Hospital sabotage or incompetence?

[Mordak]

I am just seeing what people have to say about their experience with hospital incompetence with AP service administration. Currently there is a group that is contracted with a hospital to provide anatomic pathology services, however, the hospital owns the lab and manages all of the hiring and pay of the histology related staff. Because of any number of reasons, staff continue to leave, making the production of slides and many other things related to this service be met with great difficulty. I fear this will damage the pathology groups reputation and loss of revenue. Has anyone seen systems use this tactic before to drive out contracted pathologists? Has anyone used legal recourse for such actions with success? Thanks.⁸

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[coroner]

If the hospital owns the lab, why would they intentionally mismanage things to drive out the contracted pathologists? Administration can simply choose to not renew the pathology group's contract and avoid prolonging things. If that's administration's ultimate goal, there's no need to waste time resorting to such "tactics"...just pull the plug.

 

[WEBB PINKERTON]

Why are the histotechs leaving? I have seen more than my share of histotech drama over the years leading to high turnover.

 

[Mordak]

Thanks for your replies! Low pay and irregular working hours/shift changes are a big driver for staff losses. Insofar as why the hospital would try to drive out the current group- the contract isn't up for some years. Could some degree of management inefficiency/lethargy here indicate the lack of motivation to retain histology services here and send elsewhere at the expiration of the contract? Or could they use physician complaints for bad TAT for example, as a way cite that we aren't following up on our contractual obligations and terminate the contract earlier? I suppose one would need to really read the fine lines of the contract to know how obligated the hospital is to providing histology/ihc/send out service in a reasonable time, but our TAT and reputation I fear is being damaged by this and it would seem to me there could be legal arguments made. Just picking everyone's brain or if they have been in a similar position.

 

[Dave CX]

Most hospital labs function like MASH units. You are describing something very typical.

 

[coroner]

Insofar as why the hospital would try to drive out the current group- the contract isn't up for some years.

That makes more sense. The hospital is looking to terminate the contract with cause i.e. asap vs without cause which would be a few years down the road and they don't want to wait for that for whatever reason.

Never heard of such an example myself, but it wouldn't surprise me either. It could be as you stated just blatant incompetence by the admins without any underlying motive. If that were the case, it would be hard to prove, but that means admin would be held liable for jeopardizing patient care by not providing adequate resources/support staff. The hospital has more to lose that gain from hampering AP and getting the clinician's pissed off over TAT.

Ask yourself why would they looking to send the pathology elsewhere and get rid of your group? There seems to be more to this story...

 

[WEBB PINKERTON]

AP is the red headed step child of the lab. Most hospitals don't understand how to run it. I would be surprised if anything nefarious is going on other than incompetence. Histotechs don't seem to have issues moving around. They have a good job market.

 

[CellularTherapist]

I like the idea of Hanlon's razor (never attribute to malice that which is adequately explained by stupidity) in this case, but you never know...

Side note: I am relatively new to the field... what was the reason that Pathologist's decided not to have more control of the technical component/side of AP? My underlying assumption is money based, but would love to hear some input from the long-term Pathologist's here. Just seems like the lack of control of the workflow breeds issues...

 

[gbwillner]

Who is the lab director? They should have oversight in staffing and quality issues.

 

[Dave CX]

Who is the lab director? They should have oversight in staffing and quality issues.

Not in my experience

 

[Mordak]

In some respects, we would very much like to take over the management of the lab, but I think that hospital would not like to lose the tech component, particularly from IHC and would much rather ride out a leaky ship. Is the labor market really disturbed for everyone for laboratory staffing in this covid environment? I suspect it is simply incompetence, but as pathologists we have to do a lot of bending over backwards to deflect hyperinterested clinicians. I suppose my main thought is to continually document group concerns in staffing as being a patient care issue so that they can't say they didn't know about the problem. Otherwise, were forced to basically ride out the limited staffing woes.

 

[WEBB PINKERTON]

The technical component is garbage, which is a shame and is also making it difficult to run a lab.

 

[wholeheartedly]

While it’s theoretically possible, and I never rule anything out where hospital admins are concerned, it’s more likely just crappy working conditions, short staffing, and poor management that’s driving away the techs rather than something nefarious. at least that was my experience as a lab tech. i don’t know what it is but as soon as you pull a lab tech off the bench and make them a manager they start to loose common sense about how a lab should work and start making penny wise, pound foolish types of decisions.