Several colleagues have in recent months asked me what the status of AFIP is following the BRAC commission announcement to close the institution in May of 2005. As I wrote about this September (see AFIP looking ahead) and in July ( see AFIP Not To Be Dismantled Until Replacement) news was that the AFIP would be re-organized under a Joint Pathology Center through an act of Congress. This act directed the Department of Defense to form a Joint Pathology Center (JPC) which would in essence save the AFIP from disestablishment as directed by the BRAC commission.
Final plans are now being finalized to establish the JPC as part of the Walter Reed National Military Medical Center that is going to be located in Bethesda, MD where the existing National Naval Medical Center is across the street from the NIH campus.
The most recent director's announcement on the JPC is short on the specifics about what the restructuring and modernizing will look like. The third paragraph in the below announcement summarizes this and the rest of the announcement encourages you to think and imagine about what the new AFIP will look like as a continued reference center for pathology.
In short, they need to stop thinking and imagining about some of these practices and technologies and actually deploy them to have relevance with other academic laboratories that provide patient care, consultation, education, tissue repositories and molecular diagnostics.
If they had done this earlier, the better tomorrow they envision would have happened long ago and none of this, albeit federal wrangling and a name change would not have been necessary.
I would also offer increased collaboration with civilian institutions, including sharing the wealth of the tissue repository as a value proposition for the JPC and its future.
"As most of you know, the 2008 National Defense Authorization Act (NDAA) directed the Department of Defense to establish a Joint Pathology Center (JPC) that would provide diagnostic pathology services; pathology training; pathology research; and would modernize and update AFIP's current Tissue Repository, as long as creating such a center would be consistent with the final recommendations of the 2005 Defense Base Realignment and Closure (BRAC) Commission . The Commission, as I'm sure you recall, had recommended disestablishment of the AFIP.
I can now report to you that the Assistant Secretary of Defense for Health Affairs has concluded that a Joint Pathology Center can indeed be established in DoD and still meet the requirements spelled out by both the BRAC Commission and the 2008 NDAA. I can further report that implementation plans are now being finalized to establish the Joint Pathology Center as part of the new Walter Reed National Military Medical Center.
Can I tell you exactly what the JPC will look like in terms of personnel, money and space? No, I can't. Those issues are still being worked out and it will likely be another few months before the road ahead is paved with the level of clarity and direction that I know you all are seeking. But what I can tell with clarity and direction is that we all need to embrace this process as a new beginning – an opportunity to help build a Reference Center for pathology for the federal government that's not only finely tuned to meet the current needs of our servicemembers and their families, but one that's flexible enough to incorporate the technologies and techniques that will characterize the future of pathology. This Pathology Reference Center should provide the "final diagnosis" in difficult cases. The education and training should provide a professional level type of expertise that achieves academic legitimization and a CME function that will provide solidification of pathology expertise; and research should be of the highest caliber. The Tissue Repository should be maintained and modernized by using the best talent to provide unique cases and is supported by the best and most modern techniqes.
I fully understand that many of you are disappointed and frustrated by the disestablishment of the AFIP and the transition to a Joint Pathology Center. And as someone who has spent much of my professional career here, I can certainly understand this. All of us – regardless of when we began our work with the AFIP – instantly became rich with an inheritance bequeathed to us through decades upon decades of splendid service by others who had helped make the Institute a world leader in pathology consultation, education and research. Such an inheritance is difficult to let go of; but let go of it we must so that we can focus on transferring as much of that wealth as possible to the Joint Pathology Center.
Think about a pathology center that continues to maintain and modernize AFIP's Tissue Repository so that the Military Healthcare System can access its assets for clinical care, research and training.
Think about a pathology reference center that will be an independent professional entity that is centrally located so that it's better able to provide world-class subspecialty pathology care to servicemembers, their families, and other federal agencies. And imagine such care employing the best interpretive technology, including immunohistochemical staining, telepathology services, and immunofluorescent technology.
Think about a pathology center that will include a molecular pathology laboratory that will provide state-of-the-art PCR and Fluorescent In Situ Hybridization (FISH) technology to directly support diagnostic services and other military treatment facilities – a laboratory that will focus on providing tumor marker and pharmacogenomic diagnostic studies.
Think about a pathology center that will provide opportunities for resident and fellow rotations for all pathology residencies with the Military Healthcare System, as well as a robust online Continuing Medical Education program for pathologists throughout the military.
Think about a pathology center that is enthusiastic about the future of pathology, such as the future I detailed in my previous message – a future that relies heavily on pathology informatics, large-scale experiments, development of new subspecialties, and personalized medicine tailored to the individual and his or her environment. Imagine all this and more and I'm sure you can envision the many possibilities the Joint Pathology Center could create.
Then think about this. Some of the most spirited minds in pathology exist right here in this Institute. And a spirited mind never stops within itself. It is always aspiring and going beyond itself. If it does not advance and press forward and stand at bay and clash, it is only half alive. Its pursuits are boundless; and its food is wonder, the chase, and the belief in a better tomorrow.
Let's harness this power, embrace a new beginning, and help build the best Joint Pathology Center possible as a reference center for pathology for the Federal Government."