I eagerly defer to subspecialty expert consultants as needed, but most of the time they're not needed. Hospital labs that see few, if any skins, prostates, GI's, are only in that pickle because of the cherrypicking they've already been subjected to. *in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of
RE: [Histonet] Aetna and In-Office Lab Accreditation
There are pros and cons to both business structures. I love the information I get on histonet, but why does everything have to turn into an argument? Can't we just respect each other's opinions? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Kim Donadio Sent: Monday, April 09, 2012 5:58 PM To: Daniel Schneider Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation To suggest that any physician who goes into private practice and has their own lab is any more of a money hound than any other physician at a hospital would also be disingenuous . And of course this is about money. It's about one group of people trying to get another group of people out of the lab business because they want that money. It's also about the government squeezing insurance companies into these more stringent regulations. Now I'm not against more stringent regulations but I do find it offensive of how they are going about it. The little guy will take the hits on this one. I guess what they want is a bunch of walmart like labs. Private practices serve a patient care cause just as hospital labs do. They all make a diagnosis. They all deserve to be paid. My 2 cents Sent from my iPhone On Apr 9, 2012, at 4:47 PM, Daniel Schneider dlschnei...@gmail.com wrote: This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires an employee pathologist is first and foremost to harvest profit from pathology reimbursement. Be a fly on the wall in the partners' meetings and you would know that's what they are talking about. To suggest otherwise is disingenuous. And the implication that the generalist anatomic pathologist is unqualified to be signing out skins, prostates, GI's and whatever is reprehensible. This is not cardiac bypass surgery, and AP pathologists *are* trained to do all of the above. I eagerly defer to subspecialty expert consultants as needed, but most of the time they're not needed. Hospital labs that see few, if any skins, prostates, GI's, are only in that pickle because of the cherrypicking they've already been subjected to. *in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing.* Really? The jobs follow the specimens. Given the same number of specimens, there's the same number of jobs, more or less, just under different circumstances and in different locations Unless you're suggesting that in-office labs will generate increased specimens, and thus increased jobs though overutilization, i.e. excessive numbers of unnecessary biopsies and abuse of the patient and the taxpayer. In which case I have to say there's a grain of truth. And the truth hurts. And it's not a good thing. None of this should be taken as criticism of histotechs and pathologists who find themselves working in an in-office lab. I know there's bills to pay, families to take care of, and god knows it's hard for a pathologist to find a job these days with the numbers our residency programs keep churning out (but that's another rant...). Dan Schneider, MD Amarillo, TX On Mon, Apr 9, 2012 at 12:52 PM, jdcoch...@aol.com wrote: Histonetters: In-office AP labs provide a valuable service to the practices they serve by facilitating 1) better communication between pathologists and ordering clinicians, 2) quality metrics that are practice-specific, and 3) high volume, sub-specialization for both histotechnologists and pathologists. In other words, the more of one type of histopathology a lab does (e.g., skin, prostate, GI), the better it gets. Most people would not think of having their cardiac bypass surgery done at a community hospital doing 50/year; you want to go where more than 500/year are done. In histopathology, the kinds of volume you want are in the thousands for each tissue type. Many hospital labs do little skin or prostate histology anymore. Many sub-specialty in-office AP labs may do thousands of cases of one tissue type every year. Aside from that, in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing. This requirement by an insurer for accreditation will help to validate these in-office AP labs' commitment to quality and put them on the level with their hospital counterparts. John D. Cochran, MD, FCAP ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list
Re: [Histonet] Aetna and In-Office Lab Accreditation
Well Said To suggest that any physician who goes into private practice and has their own lab is any more of a money hound than any other physician at a hospital would also be disingenuous . And of course this is about money. It's about one group of people trying to get another group of people out of the lab business because they want that money. It's also about the government squeezing insurance companies into these more stringent regulations. Now I'm not against more stringent regulations but I do find it offensive of how they are going about it. The little guy will take the hits on this one. I guess what they want is a bunch of walmart like labs. Private practices serve a patient care cause just as hospital labs do. They all make a diagnosis. They all deserve to be paid. My 2 cents Sent from my iPhone On Apr 9, 2012, at 4:47 PM, Daniel Schneider dlschnei...@gmail.com wrote: This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires an employee pathologist is first and foremost to harvest profit from pathology reimbursement. Be a fly on the wall in the partners' meetings and you would know that's what they are talking about. To suggest otherwise is disingenuous. And the implication that the generalist anatomic pathologist is unqualified to be signing out skins, prostates, GI's and whatever is reprehensible. This is not cardiac bypass surgery, and AP pathologists *are* trained to do all of the above. I eagerly defer to subspecialty expert consultants as needed, but most of the time they're not needed. Hospital labs that see few, if any skins, prostates, GI's, are only in that pickle because of the cherrypicking they've already been subjected to. *in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing.* Really? The jobs follow the specimens. Given the same number of specimens, there's the same number of jobs, more or less, just under different circumstances and in different locations Unless you're suggesting that in-office labs will generate increased specimens, and thus increased jobs though overutilization, i.e. excessive numbers of unnecessary biopsies and abuse of the patient and the taxpayer. In which case I have to say there's a grain of truth. And the truth hurts. And it's not a good thing. None of this should be taken as criticism of histotechs and pathologists who find themselves working in an in-office lab. I know there's bills to pay, families to take care of, and god knows it's hard for a pathologist to find a job these days with the numbers our residency programs keep churning out (but that's another rant...). Dan Schneider, MD Amarillo, TX On Mon, Apr 9, 2012 at 12:52 PM, jdcoch...@aol.com wrote: Histonetters: In-office AP labs provide a valuable service to the practices they serve by facilitating 1) better communication between pathologists and ordering clinicians, 2) quality metrics that are practice-specific, and 3) high volume, sub-specialization for both histotechnologists and pathologists. In other words, the more of one type of histopathology a lab does (e.g., skin, prostate, GI), the better it gets. Most people would not think of having their cardiac bypass surgery done at a community hospital doing 50/year; you want to go where more than 500/year are done. In histopathology, the kinds of volume you want are in the thousands for each tissue type. Many hospital labs do little skin or prostate histology anymore. Many sub-specialty in-office AP labs may do thousands of cases of one tissue type every year. Aside from that, in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing. This requirement by an insurer for accreditation will help to validate these in-office AP labs' commitment to quality and put them on the level with their hospital counterparts. John D. Cochran, MD, FCAP ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Aetna and In-Office Lab Accreditation
Because some things are worth arguing about or fighting for? That there are two sides to a conflict doesn't imply that the sides are equally right. It's well documented that clinicians who own their own pathology labs, and profit from the processing and reading of their biopsies, generate significantly more biopsies. Is that good for the patient? Incentives matter. Separating the biopsy grabbing from the biopsy processing/reading is one small way to remove an incentive to abuse the patient and the taxpayer. On Tue, Apr 10, 2012 at 8:47 AM, Pratt, Caroline caroline.pr...@uphs.upenn.edu wrote: There are pros and cons to both business structures. I love the information I get on histonet, but why does everything have to turn into an argument? Can't we just respect each other's opinions? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Kim Donadio Sent: Monday, April 09, 2012 5:58 PM To: Daniel Schneider Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation To suggest that any physician who goes into private practice and has their own lab is any more of a money hound than any other physician at a hospital would also be disingenuous . And of course this is about money. It's about one group of people trying to get another group of people out of the lab business because they want that money. It's also about the government squeezing insurance companies into these more stringent regulations. Now I'm not against more stringent regulations but I do find it offensive of how they are going about it. The little guy will take the hits on this one. I guess what they want is a bunch of walmart like labs. Private practices serve a patient care cause just as hospital labs do. They all make a diagnosis. They all deserve to be paid. My 2 cents Sent from my iPhone On Apr 9, 2012, at 4:47 PM, Daniel Schneider dlschnei...@gmail.com wrote: This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires an employee pathologist is first and foremost to harvest profit from pathology reimbursement. Be a fly on the wall in the partners' meetings and you would know that's what they are talking about. To suggest otherwise is disingenuous. And the implication that the generalist anatomic pathologist is unqualified to be signing out skins, prostates, GI's and whatever is reprehensible. This is not cardiac bypass surgery, and AP pathologists *are* trained to do all of the above. I eagerly defer to subspecialty expert consultants as needed, but most of the time they're not needed. Hospital labs that see few, if any skins, prostates, GI's, are only in that pickle because of the cherrypicking they've already been subjected to. *in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing.* Really? The jobs follow the specimens. Given the same number of specimens, there's the same number of jobs, more or less, just under different circumstances and in different locations Unless you're suggesting that in-office labs will generate increased specimens, and thus increased jobs though overutilization, i.e. excessive numbers of unnecessary biopsies and abuse of the patient and the taxpayer. In which case I have to say there's a grain of truth. And the truth hurts. And it's not a good thing. None of this should be taken as criticism of histotechs and pathologists who find themselves working in an in-office lab. I know there's bills to pay, families to take care of, and god knows it's hard for a pathologist to find a job these days with the numbers our residency programs keep churning out (but that's another rant...). Dan Schneider, MD Amarillo, TX On Mon, Apr 9, 2012 at 12:52 PM, jdcoch...@aol.com wrote: Histonetters: In-office AP labs provide a valuable service to the practices they serve by facilitating 1) better communication between pathologists and ordering clinicians, 2) quality metrics that are practice-specific, and 3) high volume, sub-specialization for both histotechnologists and pathologists. In other words, the more of one type of histopathology a lab does (e.g., skin, prostate, GI), the better it gets. Most people would not think of having their cardiac bypass surgery done at a community hospital doing 50/year; you want to go where more than 500/year are done. In histopathology, the kinds of volume you want are in the thousands for each tissue type. Many hospital labs do little skin or prostate histology anymore. Many sub-specialty in-office AP labs may do thousands of cases of one
RE: [Histonet] Aetna and In-Office Lab Accreditation
Start with reading Dr. Schneider's post. Then read Richard Cartun's post. Those should deal will what you are talking about very well. These in-office labs should not exist, for the very same reason the undertaker is no longer the ambulance driver. There is a very real, and significant conflict of interest. Sent from my Windows Phone From: Nicole Tatum Sent: 4/10/2012 6:45 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation Money is at the root of all finicial decisions, in-house labs and hospitals. There are many over utilization of resources within the health care field. Many gallbladder surgerious are performed unneccesarly by general surgeous who's practice are within hospitals walls. Tonsilectomy. etc. How are those specimens not self reffered to the hospitals AP lab. David you made the comment about specialities staying with there specialty and not branching out. A dermatopathologist specializes in derm specimens so why is it so far fetched that he would read derm specimens from all sources, hospitals or in-house labs. My in-house lab has a higher turn around rate, lower overhead, and cuts courier fees out. We also do a service to our patients by allowing them one stop shopping. We can service all there needs and they do not have to have multiple appointments at different facilities. This cuts down on their copay and billing from multiple doctors. Also, it would cost more for a person to have Mohs surgery in a hospital setting. As we all know cost are higher at a hospital because they have higher overhead. The hospital is self reffering when they let a surgery center or group be affiliated with them. The surgery center was allowed to join the hospital so the hospital could reep the revenue generated and process their specimens. Either way, we are all joined by a common form of employment, and one facility is not better than another. My field provides jobs and creates revenue just like yours. Insurance company are going to make changes to try and make revenue during this change into OBAMA CARE. Remeber we are not the enemy they are. Who are they to dictate how my company runs. Insurance companies have to much power and the decisions they force us to make do not always provide the best patient care. And that is the ultimate goal for any provider, to give best patient care right? This is just another hurdle we all must jump through in these comming changes. I vote we stick together and try our best to protect all our jobs. Wasnt that long ago that each of us we trying to get pay increases and bring the importance of our jobs to the fore front of pathology. The financial squeeze of the helath care system is going to be felt by all. Histology, pathology, radiology, cytology, we all must do our best to role with the punches and ensure quality care and our incomes, as well as our field, reguardless of location. Nicole Tatum, HT ASCP Thank you for that. How are things at Hartford Hospital? One of my favorite places, rotated there many years ago. Very impressive facility! Is Dr. Ricci still there? On Mon, Apr 9, 2012 at 4:43 PM, Richard Cartun rcar...@harthosp.org wrote: This was released today. Richard Statline Special Alert: New Evidence Links Self-Referral Labs to Increased Utilization, Lower Cancer Detection Rates Study co-funded by CAP Appears in April 2012 Issue of Health Affairs April 9Self-referring urologists billed Medicare for nearly 75% more anatomic pathology (AP) specimens compared to non self-referring physicians, according to a study published today in a leading health care policy journal. Furthermore, the study found no increase in cancer detection for the patients of self-referring physicians-in fact, the detection rate was 14% lower than that of non self-referring physicians. These findings, from an independent study co-funded by the CAP, provide the first clear evidence that self-referral of anatomic pathology services leads to increased utilization, higher Medicare spending, and lower rates of cancer detection. The study, led by renowned Georgetown University health care economist Jean Mitchell, PhD, will appear in the April 2012 issue of Health Affairs and is now available on the journals website. Daniel Schneider dlschnei...@gmail.com 4/9/2012 4:47 PM This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires an employee pathologist is first and foremost to harvest profit from pathology reimbursement. Be a fly on the wall in the partners' meetings and you would know that's what they are talking about. To suggest otherwise is disingenuous. And the implication that the generalist anatomic pathologist is unqualified to be signing out skins, prostates, GI's and whatever is reprehensible
RE: [Histonet] Aetna and In-Office Lab Accreditation
Really, An undertaker. Yea, theres definately a conflict here, you. No since in wasting my time. Nicole Start with reading Dr. Schneider's post. Then read Richard Cartun's post. Those should deal will what you are talking about very well. These in-office labs should not exist, for the very same reason the undertaker is no longer the ambulance driver. There is a very real, and significant conflict of interest. Sent from my Windows Phone From: Nicole Tatum Sent: 4/10/2012 6:45 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation Money is at the root of all finicial decisions, in-house labs and hospitals. There are many over utilization of resources within the health care field. Many gallbladder surgerious are performed unneccesarly by general surgeous who's practice are within hospitals walls. Tonsilectomy. etc. How are those specimens not self reffered to the hospitals AP lab. David you made the comment about specialities staying with there specialty and not branching out. A dermatopathologist specializes in derm specimens so why is it so far fetched that he would read derm specimens from all sources, hospitals or in-house labs. My in-house lab has a higher turn around rate, lower overhead, and cuts courier fees out. We also do a service to our patients by allowing them one stop shopping. We can service all there needs and they do not have to have multiple appointments at different facilities. This cuts down on their copay and billing from multiple doctors. Also, it would cost more for a person to have Mohs surgery in a hospital setting. As we all know cost are higher at a hospital because they have higher overhead. The hospital is self reffering when they let a surgery center or group be affiliated with them. The surgery center was allowed to join the hospital so the hospital could reep the revenue generated and process their specimens. Either way, we are all joined by a common form of employment, and one facility is not better than another. My field provides jobs and creates revenue just like yours. Insurance company are going to make changes to try and make revenue during this change into OBAMA CARE. Remeber we are not the enemy they are. Who are they to dictate how my company runs. Insurance companies have to much power and the decisions they force us to make do not always provide the best patient care. And that is the ultimate goal for any provider, to give best patient care right? This is just another hurdle we all must jump through in these comming changes. I vote we stick together and try our best to protect all our jobs. Wasnt that long ago that each of us we trying to get pay increases and bring the importance of our jobs to the fore front of pathology. The financial squeeze of the helath care system is going to be felt by all. Histology, pathology, radiology, cytology, we all must do our best to role with the punches and ensure quality care and our incomes, as well as our field, reguardless of location. Nicole Tatum, HT ASCP Thank you for that. How are things at Hartford Hospital? One of my favorite places, rotated there many years ago. Very impressive facility! Is Dr. Ricci still there? On Mon, Apr 9, 2012 at 4:43 PM, Richard Cartun rcar...@harthosp.org wrote: This was released today. Richard Statline Special Alert: New Evidence Links Self-Referral Labs to Increased Utilization, Lower Cancer Detection Rates Study co-funded by CAP Appears in April 2012 Issue of Health Affairs April 9Self-referring urologists billed Medicare for nearly 75% more anatomic pathology (AP) specimens compared to non self-referring physicians, according to a study published today in a leading health care policy journal. Furthermore, the study found no increase in cancer detection for the patients of self-referring physicians-in fact, the detection rate was 14% lower than that of non self-referring physicians. These findings, from an independent study co-funded by the CAP, provide the first clear evidence that self-referral of anatomic pathology services leads to increased utilization, higher Medicare spending, and lower rates of cancer detection. The study, led by renowned Georgetown University health care economist Jean Mitchell, PhD, will appear in the April 2012 issue of Health Affairs and is now available on the journals website. Daniel Schneider dlschnei...@gmail.com 4/9/2012 4:47 PM This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires an employee pathologist is first and foremost to harvest profit from pathology reimbursement. Be a fly on the wall in the partners' meetings and you would know that's what they are talking about. To suggest otherwise is disingenuous
Re: [Histonet] Aetna and In-Office Lab Accreditation
Ditto Nicole! My daughter just passed her FUNERAL DIRECTOR boards! First time, I might add. Paula K. Pierce, HTL(ASCP)HT President Excalibur Pathology, Inc. 8901 S. Santa Fe, Suite G Oklahoma City, OK 73139 405-759-3953 Lab 405-759-7513 Fax www.excaliburpathology.com From: Nicole Tatum nic...@dlcjax.com To: Davide Costanzo pathloc...@gmail.com; histonet@lists.utsouthwestern.edu Sent: Tuesday, April 10, 2012 10:18 AM Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation Really, An undertaker. Yea, theres definately a conflict here, you. No since in wasting my time. Nicole Start with reading Dr. Schneider's post. Then read Richard Cartun's post. Those should deal will what you are talking about very well. These in-office labs should not exist, for the very same reason the undertaker is no longer the ambulance driver. There is a very real, and significant conflict of interest. Sent from my Windows Phone From: Nicole Tatum Sent: 4/10/2012 6:45 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation Money is at the root of all finicial decisions, in-house labs and hospitals. There are many over utilization of resources within the health care field. Many gallbladder surgerious are performed unneccesarly by general surgeous who's practice are within hospitals walls. Tonsilectomy. etc. How are those specimens not self reffered to the hospitals AP lab. David you made the comment about specialities staying with there specialty and not branching out. A dermatopathologist specializes in derm specimens so why is it so far fetched that he would read derm specimens from all sources, hospitals or in-house labs. My in-house lab has a higher turn around rate, lower overhead, and cuts courier fees out. We also do a service to our patients by allowing them one stop shopping. We can service all there needs and they do not have to have multiple appointments at different facilities. This cuts down on their copay and billing from multiple doctors. Also, it would cost more for a person to have Mohs surgery in a hospital setting. As we all know cost are higher at a hospital because they have higher overhead. The hospital is self reffering when they let a surgery center or group be affiliated with them. The surgery center was allowed to join the hospital so the hospital could reep the revenue generated and process their specimens. Either way, we are all joined by a common form of employment, and one facility is not better than another. My field provides jobs and creates revenue just like yours. Insurance company are going to make changes to try and make revenue during this change into OBAMA CARE. Remeber we are not the enemy they are. Who are they to dictate how my company runs. Insurance companies have to much power and the decisions they force us to make do not always provide the best patient care. And that is the ultimate goal for any provider, to give best patient care right? This is just another hurdle we all must jump through in these comming changes. I vote we stick together and try our best to protect all our jobs. Wasnt that long ago that each of us we trying to get pay increases and bring the importance of our jobs to the fore front of pathology. The financial squeeze of the helath care system is going to be felt by all. Histology, pathology, radiology, cytology, we all must do our best to role with the punches and ensure quality care and our incomes, as well as our field, reguardless of location. Nicole Tatum, HT ASCP Thank you for that. How are things at Hartford Hospital? One of my favorite places, rotated there many years ago. Very impressive facility! Is Dr. Ricci still there? On Mon, Apr 9, 2012 at 4:43 PM, Richard Cartun rcar...@harthosp.org wrote: This was released today. Richard Statline Special Alert: New Evidence Links Self-Referral Labs to Increased Utilization, Lower Cancer Detection Rates Study co-funded by CAP Appears in April 2012 Issue of Health Affairs April 9—Self-referring urologists billed Medicare for nearly 75% more anatomic pathology (AP) specimens compared to non self-referring physicians, according to a study published today in a leading health care policy journal. Furthermore, the study found no increase in cancer detection for the patients of self-referring physicians-in fact, the detection rate was 14% lower than that of non self-referring physicians. These findings, from an independent study co-funded by the CAP, provide the first clear evidence that self-referral of anatomic pathology services leads to increased utilization, higher Medicare spending, and lower rates of cancer detection. The study, led by renowned Georgetown University health care economist Jean Mitchell, PhD, will appear in the April 2012 issue of Health Affairs and is now available on the journal’s website
RE: [Histonet] Aetna and In-Office Lab Accreditation
Very classy argument. Thank you for your eloquence. Sent from my Windows Phone From: Nicole Tatum Sent: 4/10/2012 8:18 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation Really, An undertaker. Yea, theres definately a conflict here, you. No since in wasting my time. Nicole Start with reading Dr. Schneider's post. Then read Richard Cartun's post. Those should deal will what you are talking about very well. These in-office labs should not exist, for the very same reason the undertaker is no longer the ambulance driver. There is a very real, and significant conflict of interest. Sent from my Windows Phone From: Nicole Tatum Sent: 4/10/2012 6:45 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation Money is at the root of all finicial decisions, in-house labs and hospitals. There are many over utilization of resources within the health care field. Many gallbladder surgerious are performed unneccesarly by general surgeous who's practice are within hospitals walls. Tonsilectomy. etc. How are those specimens not self reffered to the hospitals AP lab. David you made the comment about specialities staying with there specialty and not branching out. A dermatopathologist specializes in derm specimens so why is it so far fetched that he would read derm specimens from all sources, hospitals or in-house labs. My in-house lab has a higher turn around rate, lower overhead, and cuts courier fees out. We also do a service to our patients by allowing them one stop shopping. We can service all there needs and they do not have to have multiple appointments at different facilities. This cuts down on their copay and billing from multiple doctors. Also, it would cost more for a person to have Mohs surgery in a hospital setting. As we all know cost are higher at a hospital because they have higher overhead. The hospital is self reffering when they let a surgery center or group be affiliated with them. The surgery center was allowed to join the hospital so the hospital could reep the revenue generated and process their specimens. Either way, we are all joined by a common form of employment, and one facility is not better than another. My field provides jobs and creates revenue just like yours. Insurance company are going to make changes to try and make revenue during this change into OBAMA CARE. Remeber we are not the enemy they are. Who are they to dictate how my company runs. Insurance companies have to much power and the decisions they force us to make do not always provide the best patient care. And that is the ultimate goal for any provider, to give best patient care right? This is just another hurdle we all must jump through in these comming changes. I vote we stick together and try our best to protect all our jobs. Wasnt that long ago that each of us we trying to get pay increases and bring the importance of our jobs to the fore front of pathology. The financial squeeze of the helath care system is going to be felt by all. Histology, pathology, radiology, cytology, we all must do our best to role with the punches and ensure quality care and our incomes, as well as our field, reguardless of location. Nicole Tatum, HT ASCP Thank you for that. How are things at Hartford Hospital? One of my favorite places, rotated there many years ago. Very impressive facility! Is Dr. Ricci still there? On Mon, Apr 9, 2012 at 4:43 PM, Richard Cartun rcar...@harthosp.org wrote: This was released today. Richard Statline Special Alert: New Evidence Links Self-Referral Labs to Increased Utilization, Lower Cancer Detection Rates Study co-funded by CAP Appears in April 2012 Issue of Health Affairs April 9Self-referring urologists billed Medicare for nearly 75% more anatomic pathology (AP) specimens compared to non self-referring physicians, according to a study published today in a leading health care policy journal. Furthermore, the study found no increase in cancer detection for the patients of self-referring physicians-in fact, the detection rate was 14% lower than that of non self-referring physicians. These findings, from an independent study co-funded by the CAP, provide the first clear evidence that self-referral of anatomic pathology services leads to increased utilization, higher Medicare spending, and lower rates of cancer detection. The study, led by renowned Georgetown University health care economist Jean Mitchell, PhD, will appear in the April 2012 issue of Health Affairs and is now available on the journals website. Daniel Schneider dlschnei...@gmail.com 4/9/2012 4:47 PM This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires
RE: [Histonet] Aetna and In-Office Lab Accreditation
Hey David I think your list of people never wanting to work with you just got longer. Lee Ann -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Davide Costanzo Sent: Tuesday, April 10, 2012 12:13 PM To: Nicole Tatum; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation Very classy argument. Thank you for your eloquence. Sent from my Windows Phone From: Nicole Tatum Sent: 4/10/2012 8:18 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation Really, An undertaker. Yea, theres definately a conflict here, you. No since in wasting my time. Nicole Start with reading Dr. Schneider's post. Then read Richard Cartun's post. Those should deal will what you are talking about very well. These in-office labs should not exist, for the very same reason the undertaker is no longer the ambulance driver. There is a very real, and significant conflict of interest. Sent from my Windows Phone From: Nicole Tatum Sent: 4/10/2012 6:45 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation Money is at the root of all finicial decisions, in-house labs and hospitals. There are many over utilization of resources within the health care field. Many gallbladder surgerious are performed unneccesarly by general surgeous who's practice are within hospitals walls. Tonsilectomy. etc. How are those specimens not self reffered to the hospitals AP lab. David you made the comment about specialities staying with there specialty and not branching out. A dermatopathologist specializes in derm specimens so why is it so far fetched that he would read derm specimens from all sources, hospitals or in-house labs. My in-house lab has a higher turn around rate, lower overhead, and cuts courier fees out. We also do a service to our patients by allowing them one stop shopping. We can service all there needs and they do not have to have multiple appointments at different facilities. This cuts down on their copay and billing from multiple doctors. Also, it would cost more for a person to have Mohs surgery in a hospital setting. As we all know cost are higher at a hospital because they have higher overhead. The hospital is self reffering when they let a surgery center or group be affiliated with them. The surgery center was allowed to join the hospital so the hospital could reep the revenue generated and process their specimens. Either way, we are all joined by a common form of employment, and one facility is not better than another. My field provides jobs and creates revenue just like yours. Insurance company are going to make changes to try and make revenue during this change into OBAMA CARE. Remeber we are not the enemy they are. Who are they to dictate how my company runs. Insurance companies have to much power and the decisions they force us to make do not always provide the best patient care. And that is the ultimate goal for any provider, to give best patient care right? This is just another hurdle we all must jump through in these comming changes. I vote we stick together and try our best to protect all our jobs. Wasnt that long ago that each of us we trying to get pay increases and bring the importance of our jobs to the fore front of pathology. The financial squeeze of the helath care system is going to be felt by all. Histology, pathology, radiology, cytology, we all must do our best to role with the punches and ensure quality care and our incomes, as well as our field, reguardless of location. Nicole Tatum, HT ASCP Thank you for that. How are things at Hartford Hospital? One of my favorite places, rotated there many years ago. Very impressive facility! Is Dr. Ricci still there? On Mon, Apr 9, 2012 at 4:43 PM, Richard Cartun rcar...@harthosp.org wrote: This was released today. Richard Statline Special Alert: New Evidence Links Self-Referral Labs to Increased Utilization, Lower Cancer Detection Rates Study co-funded by CAP Appears in April 2012 Issue of Health Affairs April 9-Self-referring urologists billed Medicare for nearly 75% more anatomic pathology (AP) specimens compared to non self-referring physicians, according to a study published today in a leading health care policy journal. Furthermore, the study found no increase in cancer detection for the patients of self-referring physicians-in fact, the detection rate was 14% lower than that of non self-referring physicians. These findings, from an independent study co-funded by the CAP, provide the first clear evidence that self-referral of anatomic pathology services leads to increased utilization, higher Medicare spending, and lower rates of cancer detection. The study, led by renowned Georgetown University health care economist Jean Mitchell
RE: [Histonet] Aetna and In-Office Lab Accreditation
I don't think it was meant as a personal attack, it's a larger conceptual issue on ethics of the business principle behind the model for in-office laboratories and the debate isn't about jobs, it's about the best interest of the patient. I am sure your skill set is exceptional. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Nicole Tatum Sent: Tuesday, April 10, 2012 11:56 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation Rude is when you attack someone who is your equal. Yes, your right im a schmuck because I work in private practice. I didnt know that having my education, and completing my internship, and having 12yrs in the field made me a lesser histologist because I work in private practice. Seriouly get a grip. The conflict lies in you, if you cant see that we all are working to support our families. I really dont care where my fellow Histologist work, because I am happy they have a job and our professional is able to grow and that there are other opportunities for Histologist outside of hospitals. These in-house lab have created all new opportunities for Histologist and I back them 100%. Great thing about being an American, is I dont have to agree with you. This field has supported my family and allowed me to live comfortably, I will defend it for myself and others who will be entering the work force. I can only hope they have me for a mentor. I choose to promote my field and work with my collegues to ensure the survival of all of our jobs. Nicole Tatum HT ASCP You're just plain rude. Whenever someone is wrong, it is easy to criticize others. Takes the focus off you. Unlike you, I will not post my personal rude comments on the entire list serv. You are right, I shouldn't argue with a lesser educated schmuck either. Sent from my Windows Phone From: Nicole Tatum Sent: 4/10/2012 8:18 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation Really, An undertaker. Yea, theres definately a conflict here, you. No since in wasting my time. Nicole Start with reading Dr. Schneider's post. Then read Richard Cartun's post. Those should deal will what you are talking about very well. These in-office labs should not exist, for the very same reason the undertaker is no longer the ambulance driver. There is a very real, and significant conflict of interest. Sent from my Windows Phone From: Nicole Tatum Sent: 4/10/2012 6:45 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation Money is at the root of all finicial decisions, in-house labs and hospitals. There are many over utilization of resources within the health care field. Many gallbladder surgerious are performed unneccesarly by general surgeous who's practice are within hospitals walls. Tonsilectomy. etc. How are those specimens not self reffered to the hospitals AP lab. David you made the comment about specialities staying with there specialty and not branching out. A dermatopathologist specializes in derm specimens so why is it so far fetched that he would read derm specimens from all sources, hospitals or in-house labs. My in-house lab has a higher turn around rate, lower overhead, and cuts courier fees out. We also do a service to our patients by allowing them one stop shopping. We can service all there needs and they do not have to have multiple appointments at different facilities. This cuts down on their copay and billing from multiple doctors. Also, it would cost more for a person to have Mohs surgery in a hospital setting. As we all know cost are higher at a hospital because they have higher overhead. The hospital is self reffering when they let a surgery center or group be affiliated with them. The surgery center was allowed to join the hospital so the hospital could reep the revenue generated and process their specimens. Either way, we are all joined by a common form of employment, and one facility is not better than another. My field provides jobs and creates revenue just like yours. Insurance company are going to make changes to try and make revenue during this change into OBAMA CARE. Remeber we are not the enemy they are. Who are they to dictate how my company runs. Insurance companies have to much power and the decisions they force us to make do not always provide the best patient care. And that is the ultimate goal for any provider, to give best patient care right? This is just another hurdle we all must jump through in these comming changes. I vote we stick together and try our best to protect all our jobs. Wasnt that long ago that each of us we trying to get pay increases and bring the importance of our jobs to the fore front of pathology. The financial squeeze
RE: [Histonet] Aetna and In-Office Lab Accreditation
The words used are rude, and highly uncalled for in a public forum. Not one of my posts talked about techs at all, and very wrong assumptions were made, and quite insulting posts ensued. I have great respect for techs, always have. To suggest otherwise is more wrong than I can say. Sent from my Windows Phone From: Pratt, Caroline Sent: 4/10/2012 10:18 AM To: Nicole Tatum; Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation I don't think it was meant as a personal attack, it's a larger conceptual issue on ethics of the business principle behind the model for in-office laboratories and the debate isn't about jobs, it's about the best interest of the patient. I am sure your skill set is exceptional. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Nicole Tatum Sent: Tuesday, April 10, 2012 11:56 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation Rude is when you attack someone who is your equal. Yes, your right im a schmuck because I work in private practice. I didnt know that having my education, and completing my internship, and having 12yrs in the field made me a lesser histologist because I work in private practice. Seriouly get a grip. The conflict lies in you, if you cant see that we all are working to support our families. I really dont care where my fellow Histologist work, because I am happy they have a job and our professional is able to grow and that there are other opportunities for Histologist outside of hospitals. These in-house lab have created all new opportunities for Histologist and I back them 100%. Great thing about being an American, is I dont have to agree with you. This field has supported my family and allowed me to live comfortably, I will defend it for myself and others who will be entering the work force. I can only hope they have me for a mentor. I choose to promote my field and work with my collegues to ensure the survival of all of our jobs. Nicole Tatum HT ASCP You're just plain rude. Whenever someone is wrong, it is easy to criticize others. Takes the focus off you. Unlike you, I will not post my personal rude comments on the entire list serv. You are right, I shouldn't argue with a lesser educated schmuck either. Sent from my Windows Phone From: Nicole Tatum Sent: 4/10/2012 8:18 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation Really, An undertaker. Yea, theres definately a conflict here, you. No since in wasting my time. Nicole Start with reading Dr. Schneider's post. Then read Richard Cartun's post. Those should deal will what you are talking about very well. These in-office labs should not exist, for the very same reason the undertaker is no longer the ambulance driver. There is a very real, and significant conflict of interest. Sent from my Windows Phone From: Nicole Tatum Sent: 4/10/2012 6:45 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation Money is at the root of all finicial decisions, in-house labs and hospitals. There are many over utilization of resources within the health care field. Many gallbladder surgerious are performed unneccesarly by general surgeous who's practice are within hospitals walls. Tonsilectomy. etc. How are those specimens not self reffered to the hospitals AP lab. David you made the comment about specialities staying with there specialty and not branching out. A dermatopathologist specializes in derm specimens so why is it so far fetched that he would read derm specimens from all sources, hospitals or in-house labs. My in-house lab has a higher turn around rate, lower overhead, and cuts courier fees out. We also do a service to our patients by allowing them one stop shopping. We can service all there needs and they do not have to have multiple appointments at different facilities. This cuts down on their copay and billing from multiple doctors. Also, it would cost more for a person to have Mohs surgery in a hospital setting. As we all know cost are higher at a hospital because they have higher overhead. The hospital is self reffering when they let a surgery center or group be affiliated with them. The surgery center was allowed to join the hospital so the hospital could reep the revenue generated and process their specimens. Either way, we are all joined by a common form of employment, and one facility is not better than another. My field provides jobs and creates revenue just like yours. Insurance company are going to make changes to try and make revenue during this change into OBAMA CARE. Remeber we are not the enemy they are. Who are they to dictate how my company runs. Insurance companies have
RE: [Histonet] Aetna and In-Office Lab Accreditation
THANK YOU! -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of jdcoch...@aol.com Sent: Monday, April 09, 2012 1:53 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Aetna and In-Office Lab Accreditation Histonetters: I was informed today by The Joint Commission that an oversight was made in the original letter from Aetna regarding a new requirement for in-office AP lab accreditation. Aetna's Medical Director states in a letter to The Joint Commission: It can be CAP or JCAHO certification of their laboratory. We want to encourage providers to obtain either one of these accreditations. We will be updating the physician letter with this change... To my knowledge, TJC and CAP are the only CMS-deemed authorities for Anatomic Pathology lab accreditation since a third accreditation organization has exited that arena. In-office AP labs provide a valuable service to the practices they serve by facilitating 1) better communication between pathologists and ordering clinicians, 2) quality metrics that are practice-specific, and 3) high volume, sub-specialization for both histotechnologists and pathologists. In other words, the more of one type of histopathology a lab does (e.g., skin, prostate, GI), the better it gets. Most people would not think of having their cardiac bypass surgery done at a community hospital doing 50/year; you want to go where more than 500/year are done. In histopathology, the kinds of volume you want are in the thousands for each tissue type. Many hospital labs do little skin or prostate histology anymore. Many sub-specialty in-office AP labs may do thousands of cases of one tissue type every year. Aside from that, in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing. This requirement by an insurer for accreditation will help to validate these in-office AP labs' commitment to quality and put them on the level with their hospital counterparts. John D. Cochran, MD, FCAP ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet The information contained in this e-mail message is intended only for the personal and confidential use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, and delete the original message. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Aetna and In-Office Lab Accreditation
This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires an employee pathologist is first and foremost to harvest profit from pathology reimbursement. Be a fly on the wall in the partners' meetings and you would know that's what they are talking about. To suggest otherwise is disingenuous. And the implication that the generalist anatomic pathologist is unqualified to be signing out skins, prostates, GI's and whatever is reprehensible. This is not cardiac bypass surgery, and AP pathologists *are* trained to do all of the above. I eagerly defer to subspecialty expert consultants as needed, but most of the time they're not needed. Hospital labs that see few, if any skins, prostates, GI's, are only in that pickle because of the cherrypicking they've already been subjected to. *in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing.* Really? The jobs follow the specimens. Given the same number of specimens, there's the same number of jobs, more or less, just under different circumstances and in different locations Unless you're suggesting that in-office labs will generate increased specimens, and thus increased jobs though overutilization, i.e. excessive numbers of unnecessary biopsies and abuse of the patient and the taxpayer. In which case I have to say there's a grain of truth. And the truth hurts. And it's not a good thing. None of this should be taken as criticism of histotechs and pathologists who find themselves working in an in-office lab. I know there's bills to pay, families to take care of, and god knows it's hard for a pathologist to find a job these days with the numbers our residency programs keep churning out (but that's another rant...). Dan Schneider, MD Amarillo, TX On Mon, Apr 9, 2012 at 12:52 PM, jdcoch...@aol.com wrote: Histonetters: In-office AP labs provide a valuable service to the practices they serve by facilitating 1) better communication between pathologists and ordering clinicians, 2) quality metrics that are practice-specific, and 3) high volume, sub-specialization for both histotechnologists and pathologists. In other words, the more of one type of histopathology a lab does (e.g., skin, prostate, GI), the better it gets. Most people would not think of having their cardiac bypass surgery done at a community hospital doing 50/year; you want to go where more than 500/year are done. In histopathology, the kinds of volume you want are in the thousands for each tissue type. Many hospital labs do little skin or prostate histology anymore. Many sub-specialty in-office AP labs may do thousands of cases of one tissue type every year. Aside from that, in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing. This requirement by an insurer for accreditation will help to validate these in-office AP labs' commitment to quality and put them on the level with their hospital counterparts. John D. Cochran, MD, FCAP ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Aetna and In-Office Lab Accreditation
Amen! Thank you Dr. Schneider. Sent from my Windows Phone From: Daniel Schneider Sent: 4/9/2012 1:47 PM To: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires an employee pathologist is first and foremost to harvest profit from pathology reimbursement. Be a fly on the wall in the partners' meetings and you would know that's what they are talking about. To suggest otherwise is disingenuous. And the implication that the generalist anatomic pathologist is unqualified to be signing out skins, prostates, GI's and whatever is reprehensible. This is not cardiac bypass surgery, and AP pathologists *are* trained to do all of the above. I eagerly defer to subspecialty expert consultants as needed, but most of the time they're not needed. Hospital labs that see few, if any skins, prostates, GI's, are only in that pickle because of the cherrypicking they've already been subjected to. *in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing.* Really? The jobs follow the specimens. Given the same number of specimens, there's the same number of jobs, more or less, just under different circumstances and in different locations Unless you're suggesting that in-office labs will generate increased specimens, and thus increased jobs though overutilization, i.e. excessive numbers of unnecessary biopsies and abuse of the patient and the taxpayer. In which case I have to say there's a grain of truth. And the truth hurts. And it's not a good thing. None of this should be taken as criticism of histotechs and pathologists who find themselves working in an in-office lab. I know there's bills to pay, families to take care of, and god knows it's hard for a pathologist to find a job these days with the numbers our residency programs keep churning out (but that's another rant...). Dan Schneider, MD Amarillo, TX On Mon, Apr 9, 2012 at 12:52 PM, jdcoch...@aol.com wrote: Histonetters: In-office AP labs provide a valuable service to the practices they serve by facilitating 1) better communication between pathologists and ordering clinicians, 2) quality metrics that are practice-specific, and 3) high volume, sub-specialization for both histotechnologists and pathologists. In other words, the more of one type of histopathology a lab does (e.g., skin, prostate, GI), the better it gets. Most people would not think of having their cardiac bypass surgery done at a community hospital doing 50/year; you want to go where more than 500/year are done. In histopathology, the kinds of volume you want are in the thousands for each tissue type. Many hospital labs do little skin or prostate histology anymore. Many sub-specialty in-office AP labs may do thousands of cases of one tissue type every year. Aside from that, in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing. This requirement by an insurer for accreditation will help to validate these in-office AP labs' commitment to quality and put them on the level with their hospital counterparts. John D. Cochran, MD, FCAP ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Aetna and In-Office Lab Accreditation
To suggest that any physician who goes into private practice and has their own lab is any more of a money hound than any other physician at a hospital would also be disingenuous . And of course this is about money. It's about one group of people trying to get another group of people out of the lab business because they want that money. It's also about the government squeezing insurance companies into these more stringent regulations. Now I'm not against more stringent regulations but I do find it offensive of how they are going about it. The little guy will take the hits on this one. I guess what they want is a bunch of walmart like labs. Private practices serve a patient care cause just as hospital labs do. They all make a diagnosis. They all deserve to be paid. My 2 cents Sent from my iPhone On Apr 9, 2012, at 4:47 PM, Daniel Schneider dlschnei...@gmail.com wrote: This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires an employee pathologist is first and foremost to harvest profit from pathology reimbursement. Be a fly on the wall in the partners' meetings and you would know that's what they are talking about. To suggest otherwise is disingenuous. And the implication that the generalist anatomic pathologist is unqualified to be signing out skins, prostates, GI's and whatever is reprehensible. This is not cardiac bypass surgery, and AP pathologists *are* trained to do all of the above. I eagerly defer to subspecialty expert consultants as needed, but most of the time they're not needed. Hospital labs that see few, if any skins, prostates, GI's, are only in that pickle because of the cherrypicking they've already been subjected to. *in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing.* Really? The jobs follow the specimens. Given the same number of specimens, there's the same number of jobs, more or less, just under different circumstances and in different locations Unless you're suggesting that in-office labs will generate increased specimens, and thus increased jobs though overutilization, i.e. excessive numbers of unnecessary biopsies and abuse of the patient and the taxpayer. In which case I have to say there's a grain of truth. And the truth hurts. And it's not a good thing. None of this should be taken as criticism of histotechs and pathologists who find themselves working in an in-office lab. I know there's bills to pay, families to take care of, and god knows it's hard for a pathologist to find a job these days with the numbers our residency programs keep churning out (but that's another rant...). Dan Schneider, MD Amarillo, TX On Mon, Apr 9, 2012 at 12:52 PM, jdcoch...@aol.com wrote: Histonetters: In-office AP labs provide a valuable service to the practices they serve by facilitating 1) better communication between pathologists and ordering clinicians, 2) quality metrics that are practice-specific, and 3) high volume, sub-specialization for both histotechnologists and pathologists. In other words, the more of one type of histopathology a lab does (e.g., skin, prostate, GI), the better it gets. Most people would not think of having their cardiac bypass surgery done at a community hospital doing 50/year; you want to go where more than 500/year are done. In histopathology, the kinds of volume you want are in the thousands for each tissue type. Many hospital labs do little skin or prostate histology anymore. Many sub-specialty in-office AP labs may do thousands of cases of one tissue type every year. Aside from that, in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing. This requirement by an insurer for accreditation will help to validate these in-office AP labs' commitment to quality and put them on the level with their hospital counterparts. John D. Cochran, MD, FCAP ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Aetna and In-Office Lab Accreditation
This was released today. Richard Statline Special Alert: New Evidence Links Self-Referral Labs to Increased Utilization, Lower Cancer Detection Rates Study co-funded by CAP Appears in April 2012 Issue of Health Affairs April 9—Self-referring urologists billed Medicare for nearly 75% more anatomic pathology (AP) specimens compared to non self-referring physicians, according to a study published today in a leading health care policy journal. Furthermore, the study found no increase in cancer detection for the patients of self-referring physicians-in fact, the detection rate was 14% lower than that of non self-referring physicians. These findings, from an independent study co-funded by the CAP, provide the first clear evidence that self-referral of anatomic pathology services leads to increased utilization, higher Medicare spending, and lower rates of cancer detection. The study, led by renowned Georgetown University health care economist Jean Mitchell, PhD, will appear in the April 2012 issue of Health Affairs and is now available on the journal’s website. Daniel Schneider dlschnei...@gmail.com 4/9/2012 4:47 PM This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires an employee pathologist is first and foremost to harvest profit from pathology reimbursement. Be a fly on the wall in the partners' meetings and you would know that's what they are talking about. To suggest otherwise is disingenuous. And the implication that the generalist anatomic pathologist is unqualified to be signing out skins, prostates, GI's and whatever is reprehensible. This is not cardiac bypass surgery, and AP pathologists *are* trained to do all of the above. I eagerly defer to subspecialty expert consultants as needed, but most of the time they're not needed. Hospital labs that see few, if any skins, prostates, GI's, are only in that pickle because of the cherrypicking they've already been subjected to. *in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing.* Really? The jobs follow the specimens. Given the same number of specimens, there's the same number of jobs, more or less, just under different circumstances and in different locations Unless you're suggesting that in-office labs will generate increased specimens, and thus increased jobs though overutilization, i.e. excessive numbers of unnecessary biopsies and abuse of the patient and the taxpayer. In which case I have to say there's a grain of truth. And the truth hurts. And it's not a good thing. None of this should be taken as criticism of histotechs and pathologists who find themselves working in an in-office lab. I know there's bills to pay, families to take care of, and god knows it's hard for a pathologist to find a job these days with the numbers our residency programs keep churning out (but that's another rant...). Dan Schneider, MD Amarillo, TX On Mon, Apr 9, 2012 at 12:52 PM, jdcoch...@aol.com wrote: Histonetters: In-office AP labs provide a valuable service to the practices they serve by facilitating 1) better communication between pathologists and ordering clinicians, 2) quality metrics that are practice-specific, and 3) high volume, sub-specialization for both histotechnologists and pathologists. In other words, the more of one type of histopathology a lab does (e.g., skin, prostate, GI), the better it gets. Most people would not think of having their cardiac bypass surgery done at a community hospital doing 50/year; you want to go where more than 500/year are done. In histopathology, the kinds of volume you want are in the thousands for each tissue type. Many hospital labs do little skin or prostate histology anymore. Many sub-specialty in-office AP labs may do thousands of cases of one tissue type every year. Aside from that, in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing. This requirement by an insurer for accreditation will help to validate these in-office AP labs' commitment to quality and put them on the level with their hospital counterparts. John D. Cochran, MD, FCAP ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu
Re: [Histonet] Aetna and In-Office Lab Accreditation
Thank you for that. How are things at Hartford Hospital? One of my favorite places, rotated there many years ago. Very impressive facility! Is Dr. Ricci still there? On Mon, Apr 9, 2012 at 4:43 PM, Richard Cartun rcar...@harthosp.org wrote: This was released today. Richard Statline Special Alert: New Evidence Links Self-Referral Labs to Increased Utilization, Lower Cancer Detection Rates Study co-funded by CAP Appears in April 2012 Issue of Health Affairs April 9—Self-referring urologists billed Medicare for nearly 75% more anatomic pathology (AP) specimens compared to non self-referring physicians, according to a study published today in a leading health care policy journal. Furthermore, the study found no increase in cancer detection for the patients of self-referring physicians-in fact, the detection rate was 14% lower than that of non self-referring physicians. These findings, from an independent study co-funded by the CAP, provide the first clear evidence that self-referral of anatomic pathology services leads to increased utilization, higher Medicare spending, and lower rates of cancer detection. The study, led by renowned Georgetown University health care economist Jean Mitchell, PhD, will appear in the April 2012 issue of Health Affairs and is now available on the journal’s website. Daniel Schneider dlschnei...@gmail.com 4/9/2012 4:47 PM This is all about the money. The rest is rationalization. The reason a group of non-pathologist physicians opens an in-house pathology lab and hires an employee pathologist is first and foremost to harvest profit from pathology reimbursement. Be a fly on the wall in the partners' meetings and you would know that's what they are talking about. To suggest otherwise is disingenuous. And the implication that the generalist anatomic pathologist is unqualified to be signing out skins, prostates, GI's and whatever is reprehensible. This is not cardiac bypass surgery, and AP pathologists *are* trained to do all of the above. I eagerly defer to subspecialty expert consultants as needed, but most of the time they're not needed. Hospital labs that see few, if any skins, prostates, GI's, are only in that pickle because of the cherrypicking they've already been subjected to. *in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing.* Really? The jobs follow the specimens. Given the same number of specimens, there's the same number of jobs, more or less, just under different circumstances and in different locations Unless you're suggesting that in-office labs will generate increased specimens, and thus increased jobs though overutilization, i.e. excessive numbers of unnecessary biopsies and abuse of the patient and the taxpayer. In which case I have to say there's a grain of truth. And the truth hurts. And it's not a good thing. None of this should be taken as criticism of histotechs and pathologists who find themselves working in an in-office lab. I know there's bills to pay, families to take care of, and god knows it's hard for a pathologist to find a job these days with the numbers our residency programs keep churning out (but that's another rant...). Dan Schneider, MD Amarillo, TX On Mon, Apr 9, 2012 at 12:52 PM, jdcoch...@aol.com wrote: Histonetters: In-office AP labs provide a valuable service to the practices they serve by facilitating 1) better communication between pathologists and ordering clinicians, 2) quality metrics that are practice-specific, and 3) high volume, sub-specialization for both histotechnologists and pathologists. In other words, the more of one type of histopathology a lab does (e.g., skin, prostate, GI), the better it gets. Most people would not think of having their cardiac bypass surgery done at a community hospital doing 50/year; you want to go where more than 500/year are done. In histopathology, the kinds of volume you want are in the thousands for each tissue type. Many hospital labs do little skin or prostate histology anymore. Many sub-specialty in-office AP labs may do thousands of cases of one tissue type every year. Aside from that, in-office AP labs are an emerging frontier of employment for histologists and pathologists. In an era of high unemployment, another source of employment for our professions is a good thing. This requirement by an insurer for accreditation will help to validate these in-office AP labs' commitment to quality and put them on the level with their hospital counterparts. John D. Cochran, MD, FCAP ___ Histonet mailing list Histonet@lists.utsouthwestern.edu
