College of American Pathologists
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  President’s Desk Column


cap today

Travel in time and space

January 2002
Paul A. Raslavicus, MD

Those of us in the College who serve you often find that our assignments make us travelers in time and space. No longer are we confined to one workplace environment; rather, we are propelled into a jet stream of activity. My November experiences are an example.

The month started with a Chicago fly-in for a two-day special Board of Governors session dedicated to facilitated self-analysis and the proposed Strategic Plan. Debate over the Strategic Plan has been intense and serious and is still in progress. We are all aware of the challenges we face as a profession and as a specialty, and your Board is taking due time to chart our future course.

Soon thereafter, I returned to Illinois to dedicate the new east wing of the CAP headquarters. In doubling the scope of College activities, number of employees, and membership over the past 12 years, we had outgrown our space. The expanded facility has put all of our activities in the Chicago area under one roof and will accommodate the College’s growth in the years to come. Please visit your College home when you’re in town.

At the Board of Governors meeting that followed, issues related to the growth of our association were foremost in our minds, and some of these issues had an international flavor. The Board considered several House of Delegates resolutions regarding the College’s international reach. The first asked that our relationships with international medical graduate pathologists be evaluated with respect to membership enrollment and committee appointments. These matters have been referred to our Membership Committee for further analysis and recommendations. In the meantime, the College welcomes and needs the input of all. I myself have personal sensitivity to the needs of those from foreign lands who have made their homes here.

The strategic planning discussions have addressed another House resolution with respect to our global vision and strategy for international activities. Is our philanthropic mission to promote excellence in pathology confined to pathology practiced in the United States? In what ways does our international involvement promote the quality of anatomic and clinical pathology in the world, including in this country? Is the current level of involvement appropriate to maintain a place at the table when globalization is taking place not only in industry but also in medicine? Alternatively, are the resources being used now in international involvement consistent with the likely benefits?

These issues were very much on my mind as I traveled from the Board meeting to Germany for the World Congress of the World Association of Societies of Pathology and Laboratory Medicine (WASPaLM), whose membership represents about 40 pathology organizations from all over the world. The College has a long association with WASPaLM and manages its secretariats for informatics and Commission on World Standards and Accreditation, or COWSA. In the latter role, because COWSA of WASPaLM has liaison status with the International Organization for Standardization, or ISO, the COWSA secretariat participates in ISO standard-setting. In addition, WASPaLM represents pathology in the World Health Organization.

I am pleased to note that Kenneth McClatchey, DDS, MD, editor of the Archives of Pathology & Laboratory Medicine and former CAP governor, was elected president-elect. The chair of our International Committee, Henry Travers, MD, also a former governor, was elected secretary-treasurer. With their ascendancy, we hope WASPaLM will further develop its leadership role in our specialty.

As a sign of this leadership, WASPaLM has endorsed SNOMED as its preferred medical terminology. SNOMED is the College’s prize entry for advocacy for international excellence in medicine. From its humble beginnings, SNOMED has grown to become the most comprehensive clinical terminology in the world. SNOMED Clinical Terms, being released this month, is the product of collaboration between the CAP and the United Kingdom’s National Health Service. The classification system is now employed in more than 40 countries spanning five continents.

A further example of our international presence is the College’s Laboratory Accreditation Program. The LAP now accredits 103 overseas civilian laboratories and another 100 labs on U.S. military bases. Our accreditation teams visit laboratories from Argentina to South Korea, and from Belgium to Saudi Arabia. Most recently, the LAP has been working with a private, not-for-profit organization in Singapore to launch a joint venture for continued accreditation of six clinical and medical laboratories in that country. Among newly assigned deputy international regional commissioners are College fellows Samir Amr, MD, for the Middle East, and Yun Sik Kwak, MD, PhD, for the Far East.

Surveys are international in scope as well. The College provided proficiency testing materials to laboratories in 67 countries last year, most through our contract with the U.S. Department of Defense to serve military bases. Next month, we are cosponsoring with the CDC the Global Odyssey Conference in Atlanta, which is aimed at improving communication and collaboration among proficiency testing providers worldwide.

On a less grand but no less international scale, the CAP has liaisons to the International Committee for Standardization in Hematology and the International Society for Thrombosis and Hemostasis, and it is kept apprised of International Union Against Cancer activities. We also are a part of the International Liaison Committee of Presidents, which held its most recent gathering in October in Philadelphia. There, the presidents of pathology organizations from the UK, Australasia, Ireland, and Canada met with the College leadership to exchange information on scope of practice, competency assessment and maintenance, tissue procurement, gene patenting and genetic testing, and other issues.

Yes, the College has many international ventures. But in late November I was back in the United States to attend the American Medical Association meeting in San Francisco, where American medicine and American issues took center stage. Professional autonomy, protecting Americans from the dangers of terrorism, and lack of appropriate payment for pathologists and other physicians were paramount. Your delegates represented you well there.

As I flew home, I realized that as we travel in time and space we must define our priorities. We must choose carefully which jet streams to follow, which interests to protect, and which global—and national—opportunities to pursue.