Thomas M. Sodeman, MD
Less than an hour after I was sworn in as your new president of the CAP, I
was chairing a meeting of the Board of Governors called to discuss how we could
help those who had been in the path of Hurricane Katrina. We voted unanimously
to establish the CAP Foundation Hurricane Katrina Humanitarian Fund to support
pathologists and pathology services affected by the hurricane, especially services
for medically underserved patients. We also voted to allocate $100,000 from
CAP reserves to match donations dollar for dollar. And two days later, members
of the House of Delegates Steering Committee announced they would provide another
$6,000 in matching funds out of their own pockets.
The CAP Foundation Board appointed a seven-member steering committee chaired
by Kim Collins, MD, to determine how those funds will be allocated. Pathologists
and pathology residents have lost textbooks, computers, and most of their personal
belongings. Many have lost their jobs; entire households are without employment.
The Association of Pathology Chairs has been working hard to relocate displaced
pathologists in training. Training programs have opened their arms to 30 residents
and their faculty. Dr. Collins and her committee members are scrambling to assess
how we can help restore medical and laboratory services once provided by now
devastated hospitals. For all patients, but especially those who were medically
underserved in the first place, the loss of a public health clinic can “upgrade”
a Category Five hurricane to a personal catastrophe.
Less than three weeks after CAP’05, the Hurricane Katrina Humanitarian
Fund stood at $81,500, and only those who were at the annual meeting even knew
about it. Remaining funds are available to match the next $65,250 in donations
from the membership. Katrina Hurricane Relief is a link on the home page. Please
go to www.cap.org and do what you can. Checks are to be written to the CAP Foundation
Katrina Fund, and contributions are tax-deductible.
A lot of good things happened at CAP ’05; the meeting gets better every
year. We logged record attendance—more than 2,300, including 1,300 pathologists,
which is more than double the number of pathologists at CAP ’03. The workshops
and social events buzzed all week long. Everywhere you went, people were engaged
and upbeat. We also had record attendance at our House of Delegates meeting.
That group is discovering its potential, which is great fun. More and better
things come out of the House each time the delegates meet.
The Sept. 13 pathology reporting workshop is a good example of that; it began
with a House of Delegates resolution. The estimable faculty, guided by Education
Committee chair M. Elizabeth H. Hammond, MD, employed wireless personal-response
systems (think “Who Wants to Be a Millionaire”) to create a dynamic
give-and-take, and the audience became a hard-working team in no time at all.
I would like you to finish reading my column, but as soon as you do,
please visit the CAP Web site and check out the resources on pathology
reporting, including slides that summarize the educational content and
consensus findings from the workshop. (Go to www.cap.org, log in, and
select Pathologists from the navigation bar at the top. Next, click on
Practice Resources from the navigation bar on the left to reveal the pathology
reporting resources.) Get a cup of coffee and settle in for a good read.
It’s the next best thing to being there. Well, maybe second-to-next
best: Had you been there, you would have had a vote.
All day long, participants learned from and worked with experts on various
aspects of pathology reporting. I don’t want to give away the plot,
because you really should go to that posting, but they have set our educational
priorities. CAP programs and materials, they said, should bring pathologists
up to speed on what the minimal elements of a report should be. Our reports
should be clear and consistent for patient care. We should be talking
about how information is best communicated to clinicians, including amendments,
consults, and addenda. We must learn to eliminate ambiguous terminology,
plainly state the diagnosis when there is one, and make a clear statement
about diagnostic uncertainty when it exists. And each of us should be
working within our institutions for information systems changes that will
support clear, useful, readily shared data repositories.
Standardizing the pathology report is not our issue alone. National and
international efforts are underway to ensure that there are clear standards
for handling pathology reports as part of the electronic medical record.
Pathologists must participate in this process and, to do so, we must establish
how the report can best reflect the content we believe is required for
good patient care.
Pathology reports are a form of communication, and what works in one
setting may not work in the next. Much of this is institution-specific.
If we persist, we can make sure that patient care is based on complete
and accurate reports. It’s part of the job.
We’ve done the initial needs analysis and will do more. You’ll
be hearing more on this topic in months to come, and there will be a followup
session at CAP ’06. If you have ideas for ways we can improve our pathology
reporting education, or improve anything at all for that matter, please write
to me at the e-mail address below. And mark your calendars to attend CAP ’06
in San Diego, Sept. 10–13.
Dr. Sodeman welcomes communication from CAP members. Write to him at president@CAP.org.