Re: [Histonet] HistoBath, HistoChill, Clini-RF
Dear Bob, I would just like to point out that the recommended freezing fluid for the Bright Clini-RF Rapid -80c tissue freezer is 3M's Novec HFE-7100 not 7000 as you state. Best regards Alan Bright www.brightinstruments.com Sent from my BlackBerry® wireless device -Original Message- From: Bob Richmond rsrichm...@gmail.com Sender: histonet-boun...@lists.utsouthwestern.edu Date: Mon, 9 Apr 2012 09:16:23 To: Histonet@lists.utsouthwestern.eduhistonet@lists.utsouthwestern.edu Subject: [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 -- BEGIN-ANTISPAM-VOTING-LINKS -- Teach SpamSniper if this mail (ID 01GTNjypu) is spam: Spam: http://admin.spamsniper.co.uk/canit/b.php?i=01GTNjypum=00c557cef5d5t=20120409c=s Not spam: http://admin.spamsniper.co.uk/canit/b.php?i=01GTNjypum=00c557cef5d5t=20120409c=n Forget vote: http://admin.spamsniper.co.uk/canit/b.php?i=01GTNjypum=00c557cef5d5t=20120409c=f -- END-ANTISPAM-VOTING-LINKS ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] HistoBath, HistoChill, Clini-RF
Can you use the 3M freezing fluid in a histobath instead of isopentane? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of abri...@brightinstruments.com Sent: Tuesday, April 10, 2012 6:46 AM To: Bob Richmond; histonet-boun...@lists.utsouthwestern.edu; Histonet Subject: Re: [Histonet] HistoBath, HistoChill, Clini-RF Dear Bob, I would just like to point out that the recommended freezing fluid for the Bright Clini-RF Rapid -80c tissue freezer is 3M's Novec HFE-7100 not 7000 as you state. Best regards Alan Bright www.brightinstruments.com Sent from my BlackBerry(r) wireless device -Original Message- From: Bob Richmond rsrichm...@gmail.com Sender: histonet-boun...@lists.utsouthwestern.edu Date: Mon, 9 Apr 2012 09:16:23 To: Histonet@lists.utsouthwestern.eduhistonet@lists.utsouthwestern.edu Subject: [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 -- BEGIN-ANTISPAM-VOTING-LINKS -- Teach SpamSniper if this mail (ID 01GTNjypu) is spam: Spam: http://admin.spamsniper.co.uk/canit/b.php?i=01GTNjypum=00c557cef5d5t=20120409c=s Not spam: http://admin.spamsniper.co.uk/canit/b.php?i=01GTNjypum=00c557cef5d5t=20120409c=n Forget vote: http://admin.spamsniper.co.uk/canit/b.php?i=01GTNjypum=00c557cef5d5t=20120409c=f -- END-ANTISPAM-VOTING-LINKS This message has been scanned and no issues discovered. To report this email as SPAM, please forward it to s...@websense.com. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] HistoBath, HistoChill, Clini-RF
Dear Sue, Defiantly yes, it is much safer and more eco friendly. We supply a suitable dunking container with our Clin-RF as the specimens need to be contained to stop them floating in the 3M's fluid. Best regards Alan Bright www.brightinstruments.com Sent from my BlackBerry® wireless device -Original Message- From: Sue Hunter shun...@beaumont.edu Date: Tue, 10 Apr 2012 11:38:12 To: abri...@brightinstruments.comabri...@brightinstruments.com; Bob Richmondrsrichm...@gmail.com; histonet-boun...@lists.utsouthwestern.eduhistonet-boun...@lists.utsouthwestern.edu; Histonethistonet@lists.utsouthwestern.edu Subject: RE: [Histonet] HistoBath, HistoChill, Clini-RF Can you use the 3M freezing fluid in a histobath instead of isopentane? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of abri...@brightinstruments.com Sent: Tuesday, April 10, 2012 6:46 AM To: Bob Richmond; histonet-boun...@lists.utsouthwestern.edu; Histonet Subject: Re: [Histonet] HistoBath, HistoChill, Clini-RF Dear Bob, I would just like to point out that the recommended freezing fluid for the Bright Clini-RF Rapid -80c tissue freezer is 3M's Novec HFE-7100 not 7000 as you state. Best regards Alan Bright www.brightinstruments.com Sent from my BlackBerry(r) wireless device -Original Message- From: Bob Richmond rsrichm...@gmail.com Sender: histonet-boun...@lists.utsouthwestern.edu Date: Mon, 9 Apr 2012 09:16:23 To: Histonet@lists.utsouthwestern.eduhistonet@lists.utsouthwestern.edu Subject: [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 -- This message has been scanned and no issues discovered. To report this email as SPAM, please forward it to s...@websense.com. -- BEGIN-ANTISPAM-VOTING-LINKS -- Teach SpamSniper if this mail (ID 01GUbCehP) is spam: Spam: http://admin.spamsniper.co.uk/canit/b.php?i=01GUbCehPm=134cc5b01928t=20120410c=s Not spam: http://admin.spamsniper.co.uk/canit/b.php?i=01GUbCehPm=134cc5b01928t=20120410c=n Forget vote: http://admin.spamsniper.co.uk/canit/b.php?i=01GUbCehPm=134cc5b01928t=20120410c=f -- END-ANTISPAM-VOTING-LINKS ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
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
[Histonet] Re: HistoBath, HistoChill, Clini-RF
Sue Hunter asks: Can you use the 3M freezing fluid in a HistoBath instead of isopentane? I haven't seen it done, but I understand that the 3M freezing fluid can be used in the old HistoBath, if you still have one of them. Alan Bright pointed out something I didn't know - that because of the greater density of the 3M freezing liquid, specimens float in it. Bob Richmond Samurai Pathologist Knoxville TN ___ 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. This
[Histonet] Microwave processors
Hi histonetters! Our pathologists want to turn around skin biopsies same day and are again looking at microwave processors. Due to a bad past experience, I'm not enthused but perhaps there is someone out there who loves their microwave processor? Even on derm? Or has anyone worked out a good rapid derm processing protocol on a conventional processor? Thank you so much! Erin Erin Martin, Histology Supervisor UCSF Dermatopathology Service 415-353-7248 Confidentiality Notice The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or priviledged material. Any review, retransmission, dissemination or other use of, or taking of any actin in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Current Histology Openings
Allied Search Partners is looking for qualified histology professionals to fill the below positions. Interested candidates should forward an updated resume to bran...@alliedsearchpartners.com for a full job description and consideration for hire. All the below positions are for permanent placement and direct hire. 1) Histology Manager- Ft. Myers, FL 2) Immunospecialist- Tyler, TX 3) Histotechnician or Histotechnologist- Naples, FL 4) Histotechnologist (Lead)- Fort Myers, FL 5) Histotechnician or Histotechnologist- Knoxville, TN 6) Histotechnician or Histotechnologist- Port Chester, NY 7) Histotechnician or Histotechnologist- Denver, CO 8) Mohs Technician- Denver, CO 9) Histotechnician or Histotechnologist (part time)- Portland, OR -- *If you wish to no longer receive emails from Allied Search Partners please respond to this email message with remove. Brannon Owens, Recruitment Manager LinkedIn: http://www.linkedin.com/pub/brannon-owens/28/528/823 http://www.linkedin.com/pub/brannon-owens/28/528/823 Allied Search Partners T: 888.388.7571 ext. 106 F: 888.388.7572 www.alliedsearchpartners.com http://www.alliedsearchpartners.com/ Tell us about your experience with ASP by clicking on this link: http://ratepoint.com/tellus/82388 http://www.alliedsearchpartners.com/ This email including its attachments is intended only for the confidential use of the individual to whom it is addressed. If you are not the intended recipient, any use, dissemination, distribution or copying of this message or its attachments is prohibited. If you have received this message in error, please notify us immediately, and delete this message and its attachments permanently from your system. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
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.
[Histonet] Sweetheart of a day job - Arizona
Hi Guys- I'm SO excited! One of the places I temped and trained a bench tech oh-so-many years ago is looking to hire another Histotech. They're growing leaps and bounds. The Pathologist is the same I worked with--nice guy, good at his job--and the community is awesome. They're looking for a registered or eligible tech with at least one year for a M-F day shift. It's a hospital--one of those places you can stay forever and be happy in your job. The pay is good, relocation assistance is available. I'd be delighted to help them find their 'right' fit. Call my cell or email--attach your resume if you have one or we can write it together... Thank you! Cheryl Kerry, HT(ASCP) Full Staff Inc. Staffing the AP Lab by helping one GREAT Tech at a time. 281.852.9457 Office 800.756.3309 Phone Fax ad...@fullstaff.org Sign up for the FREE newsletter AP News--updates, tricks of the trade and current issues for Anatomic Pathology Clinical Labs. Send a 'subscribe' request to apn...@fullstaff.org. Please include your name and specialty in the body of the email. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Lab Assistants
Does anyone know of a regulation (CLIA, CAP, JACHO) for a lab assistants / non certified working in histology (embedding, cutting, staining, coverslipping and changing solutions) ? I know many out there have strong opinions about this subject but I am interested in the actual regulations. I am needing this to present to my docs. Thanks! ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Elastic Stain
Are the slides differentiated individually using mcroscopic checks? ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Hot Histology Job Alert from RELIA Solutions. Histology Tech needed - Days Full time in Kingman, AZ
Hi Histonetters. I hope everyone is having a great day. I am excited to tell you about an opportunity that I have with a client in Kingman, AZ. This is a fulltime permanent day shift position and my client offers a competitive salary, nice benefits and a great group of people to work with. They need someone who is ASCP certified or eligible and has at least 1 year of histology experience preferably in a hospital environment. I have heard great things about this facility and would love to introduce you to them. If you would like more information please contact me toll free at 866-607-3542 or by email at rel...@earthlink.net Thanks-Pam Thank You! Pam Barker President RELIA Specialists in Allied Healthcare Recruiting 5703 Red Bug Lake Road #330 Winter Springs, FL 32708-4969 Phone: (407)657-2027 Cell: (407)353-5070 FAX: (407)678-2788 E-mail: rel...@earthlink.net www.facebook.comPamBarkerRELIA www.linkedin.com/in/reliasolutions www.twitter.com/pamatrelia ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Slippery Floors due to paraffin
I was also taught years ago to make sure housekeeping does not put wax on your path lab floors. Helayne Parker, H.T. (ASCP) Pathology Section Head Skaggs Regional Medical Center The Best Place to Get Better P.O. Box 650, Branson Missouri 65615 Direct: 417-335-7254 Fax: 417-335-7127 E-Mail: hpar...@skaggs.net Web: www.skaggs.net CONFIDENTIALITY NOTICE - This e-mail transmission, and any documents, files or previous e-mail messages attached to it may contain information that is confidential or legally privileged. If you are not the intended recipient, or a person responsible for delivering it to the intended recipient, you are hereby notified that you must not read this transmission and that any disclosure, copying, printing, distribution or use of any of the information contained in or attached to this transmission is STRICTLY PROHIBITED. If you have received this transmission in error, please immediately notify the sender by telephone or return e-mail and delete the original transmission and its attachments without reading or saving in any manner. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
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
[Histonet] RE: Microwave processors
Erin, We have Sakura's Xpress and skins have always turned out just fine for us. It is very easy to use and maintain. Jeanine H. Bartlett Centers for Disease Control and Prevention Infectious Diseases Pathology Branch 404-639-3590 jeanine.bartl...@cdc.hhs.gov -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martin, Erin Sent: Tuesday, April 10, 2012 10:38 AM To: histonet Subject: [Histonet] Microwave processors Hi histonetters! Our pathologists want to turn around skin biopsies same day and are again looking at microwave processors. Due to a bad past experience, I'm not enthused but perhaps there is someone out there who loves their microwave processor? Even on derm? Or has anyone worked out a good rapid derm processing protocol on a conventional processor? Thank you so much! Erin Erin Martin, Histology Supervisor UCSF Dermatopathology Service 415-353-7248 Confidentiality Notice The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or priviledged material. Any review, retransmission, dissemination or other use of, or taking of any actin in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. ___ 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] Microwave processors
I believe there was a conference this month in your area and they were introducing a new to the market rapid traditional constant feed processor. Let me see if I can track down the info. :) -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martin, Erin Sent: Tuesday, April 10, 2012 10:38 AM To: histonet Subject: [Histonet] Microwave processors Hi histonetters! Our pathologists want to turn around skin biopsies same day and are again looking at microwave processors. Due to a bad past experience, I'm not enthused but perhaps there is someone out there who loves their microwave processor? Even on derm? Or has anyone worked out a good rapid derm processing protocol on a conventional processor? Thank you so much! Erin Erin Martin, Histology Supervisor UCSF Dermatopathology Service 415-353-7248 Confidentiality Notice The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or priviledged material. Any review, retransmission, dissemination or other use of, or taking of any actin in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. ___ 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] RE: Microwave processors
We cannot say the same, we had issues with shaves appearing cooked. We had specialists out several times and after many suggestions, nothing resolved the issue. It doesn't happen consistently but it definitely happens and we even attempted to track by tech or shifts or when the solutions were changed and no patterns could be found after several years. Sakura has a new vendor for reagents now and they are going to come run some test slides but the VIP quality for derm keeps the pathologists much happier based on our experience. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bartlett, Jeanine (CDC/OID/NCEZID) Sent: Tuesday, April 10, 2012 12:14 PM To: Martin, Erin; histonet Subject: [Histonet] RE: Microwave processors Erin, We have Sakura's Xpress and skins have always turned out just fine for us. It is very easy to use and maintain. Jeanine H. Bartlett Centers for Disease Control and Prevention Infectious Diseases Pathology Branch 404-639-3590 jeanine.bartl...@cdc.hhs.gov -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martin, Erin Sent: Tuesday, April 10, 2012 10:38 AM To: histonet Subject: [Histonet] Microwave processors Hi histonetters! Our pathologists want to turn around skin biopsies same day and are again looking at microwave processors. Due to a bad past experience, I'm not enthused but perhaps there is someone out there who loves their microwave processor? Even on derm? Or has anyone worked out a good rapid derm processing protocol on a conventional processor? Thank you so much! Erin Erin Martin, Histology Supervisor UCSF Dermatopathology Service 415-353-7248 Confidentiality Notice The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or priviledged material. Any review, retransmission, dissemination or other use of, or taking of any actin in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. ___ 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 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
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
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 of
[Histonet] Aetna and In-Office Lab Accreditation
Okay, let's move on people. It's getting too personal instead of professional. Enough already -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Pratt, Caroline Sent: Tuesday, April 10, 2012 12:19 PM 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 to much power and the decisions they force us to make do not always
[Histonet] Histology Openings
Currently working on a variety of permanent, fulltime histology positions available nationwide (NY, NC, MD, AZ, CT, CO, TX FL and TN). Please feel free to e-mail me for more information- kait...@prometheushealthcare.com ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] In House Labs in WSJ
The Wall Street Journal served up a timely article for us. You'll see both sides of the argument below. One side is right. DLS HEALTH INDUSTRY April 9, 2012, 7:22 p.m. ET Prostate-Test Fees Challenged By CHRISTOPHER WEAVER Doctors in urology groups that profit from tests for prostate cancer order more of them than doctors who send samples to independent laboratories, according to a study Monday in the journal Health Affairs. The study found that doctors' practices that do their own lab work bill the federal Medicare program for analyzing 72% more prostate tissue samples per biopsy while detecting fewer cases of cancer than counterparts who send specimens to outside labs. Hiring pathologists boosts revenue for a practice and creates a potential incentive to increase the number of tests ordered, said Jean Mitchell, a Georgetown University economist and author of the study. That fewer cancers were detected—21% versus 35% for those sent to external labs, according to the study—suggests financial incentives may play a role in decisions to order the tests, Ms. Mitchell said. Some urologists said the research doesn't necessarily indicate financial motives. Urologists in larger group practices that have in-house pathologists may be more aggressive in testing because they seek to catch cancer earlier, said Steven Schlossberg, a Yale urologist who heads a health-policy panel for the American Urological Association and wasn't involved in the research. Also, Dr. Schlossberg noted, the figures, which cover 36,261 biopsies from 2005 through 2007, are five years old. The study was financed by the College of American Pathologists and the American Clinical Laboratory Association. It is the last salvo in a turf war between laboratory companies and physician groups that have opened their own labs to conduct tests. Regulators and economists scrutinizing the growing costs of health care have targeted a range of related activities by doctors, known as self-referrals. Although a set of 1990s-era laws, named for their proponent, Rep. Pete Stark (D., Calif.), ban doctors from referring patients to most companies in which they have a financial interest, urology groups can enter the pathology business because of an exemption for certain services performed within physicians' offices. The pathologists and other groups are lobbying Congress to end the exemption. At issue in the study is a quirk of billing for lab procedures. Labs get paid based on the number of jars used to hold specimens from a prostate biopsy. Doctors can choose to put several specimens in one jar or put each in its own jar, potentially boosting lab fees, which averaged about $104 a jar in 2010, according to the study. Urologists in practices with in-house pathologists sent 11.4 jars per biopsy for testing versus 5.9 jars per biopsy for other doctors in 2005. Some doctors say that separating the samples can help them better map any cancer. In addition, urologists in recent years have been taking more samples during a biopsy to better identify the location of any cancer, said John Hollingsworth, an assistant professor of urology at the University of Michigan. The standard number of samples taken doubled to 12 over the last decade, he said. The Health Affairs study's conclusions are largely around billing practices, not around clinical practices, said George Kwass, a pathologist based in Massachusetts and board member of the College of American Pathologists. Urologists who team up with pathologists appear to bill more, he said, leading to potential waste. Urology groups are consolidating, and increasingly moving into the pathology business. One large practice based on New York's Long Island, Integrated Medical Professionals, opened its lab in 2010 to control costs and because doctors encountered errors in outside test results, said the group's chairman, Deepak Kapoor. We don't make a fortune on pathology, Dr. Kapoor said. But lab businesses are seeing revenue vanish. Texas pathology group ProPath stopped getting prostate tissue from large urology groups more than four years ago, said executive director Krista Crews, when these clients began doing lab work in-house. The group still gets referrals from small, one and two-doctor practices, she said. Large laboratory companies are worried about the trend, too. Quest Diagnostics Inc. DGX -2.52%said in its latest annual filings that if physicians, including urologists as well as gastroenterologists and skin and cancer doctors, continued to internalize testing services, it could reduce the company's sales. Write to Christopher Weaver at christopher.wea...@wsj.com Copyright 2012 Dow Jones Company, Inc. All Rights Reserved This copy is for your personal, non-commercial use only. Distribution and use of this material are governed by our Subscriber Agreement and by copyright law. For non-personal use or to order multiple copies, please contact Dow Jones Reprints at 1-800-843-0008 or visit
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 to
RE: [Histonet] In House Labs in WSJ
Not surprising since our health care system is biased to pay for tests and treatments, not results. On top of this there are serious questions as to whether the PSA screening that leads to biopsies is useful in the long term. There is a recommendation out there to stop PSA screening for most men since it is largely non-specific. That test is what leads to the biopsies. Less screening = fewer biopsies = less revenue. Tim Morken -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Daniel Schneider Sent: Tuesday, April 10, 2012 11:22 AM To: Histonet Subject: [Histonet] In House Labs in WSJ The Wall Street Journal served up a timely article for us. You'll see both sides of the argument below. One side is right. DLS HEALTH INDUSTRY April 9, 2012, 7:22 p.m. ET Prostate-Test Fees Challenged By CHRISTOPHER WEAVER Doctors in urology groups that profit from tests for prostate cancer order more of them than doctors who send samples to independent laboratories, according to a study Monday in the journal Health Affairs. The study found that doctors' practices that do their own lab work bill the federal Medicare program for analyzing 72% more prostate tissue samples per biopsy while detecting fewer cases of cancer than counterparts who send specimens to outside labs. Hiring pathologists boosts revenue for a practice and creates a potential incentive to increase the number of tests ordered, said Jean Mitchell, a Georgetown University economist and author of the study. That fewer cancers were detected-21% versus 35% for those sent to external labs, according to the study-suggests financial incentives may play a role in decisions to order the tests, Ms. Mitchell said. Some urologists said the research doesn't necessarily indicate financial motives. Urologists in larger group practices that have in-house pathologists may be more aggressive in testing because they seek to catch cancer earlier, said Steven Schlossberg, a Yale urologist who heads a health-policy panel for the American Urological Association and wasn't involved in the research. Also, Dr. Schlossberg noted, the figures, which cover 36,261 biopsies from 2005 through 2007, are five years old. The study was financed by the College of American Pathologists and the American Clinical Laboratory Association. It is the last salvo in a turf war between laboratory companies and physician groups that have opened their own labs to conduct tests. Regulators and economists scrutinizing the growing costs of health care have targeted a range of related activities by doctors, known as self-referrals. Although a set of 1990s-era laws, named for their proponent, Rep. Pete Stark (D., Calif.), ban doctors from referring patients to most companies in which they have a financial interest, urology groups can enter the pathology business because of an exemption for certain services performed within physicians' offices. The pathologists and other groups are lobbying Congress to end the exemption. At issue in the study is a quirk of billing for lab procedures. Labs get paid based on the number of jars used to hold specimens from a prostate biopsy. Doctors can choose to put several specimens in one jar or put each in its own jar, potentially boosting lab fees, which averaged about $104 a jar in 2010, according to the study. Urologists in practices with in-house pathologists sent 11.4 jars per biopsy for testing versus 5.9 jars per biopsy for other doctors in 2005. Some doctors say that separating the samples can help them better map any cancer. In addition, urologists in recent years have been taking more samples during a biopsy to better identify the location of any cancer, said John Hollingsworth, an assistant professor of urology at the University of Michigan. The standard number of samples taken doubled to 12 over the last decade, he said. The Health Affairs study's conclusions are largely around billing practices, not around clinical practices, said George Kwass, a pathologist based in Massachusetts and board member of the College of American Pathologists. Urologists who team up with pathologists appear to bill more, he said, leading to potential waste. Urology groups are consolidating, and increasingly moving into the pathology business. One large practice based on New York's Long Island, Integrated Medical Professionals, opened its lab in 2010 to control costs and because doctors encountered errors in outside test results, said the group's chairman, Deepak Kapoor. We don't make a fortune on pathology, Dr. Kapoor said. But lab businesses are seeing revenue vanish. Texas pathology group ProPath stopped getting prostate tissue from large urology groups more than four years ago, said executive director Krista Crews, when these clients began doing lab work in-house. The group still gets referrals from small, one and two-doctor
Re: [Histonet] New to paraffin cutting - seeking advice
I hope you're not training yourself to use a microtome. Please tell me you have an experienced cutter supervising you. Sincerely, Jay A. Lundgren M.S., HTL (ASCP) ___ 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] RE: Microwave processors
I have used the Sakura and Milestone( original offerings from some time ago and also later models). The variables are changed from conventional processing, and so you have to think about different things. When I have worked places that tried to transition to MW from conventional, the trouble starts when they try to design the programs like a conventional processor. My *theory*, which is based on some research over the last 5 years and as referenced by published literature on MW use in pathology, has to do with the polarity ( molecular composition) and the water content. The effect is more molecular than physical. You do have to customize for this with more detailed programs to get the best results in my experience. Dimensions and thickness are even more important than in conventional. Once you get over the change hurdle, it works ok and saves loads of time, decreases turn around and lets you move your staff in desirable ways. There is a revision of the CLSI MW guidelines that hopefully will get out there soon. I think when this is out it will help explain and help those wanting to use MW processors to improve TAT without tissue effects. In the meantime, I just did some basic literature searches and this really cleared up my understanding of the process and has helped me with programming these instruments.Joelle Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Tue, 10 Apr 2012 12:36:00 -0400 From: caroline.pr...@uphs.upenn.edu To: j...@cdc.gov; erin.mar...@ucsf.edu; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: Microwave processors CC: We cannot say the same, we had issues with shaves appearing cooked. We had specialists out several times and after many suggestions, nothing resolved the issue. It doesn't happen consistently but it definitely happens and we even attempted to track by tech or shifts or when the solutions were changed and no patterns could be found after several years. Sakura has a new vendor for reagents now and they are going to come run some test slides but the VIP quality for derm keeps the pathologists much happier based on our experience. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bartlett, Jeanine (CDC/OID/NCEZID) Sent: Tuesday, April 10, 2012 12:14 PM To: Martin, Erin; histonet Subject: [Histonet] RE: Microwave processors Erin, We have Sakura's Xpress and skins have always turned out just fine for us. It is very easy to use and maintain. Jeanine H. Bartlett Centers for Disease Control and Prevention Infectious Diseases Pathology Branch 404-639-3590 jeanine.bartl...@cdc.hhs.gov -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martin, Erin Sent: Tuesday, April 10, 2012 10:38 AM To: histonet Subject: [Histonet] Microwave processors Hi histonetters! Our pathologists want to turn around skin biopsies same day and are again looking at microwave processors. Due to a bad past experience, I'm not enthused but perhaps there is someone out there who loves their microwave processor? Even on derm? Or has anyone worked out a good rapid derm processing protocol on a conventional processor? Thank you so much! Erin Erin Martin, Histology Supervisor UCSF Dermatopathology Service 415-353-7248 Confidentiality Notice The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or priviledged material. Any review, retransmission, dissemination or other use of, or taking of any actin in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer. ___ 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 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
Re: [Histonet] Leica Bond IHC Platform
Use it everyday. Are you looking for opinions? Sent from my Verizon Wireless BlackBerry -Original Message- From: Wellen Terrence D. :LPH Lab twel...@lhs.org Date: Thu, 5 Apr 2012 00:06:04 To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Leica Bond IHC Platform Does anyone have any experience with this product? Terrence Wellen HT(ASCP) Legacy Good Samaritan Hospital Portland, OR ___ 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] Flammable cabinets
Can anybody explain how much alcohol or other flammables we can store in a flammable cabinet in a room? I have read the CAP guidelines and am still confused. Do the CAP guidelines only have to do with stored reagents outside of a flammable cabinet? What am I missing? James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Flammable cabinets
We are a research lab and usually the restrictions apply to flammables outside the cabinet. I believe they don't want more than 100-150ml of any one flammable. I don't think there is a restriction to what's stored inside one--probably depends upon the size of the cabinet. Peggy 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 Vickroy, Jim Sent: Tuesday, April 10, 2012 4:57 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Flammable cabinets Can anybody explain how much alcohol or other flammables we can store in a flammable cabinet in a room? I have read the CAP guidelines and am still confused. Do the CAP guidelines only have to do with stored reagents outside of a flammable cabinet? What am I missing? James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ 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
Re: [Histonet] In House Labs in WSJ
Less screening = fewer biopsies = less revenue = less prostate cancers caught early = more deaths to prostate cancers. Would you not agree? And for all those advocating closure of private labs, do you also feel the same way about private pathologist owned labs who reep the benefits of getting all the out PT work from affiliated physicians while they also get a fee to serve as medical directors of hospital labs and get the pc portion of hospital work of which they can order as many test they want so they get the pc portion while the hospital gets the tc and all the big bills associated with doing the test making it hard on tax payer as well because so much in a hospital is already subsidize by the gov. Is what you really want is to have all pathologist as employees of the hospitals? And have the hospital bill global. And a few walmart like reference labs I'm just curious as to the exact position of some on here. Thanks Kim Sent from my iPhone On Apr 10, 2012, at 2:39 PM, Morken, Timothy timothy.mor...@ucsfmedctr.org wrote: Not surprising since our health care system is biased to pay for tests and treatments, not results. On top of this there are serious questions as to whether the PSA screening that leads to biopsies is useful in the long term. There is a recommendation out there to stop PSA screening for most men since it is largely non-specific. That test is what leads to the biopsies. Less screening = fewer biopsies = less revenue. Tim Morken -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Daniel Schneider Sent: Tuesday, April 10, 2012 11:22 AM To: Histonet Subject: [Histonet] In House Labs in WSJ The Wall Street Journal served up a timely article for us. You'll see both sides of the argument below. One side is right. DLS HEALTH INDUSTRY April 9, 2012, 7:22 p.m. ET Prostate-Test Fees Challenged By CHRISTOPHER WEAVER Doctors in urology groups that profit from tests for prostate cancer order more of them than doctors who send samples to independent laboratories, according to a study Monday in the journal Health Affairs. The study found that doctors' practices that do their own lab work bill the federal Medicare program for analyzing 72% more prostate tissue samples per biopsy while detecting fewer cases of cancer than counterparts who send specimens to outside labs. Hiring pathologists boosts revenue for a practice and creates a potential incentive to increase the number of tests ordered, said Jean Mitchell, a Georgetown University economist and author of the study. That fewer cancers were detected-21% versus 35% for those sent to external labs, according to the study-suggests financial incentives may play a role in decisions to order the tests, Ms. Mitchell said. Some urologists said the research doesn't necessarily indicate financial motives. Urologists in larger group practices that have in-house pathologists may be more aggressive in testing because they seek to catch cancer earlier, said Steven Schlossberg, a Yale urologist who heads a health-policy panel for the American Urological Association and wasn't involved in the research. Also, Dr. Schlossberg noted, the figures, which cover 36,261 biopsies from 2005 through 2007, are five years old. The study was financed by the College of American Pathologists and the American Clinical Laboratory Association. It is the last salvo in a turf war between laboratory companies and physician groups that have opened their own labs to conduct tests. Regulators and economists scrutinizing the growing costs of health care have targeted a range of related activities by doctors, known as self-referrals. Although a set of 1990s-era laws, named for their proponent, Rep. Pete Stark (D., Calif.), ban doctors from referring patients to most companies in which they have a financial interest, urology groups can enter the pathology business because of an exemption for certain services performed within physicians' offices. The pathologists and other groups are lobbying Congress to end the exemption. At issue in the study is a quirk of billing for lab procedures. Labs get paid based on the number of jars used to hold specimens from a prostate biopsy. Doctors can choose to put several specimens in one jar or put each in its own jar, potentially boosting lab fees, which averaged about $104 a jar in 2010, according to the study. Urologists in practices with in-house pathologists sent 11.4 jars per biopsy for testing versus 5.9 jars per biopsy for other doctors in 2005. Some doctors say that separating the samples can help them better map any cancer. In addition, urologists in recent years have been taking more samples during a biopsy to better identify the location of any cancer, said John Hollingsworth, an assistant
[Histonet] Labeling specimens in the OR
Does anyone have experience with the labeling and bar coding of surgical pathology specimens in the OR? Please send your experience to apres...@jhmi.edu ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] In House Labs in WSJ
From the New York Times: 1) U.S. Panel Says No to Prostate Screening for Healthy Men By GARDINER HARRIS Published: October 6, 2011 Healthy men should no longer receive a P.S.A. blood test to screen for prostate cancer because the test does not save lives over all and often leads to more tests and treatments that needlessly cause pain, impotence and incontinence in many, a key government health panel has decided. The draft recommendation, by the United States Preventive Services Task Force and due for official release next week, is based on the results of five well-controlled clinical trials and could substantially change the care given to men 50 and older. There are 44 million such men in the United States, and 33 million of them have already had a P.S.A. test - sometimes without their knowledge - during routine physicals. The task force's recommendations are followed by most medical groups. Two years ago the task force recommended that women in their 40s should no longer get routine mammograms, setting off a firestorm of controversy. The recommendation to avoid the P.S.A. test is even more forceful and applies to healthy men of all ages. Unfortunately, the evidence now shows that this test does not save men's lives, said Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force. This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does. Article continues 2) Prostate Test Found to Save Few Lives By GINA KOLATA Published: March 18, 2009 The PSA blood test, used to screen for prostate cancer, saves few lives and leads to risky and unnecessary treatments for large numbers of men, two large studies have found. Mortality Results from a Randomized Prostate-Cancer Screening Trial (The New England Journal of Medicine) Screening and Prostate-Cancer Mortality in a Randomized European Study (The New England Journal of Medicine) The findings, the first based on rigorous, randomized studies, confirm some longstanding concerns about the wisdom of widespread prostate cancer screening. Although the studies are continuing, results so far are considered significant and the most definitive to date. The PSA test, which measures a protein released by prostate cells, does what it is supposed to do - indicates a cancer might be present, leading to biopsies to determine if there is a tumor. But it has been difficult to know whether finding prostate cancer early saves lives. Most of the cancers tend to grow very slowly and are never a threat and, with the faster-growing ones, even early diagnosis might be too late. The studies - one in Europe and the other in the United States - are some of the most important studies in the history of men's health, said Dr. Otis Brawley, the chief medical officer of the American Cancer Society. In the European study, 48 men were told they had prostate cancer and needlessly treated for it for every man whose death was prevented within a decade after having had a PSA test. Dr. Peter B. Bach, a physician and epidemiologist at Memorial Sloan-Kettering Cancer Center, says one way to think of the data is to suppose he has a PSA test today. It leads to a biopsy that reveals he has prostate cancer, and he is treated for it. There is a one in 50 chance that, in 2019 or later, he will be spared death from a cancer that would otherwise have killed him. And there is a 49 in 50 chance that he will have been treated unnecessarily for a cancer that was never a threat to his life. Article continues -Original Message- From: Kim Donadio [mailto:one_angel_sec...@yahoo.com] Sent: Tuesday, April 10, 2012 2:33 PM To: Morken, Timothy Cc: Daniel Schneider; Histonet Subject: Re: [Histonet] In House Labs in WSJ Less screening = fewer biopsies = less revenue = less prostate cancers caught early = more deaths to prostate cancers. Would you not agree? And for all those advocating closure of private labs, do you also feel the same way about private pathologist owned labs who reep the benefits of getting all the out PT work from affiliated physicians while they also get a fee to serve as medical directors of hospital labs and get the pc portion of hospital work of which they can order as many test they want so they get the pc portion while the hospital gets the tc and all the big bills associated with doing the test making it hard on tax payer as well because so much in a hospital is already subsidize by the gov. Is what you really want is to have all pathologist as employees of the hospitals? And have the hospital bill global. And a few walmart like reference labs I'm just curious as to the exact position of some on here. Thanks Kim Sent from my iPhone On Apr 10, 2012, at 2:39 PM, Morken, Timothy timothy.mor...@ucsfmedctr.org wrote: Not surprising since our health care
[Histonet] ASCP Exam
Hello fellow histonetters!!! I have begun studying for the ASCP HT exam. Any guidance/studying suggestions/study booklets/tactics you can throw out at me would be greatly appreciated. Any recent exam takers out there? Oh yeah, and also, since I am planning on relocating to California, does anyone know if that state has it's own state licensure? Thanks again!! -Bharti Parihar ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] In House Labs in WSJ
I find it interesting (and slightly amusing) that a professor of pediatrics is chairwoman of the task force on PSA testing. After my early publications on PSA IPXs, I thought that I was over that now I am in a Children's Hospital. Now I am not so sure! Regards Tony Henwood JP, MSc, BAppSc, GradDipSysAnalys, CT(ASC), FFSc(RCPA) Laboratory Manager Senior Scientist Tel: 612 9845 3306 Fax: 612 9845 3318 the children's hospital at westmead Cnr Hawkesbury Road and Hainsworth Street, Westmead Locked Bag 4001, Westmead NSW 2145, AUSTRALIA -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, Timothy Sent: Wednesday, 11 April 2012 7:49 AM To: Kim Donadio Cc: Histonet Subject: RE: [Histonet] In House Labs in WSJ From the New York Times: 1) U.S. Panel Says No to Prostate Screening for Healthy Men By GARDINER HARRIS Published: October 6, 2011 Healthy men should no longer receive a P.S.A. blood test to screen for prostate cancer because the test does not save lives over all and often leads to more tests and treatments that needlessly cause pain, impotence and incontinence in many, a key government health panel has decided. The draft recommendation, by the United States Preventive Services Task Force and due for official release next week, is based on the results of five well-controlled clinical trials and could substantially change the care given to men 50 and older. There are 44 million such men in the United States, and 33 million of them have already had a P.S.A. test - sometimes without their knowledge - during routine physicals. The task force's recommendations are followed by most medical groups. Two years ago the task force recommended that women in their 40s should no longer get routine mammograms, setting off a firestorm of controversy. The recommendation to avoid the P.S.A. test is even more forceful and applies to healthy men of all ages. Unfortunately, the evidence now shows that this test does not save men's lives, said Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force. This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does. Article continues 2) Prostate Test Found to Save Few Lives By GINA KOLATA Published: March 18, 2009 The PSA blood test, used to screen for prostate cancer, saves few lives and leads to risky and unnecessary treatments for large numbers of men, two large studies have found. Mortality Results from a Randomized Prostate-Cancer Screening Trial (The New England Journal of Medicine) Screening and Prostate-Cancer Mortality in a Randomized European Study (The New England Journal of Medicine) The findings, the first based on rigorous, randomized studies, confirm some longstanding concerns about the wisdom of widespread prostate cancer screening. Although the studies are continuing, results so far are considered significant and the most definitive to date. The PSA test, which measures a protein released by prostate cells, does what it is supposed to do - indicates a cancer might be present, leading to biopsies to determine if there is a tumor. But it has been difficult to know whether finding prostate cancer early saves lives. Most of the cancers tend to grow very slowly and are never a threat and, with the faster-growing ones, even early diagnosis might be too late. The studies - one in Europe and the other in the United States - are some of the most important studies in the history of men's health, said Dr. Otis Brawley, the chief medical officer of the American Cancer Society. In the European study, 48 men were told they had prostate cancer and needlessly treated for it for every man whose death was prevented within a decade after having had a PSA test. Dr. Peter B. Bach, a physician and epidemiologist at Memorial Sloan-Kettering Cancer Center, says one way to think of the data is to suppose he has a PSA test today. It leads to a biopsy that reveals he has prostate cancer, and he is treated for it. There is a one in 50 chance that, in 2019 or later, he will be spared death from a cancer that would otherwise have killed him. And there is a 49 in 50 chance that he will have been treated unnecessarily for a cancer that was never a threat to his life. Article continues -Original Message- From: Kim Donadio [mailto:one_angel_sec...@yahoo.com] Sent: Tuesday, April 10, 2012 2:33 PM To: Morken, Timothy Cc: Daniel Schneider; Histonet Subject: Re: [Histonet] In House Labs in WSJ Less screening = fewer biopsies = less revenue = less prostate cancers caught early = more deaths to prostate cancers. Would you not agree? And for all those advocating closure of private labs, do you also feel the same way about private pathologist owned labs who reep the
Re: [Histonet] In House Labs in WSJ
A key government health panel has decided it says. Ok. I give. Sent from my iPhone On Apr 10, 2012, at 5:48 PM, Morken, Timothy timothy.mor...@ucsfmedctr.org wrote: From the New York Times: 1) U.S. Panel Says No to Prostate Screening for Healthy Men By GARDINER HARRIS Published: October 6, 2011 Healthy men should no longer receive a P.S.A. blood test to screen for prostate cancer because the test does not save lives over all and often leads to more tests and treatments that needlessly cause pain, impotence and incontinence in many, a key government health panel has decided. The draft recommendation, by the United States Preventive Services Task Force and due for official release next week, is based on the results of five well-controlled clinical trials and could substantially change the care given to men 50 and older. There are 44 million such men in the United States, and 33 million of them have already had a P.S.A. test - sometimes without their knowledge - during routine physicals. The task force's recommendations are followed by most medical groups. Two years ago the task force recommended that women in their 40s should no longer get routine mammograms, setting off a firestorm of controversy. The recommendation to avoid the P.S.A. test is even more forceful and applies to healthy men of all ages. Unfortunately, the evidence now shows that this test does not save men's lives, said Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force. This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does. Article continues 2) Prostate Test Found to Save Few Lives By GINA KOLATA Published: March 18, 2009 The PSA blood test, used to screen for prostate cancer, saves few lives and leads to risky and unnecessary treatments for large numbers of men, two large studies have found. Mortality Results from a Randomized Prostate-Cancer Screening Trial (The New England Journal of Medicine) Screening and Prostate-Cancer Mortality in a Randomized European Study (The New England Journal of Medicine) The findings, the first based on rigorous, randomized studies, confirm some longstanding concerns about the wisdom of widespread prostate cancer screening. Although the studies are continuing, results so far are considered significant and the most definitive to date. The PSA test, which measures a protein released by prostate cells, does what it is supposed to do - indicates a cancer might be present, leading to biopsies to determine if there is a tumor. But it has been difficult to know whether finding prostate cancer early saves lives. Most of the cancers tend to grow very slowly and are never a threat and, with the faster-growing ones, even early diagnosis might be too late. The studies - one in Europe and the other in the United States - are some of the most important studies in the history of men's health, said Dr. Otis Brawley, the chief medical officer of the American Cancer Society. In the European study, 48 men were told they had prostate cancer and needlessly treated for it for every man whose death was prevented within a decade after having had a PSA test. Dr. Peter B. Bach, a physician and epidemiologist at Memorial Sloan-Kettering Cancer Center, says one way to think of the data is to suppose he has a PSA test today. It leads to a biopsy that reveals he has prostate cancer, and he is treated for it. There is a one in 50 chance that, in 2019 or later, he will be spared death from a cancer that would otherwise have killed him. And there is a 49 in 50 chance that he will have been treated unnecessarily for a cancer that was never a threat to his life. Article continues -Original Message- From: Kim Donadio [mailto:one_angel_sec...@yahoo.com] Sent: Tuesday, April 10, 2012 2:33 PM To: Morken, Timothy Cc: Daniel Schneider; Histonet Subject: Re: [Histonet] In House Labs in WSJ Less screening = fewer biopsies = less revenue = less prostate cancers caught early = more deaths to prostate cancers. Would you not agree? And for all those advocating closure of private labs, do you also feel the same way about private pathologist owned labs who reep the benefits of getting all the out PT work from affiliated physicians while they also get a fee to serve as medical directors of hospital labs and get the pc portion of hospital work of which they can order as many test they want so they get the pc portion while the hospital gets the tc and all the big bills associated with doing the test making it hard on tax payer as well because so much in a hospital is already subsidize by the gov. Is what you really want is to have all pathologist as employees of the hospitals? And have the
Re: [Histonet] Labeling specimens in the OR
If you want barcodes on tour specimens directly from the or. Have your HIS system interfaced with your pathology information system. That way when path gets your specimen they just scan the bar code and the patients data drops into thier path system. Depending on the system you get path should be able to track specimens coming to them. My favorite system I've used so far has been Cerner copath. It was pretty easy to use. I'm sure there are other good ones though. Hope this helps Kim D Sent from my iPhone On Apr 10, 2012, at 5:52 PM, Arlene Prescott apres...@jhmi.edu wrote: Does anyone have experience with the labeling and bar coding of surgical pathology specimens in the OR? Please send your experience to apres...@jhmi.edu ___ 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] Processing Autopsies
Our lab processes a high number of autopsies; however we always seem to have tissue that needs to be reprocessed; particularly brains. Does anyone out there have any suggestions as to what an optimal processing cycle would be? We are finding it hard to find a happy medium as there always seems to be something that is underprocessed, or sometimes even overprocessed. Thanks. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Processing Autopsies
Brains in particular need to be fixed real well If it's a whole brain what I've done is hang the brain by a mesh or strings into a large brain bucket so it's not touching the sides or bottom. Fix for few days then get you sections. I'd go textbook on the 3 mm thick sections for processing and don't over process that will cause them to be friable. Hate that. Try a few blocks a couple different ways and what kind of alcohol are you using? Reagent grade is fine. For processing well fixed brain I've had good success with a straight 30 min for every thing. Hope this helps Kim D I'm out :) Sent from my iPhone On Apr 10, 2012, at 7:14 PM, Meryl Roberts mery...@hotmail.com wrote: Our lab processes a high number of autopsies; however we always seem to have tissue that needs to be reprocessed; particularly brains. Does anyone out there have any suggestions as to what an optimal processing cycle would be? We are finding it hard to find a happy medium as there always seems to be something that is underprocessed, or sometimes even overprocessed. Thanks. ___ 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] RE: Flammable cabinets
In my experience, restrictions are determined by fire codes and zones. I would talk to your safety officer or facilities, or a local fire marshal. Jennifer Jennifer Schumacher, MA, HTL (ASCP) Hematopathology Supervisor I University of Minnesota Medical Center, Fairview I Phone 612-273-3229 I Fax 612-624-6662 I Pager 612-899-9295 I Address L227-2 MMC 198, 420 Delaware St SE, Minneapolis, MN 55455 I Email jschu...@fairview.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sherwood, Margaret Sent: Tuesday, April 10, 2012 4:30 PM To: 'Vickroy, Jim'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Flammable cabinets We are a research lab and usually the restrictions apply to flammables outside the cabinet. I believe they don't want more than 100-150ml of any one flammable. I don't think there is a restriction to what's stored inside one--probably depends upon the size of the cabinet. Peggy 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 Vickroy, Jim Sent: Tuesday, April 10, 2012 4:57 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Flammable cabinets Can anybody explain how much alcohol or other flammables we can store in a flammable cabinet in a room? I have read the CAP guidelines and am still confused. Do the CAP guidelines only have to do with stored reagents outside of a flammable cabinet? What am I missing? James Vickroy BS, HT(ASCP) Surgical and Autopsy Pathology Technical Supervisor Memorial Medical Center 217-788-4046 This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. ___ 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
Re: [Histonet] In House Labs in WSJ
Less screening = fewer biopsies = less revenue = less prostate cancers caught early = more deaths to prostate cancers. Would you not agree? According to the study referenced earlier, just the opposite is true. Increased utilization arising from in-house laboratories has proven to be less effective, and much more costly than their traditional counterparts. No benefit to the patient at all, actually a detriment. The best results still come from outfits owned and operated by pathologists and/or hospitals, and at a significantly lower cost. And for all those advocating closure of private labs, do you also feel the same way about private pathologist owned labs who reep the benefits of getting all the out PT work from affiliated physicians while they also get a fee to serve as medical directors of hospital labs and get the pc portion of hospital work of which they can order as many test they want so they get the pc portion while the hospital gets the tc and all the big bills associated with doing the test making it hard on tax payer as well because so much in a hospital is already subsidize by the gov. Private labs outside of the hospital, owned by pathologists, do not represent the group of non-pathologist owned in-office labs we have discussed. There are no complaints arising over pure pathology labs, operated by pathologists. The complaints are in reference to private labs within a GI clinic, or in a urologists' office, etc. Is what you really want is to have all pathologist as employees of the hospitals? And have the hospital bill global. Doctors in hospital settings are very rarely employed by the hospital, with the exception being academia. In most cases, the pathology group handles their own billing for professional fees. Just like radiologists, surgeons, anaesthesiologists and most others working in a hospital are not employed by that hospital. And a few walmart like reference labs I'm just curious as to the exact position of some on here. Thanks Kim Sent from my iPhone On Apr 10, 2012, at 2:39 PM, Morken, Timothy timothy.mor...@ucsfmedctr.org wrote: Not surprising since our health care system is biased to pay for tests and treatments, not results. On top of this there are serious questions as to whether the PSA screening that leads to biopsies is useful in the long term. There is a recommendation out there to stop PSA screening for most men since it is largely non-specific. That test is what leads to the biopsies. Less screening = fewer biopsies = less revenue. Tim Morken -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto: histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Daniel Schneider Sent: Tuesday, April 10, 2012 11:22 AM To: Histonet Subject: [Histonet] In House Labs in WSJ The Wall Street Journal served up a timely article for us. You'll see both sides of the argument below. One side is right. DLS HEALTH INDUSTRY April 9, 2012, 7:22 p.m. ET Prostate-Test Fees Challenged By CHRISTOPHER WEAVER Doctors in urology groups that profit from tests for prostate cancer order more of them than doctors who send samples to independent laboratories, according to a study Monday in the journal Health Affairs. The study found that doctors' practices that do their own lab work bill the federal Medicare program for analyzing 72% more prostate tissue samples per biopsy while detecting fewer cases of cancer than counterparts who send specimens to outside labs. Hiring pathologists boosts revenue for a practice and creates a potential incentive to increase the number of tests ordered, said Jean Mitchell, a Georgetown University economist and author of the study. That fewer cancers were detected-21% versus 35% for those sent to external labs, according to the study-suggests financial incentives may play a role in decisions to order the tests, Ms. Mitchell said. Some urologists said the research doesn't necessarily indicate financial motives. Urologists in larger group practices that have in-house pathologists may be more aggressive in testing because they seek to catch cancer earlier, said Steven Schlossberg, a Yale urologist who heads a health-policy panel for the American Urological Association and wasn't involved in the research. Also, Dr. Schlossberg noted, the figures, which cover 36,261 biopsies from 2005 through 2007, are five years old. The study was financed by the College of American Pathologists and the American Clinical Laboratory Association. It is the last salvo in a turf war between laboratory companies and physician groups that have opened their own labs to conduct tests. Regulators and economists scrutinizing the growing costs of health care have targeted a range of related activities by doctors, known as self-referrals. Although a set of 1990s-era laws, named for their proponent, Rep. Pete Stark (D., Calif.), ban doctors
[Histonet] TBS ATP1
Hello everybody, I am looking for the SERVICE MANUAL for the Tissue Processor TBS ATP1 . Could anyone help me . RegardsRicky ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Histobath
Clini -RF from Hacker is nice cuz it sits on the floor next to the cryostat at working height. Gets a lot colder too. - Original Message - From: Bernice Frederick b-freder...@northwestern.edu To: Patsy Ruegg pru...@ihctech.net, Margaret' 'Sherwood msherw...@partners.org, Marilyn A Weiss marilyn.a.we...@kp.org, histonet@lists.utsouthwestern.edu Sent: Monday, April 9, 2012 7:45:38 AM Subject: 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 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] RE: Microwave processors
I use the Milestone Pathos Delta in my Dermpath lab and have had amazing results. As long as you follow their recommendations for processing times it works out perfectly. I am able to do small biopsies in as little as an hour and twenty minutes or big excisions in 3-4 hours with great results. Obviously I prefer Milestone over Pathos, but a couple of big reasons is because you are not limited to 3mm sections, you can process big and small tissue together using times for big tissue and it will not destroy your small biopsies, it's completely automated(no fixing and pre-process solution before loading on processor and you are not REQUIRED to use their proprietary reagents(although they are really good as well). This is just my personal opinion from using it in a Derm only practice. One last thing is that the customer service and attention they give to the customer is second to none. Hope this helps! Good luck!! Carlos On Apr 10, 2012, at 1:07 PM, joelle weaver joellewea...@hotmail.com wrote: I have used the Sakura and Milestone( original offerings from some time ago and also later models). The variables are changed from conventional processing, and so you have to think about different things. When I have worked places that tried to transition to MW from conventional, the trouble starts when they try to design the programs like a conventional processor. My *theory*, which is based on some research over the last 5 years and as referenced by published literature on MW use in pathology, has to do with the polarity ( molecular composition) and the water content. The effect is more molecular than physical. You do have to customize for this with more detailed programs to get the best results in my experience. Dimensions and thickness are even more important than in conventional. Once you get over the change hurdle, it works ok and saves loads of time, decreases turn around and lets you move your staff in desirable ways. There is a revision of the CLSI MW guidelines that hopefully will get out there soon. I think when this is out it will help explain and help those wanting to use MW processors to improve TAT without tissue effects. In the meantime, I just did some basic literature searches and this really cleared up my understanding of the process and has helped me with programming these instruments.Joelle Joelle Weaver MAOM, HTL (ASCP) QIHC Date: Tue, 10 Apr 2012 12:36:00 -0400 From: caroline.pr...@uphs.upenn.edu To: j...@cdc.gov; erin.mar...@ucsf.edu; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: Microwave processors CC: We cannot say the same, we had issues with shaves appearing cooked. We had specialists out several times and after many suggestions, nothing resolved the issue. It doesn't happen consistently but it definitely happens and we even attempted to track by tech or shifts or when the solutions were changed and no patterns could be found after several years. Sakura has a new vendor for reagents now and they are going to come run some test slides but the VIP quality for derm keeps the pathologists much happier based on our experience. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bartlett, Jeanine (CDC/OID/NCEZID) Sent: Tuesday, April 10, 2012 12:14 PM To: Martin, Erin; histonet Subject: [Histonet] RE: Microwave processors Erin, We have Sakura's Xpress and skins have always turned out just fine for us. It is very easy to use and maintain. Jeanine H. Bartlett Centers for Disease Control and Prevention Infectious Diseases Pathology Branch 404-639-3590 jeanine.bartl...@cdc.hhs.gov -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martin, Erin Sent: Tuesday, April 10, 2012 10:38 AM To: histonet Subject: [Histonet] Microwave processors Hi histonetters! Our pathologists want to turn around skin biopsies same day and are again looking at microwave processors. Due to a bad past experience, I'm not enthused but perhaps there is someone out there who loves their microwave processor? Even on derm? Or has anyone worked out a good rapid derm processing protocol on a conventional processor? Thank you so much! Erin Erin Martin, Histology Supervisor UCSF Dermatopathology Service 415-353-7248 Confidentiality Notice The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or priviledged material. Any review, retransmission, dissemination or other use of, or taking of any actin in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you receive this in error, please contact the sender and delete the material from any computer.
Re: [Histonet] ASCP Exam
California does not have state licensure for histotechs. There is no regulation that histotechs even have to be certified, but many of the facilities will only hire certified technicians. The NSH has a list of study materials at http://www.nsh.org/content/certification-exam-study-aids Bharti Parihar bhartolog...@gmail.com Sent by: histonet-boun...@lists.utsouthwestern.edu 04/10/2012 03:50 PM To Histonet Archive histonet@lists.utsouthwestern.edu cc Subject [Histonet] ASCP Exam Hello fellow histonetters!!! I have begun studying for the ASCP HT exam. Any guidance/studying suggestions/study booklets/tactics you can throw out at me would be greatly appreciated. Any recent exam takers out there? Oh yeah, and also, since I am planning on relocating to California, does anyone know if that state has it's own state licensure? Thanks again!! -Bharti Parihar ___ 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
