September 14, 2014

Thoughts on CAP ’14 – Part 1: Highlights and Lowlights

BY Dr. Keith J. Kaplan

IMG_6497Always good to attend a meeting in Chicago, particularly outside the months of December to February. Hyatt Regency location is great, right along the river close to good restaurants and the lakefront but too many escalators that I think partitions the meeting a bit to allow for a more “open floor plan” for networking. Have been partial to the Sheraton for a river location meeting but CAP staff told me lack of meeting rooms required for number of CME events limits us. Anyways, the next few CAP meetings will be outside of Chicago in Nashville, Las Vegas and DC, slightly different locales than some of the historical favorites.

Attended the House of Delegates meeting as a representative from North Carolina. The board of the House and the CAP staff always put on a full agenda with interesting presentations and some discussion related to issues of the day and those coming down the pike for our specialty. More information on the CAP House of Delegates is available here.

This meeting seemed to be well attended. A new board was elected and updates from the Speaker, government affairs and practice management were presented. A panel on lean processing presented keys to implementation and ways to minimize errors and improve quality in laboratories.

The House of Delegates meeting perhaps was highlighted by the luncheon speaker, former White House Press Secretary, Dana Perino who spoke about what it is like to work with the President of the United States everyday and the relationship and responsibility the job requires. She spoke about lessons is leadership, staying cool in the face of adversity and facing the press corps and hence the American public everyday. She related some stories about her visits with Navy seals and wounded military at Walter Reed intermixed with some self-deprecating stories, particularly about her height (or lack thereof). It was honest to see you could work at the highest level of your profession and still not take yourself too seriously. Dr. Stephen Ruby over at entreprenurialpractice.com has a more in-depth post on what he learned from public speaking listening to Mrs. Perino speak that is worth a read. Mrs. Perino’s prediction for 2016: She claimed she has no idea. She thinks if Hillary Clinton runs she will win. Jeb Bush entering the race would make it interesting but she isn’t convinced it will happen.

Bw99g_SCIAADiUjSunday had two highlights from my meeting attendance. One I already covered – meeting Kimberly Jewett, hearing her story and discovering for myself the extreme lack of physicians and pathologists as patient advocates which I posted at Kimberly’s Story and the Power of Pathology 2.0. The day was capped off by hearing Dr. Michio Kaku speak as the keynote speaker on what healthcare and medicine and hospitals may look like 50 years into the future. A fantastic speaker and storyteller who laid out the balance of potential technologies in the future and the potential issues regarding cost, access and privacy. He admitted, like Yogi Berra before him, “It’s tough to make predictions, especially about the future.” Photo courtesy of Dr. Michael Misialek, Associate Chair of Pathology, Newton-Wellesley Hospital, Newton, MA.

There were a couple of lowlights as well worth noting. First and foremost, there was no mention during the course of the House of Delegates meeting a couple of key issues that continue to permeate the pathology landscape, namely, overutilization and overbilling with potentially deceptive inappropriate self-referral practices and overutilization noticed by other practicing pathologists about inappropriate use of immunohistochemical stains image analysis CPT codes. The Pathologyblawg discussed what one Medicare contractor has recently proposed with some preliminary data on the use of the quantitative IHC code (88361) last week. The matter was raised during the course of the meeting and in sidebars but no discussion was had. Comments by several delegates suggested the College and the House may already be a decade or more behind this issue and our ability to advocate for ourselves on the matter may already be lost.

Secondly, no House or member-wide discussions were held on the matter of the recent issue of College executive staff salaries recently brought to the attention of many of the College’s members through Pathologyblawg.com by way of citizenaudit.org. Without knowing more about how non-for-profits are structured and how salaries are derived based on income and revenue and what would be fair market value compared with other laboratory and non-laboratory related non-for-profit entities, I can’t speak directly to whether the numbers are reasonable. However, many I spoke with were concerned about the lack of discussion on this matter to the membership to date. Admittedly, the meeting program schedule and agendas were probably already finished to add this or present the matter in some “town hall” format perhaps at CAP ’14. Based on filing dates, the 2013 filing information should be available this Fall.

image004cropped_edited-1Nonetheless, despite what Jon Stewart says, Chicago’s pizza is still better than New York’s. Photo courtesy of Dr. Victor Brodsky, Medical Director of Informatics and Assistant Professor in the Department of Pathology and Laboratory Medicine and Assistant Professor of Public Health at New York’s own Weill Cornell Medical College.

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