Re: [Histonet] Looking for a Olympus BH2 microscope bag -- please sell me one of yours!

[Daniel Schneider via Histonet]

She shouldn't sweat it.  When I took the boards I don't recall anyone
bringing their own scope. I'm sure people do it, but it's overkill. Someone
should gently encourage her to use the microscope provided on-site.  It
works the same as her BH2. I can't remember what make it was but the board
can tell her. I had no trouble with it -- there were no surprises with
respect to the scope.

And then she won't have to worry about lugging her scope across the country.

On Thu, Sep 17, 2015 at 9:01 AM, Lake, Kim S via Histonet <
histonet@lists.utsouthwestern.edu> wrote:

> One of our residents is going to take her boards in a few months, and she
> would like to take along her (ancient!) Olympus BH2 microscope. Does anyone
> have a BH2 microscope travel bag/case that they would be willing to sell to
> us?
>
> Alternatively, does anyone have any favorite retailers of vintage
> microscope bags that they can recommend?
>
> Thanks!
>
>
> Kim Lake MT(ASCP)
> Laboratory Manager
> University of Iowa Oral Pathology Laboratory
> S387 Dental Science Building
> Iowa City, IA 52242
>
> Phone: 319 384 4433
> Fax: 319 353 5569
> Email: kim-l...@uiowa.edu
>
>
>
>
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Re: [Histonet] billing question

[Daniel Schneider]

That's correct, Hazel.

Daniel Schneider, MD
Amarillo, TX

On Thu, Jan 22, 2015 at 3:14 PM, Horn, Hazel V hor...@archildrens.org
wrote:

 Scenario: I am billing for immunostains and there are 3 specimens; A, B, C.
 Pathologist orders 1 stain on all 3 specimens.  I bill 3  88342's.
 Pathologist orders 2 stains each on A and B.  I bill 2  88342's and 2
 88341's.

 Is this correct?

 Hazel Horn
 Supervisor of Histology/Autopsy/Transcription
 Anatomic Pathology
 Arkansas Children's Hospital
 1 Children's Way | Slot 820| Little Rock, AR 72202
 501.364.4240 direct | 501.364.1241 fax
 hor...@archildrens.orgmailto:hor...@archildrens.org
 archildrens.orghttp://www.archildrens.org/








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Re: [Histonet] Re: Pathologists' Names on HE Labels

[Daniel Schneider]

You can get Sharpies and highlighters in at least 7 different colors. We
color code the pathologists (Dr's Red, Blue, Pink, Orange, Purple, Green,
and Yellow.)   The Sharpies and highlighters are distributed in the
appropriate departments, and the slides and paperwork get a quick mark of
color to facilitate their delivery to the appropriate pathologist.

Dan Schneider
Amarillo, TX

On Sat, Jan 5, 2013 at 1:37 PM, Bob Richmond rsrichm...@gmail.com wrote:

 Pathologist's name on the slide? I'd just like to see the patient's
 name on the slide. It helps me not mix up cases, but the old-timer
 histotechnologists really resist it.

 I guess you can legal-beagle reasons not to put the pathologist's name
 on the slide, but I don't see anything wrong with it. Seems like
 initials would suffice.

 Bob Richmond
 Samurai Pathologist
 Maryville TN

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Re: [Histonet] The Rise of Physician Owned/Operated Labs (POLs) and future trends

[Daniel Schneider]

I don't doubt what you're saying, but can you source this info more 
specifically than a consultant?  I'm going to discuss this with my colleagues 
and they're going to ask me.

Needless to say, a 10-20% cut in the TC of 88305, coming down the pipe in a 
month or two, is a big deal.

Dan Schneider, MD

Sent from my iPhone

On Oct 31, 2012, at 6:49 AM, Webster, Thomas S. twebs...@crh.org wrote:

 I am scared to see what is going to happen to the technical component of 
 88305 next month. A consultant is telling people to prepare for a 10 to 20 
 percent cut. Immunos and cytology enhancement 88112 are going to be slashed 
 for 2014. It's going to be very difficult for smaller AP labs to survive. The 
 medicare business helps keep the doors open for some labs with low client 
 pricing and the other payers will reduce payments as well.
 
 
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Re: [Histonet] Aetna and In-Office Lab Accreditation

[Daniel Schneider]

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

[Histonet] In House Labs in WSJ

[Daniel Schneider]

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

[Daniel Schneider]

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





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Re: [Histonet] Two Questions

[Daniel Schneider]

On 4/27/11, Nicole Tatum nic...@dlcjax.com wrote:
 1st.   Does anyone know if there is a rule or law that states a lab must
 have a door?

I suspect that it's not explicitly spelled out, but I'd caution you,
if you build a lab without doors, you have to make provisions to
provide food and water for the HT's imprisoned inside. It's easier to
put in doors.

DLS

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Re: [Histonet] Re: Grossing Technician Qualifications

[Daniel Schneider]

Just to clarify or perhaps cloud the picture a little more

Not all grossing is grossing.

So when we're talking about transferring small biopsies, in their
entirety, from a formalin container to a cassette, and describing the size,
number, and color of the tissue pieces submitted, with no dissection or
knowledge of anatomy required, that's not grossing in the strict sense, at
least according to CAP the last time I looked, which admittedly was a couple
of years ago.

So what sort of educational achievements, training, or credentials are
required for the above?

Dan Schneider
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Re: [Histonet] Re: Grossing Technician Qualifications

[Daniel Schneider]

Really. Are you sure?

Received in formalin, labeled with the patient's name and number, the
specimen consists of a single tan-gray fragment of tissue measuring 3
millimeters in greatest dimension, submitted entirely in A1 requires 60
some odd hours?

I have no gripe with requiring a certain degree of credentials for any
grossing which requires dissection, judgement, and knowledge of anatomy, but
this is merely counting, measuring, and transferring.  I think the CAP term
was processing as distinguished from grossing.  So processing (in the
above sense, not in the histo sense) is gone now?

Is this coming from CAP?  Could someone give me chapter and verse so that I
can make copies and discuss it with my colleagues locally?

Thanks,

On Wed, May 19, 2010 at 1:38 PM, Mahoney,Janice A 
janice.maho...@alegent.org wrote:

 Things have changed.  All grossing is back to being grossing.
 Jan Mahoney
 Omaha, NE

 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu [mailto:
 histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Daniel Schneider
 Sent: Wednesday, May 19, 2010 12:58 PM
 To: histonet@lists.utsouthwestern.edu
 Subject: Re: [Histonet] Re: Grossing Technician Qualifications

  Just to clarify or perhaps cloud the picture a little more

 Not all grossing is grossing.

 So when we're talking about transferring small biopsies, in their
 entirety, from a formalin container to a cassette, and describing the size,
 number, and color of the tissue pieces submitted, with no dissection or
 knowledge of anatomy required, that's not grossing in the strict sense,
 at
 least according to CAP the last time I looked, which admittedly was a
 couple
 of years ago.

 So what sort of educational achievements, training, or credentials are
 required for the above?

 Dan Schneider
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Re: [Histonet] Peripheral Blood Smears

[Daniel Schneider]

On Thu, Feb 11, 2010 at 8:27 AM, dkb...@chs.net wrote:

 Hematology doesn't stain our
 slides.


Why not?
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Re: [Histonet] Peripheral Blood Smears

[Daniel Schneider]

It seems odd to me that Histology is producing a better Wright Giemsa than
Hematology can.  It's their bread and butter.  Who is the pathologist over
Hematology?  Perhaps y'all can have a little pow-wow, and help Hematology
improve their stain.  (Is it that your pathologists want a manual stain and
hematology is using an automated stainer and the docs don't like the way it
looks?  Automated stainers can be tweaked. Besides, hematology should be
able to do manual stains.)

On Thu, Feb 11, 2010 at 9:02 AM, dkb...@chs.net wrote:


  I would love to get them out of histology, but the pathologist want us to
 stain them.  They are not happy with the hematology stain.  Also the report
 is generated through Histology when it is for pathologist review.


 Debbie M. Boyd, HT(ASCP) l Chief Histologist l Southside Regional Medical
 Center I
 200 Medical Park Boulevard l Petersburg, Va.  23805 l T: 804-765-5050 l F:
 804-765-5582 l dkb...@chs.net






   *Daniel Schneider dlschnei...@gmail.com*
 Sent by: histonet-boun...@lists.utsouthwestern.edu

 02/11/2010 09:57 AM
To
 dkb...@chs.net
 cc
 histonet@lists.utsouthwestern.edu
 Subject
 Re: [Histonet] Peripheral Blood Smears




  On Thu, Feb 11, 2010 at 8:27 AM, dkb...@chs.net wrote:

  Hematology doesn't stain our
  slides.


 Why not?
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Re: [Histonet] Clarification on pod labs

[Daniel Schneider]

What we have here is market distortion by a payment scheme that  
doesn't reflect the real costs.  You have to ask yourself why would a  
urologist/dermatologist/gastroenterologist want to mess with a  
histology lab?
Follow the money.  Processing biopsies, I.e. the technical component  
of CPT code 88305, is ridiculously profitable. It's reimbursement is  
way out of proportion to the actual costs involved, which is why these  
clinicians are willing to invest in small inefficient in-office labs  
-- they're still going to clean up. Cha Ching!  Hospital based  
pathologists rely on the profitable biopsy business to make up for the  
time and resources devoted to less profitable sides of their work, for  
example resection specimens ( CPT code 88307's and 88309's)that are  
reimbursed more than a biopsy but not proportionate to the cost of  
processing them ( complex grossing requring more time and expertise  
from  a PA or often a pathologist, as well as many blocks to process,  
embed, and cut,  and more time at the scope reviewing these many  
slides.). When someone else cherry picks the biopsies, hospital labs  
suffer.  But you say, it's just business, it's the American way.  But  
it's only that way because of fat reimbursement for the TC on 88305.  
Cut that significantly, and all these in-office labs become  
liabilities, not profit centers.  The urologists/derms/GI's will then  
close their labs, and their histotechs will get kicked to the curb.   
Given the healthcare climate in this country, and the fact that  
everybody knows the technical component on 88305 is relatively rich,  
how likely do you think that is?



Dan Schneider
(Obligatory Disclosure:  I
a Hospital Based Pathologist.)

Sent from my iPhone

On Feb 7, 2010, at 1:32 PM, Andrew Burgeson nap...@siscom.net wrote:


When referring to all labs in the USA being
privately-owned, I am, of course, excluding government
facilities. BUT...even those facilities employ people who
make $ working in this field and so have some interest in
the discussions.

Also, due to the fact that MEDICARE is such a big factor in
US medical reimbursements, anyone with a Medicare ID who
gets paid by the government is, in a sense, a government
provider. So in this sense, the system is mixed.

My post refers specifically to non-government labs. (with
the understanding that most everyone bills medicare)

AB

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Re: [Histonet] RE: CPT code 88313 on non-gynecological cases

[Daniel Schneider]

Can you cite some authority or reference on this?  I'm very interested in
the answer.

This issue came up a year or so ago in our practice.  It was determined that
we couldn't charge extra for the Diff-Quik, but I'm not sure I understood
why not.  I was trained  to interpret all thyroid FNA's with both the usual
Pap stain, as well as a DQ, so it's not at all a trivial number of cases.
My colleagues seemed OK with interpreting them with Pap stain only, since
we'd have to eat the cost on the DQ.  Or do we?  If we can bill 88313 for
the DQ on thyroid FNA's, then we will probably go back to doing it.

Dan Schneider

On Thu, Feb 4, 2010 at 12:39 PM, Smith Wanda
wanda.sm...@hcahealthcare.comwrote:

 Yes, that is correct for Diff Quik stains on Non-gyn specimens.
 Wanda


 WANDA G. SMITH, HTL(ASCP)HT
 Pathology Supervisor
 TRIDENT MEDICAL CENTER
 9330 Medical Plaza Drive
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 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu [mailto:
 histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Leblanc, Barbara
 Ann
 Sent: Thursday, February 04, 2010 1:36 PM
 To: histo...@pathology.swmed.edu
 Subject: [Histonet] CPT code 88313 on non-gynecological cases

 Hello to all:

 On non-gyn cases which have smears stained with Diff-Quik, are you charging
 88313 (special stain) for the Diff-Quik. Our hospital coder insists that we
 can and should be charging this on all non-gyn cases when a Diff-Quik stain
 is performed, besides the routine normal charges.
 Thanks for your input.

 Barbara
 LSUMC Histology
 Lafayette, LA
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Re: [Histonet] Sakura Rapid Tissue Processor

[Daniel Schneider]

Actually, that was perfect, wordy replies are what I had hoped for.

How is the automated embedding working out for you?  The way I see things,
automated embedding is the true killer feature of the Xpress -- that is, if
it works.

Why don't skins process well on the Xpress?  (When I first appreciated the
automated embedding feature, my first thought was Great, no more
misembedded pigmented skin lesions!  But if we can't do skins, well...)

Breasts cancers require at least 8 hours formalin fixation for reliable
Her2Neu FISH; presumably that's why you've been told not to do breasts on
the Xpress.  That said, is there a reason why we couldn't or shouldn't
process breast core Bx's on the Xpress provided they've been sitting
overnight in formalin?
Thanks!!!
Daniel Schneider
On Tue, Jul 28, 2009 at 7:20 AM, Jean Warren jwarre...@cinci.rr.com wrote:

 We have the Sakura rapid tissue processor at my hospital lab, which is a
 large private hospital. We have had it three years and it has been somewhat
 of a disappointment::

 We have been told that you should not process breasts in it, because you
 will not get reliable
 results for FISH.

 Its implementation has created schedule changes that have caused some good
 techs to leave.

 The scenario to get a case out the same day is rare.
 If a patient has surgery at 7 am and we receive it by 8 am, it is
 accessioned
 and grossed in.
 Except for biopsies, the specimen still will need 2 hours fixation in
 formalin. When
 we receive it in Histology at 1030 am, it must go in pre-processing
 solution
 for 30 minutes. At 1100, we process it for approx 1 hour.
 Then embed, cut and stain. Our docs would get it well after lunch and, if
 all is
 OK, they can get the report out.
 And, there are not many cases that meet that time criterion.

 One other drawback is that it is more labor intensive to handle 10 blocks
 ten times a day than to handle 100 at one time. Our lab processes from
 400-750 blocks a day and less than 100 a day are processed on that
 processor. All we are handling on the instrument are bxs, bone marrows and
 cytology blocks. If too large a specimen is placed on it,  we usually have a
 problem. Endometrial bxs, skins and cones have not had favorable results.

 On the other hand, biopsies, especially livers, look and cut better. Our
 hematology expert wants all bone marrows done that way. We also rapid
 process most cytology that way, but bloody cases still need formalin
 fixation.

 It is much simpler to change the processor ( and more expensive ).

 We tried to do most specimens on it with terrible failure. If anyone gets
 it, I
 would recommend starting slowly with a few specimen types and gradually
 adding.

 Our hope is that it will be more useful in the future.

 I know, rather wordy answer!

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[Histonet] Sakura Tissue Tek Xpress

[Daniel Schneider]

My group is considering the purchase of the Sakura Tissue Tek Xpress
Continuous Rapid Tissue Processor.

Can any Histonetters give me feedback on their experience with this
instrument?

I'd like to hear the good and the bad.

Can you justify the cost?

How did you modify your staffing schedule?

Does it produce quality results on biopsies? and on surgicals? and fatty
tissue?

How does it effect IHC?

Feel free to reply on the Histonet, or, if you'd prefer, you may email me
privately.

Thank you!
Daniel Schneider, MD
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[Histonet] Job: Histology Supervisor in Amarillo, Texas

[Daniel Schneider]

I'm a pathologist in an established group practice in Amarillo, Texas.
We're seeking a histology supervisor.  Ideally, we're hiring a permanent
employee; however, individuals preferring a locum tenens arrangement (for at
least one month) should apply as well.

The desired candidate should anticipate very competive compensation.

We're seeking someone with excellent communication and people skills, as
well as the requisite technical expertise.

If you're interested, or know someone who might be, please drop me an email
and we'll discuss the specifics.

Daniel Schneider, MD
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[Histonet] Job: Histotech in Amarillo, Texas

[Daniel Schneider]

I'm a pathologist in an established group practice in Amarillo, Texas.
We're seeking well-trained, experienced histotechs.  Ideally, we're hiring a
permanent employee; however, individuals preferring a locum tenens
arrangement (for at least one month) should apply as well.

We're seeking well-trained, experienced histotechs.

The desired candidate should anticipate very competive compensation.

Individuals interested in a supervisory or management position should refer
to my earlier post seeking a Histology Supervisor.

If you're interested, or know someone who might be, please drop me an email
and we'll discuss the specifics.

Daniel Schneider, MD

On Mon, Jul 13, 2009 at 11:08 AM, Daniel Schneider dlschnei...@gmail.comwrote:


 I'm a pathologist in an established group practice in Amarillo, Texas.
 We're seeking a histology supervisor.  Ideally, we're hiring a permanent
 employee; however, individuals preferring a locum tenens arrangement (for at
 least one month) should apply as well.

 The desired candidate should anticipate very competive compensation.

 We're seeking someone with excellent communication and people skills, as
 well as the requisite technical expertise.

 If you're interested, or know someone who might be, please drop me an email
 and we'll discuss the specifics.

 Daniel Schneider, MD



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Re: [Histonet] Reusing specimen containers

[Daniel Schneider]

I have no idea what CAP or JCAHO says about this but it's a very bad idea.
Cross contamination happens.  If you reuse containers -- and I don't care
what precautions you take -- you will rarely or occasionally fail to
adequately clean a container and you will end up mixing patient tissues.

The cost of a specimen container is a minute fraction of the cost of
processing a specimen.  Ask yourself how much money you're really saving.
You're scrapping for pennies.  Or is this some sort of green initiative?
 In any case, it's asking for problems

Daniel Schneider





On Tue, Apr 21, 2009 at 11:43 AM, Kelly Colpitts kelly_colpi...@hotmail.com
 wrote:


 Hi Histoland!



 I'm just wondering what folks out there are doing about specimen
 containers.  Is anyone cleaning them out and reusing them?  Is there any CAP
 or Joint Commission regulations that say that all specimen containers can
 only be used once or can you reuse them as long as they have been thoroughly
 cleaned?



 Thanks for you all your input,

 Kelly

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Moderator? Re: [Histonet] I'm outta here

[Daniel Schneider]

Is there a list moderator?
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Re: [Histonet] Please help! In dire need of user manuals

[Daniel Schneider]

Have you asked Sakura, Leica, and Microm?

It would be interesting if they wouldn't provide manuals for their
equipment, used or not.


On Thu, Mar 26, 2009 at 11:18 AM, Jennifer Anderson
jander...@halozyme.comwrote:

 Hello Everyone.



 I our lab we've purchased all used equipment.  None of these instruments
 came with a user's manual.  I am in need of a manual (hard-copy or PDF)
 for the following:



 Sakura Tissue-Tek VIP 3000

 Leica Jung Histo Embedder

 Microm HM335E Microtome



 I do realize that requesting a copy of these is a lot to ask of someone.
 It takes a lot of time to copy a 50-page manual.  I'll repay the favor,
 if at all possible.  I'm hoping that a vendor may raise their hand and
 offer a copy?  I won't hold my breath for that...



 Thanks everyone.



 Jennifer M. Anderson, Scientist

 Halozyme Therapeutics, Inc.

 11404 Sorrento Valley Road

 San Diego, CA 92121

 858-704-8333

 jander...@halozyme.com mailto:jander...@halozyme.com






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Begging for a skilled, certified HT (was Re: [Histonet] uncertified techs in Histology

[Daniel Schneider]

Where I come from, trained certified histotechs are rare as hen's teeth, and
the work is looking for them.  We employ OJT's because we have no
alternatives.  I wish our lab was 100% ASCP certified, program trained HT's.

In all seriousness, my group could use some trained certified histotechs.
If there are any trained certified histotechs out there who would seriously
entertain relocating to West Texas for long term employment, PLEASE email me
your resume and salary requirements.  If you have any questions before you
send your resume, don't hesitate to email me.

Daniel Schneider

On Wed, Feb 11, 2009 at 8:55 AM, Steven Coakley sjchta...@yahoo.com wrote:

 Any thoughts or experiences with my fellow HT/HTL's(ASCP).  What the big
 advantage do all these facilities think there gaining by going with
 unregistered techs, especially when theres always ongoing quality issues *when
 theres so many trained certified HT looking for work?*  In my area of the
 country I can't believe how many Hospitals go this way.



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Re: [Histonet] training materials

[Daniel Schneider]

I would be very interested in these suggestions as well, as we would like to
improve the quality of skin embedding.

Thanks!

On Thu, Dec 11, 2008 at 10:59 AM, Jennifer Johnson
[EMAIL PROTECTED]wrote:


 Can anyone suggest a really good book, atlas, etc. for embedding?  The girl
 that took my place at my last job is having a really hard time (especially
 with skin) and I told her I would ask the experts.

 Thanks,
 Jennifer Johnson, HTL (ASCP)
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[Histonet] Storage of unstained slides? (was Re: Saving unstained slides

[Daniel Schneider]

Thank you everyone, that was very helpful information.

How do you store your unstained slides? Specifically, how do you store them
during the initial period between cutting and sign-out, and, if they are
kept after sign-out, how are they stored, if differently?

We have a not so insignificant volume, and I'm concerned that my
histotechnologists will kill me, so practical advice as far as how to do
this in a work-flow friendly, organized, efficient fashion is appreciated.
Obviously preserving/protecting the exposed tissue on the slide is of key
importance.  Also, our lab is not unusual in that space is scarce.

Thanks!
Daniel Schneider
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