This blog is about 6 months old and as frequent readers of this blog know, most post contents are re-posted news items I think may be of interest in digital pathology and the pathology community in general. Occasionally, I make some opinions about the piece and/or comment on its importance. In doing so, 2 items have surprised me, the amount of positive feedback and interest and the amount of content that in actuality is re-published or re-posted on blogs routinely, with or without original ideas about a news story.
Some bloggers create several original ideas or opinions while others post thoughts on particular items they find of interest. Some personalize with family photos, trip stories or recount a recent illness perhaps to help others in need.
My recent posting about the ASCP/USCAP seminar to be held on “sleaze, graft and corruption” received a record number of page views. Several comments from pathologists, residents, medical students and vendor associates were received about the meeting announcement. I felt only one was suitable for posting without editing their comments but all came down to the same thought, “Is this a joke?”
Esteemed colleagues, this is no joke. This is for real. While the CAP works with the Centers for Medicare and Medicaid (CMS) on anti-markup rules, POD labs and Stark Legislation, pathologists are being employed by urology and gastroenterology groups to read their slides from office biopsies acquired by their practice, sent to the lab and pathologist that they own and operate. People are splitting hairs whether it is the “same building” or “centralized facility”. Come on.
When is the last time you saw a radiologist working in the back of a neurosurgeon’s office reading CT and MRI scans who just happens to own the equipment and pay the radiologist’s salary for his/her services? How about a cardiothoracic surgeon who is employed by a cardiology group or a pediatrician employed by an obstetrician. It is absurd. Those physicians lose objectivity, autonomy and there are obvious self-referral issues and conflicts of interest that go far beyond loss of appropriate payment for technical component and professional component.
The joke is that this is happening in pathology and occurs very rarely among or to other specialties. Pathology residents and fellows are being successfully recruited into these groups. Historically, internists ran clinical laboratories before clinical pathology took hold, in large part, being of the large technical component reimbursements. It of course is common practice in many physician’s offices with point of care testing who employ phlebotomists and medical technologists. Many dermatopathology-trained dermatologists read their own biopsies. Again, how many pulmonologists own the chest x-ray machine and hi-res CT scanner and employ radiologist(s)?
So, we are left with articles, grand rounds and seminars at academic meetings with objectives of these programs to “demonstrate increased awareness”, “acquire technologies to compete” and “help pathology organizations combat this threat” with words such as “pathology, surgical pathologist, sleaze and corruption” in the title.