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August 2005
President’s Desk

It has been two years since we embarked on this journey, and as my term draws to a close, I find myself looking forward and backward at once. In this, my penultimate column, I would like to consider where we’ve been. Next month, we’ll talk about where we’re going.

I must apologize at the outset for presenting a snapshot view of developments that have been gestating for years. I also regret that we do not have space to provide updates on the many fine ongoing programs whose excellence is not news. Given those caveats, I present for your consideration a brief review of events transpiring since I joined your leadership team as president-elect.

The early-2003 decision to host an independent annual meeting on six months’ notice was a turning point for the College. CAP leaders and staff have always partnered extremely well, but this move strengthened those ties because it called for an immediate and exponential boost in outside-the-box thinking. Our staff experienced the fun of intelligent risk-taking and the result was a cultural shift. The College staff, always outstanding, continues to thrive.

Until CAP ’03, the College functioned in some ways like a virtual professional community. We came together only as part of another group—at USCAP, for example, or in conjunction with the ASCP. It was never just us. With CAP ’03, the College asserted an independent identity. We enjoyed cutting-edge seminars and lively workshops tailored to the needs of pathologists. In the evenings, we crowded the dance floor, caught up with old friends, and introduced our families to our colleagues.

A few months before CAP ’03, we signed a licensing agreement with the federal government making SNOMED an integral element of the Unified Medical Language System Metathesaurus of the National Library of Medicine. And later that fall we established a direct-reporting executive committee to manage day-to-day decisions. Board meetings were reframed to accommodate substantive tactical discussions and educational presentations by outside experts.

The College has been able to invest in the future of our specialty because sound management has fostered financial stability. And we have always understood the importance of playing to our strengths. The planning for CAP ’03 convinced us that we alone were qualified to provide the right educational opportunities to pathologists. That summer, we agreed to create a top-notch department of education functioning under a new education committee so we could more effectively focus on this key aspect of our mission.

Not long after I became president, we learned with great pride of a decision by the American College of Surgeons mandating that all tumor registry entries include each essential element identified in the CAP cancer protocols. Since then, new data from Canada have shown a clear link between use of the CAP protocols and improvements in patient care. I firmly believe that the CAP protocols will emerge as one of our finest contributions to the public health.

We can also be proud of steps already taken by the Future of Pathology, or FOP, group, a powerful new coalition of pathology specialty societies launched in June 2004. Last summer, an FOP working group met with program directors and agreed to survey employers who had hired recent graduates about how well new recruits functioned in the workplace. More on that next month.

The College was not happy to learn last winter that the Department of Health and Human Services had decided to implement 1992 regulations that called for gynecological proficiency testing under the Clinical Laboratory Improvement Amendments of 1988. We strongly disagreed with the fundamental premises, and field reports on the new program indicated it was outdated. In May, we joined all major national pathology organizations and virtually all state pathology societies in urging the Department of Health and Human Services to review these regulations.

We continue to promote appropriate compensation for clinical pathology services, a matter of principle and medical necessity. My mail tells me that many pathologists are investing about 30 percent of their time in clinical pathology, but not that they are paid for it. These important services must be adequately compensated.

It has been gratifying to see the growing sophistication with which our state pathology societies approach legislative advocacy. Communication has never been better. Recent state-level initiatives to protect the pathologist’s right to bill directly for services have been well organized and focused.

The College responded quickly and effectively to the tragic events at Maryland General Hospital in early 2004, testifying before Congress, supporting legislation to protect whistleblowers, and launching an exhaustive review of accreditation procedures. Next month we will talk more about changes planned for the Laboratory Accreditation Program that will promote a better public understanding of what accreditation can and cannot accomplish.

I do believe that at the end of the day, the finest moments of these two years will be those that brought us closer to one another and to our natural allies. As I travel around the country, I continually meet outstanding pathologists who make me proud to be a member of the College. To paraphrase a silly television commercial that aired years ago, the closer I got, the better you looked. It has been an honor to serve. Thank you for the privilege.


Dr. Kass welcomes communication from members. Send your letters to her at president@cap.org.