College of American Pathologists
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Where there’s a will, there’s a way—and there’s Dr. Baptist: How a New Jersey pathologist is working to improve labs in India

June 2004
Karen L. Wagner

Helping out his alma mater in India is nothing new for Selwyn J. Baptist, MD. But little did Dr. Baptist know that his latest efforts would lead from the laboratory at his former medical school to labs across India.

Through his alumni association at St. John’s Medical College, Bangalore, Dr. Baptist participates in a donation program in which used medical equipment is sent to the school’s affiliated hospital. He had arranged a few years ago to have two Nova Stat whole blood analyzers sent from the St. Barnabas Medical Center, Livingston, NJ, where he is associate chairman of the Department of Pathology, to the biochemistry laboratory at St. John’s hospital.

More recently, in 2002, Dr. Baptist traveled to the cities of Mumbai and Bangalore, where he led the first team of CAP laboratory inspectors in India. The country has about 25,400 registered clinical laboratories and approximately four or five times more that are unregistered. Approximately 35 of the registered labs, Dr. Baptist says, are accredited by the National Accreditation Board for Calibrating and Testing Labs, India’s accreditation agency. Based on reports from Dr. Baptist’s team, the CAP granted accreditation to three labs-and St. John’s wasn’t one of them.

"There is no regulatory requirement in India for a lab to be accredited," says Dr. Baptist, who was a member of the first graduating class at St. John’s, which was founded in 1963. "There’s a great need to raise the standard of testing."

While in India, Dr. Baptist and his team conducted seminars on the CAP Laboratory Accreditation Program. At one seminar, attendees from St. John’s asked Dr. Baptist to visit the school’s laboratory. He agreed.

Dr. Baptist was impressed with the laboratory, but when asked if he thought the lab could earn CAP accreditation, he pointed out various deficiencies. Some of those deficiencies, such as failure to record refrigerator and freezer temperatures, could be easily corrected by laboratorians familiarizing themselves with them by downloading the inspection checklist from the CAP Web site.

But for labs like St. John’s, the biggest obstacle to receiving CAP accreditation is obtaining the funding necessary to correct deficiencies, participate in proficiency testing, and pay the accreditation fees, Dr. Baptist says. He reasoned that if the administratively separate Department of Pathology at St. John’s could become accredited, then the school’s pathologists could learn the concepts necessary to meet international standards, "and then these trained pathologists could go out and incorporate these concepts into the labs they would set up elsewhere," Dr. Baptist says. And St. John’s quality improvement program would become the model for other pathology departments.

So, Dr. Baptist offered to help the pathologists at St. John’s raise the money. "I estimated the cost for an initial inspection would be in the ballpark of $7,000," he says.

Back in the United States, Dr. Baptist presented this idea to 70 or so alums attending a biannual meeting of the North American chapter of St. John’s Medical College Alumni Association. The chapter agreed to provide the funds for the initial accreditation. Donations could be made to a separate charitable organization, Friends of St. John’s Foundation, to cover ongoing expenses.

As other native Indian pathologists learned of his intentions, Dr. Baptist formed an advisory committee to help pathology departments of medical colleges and teaching hospitals in India seek accreditation. Dr. Baptist co-chairs the committee with CAP member Nirag Jhala, MD, past-president of the Association of Indian Pathologists in North America. (CAP member Vijay Joshi, MD, also serves on the committee.)

The committee outlined how pathologists from India who are practicing in the United States can work with the CAP and pathologists in India to raise awareness of the standards issue and establish accreditation programs. The committee and its counterparts in India are also planning to lobby the Indian government to tighten the qualifications of those who direct laboratories.

Dr. Baptist says it will probably be two years before the St. John’s lab is inspected for CAP accreditation. He predicts the labs that become accredited will be able to recoup the costs through India’s burgeoning outsourcing industry. Many American and European companies that use laboratories in India for clinical research and testing prefer to use labs that have high standards, he says. "So, the laboratories are realizing that there is good business if they raise their standards."

Since his first trip in 2002, Dr. Baptist has returned to India to reinspect the three labs that are CAP accredited and to conduct inspector training courses. In addition, he’s lectured to groups of pathologists in India about quality improvement in clinical laboratory testing. In the United States, he speaks to pathologists who attended medical school in India about how they can set up similar quality improvement programs at their alma maters.

Through it all, Dr. Baptist has donated his time and money. "After I started working on this project [at St. John’s], I realized that I was also in a unique position to help raise the standards of clinical laboratory testing in India," he says. "I decided to do this because I can help make things better in a field that I love and a country that I will always love."

Karen L. Wagner is a freelance writer in Forest Lake, Ill.