Anatomic pathology is a medical specialty that is concerned with the diagnosis of disease based on the macroscopic, microscopic, biochemical, immunologic and molecular examination of organs and tissues. It is one of two branches of pathology, the other being clinical pathology, the diagnosis of disease through the laboratory analysis of bodily fluids and/or tissues. Often, pathologists practice both anatomical and clinical pathology, a combination known as general pathology.
Anatomic pathology relates to the processing, examination, and diagnosis of surgical specimens by a physician trained in pathological diagnosis. Clinical pathology is the division that processes the test requests more familiar to the general public, such as blood cell counts, coagulation studies, urinalysis, blood glucose level determinations and throat cultures. Its subsections include chemistry, hematology, microbiology, immunology, urinalysis and blood bank.
Anatomical pathology is itself divided in subspecialties, the main ones being surgical pathology (breast, gynecological, endocrine, gastrointestinal, GU, soft tissue, head and neck, dermatopathology), neuropathology, hematopathology, cytopathology, histopathology, pulmonary pathology, renal pathology and forensic pathology.
Anatomic pathology is one of the two primary certifications offered by the American Board of Pathology (the other is clinical pathology) and one of three primary certifications offered by the American Osteopathic Board of Pathology. To be certified in anatomic pathology, the trainee must complete four years of medical school followed by three years of residency training. Many U.S. pathologists are certified in both anatomic pathology and clinical pathology, which requires a total of four years of residency. After completing residency, many pathologists enroll in further years of fellowship training to gain expertise in a subspecialty.
Anatomic pathologists usually work in hospitals, investigating the effects of disease on the human body via autopsies and microscopic examination of tissues, cells, and other specimens. Medical laboratory directors are responsible for the sophisticated laboratory tests on samples of tissues or fluids and the quality and accuracy of the tests. The practice of pathology is most often conducted in community hospitals or in academic medical centers, where patient care, diagnostic services, and research go hand in hand.
AMONG THE ROUGHLY 6,500 HOSPITALS OPERATING in the United States, only about 125 (2.5%) have closed in the past five years. But in the coming years, some 450 hospitals are at risk of closing. Analysts at Morgan Stanley said 600 other hospitals have weak finances that could lead them to close.
STEP BY STEP, HEALTHCARE IN THE UNITED STATES is moving toward a system in which clinical care is fully integrated and providers are reimbursed for the value they provide. This trend presents clinical laboratories and anatomic pathology groups with a challenge and an opportunity.
The challenge comes because being a value-added contributor requires labs to adopt
CEO SUMMARY: Payers and health system administrators generally agree that healthcare is moving away from fee-for-service toward value-based payment. Because adoption of value-based contracts is slower for pathologists than for other providers, pathologists have the opportunity to define how provider systems can pay for value contributed by pathologists. However, to take advantage of this opportunity,
FOR MORE THAN TWO DECADES, leaders and forward-thinkers in the pathology profession bemoaned the fact that lab tests and anatomic pathology services were priced as commodities. From the podiums of various lab and healthcare conferences, they urged their peers to identify, document, and educate health insurers and others about the true value of lab tests.
RECENTLY TWO OF THE NATION’S LARGEST HEALTH INSURERS abandoned a managed care contracting strategy that they adopted 11 years ago. Back in 2007, UnitedHealthcare and Aetna each were willing to grant exclusive national provider status to a single lab company in exchange for deeply-discounted lab best prices. (See TDRs, Oct. 16, 2006, Feb. 19, 2007, and
Wake Forest Baptist Medical Center of Wake Forest, N.C., has been notified by the Centers for Medicare and Medicaid Services (CMS), in a letter dated June 15, that it is back in compliance with Medicare Conditions of Participation. Earlier this year, following inspection of the hospital and its anatomic pathology department, federal and state officials identified
CEO SUMMARY: As health networks and hospitals consider outsourcing their lab outreach programs, the lab team at Dartmouth-Hitchcock Medical Center (D-H) offers lessons about the value of retaining outreach. D-H is now in the eighth year of a sustained expansion of its laboratory outreach business. It has combined its lab outreach strategy with a proven
IT’S TIME FOR ALL CLINICAL LABS AND ANATOMIC PATHOLOGY GROUPS to pay closer attention to the advances in genetic medicine and precision medicine. Events are moving even faster than most experts have predicted.
As you will read on pages 3-4, two innovative health networks are on the verge of offering sophisticated genetic tests to patients visiting
CEO SUMMARY: After hospital labs and pathology groups implement Lean and process improvement methods to harvest the easiest cost savings and boost quality, they often take the next step of introducing real-time analytics systems. Access to detailed data about workflows, productivity, and turnaround times then drives continuous improvement projects. At St. Joseph’s Hospital and Medical
CEO SUMMARY: For medical directors and pathologists interested in improving their labs’ compliance with CLIA regulations, a report from federal and state inspectors of an inspection of the pathology lab at the Wake Forest Baptist Medical Center offers insights into what issues caught the inspectors’ attention. During their visit in February, the government lab inspectors