Making the Rounds with Dr. Volk

Alec Bose:

At this year's annual meeting, Dr. Emily Volk became the president of the College of American Pathologists. We wanted to sit down with Dr. Volk and hear from her what some of the top goals she had for the college, as well as some of the pressing advocacy priorities she plans to tackle during her time in office. Dr. Volk, thank you so much for joining us today. We really appreciate it and we're honored to have you.

Dr. Emily Volk:

It's wonderful to be here. Thank you so much.

Alec Bose:

Many of our members tell us this is a really exciting time for pathology. What are some of the opportunities that excite you the most? When you think about the future of pathology, what is that thing that excites you as a profession?

Dr. Emily Volk:

I think one of the most exciting things about pathology is that we really are on the cutting edge of technology and what we do touches every patient who comes into hospitals and into the ambulatory setting. Most patients need a blood test. Most patients get some kind of laboratory testing, so our reach remains far and wide in healthcare. We also have a reach into the latest and greatest technologies to include artificial intelligence and machine learning. I'm very excited about what those technologies can do to further enhance pathologists' abilities to impact patient care and really contribute on a very meaningful level.

The other thing that I'm very excited about is there are a lot of openings for pathologists in the country. There are more job openings for pathologists right now than there have been in decades. Although this is a terrific opportunity for pathologists who are looking for jobs, it also is a little bit of a threat in that if there aren't enough pathologists to fill these positions, will the system find shortcuts to fill these positions with folks who are less qualified than pathologists to do laboratory medicine? I think it's an exciting time because pathologists can certainly demand the appropriate kinds of packages, reimbursement wise, to do the work that we do. On the other hand, if there aren't enough of us down the road, this could pose a threat to the profession.

Alec Bose:

I've heard that echoed before in a lot of sentiments that the pipeline in the next generation of pathologists is very important. That's one of those things that concerns you, but what are some of the other changes that you've seen in the field that may concern you or things that may be coming up that you're worried about?

Dr. Emily Volk:

I want to make sure that, again, pathology the profession represents the best and the brightest of physicians in the United States and across the world. Part of that success is that we have a diverse community of pathologists, and if we're not pulling talent from a variety of different communities and folks of different backgrounds, ethnic, religious and so forth, we're not demonstrating our best selves. We've got to make sure that in our pipeline efforts, we are reaching into communities that may not have considered STEM kinds of programs, medicine, and in particular pathology as possibilities for bright young students in communities that may be underrepresented in medicine.

Alec Bose:

Now that you are president, what are some of your goals for the profession and the CAP as an organization during your tenure?

Dr. Emily Volk:

The three areas that I see as my main focus during this short time that I have as president of the college are innovation, diversity, equity, and inclusion, and what it means to be an FCAP. With regards to innovation, I want to make sure that pathologists and the organization that is the CAP are ready and positioned well to take full advantage of innovation as it comes down the pike. Innovation can mean something different to every person you talk to, but I want to make sure that we're being as creative as possible and that we're taking full advantage of technology to reach our members and our participating laboratories. I want to make sure that we're using technology to its fullest to make it easy to be an accredited lab with the CAP. Now, not easy in that we want to lower our quality standards, but easy in so far as how the laboratories interface with the CAP. That we do everything we can to smooth out any glitchiness and that we promote interoperability between our laboratories and the college.

I think that removing barriers to connecting with the CAP as a resource for excellence with our partner laboratories is critical. We also can continue to enhance how we use technology to connect with our membership. We've certainly had to do some of this through Zoom meetings and through our hybrid meeting this last fall at CAP21. We connected with more members virtually than we did in person. I think that was a terrific success in that we had over 1400 pathologists participating in CAP21, and again, the vast majority did that virtually. I think we need to continue to get better at that and understand how members want to connect. I think the CAP app is a terrific next step to help members stay connected through technology, and we can continue to use MyCAP app as a platform to pilot innovative techniques to connect with members and allow members to connect with each other.

As far as diversity, equity, and inclusion is concerned, I think we need to make sure that we are drawing from the best and the brightest from amongst all groups of physicians to make sure that we have representation in the specialty from communities that have heretofore been underrepresented. We know that it's good business to have a diverse workforce. It's good business to have the CAP be a place for everybody, feels like they're at home, who is a board-certified pathologist. We still have a lot of work to do on that, but I'm very excited about Dr. Fitzhugh's leadership over our new DE&I committee, which reports directly to the board, and I very much appreciate the leadership of Dr. Monica De Baca and Dr. Kathy Knight, who will be participating on that important committee. Very much appreciate everyone's work on that as well as the partnership with the staff to include our HR Vice President, Pam Mix of the CAP.

From the, what does it mean to be an FCAP perspective? I'm really excited to take a deeper look at what being a Fellow of the College of American Pathologists means to the fellows and means to residents who are preparing to become candidates to be fellows of the College of American Pathologists. I put those initials behind my MD with great pride, and my hope is that others do too. Our organization is the largest organization of pathologists, and we have a code of professionalism that asks us to be our best day in and day out for our patients. I think we need to work on really expounding on that and making it known what it means to be an FCAP. I think in doing so, we will increase the pride that FCAPs have in their organization, and I think we'll also shore up what it means to be a professional and a fully engaged pathologist.

Alec Bose:

You listed a lot of great positive changes. How do you feel the members of the CAP, and you finished off with the FCAP, which I appreciate, how do you feel members can help drive that positive change for the profession and how can they really make a difference?

Dr. Emily Volk:

Members are the heart of the organization. I think what all of us can do every day is to model what it means to be an excellent doctor and excellent pathologist. I think that can be just the small things, from treating the people that you work with with respect, putting your patients first, making sure that you're following the latest and greatest guidelines published by the CAP, and that you're staying current on the medical knowledge that you need to be an excellent pathologist. It can also mean taking part in medical staff leadership in your hospital or being a leader in your group practice. It may mean mentoring laboratory technologists in their careers or mentoring medical students or young pathologists if you're a person who's got a little bit more gray hair. I think modeling excellence in the many ways that folks can model excellence is really what members can do to drive positive change.

Alec Bose:

As president, how do you hope to engage members to advocate on the federal and state level?

Dr. Emily Volk:

Well, one thing I'm going to be doing is speaking at a lot of state pathology society meetings and participating with our state pathology societies' engagement efforts with some of our CAP staff who do the work to make that a possibility. I'm thinking of Megan Wick and Janelle Pippen. They do a wonderful job in setting up these monthly calls with our state pathology society leaders so CAP can communicate with these folks. We can hear from them to understand what concerns they have, and then they can hear from us about what kinds of resources we can offer and so forth. We really support each other. I'll be doing a lot of engagement both virtually and hopefully in person with some of these state pathology society visits.

The other thing I'll be doing is participating in the Pathologist Leadership Summit coming up this spring. At this point, I think we anticipate a hybrid meeting with some in-person component, depending of course on how the pandemic goes. We can't predict that fully. The other thing I'll be doing is participating in the virtual fly-ins where we are able to leverage technology once again to connect with our lawmakers, our representatives in Congress, and let them know what our issues are.

One of the biggest things on pathologists minds these days are looming pay cuts through Medicare. Again, we just did a virtual plan a couple of weeks ago and it was a huge success. We had hundreds of meetings with fellows of the College of American Pathologists and their congressional representatives. What a marvelous thing to be able to participate in. I mean, this is representative democracy at its best. With everyone so concerned about the state of our democracy right now, to be able to participate in our representative democracy through the PATH MET Program, I think is just wonderful.

The other thing I will encourage folks to do is to donate to backpack. For those who are eligible to donate, I will encourage all pathologists, even those who don't feel like they can donate very much because they've got school loans or they're residents, a $5 a month donation puts your name on the list of Path Pack donors, and the more names we have on that list, the better. If you can donate at the maximum level, fabulous. We certainly understand that not everybody can, and we still want your participation.

Alec Bose:

Thank you, Dr. Volk. You touched on the Medicare cuts and I think that was something important. That leads into my next question, and that's the specific policies that the CAP is advocating for. Are there any policies that you are looking at specifically that you believe are very important or will be very impactful towards pathologists?

Dr. Emily Volk:

I do. I mean, first of all, fundamentally we believe pathologists are critical members of the medical team. We are physicians first and foremost, and we should be appropriately reimbursed for the work that we do. Because of the budget neutrality rules that are in place, we recognize that pathologists are facing some significant cuts to Medicare, and so we are doing the virtual fly-ins, we're communicating with Congress our concerns, and we are cautiously optimistic that some of these cuts will be averted by the end of the year. The engagement though by individual members and the contact by individual members of the CAP with their congressional representatives makes all the difference. If they hear from their constituents that these cuts are a problem, that will increase the likelihood that something gets done.

The other thing that we're very much looking at right now are some issues with private insurers to include Cigna. We are working with state pathology societies and members to understand what Cigna's intention is in indicating that they are reluctant to appropriately reimburse pathologists for the professional component of clinical pathology. Understanding the impact that that will have on individual practices and doing what we can to work with Cigna or work outside of Cigna to convince them that this is inappropriate and that pathologists need to be paid for this medical work that they do. I want to hear from the members, and the members are welcome to email president@cap.org with their concerns. I understand a little bit about what I see going on with pathology practices, but there's always more to learn, and we want to know here at CAP what things are on the members' minds and what we can do to support them in their practices.

Alec Bose:

Fantastic. I think that's a great place to leave it. Dr. Volk, thank you so much for joining us today. We really appreciate it.

Dr. Emily Volk:

My pleasure. Thank you.

Alec Bose:

For more updates from the CAP and other advocacy content, be sure to visit CAP.org/advocacy.

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