Katrina relief,
  and a focus on reports

November 2005

President’s Desk

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.