Travel in time and space
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
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
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
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