RE: [Histonet] Histobath
Fisher owns Shandon. Part of Thermo-fisher. Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility ECOGPCO-RL Robert. H. Lurie Cancer Center Northwestern University 710 N Fairbanks Court Olson 8-421 Chicago,IL 60611 312-503-3723 b-freder...@northwestern.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Patsy Ruegg Sent: Sunday, April 08, 2012 2:16 PM To: 'Sherwood, Margaret'; marilyn.a.we...@kp.org; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Histobath Is Shandon still around, I never see them anymore? Patsy Ruegg, HT(ASCP)QIHC IHCtech 12635 Montview Blvd. Ste.215 Aurora, CO 80045 720-859-4060 fax 720-859-4110 www.ihctech.net www.ihcrg.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sherwood, Margaret Sent: Friday, April 06, 2012 12:52 PM To: 'marilyn.a.we...@kp.org'; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Histobath I googled Histobath and Shandon sells them, plus some other on-line companies. Check it out. Peggy Sherwood Research Specialist, Photopathology Wellman Center for Photomedicine (EDR 214) Massachusetts General Hospital 50 Blossom Street Boston, MA 02114-2696 617-724-4839 (voice mail) 617-726-6983 (lab) 617-726-1206 (fax) msherw...@partners.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of marilyn.a.we...@kp.org Sent: Friday, April 06, 2012 2:40 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Histobath We are desperately looking for a Histobath. I know they do not make them anymore but if someone has a old one they are not using or a company can get their hands on one, we would be eternally grateful. Our Lab Manager would prefer we do not us Liquid Nitrogen. We love the Histobaths we have now. Marilyn Weiss HT (ASCP) cm Kaiser Permanente Hospital San Diego, Ca marilyn.a.we...@kp.org NOTICE TO RECIPIENT: If you are not the intended recipient of this e-mail, you are prohibited from sharing, copying, or otherwise using or disclosing its contents. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and permanently delete this e-mail and any attachments without reading, forwarding or saving them. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet The information in this e-mail is intended only for the person to whom it is addressed. If you believe this e-mail was sent to you in error and the e-mail contains patient information, please contact the Partners Compliance HelpLine at http://www.partners.org/complianceline . If the e-mail was sent to you in error but does not contain patient information, please contact the sender and properly dispose of the e-mail. ___ 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 requiring CAP accreditation for non-hospital labs
I know many certified techs in independent labs and I know for a fact that at least two of them are CAP certified. I can see where an insurance company would want a lab that is doing work that will determine a patient treatment to be on the up and up. I work in cancer research and as the lab for ECOG (Eastern Cooperative Oncology Group)of which many of you submit blocks to for patients on clinical trials. We are in our CAP window right now (so the bosses are stressed). We are all registered techs. And our work can determine chemo arm, future treatments (archival blocks are used for new therapies). Don't mess with us techs not in a hospital. I did it for 20 years. Bernice Bernice Frederick HTL (ASCP) Senior Research Tech Pathology Core Facility ECOGPCO-RL Robert. H. Lurie Cancer Center Northwestern University 710 N Fairbanks Court Olson 8-421 Chicago,IL 60611 312-503-3723 b-freder...@northwestern.edu -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Nicole Tatum Sent: Monday, April 09, 2012 7:29 AM To: Davide Costanzo; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna requiring CAP accreditation for non-hospital labs Wow David, I strongly disagree with you. I happen to work and run at Dermatopathology lab and I am a licensed Histotechnologist. I have worked in the field for twelve years and I produce the same quality of work that I would if I was in a hospital. I also have to comply with the same state and CLIA rules you do. If not we woundlt be treading on thim ice we would be closed down. CLIA would not let my facility remain open if I was not producing the quality of work expected from all histology laboratories. Also, I cannt believe you would want our labs closed down. Do you know how many of YOUR FELLOW histologist you would put out of work. David is such a team player In reguards to stark laws. Maybe you should read what it actually means We only process specimens within our our facility and our slides ARE read by a licensed dermatopathologist. So, please tell me how my work is any less important than ur hospital job? And let me tell you this about my mediocker job. I work M-F 9-5. no weekends and no on-call. I also have full benefits and 401K. So, Im sorry that you feel our labs are some how underqualified, but I would not go back to hospital work, to save my life. Thanks for having my back, your fellow histologist. Nicole Tatum, HT ASCP This is a fascinating thread!! So what are your thoughts on this - It would appear that, if other insurers follow suit, this could pose a huge burden on dermatologists that do their own tissue processing, and all the GI labs across the country that are popping up doing their own in-house histology. It may be hard, and in some cases not possible for those labs to become CAP accredited. In my opinion, that would be a great thing, to see all those physician offices doing histology close their lab doors, and focus on thier own specialty rather than invade the pathology world from which they were not trained. It would seem, to the average witness, that these facilities are treading on very thin ice as it is. It certainly does appear to be a violation of Stark laws that were created for a very good reason. In addition, these offices have stolen the bread and butter from large labs, and hospital pathology departments and left behind the far less profitable work. It would be nice to see that work return to the place it belongs - in Pathology laboratories. It may be a pipe dream at this point, but who knows - maybe this is the start of a very, very good thing. On Fri, Apr 6, 2012 at 2:56 PM, Kim Donadio one_angel_sec...@yahoo.comwrote: Yikes I just 2 sec ago said that lol Sent from my iPhone On Apr 6, 2012, at 4:51 PM, Jesus Ellin jel...@yumaregional.org wrote: There are several frame of minds here, but most closely this aligns with the affordable care act and quality outcomes for patients. I to agree with the statement that other agencies can provide good quality outcomes, but Anatomic pathology is changing so rapidly. From all aspects, but if you look at who bills for most of the CMS testing it falls under hospital based laboratories, yet the government decides reimbursement based on what the large labs make.. In the end we are seeing consolidation,, but I hope someone comes to the forefront to speak for us all. Sent from my iPad On Apr 6, 2012, at 1:41 PM, Carol Torrence ctorre...@kmcpa.com wrote: I too have been through many CAP inspections in the past. Passing is not my concern - how about expense, prep time, time away to inspect a peer. We are a small private lab also so this a bit of a pain. There is no way that CAP will be able to accommodate the workload that will ensue if this becomes a trend. Which I think it will and there
[Histonet] HistoBath, HistoChill, Clini-RF
Terri Bishop at SPScientific sent me an e-mail about HistoChill, a frozen section freezing bath that replaces the discontinued HistoBath. Terri didn't feel it was appropriate for a vendor to post this directly on HistoNet, so I am. You can contact Terri Bishop at terri.bis...@spscientific.com HistoChill has been available for about a year. You can see the brochure at http://www.spscientific.com/Air-Stream-/-Baths-/-Chillers-/-Traps-/-Probes.aspx I'm pleased that they are specifically recommending using 3M's non-flammable perfluorocarbon HFE-7000 coolant, and not isopentane or acetone. (I feel like I've struck a blow for lab safety!) As has been noted on HistoNet before, Hacker Instruments offers Alan Bright's Clini-RF, a competing product. I have no commercial connection with any of the companies I've mentioned, and I have no personal experience with either instrument. Bob Richmond Samurai Pathologist Knoxville TN ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Aetna requiring CAP accreditation for non-hospital labs
Bravo Nicole! Yet another pompous post from D. 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: Monday, April 9, 2012 7:29 AM Subject: Re: [Histonet] Aetna requiring CAP accreditation for non-hospital labs Wow David, I strongly disagree with you. I happen to work and run at Dermatopathology lab and I am a licensed Histotechnologist. I have worked in the field for twelve years and I produce the same quality of work that I would if I was in a hospital. I also have to comply with the same state and CLIA rules you do. If not we woundlt be treading on thim ice we would be closed down. CLIA would not let my facility remain open if I was not producing the quality of work expected from all histology laboratories. Also, I cannt believe you would want our labs closed down. Do you know how many of YOUR FELLOW histologist you would put out of work. David is such a team player In reguards to stark laws. Maybe you should read what it actually means We only process specimens within our our facility and our slides ARE read by a licensed dermatopathologist. So, please tell me how my work is any less important than ur hospital job? And let me tell you this about my mediocker job. I work M-F 9-5. no weekends and no on-call. I also have full benefits and 401K. So, Im sorry that you feel our labs are some how underqualified, but I would not go back to hospital work, to save my life. Thanks for having my back, your fellow histologist. Nicole Tatum, HT ASCP This is a fascinating thread!! So what are your thoughts on this - It would appear that, if other insurers follow suit, this could pose a huge burden on dermatologists that do their own tissue processing, and all the GI labs across the country that are popping up doing their own in-house histology. It may be hard, and in some cases not possible for those labs to become CAP accredited. In my opinion, that would be a great thing, to see all those physician offices doing histology close their lab doors, and focus on thier own specialty rather than invade the pathology world from which they were not trained. It would seem, to the average witness, that these facilities are treading on very thin ice as it is. It certainly does appear to be a violation of Stark laws that were created for a very good reason. In addition, these offices have stolen the bread and butter from large labs, and hospital pathology departments and left behind the far less profitable work. It would be nice to see that work return to the place it belongs - in Pathology laboratories. It may be a pipe dream at this point, but who knows - maybe this is the start of a very, very good thing. On Fri, Apr 6, 2012 at 2:56 PM, Kim Donadio one_angel_sec...@yahoo.comwrote: Yikes I just 2 sec ago said that lol Sent from my iPhone On Apr 6, 2012, at 4:51 PM, Jesus Ellin jel...@yumaregional.org wrote: There are several frame of minds here, but most closely this aligns with the affordable care act and quality outcomes for patients. I to agree with the statement that other agencies can provide good quality outcomes, but Anatomic pathology is changing so rapidly. From all aspects, but if you look at who bills for most of the CMS testing it falls under hospital based laboratories, yet the government decides reimbursement based on what the large labs make.. In the end we are seeing consolidation,, but I hope someone comes to the forefront to speak for us all. Sent from my iPad On Apr 6, 2012, at 1:41 PM, Carol Torrence ctorre...@kmcpa.com wrote: I too have been through many CAP inspections in the past. Passing is not my concern - how about expense, prep time, time away to inspect a peer. We are a small private lab also so this a bit of a pain. There is no way that CAP will be able to accommodate the workload that will ensue if this becomes a trend. Which I think it will and there will be more insurance companies aligning themselves with the larger labs as preferred. My fear is that local healthcare will be so undercut that it will become more difficult if not impossible for even hospital labs to compete. I will never be convinced that big is better. I believe Aetna will hear from CAP on this issue due to the increased workload to them...deadlines may have to be extended. We are hearing from a CAP member that they will not be able to be accredited in such a short time, according to CAP. -Original Message- From: Kim Donadio [mailto:one_angel_sec...@yahoo.com] Sent: Thursday, April 05, 2012 6:31 PM To: Katelin Lester Cc: Carol Torrence; histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Aetna requiring CAP accreditation for non-hospital
RE: [Histonet] Aetna requiring CAP accreditation for non-hospital labs
The problem here seems to be that there are those who are upset that independent labs seem to take work away from hospitals. This in fact is probably true, but I for one have more than enough work for the 4 of us. All independent labs are inspected and have regulations to follow. We are all professionals. The days of hiring folks off the street to perform semi complex testing are over. Not everyone can work in a hospital setting. There is enough work out there for all of us regardless of where the work is performed. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Pierce Sent: Monday, April 09, 2012 9:20 AM To: Nicole Tatum; Histonet Subject: Re: [Histonet] Aetna requiring CAP accreditation for non-hospital labs Bravo Nicole! Yet another pompous post from D. 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: Monday, April 9, 2012 7:29 AM Subject: Re: [Histonet] Aetna requiring CAP accreditation for non-hospital labs Wow David, I strongly disagree with you. I happen to work and run at Dermatopathology lab and I am a licensed Histotechnologist. I have worked in the field for twelve years and I produce the same quality of work that I would if I was in a hospital. I also have to comply with the same state and CLIA rules you do. If not we woundlt be treading on thim ice we would be closed down. CLIA would not let my facility remain open if I was not producing the quality of work expected from all histology laboratories. Also, I cannt believe you would want our labs closed down. Do you know how many of YOUR FELLOW histologist you would put out of work. David is such a team player In reguards to stark laws. Maybe you should read what it actually means We only process specimens within our our facility and our slides ARE read by a licensed dermatopathologist. So, please tell me how my work is any less important than ur hospital job? And let me tell you this about my mediocker job. I work M-F 9-5. no weekends and no on-call. I also have full benefits and 401K. So, Im sorry that you feel our labs are some how underqualified, but I would not go back to hospital work, to save my life. Thanks for having my back, your fellow histologist. Nicole Tatum, HT ASCP This is a fascinating thread!! So what are your thoughts on this - It would appear that, if other insurers follow suit, this could pose a huge burden on dermatologists that do their own tissue processing, and all the GI labs across the country that are popping up doing their own in-house histology. It may be hard, and in some cases not possible for those labs to become CAP accredited. In my opinion, that would be a great thing, to see all those physician offices doing histology close their lab doors, and focus on thier own specialty rather than invade the pathology world from which they were not trained. It would seem, to the average witness, that these facilities are treading on very thin ice as it is. It certainly does appear to be a violation of Stark laws that were created for a very good reason. In addition, these offices have stolen the bread and butter from large labs, and hospital pathology departments and left behind the far less profitable work. It would be nice to see that work return to the place it belongs - in Pathology laboratories. It may be a pipe dream at this point, but who knows - maybe this is the start of a very, very good thing. On Fri, Apr 6, 2012 at 2:56 PM, Kim Donadio one_angel_sec...@yahoo.comwrote: Yikes I just 2 sec ago said that lol Sent from my iPhone On Apr 6, 2012, at 4:51 PM, Jesus Ellin jel...@yumaregional.org wrote: There are several frame of minds here, but most closely this aligns with the affordable care act and quality outcomes for patients. I to agree with the statement that other agencies can provide good quality outcomes, but Anatomic pathology is changing so rapidly. From all aspects, but if you look at who bills for most of the CMS testing it falls under hospital based laboratories, yet the government decides reimbursement based on what the large labs make.. In the end we are seeing consolidation,, but I hope someone comes to the forefront to speak for us all. Sent from my iPad On Apr 6, 2012, at 1:41 PM, Carol Torrence ctorre...@kmcpa.com wrote: I too have been through many CAP inspections in the past. Passing is not my concern - how about expense, prep time, time away to inspect a peer. We are a small private lab also so this a bit of a pain. There is no way that CAP will be able to accommodate the workload that will ensue if this becomes
RE: [Histonet] Aetna requiring CAP accreditation for non-hospital labs
Ditto Paula! Lee Ann Baldridge IUSM Indpls., IN -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Pierce Sent: Monday, April 09, 2012 9:20 AM To: Nicole Tatum; Histonet Subject: Re: [Histonet] Aetna requiring CAP accreditation for non-hospital labs Bravo Nicole! Yet another pompous post from D. 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: Monday, April 9, 2012 7:29 AM Subject: Re: [Histonet] Aetna requiring CAP accreditation for non-hospital labs Wow David, I strongly disagree with you. I happen to work and run at Dermatopathology lab and I am a licensed Histotechnologist. I have worked in the field for twelve years and I produce the same quality of work that I would if I was in a hospital. I also have to comply with the same state and CLIA rules you do. If not we woundlt be treading on thim ice we would be closed down. CLIA would not let my facility remain open if I was not producing the quality of work expected from all histology laboratories. Also, I cannt believe you would want our labs closed down. Do you know how many of YOUR FELLOW histologist you would put out of work. David is such a team player In reguards to stark laws. Maybe you should read what it actually means We only process specimens within our our facility and our slides ARE read by a licensed dermatopathologist. So, please tell me how my work is any less important than ur hospital job? And let me tell you this about my mediocker job. I work M-F 9-5. no weekends and no on-call. I also have full benefits and 401K. So, Im sorry that you feel our labs are some how underqualified, but I would not go back to hospital work, to save my life. Thanks for having my back, your fellow histologist. Nicole Tatum, HT ASCP This is a fascinating thread!! So what are your thoughts on this - It would appear that, if other insurers follow suit, this could pose a huge burden on dermatologists that do their own tissue processing, and all the GI labs across the country that are popping up doing their own in-house histology. It may be hard, and in some cases not possible for those labs to become CAP accredited. In my opinion, that would be a great thing, to see all those physician offices doing histology close their lab doors, and focus on thier own specialty rather than invade the pathology world from which they were not trained. It would seem, to the average witness, that these facilities are treading on very thin ice as it is. It certainly does appear to be a violation of Stark laws that were created for a very good reason. In addition, these offices have stolen the bread and butter from large labs, and hospital pathology departments and left behind the far less profitable work. It would be nice to see that work return to the place it belongs - in Pathology laboratories. It may be a pipe dream at this point, but who knows - maybe this is the start of a very, very good thing. On Fri, Apr 6, 2012 at 2:56 PM, Kim Donadio one_angel_sec...@yahoo.comwrote: Yikes I just 2 sec ago said that lol Sent from my iPhone On Apr 6, 2012, at 4:51 PM, Jesus Ellin jel...@yumaregional.org wrote: There are several frame of minds here, but most closely this aligns with the affordable care act and quality outcomes for patients. I to agree with the statement that other agencies can provide good quality outcomes, but Anatomic pathology is changing so rapidly. From all aspects, but if you look at who bills for most of the CMS testing it falls under hospital based laboratories, yet the government decides reimbursement based on what the large labs make.. In the end we are seeing consolidation,, but I hope someone comes to the forefront to speak for us all. Sent from my iPad On Apr 6, 2012, at 1:41 PM, Carol Torrence ctorre...@kmcpa.com wrote: I too have been through many CAP inspections in the past. Passing is not my concern - how about expense, prep time, time away to inspect a peer. We are a small private lab also so this a bit of a pain. There is no way that CAP will be able to accommodate the workload that will ensue if this becomes a trend. Which I think it will and there will be more insurance companies aligning themselves with the larger labs as preferred. My fear is that local healthcare will be so undercut that it will become more difficult if not impossible for even hospital labs to compete. I will never be convinced that big is better. I believe Aetna will hear from CAP on this issue due to the increased workload to them...deadlines may have to be extended. We are hearing from a CAP member that they will not be able
Re: [Histonet] Lets talk forceps
Here in Tucson we have the wonderful luxury of having the best (and largest) gem and minerals show in the country every February. I always head to the jewelry making tools table when I need forceps, scissors, spatulas, etc. Last time I bought some they were 3/$10. So if anybody is in need send me an email the begining of next February and I'll look for what you need. If you can't wait and don't have a Hobby Lobby near you try googling and I bet you will come up with some companies that sell fine forceps. Andi G On Apr 8, 2012, at 12:15 PM, Patsy Ruegg wrote: I get my forceps, even the fine bent ones at Hobby Lobby in the jewelry making section, they are much cheaper than the medical supply companies and in my experience just as good. Patsy Ruegg, HT(ASCP)QIHC IHCtech 12635 Montview Blvd. Ste.215 Aurora, CO 80045 720-859-4060 fax 720-859-4110 www.ihctech.net www.ihcrg.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Emily Sours Sent: Friday, April 06, 2012 1:03 PM To: Bartlett, Jeanine (CDC/OID/NCEZID); histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Lets talk forceps Roboz makes great forceps and they aren't expensive. I think Storz may have bought them out. Emily The whole point of this country is if you want to eat garbage, balloon up to 600 pounds and die of a heart attack at 43, you can! You are free to do so. To me, that’s beautiful. --Ron Swanson On Fri, Apr 6, 2012 at 9:43 AM, Bartlett, Jeanine (CDC/OID/NCEZID) j...@cdc.gov wrote: I really like these and I have small hands and have had carpal tunnel surgery. Surgipath ergonomic forceps now available through Leica: 38DI15585 38DI15590 These both have a 5 ½ handle. One is curved and the other straight. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto: histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Tiffeny Magee Sent: Friday, April 06, 2012 9:33 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Lets talk forceps I would love to buy a top of the line pair of forceps. One in partial that is smallish for a woman's hand and most importantly doesn't stick to the tissue on the water bath when I'm separating my sections. So does anyone have histology HT forceps they highly recommend? Thanks Tiffeny Magee ___ 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Cassette labeling problem
It may be your cassette and not your marker. That was the problem we encountered awhile ago. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Tim Wheelock Sent: Monday, April 09, 2012 11:17 AM To: Histonet Subject: [Histonet] Cassette labeling problem Hi All: Lately I have been having problems with the ink fading-and/or simply coming off in pieces-from our processing cassettes. I use Securline Marker 2/Superfrost pens. The writing seems to hold fine even if the cassettes sit in formalin for several weeks. So I am assuming that the problem comes either in the processing or embedding stage. I think the ink was still fine when I removed the cassette basket from the processor's retort, but I can't remember for sure. Then, I let the cassettes sit in Surgipath Embedding Media for two hours before embedding the tissue, since my Shandon XP processor has only 2 wax reservoirs. I have noticed lately that pieces of ink are coming off of the cassettes into the embedding media, making some-but not all-of the cassettes impossible to read.. I have turned down the temperature of the cassette holding tank, in case the temperature of the embedding media is pulling the ink off. Has anyone experienced this before, and if so, how did you overcome it? Are the Securline Marker 2/Superfrost pens appropriate for cassettes? Thank you for any advice you can provide, Tim Wheelock Harvard Brain Tissue Resource Center McLean Hospital Belmont, MA. 617-855-3592 ___ 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 requiring CAP accreditation for non-hospital labs
I agree with Nicole. Davide, personally I think you went over the line. Many Histotechs out here are just as qualified and thier work is just as important as anyone elses. As a person who has worked in both situations, I think this date line is a bit unfair and your comment uncalled for. I spoke with CAP this morning and they agree the time frame is too short. I am told they have contacted Aetna to try and get some kind of leeway for people who have at least applied as they tell me there is no way we can get accreditation by that deadline.They are bombed with calls/applications. With all this said, and my ego now put back in my pocket. We need to support each other as professionals of our feild. These are hard times for healthcare professionals all around with many new regualtions around the bend. So lets try to stick together as a group of professionals and I suggest we all contact Aetna, and any governmental agency's we can regarding this. Because what starts here with one can certainly get out of hand rapidly; and dont always think you'll be on the side thats not getting the hit. Situations change. Best Regards Kim D From: Nicole Tatum nic...@dlcjax.com To: Davide Costanzo pathloc...@gmail.com; histonet@lists.utsouthwestern.edu Sent: Monday, April 9, 2012 8:29 AM Subject: Re: [Histonet] Aetna requiring CAP accreditation for non-hospital labs Wow David, I strongly disagree with you. I happen to work and run at Dermatopathology lab and I am a licensed Histotechnologist. I have worked in the field for twelve years and I produce the same quality of work that I would if I was in a hospital. I also have to comply with the same state and CLIA rules you do. If not we woundlt be treading on thim ice we would be closed down. CLIA would not let my facility remain open if I was not producing the quality of work expected from all histology laboratories. Also, I cannt believe you would want our labs closed down. Do you know how many of YOUR FELLOW histologist you would put out of work. David is such a team player In reguards to stark laws. Maybe you should read what it actually means We only process specimens within our our facility and our slides ARE read by a licensed dermatopathologist. So, please tell me how my work is any less important than ur hospital job? And let me tell you this about my mediocker job. I work M-F 9-5. no weekends and no on-call. I also have full benefits and 401K. So, Im sorry that you feel our labs are some how underqualified, but I would not go back to hospital work, to save my life. Thanks for having my back, your fellow histologist. Nicole Tatum, HT ASCP This is a fascinating thread!! So what are your thoughts on this - It would appear that, if other insurers follow suit, this could pose a huge burden on dermatologists that do their own tissue processing, and all the GI labs across the country that are popping up doing their own in-house histology. It may be hard, and in some cases not possible for those labs to become CAP accredited. In my opinion, that would be a great thing, to see all those physician offices doing histology close their lab doors, and focus on thier own specialty rather than invade the pathology world from which they were not trained. It would seem, to the average witness, that these facilities are treading on very thin ice as it is. It certainly does appear to be a violation of Stark laws that were created for a very good reason. In addition, these offices have stolen the bread and butter from large labs, and hospital pathology departments and left behind the far less profitable work. It would be nice to see that work return to the place it belongs - in Pathology laboratories. It may be a pipe dream at this point, but who knows - maybe this is the start of a very, very good thing. On Fri, Apr 6, 2012 at 2:56 PM, Kim Donadio one_angel_sec...@yahoo.comwrote: Yikes I just 2 sec ago said that lol Sent from my iPhone On Apr 6, 2012, at 4:51 PM, Jesus Ellin jel...@yumaregional.org wrote: There are several frame of minds here, but most closely this aligns with the affordable care act and quality outcomes for patients. I to agree with the statement that other agencies can provide good quality outcomes, but Anatomic pathology is changing so rapidly. From all aspects, but if you look at who bills for most of the CMS testing it falls under hospital based laboratories, yet the government decides reimbursement based on what the large labs make.. In the end we are seeing consolidation,, but I hope someone comes to the forefront to speak for us all. Sent from my iPad On Apr 6, 2012, at 1:41 PM, Carol Torrence ctorre...@kmcpa.com wrote: I too have been through many CAP inspections in the past. Passing is not my concern - how about expense, prep time, time away to inspect a peer. We are a small private lab also so this a bit of a pain.
RE: [Histonet] Cassette labeling problem
@Linda...How did you figure out it was your cassettes? Sometimes I have a problem with my cassette marker coming off my cassettes too no matter what brand of cassette marker I use. Please let me know your secret :) What are the best brand of cassettes to use? Nancy Heath, HT (ASCP) Neuropathology Technician Pathology Tech Specialist Dept. of Pathology., Div. of Neuropathology Rhode Island Hospital APC Blding, Flr 12, Rm 211 593 Eddy Street Providence, RI 02903 lab: 401-444-3246 fax: 401-444-8514 nhe...@lifespan.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Blazek, Linda Sent: Monday, April 09, 2012 11:20 AM To: 'Tim Wheelock'; Histonet Subject: RE: [Histonet] Cassette labeling problem It may be your cassette and not your marker. That was the problem we encountered awhile ago. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Tim Wheelock Sent: Monday, April 09, 2012 11:17 AM To: Histonet Subject: [Histonet] Cassette labeling problem Hi All: Lately I have been having problems with the ink fading-and/or simply coming off in pieces-from our processing cassettes. I use Securline Marker 2/Superfrost pens. The writing seems to hold fine even if the cassettes sit in formalin for several weeks. So I am assuming that the problem comes either in the processing or embedding stage. I think the ink was still fine when I removed the cassette basket from the processor's retort, but I can't remember for sure. Then, I let the cassettes sit in Surgipath Embedding Media for two hours before embedding the tissue, since my Shandon XP processor has only 2 wax reservoirs. I have noticed lately that pieces of ink are coming off of the cassettes into the embedding media, making some-but not all-of the cassettes impossible to read.. I have turned down the temperature of the cassette holding tank, in case the temperature of the embedding media is pulling the ink off. Has anyone experienced this before, and if so, how did you overcome it? Are the Securline Marker 2/Superfrost pens appropriate for cassettes? Thank you for any advice you can provide, Tim Wheelock Harvard Brain Tissue Resource Center McLean Hospital Belmont, MA. 617-855-3592 ___ 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 requiring CAP accreditation for non-hospital labs
Kim, I agree that there must be broad based support for all the histotech's working in those offices. Again, several read something into my post that was not in it. Nowhere did I mention the techs, nor express any concern over the quality of those techs. I am quite sure some of the best histotechs in America work in those settings. I would think that the majority of the techs working in those offices would find new jobs popping up all over if those labs were forced to close. The work still needs to get done, so I think assuming there would be hundreds of techs out of work is not realistic. Hopefully someone out there knows the answer to this question - I have heard (cannot confirm) that these types of labs in physician offices are banned in some states already. Pennsylvania was mentioned once at a conference as being one of those states. Does anyone out there know of this, and if it is true? I cannot find info in print, which I prefer to do before commenting. One Medical Director local to me at a major University stated that there is a push now to spread law through some Congressional hearings currently under way to force the closure of physician owned labs of that sort on a Federal level. I cannot confirm this either, however it does seem logical to think that the powers in Pathology would be fighting hard behind closed doors to figure out a way to shut these places down. There are problems in healthcare in this country on so many levels, this is just another example of one of many. The Aetna issue is not entirely related to this scenario, but in the end it still may have the desired effect by those that are pushing for office lab closure if it catches on with other insurance providers. I do think there is a lot going on behind the scenes here that none of us are aware of. Where did this Aetna letter come from? What sparked it? It shouldn't be any surprise to find out that physicians in larger pathology departments, or pathology organizations are behind this in some capacity. I share the opinion of my former medical director that these labs are short-lived, that the government will eventually shut them down. This is kick-back, no matter how you slice it. Loopholes that exist today, are likely to be removed tomorrow. The lucrative business they experience today is enough to keep them in the game, but I think they know the risks, and are aware of the fact that this party will end at some point. It is not pompous, and I resent that allegation. How would dermatologists feel if we decided to do punch biopsies in pathology labs? If a pathologist is not allowed to do colonoscpoy, why is a GI doc allowed to do histology? My comment is simple - they should not be allowed to. Practice of medicine should be limited to what you are trained in, not what makes you the most cash. Greed is a big part of what is destroying healthcare in this country. As for histotechs, I fully support the profession. To suggest otherwise is a tainted opinion, and not factual at all. I have worked alongside techs for 24 years, and clearly value every aspect of what they do. It is not an easy job, it is often thankless and that is unfortunate. This subject has nothing to do with the techs, and for those that love their job in these physician office labs I do feel sorry for, as that is not a job that will be around forever by all indications. On Mon, Apr 9, 2012 at 8:40 AM, Kim Donadio one_angel_sec...@yahoo.comwrote: I agree with Nicole. Davide, personally I think you went over the line. Many Histotechs out here are just as qualified and thier work is just as important as anyone elses. As a person who has worked in both situations, I think this date line is a bit unfair and your comment uncalled for. I spoke with CAP this morning and they agree the time frame is too short. I am told they have contacted Aetna to try and get some kind of leeway for people who have at least applied as they tell me there is no way we can get accreditation by that deadline.They are bombed with calls/applications. With all this said, and my ego now put back in my pocket. We need to support each other as professionals of our feild. These are hard times for healthcare professionals all around with many new regualtions around the bend. So lets try to stick together as a group of professionals and I suggest we all contact Aetna, and any governmental agency's we can regarding this. Because what starts here with one can certainly get out of hand rapidly; and dont always think you'll be on the side thats not getting the hit. Situations change. Best Regards Kim D *From:* Nicole Tatum nic...@dlcjax.com *To:* Davide Costanzo pathloc...@gmail.com; histonet@lists.utsouthwestern.edu *Sent:* Monday, April 9, 2012 8:29 AM *Subject:* Re: [Histonet] Aetna requiring CAP accreditation for non-hospital labs Wow David, I strongly disagree with you. I happen to work and run at Dermatopathology lab and I am a licensed
Re: [Histonet] Aetna requiring CAP accreditation for non-hospital labs
I can't really reply to all this. Maybe someone else can. I do not consider private owned labs as kick backs. They provide a service which does not need to be done in a hospital. They deserve to be paid. Seriously would you want all work to have to go to a hospital lab? I hope not. Would u want hospitals to have to do MOHs ? I hope not. Best wishes Kim D Sent from my iPhone On Apr 9, 2012, at 12:31 PM, Davide Costanzo pathloc...@gmail.com wrote: Kim, I agree that there must be broad based support for all the histotech's working in those offices. Again, several read something into my post that was not in it. Nowhere did I mention the techs, nor express any concern over the quality of those techs. I am quite sure some of the best histotechs in America work in those settings. I would think that the majority of the techs working in those offices would find new jobs popping up all over if those labs were forced to close. The work still needs to get done, so I think assuming there would be hundreds of techs out of work is not realistic. Hopefully someone out there knows the answer to this question - I have heard (cannot confirm) that these types of labs in physician offices are banned in some states already. Pennsylvania was mentioned once at a conference as being one of those states. Does anyone out there know of this, and if it is true? I cannot find info in print, which I prefer to do before commenting. One Medical Director local to me at a major University stated that there is a push now to spread law through some Congressional hearings currently under way to force the closure of physician owned labs of that sort on a Federal level. I cannot confirm this either, however it does seem logical to think that the powers in Pathology would be fighting hard behind closed doors to figure out a way to shut these places down. There are problems in healthcare in this country on so many levels, this is just another example of one of many. The Aetna issue is not entirely related to this scenario, but in the end it still may have the desired effect by those that are pushing for office lab closure if it catches on with other insurance providers. I do think there is a lot going on behind the scenes here that none of us are aware of. Where did this Aetna letter come from? What sparked it? It shouldn't be any surprise to find out that physicians in larger pathology departments, or pathology organizations are behind this in some capacity. I share the opinion of my former medical director that these labs are short-lived, that the government will eventually shut them down. This is kick-back, no matter how you slice it. Loopholes that exist today, are likely to be removed tomorrow. The lucrative business they experience today is enough to keep them in the game, but I think they know the risks, and are aware of the fact that this party will end at some point. It is not pompous, and I resent that allegation. How would dermatologists feel if we decided to do punch biopsies in pathology labs? If a pathologist is not allowed to do colonoscpoy, why is a GI doc allowed to do histology? My comment is simple - they should not be allowed to. Practice of medicine should be limited to what you are trained in, not what makes you the most cash. Greed is a big part of what is destroying healthcare in this country. As for histotechs, I fully support the profession. To suggest otherwise is a tainted opinion, and not factual at all. I have worked alongside techs for 24 years, and clearly value every aspect of what they do. It is not an easy job, it is often thankless and that is unfortunate. This subject has nothing to do with the techs, and for those that love their job in these physician office labs I do feel sorry for, as that is not a job that will be around forever by all indications. On Mon, Apr 9, 2012 at 8:40 AM, Kim Donadio one_angel_sec...@yahoo.com wrote: I agree with Nicole. Davide, personally I think you went over the line. Many Histotechs out here are just as qualified and thier work is just as important as anyone elses. As a person who has worked in both situations, I think this date line is a bit unfair and your comment uncalled for. I spoke with CAP this morning and they agree the time frame is too short. I am told they have contacted Aetna to try and get some kind of leeway for people who have at least applied as they tell me there is no way we can get accreditation by that deadline.They are bombed with calls/applications. With all this said, and my ego now put back in my pocket. We need to support each other as professionals of our feild. These are hard times for healthcare professionals all around with many new regualtions around the bend. So lets try to stick together as a group of professionals and I suggest we all contact Aetna, and any governmental agency's we can
[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
[Histonet] Gary Steinke is out of the office
I will be out of the office starting 04/06/2012 and will not return until 04/11/2012. I will be unavailable until at least April 11th due to a family emergency. If you need immediate help, please contact our Healthcare Customer Care Group at 877-881-1192 or by email at healthcareserv...@vwr.com. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] elastic stain
All, I have used a new Verhoeff-Van Gieson stain kit (from BBC) for elastic fibers and have run a large number of slides. I am noticing differences in the staining intensities throughout the samples. I see that there are darker sites and lighter sites within the same panelists. This is not due to a treatment effect because these intensity differences are seen in the controls also. I am fairly confident that our tech has sectioned all the samples at 5um and has stained the slides with all the same timings. Does anyone have an explanation as to why this is occurring? The staining intensity differences are mainly in the epidermis but if that is staining darker/lighter my concern is that the elastic fibers in the dermis are doing the same and will skew the results when they are quantified with a spectral camera. Any help will be greatly appreciated. Thank you in advance. Kristopher L. Kalleberg Research Scientist Unilever RD 40 Merritt Blvd. Trumbull, CT 06611 p 203.381.5765 f 203.381.5476 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
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
[Histonet] (no subject)
Philosompephe,r___ 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
[Histonet] New to paraffin cutting - seeking advice
Hello everyone! I have had such wonderful feedback regarding plastic embedded specimens and now I am moving onto paraffin. The majority of the specimens I am going to be cutting are paraffin embedded decal rabbit femurs. I am using a Leica RM2255 and there is an option for retraction (after each section) and blade angle. I need to practice a lot because right now my sections are crinkly even though I have my samples on ice, but hopefully practice makes perfect! So I want to ask you all a few questions regarding settings and technique and one about HE staining. What angle should the blade be at - I have it set at 0 for the moment. What about the retraction option - I have it set at 15um. The sections are being cut at 4um. When the blade has pieces of paraffin on it, do I need to clean that off? How do I remove this paraffin because I don't want to dull the blade? If not, does that impact the section quality and should I be moving to a different area of the blade? I am looking into flotation baths that are relatively inexpensive. In particular, I am looking for a simple bath with a glass pyrex dish. Do you have any suggestions on where to purchase one from? Lastly, I am going back to HE staining of plastic embedded undecalcified bone, specifically hematoxylin, for a brief moment. When I use a clearing solution I know that I am trying to destain a bit from the undecalcified bone to make a lighter stain, but does this also significantly destain the nuclei? Right now, I need to leave the sample staining in Harris's hematoxylin for more than 4 mins to get the nuclei stained nicely, but I need to destain because the section is too dark. I just don't want to destain the nuclei too much, but want a lighter stain on the undecal bone. Again, thank you all for your support and advice, it is much appreciated! Sincerely, Merissa ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
