How do you mean? Rounding with clinicians will prevent a decline in medicare reimbursement?
I still don't understand what transformation means. Is it only rounding with clinicians, or was there more to it?
I think the way people (and I mean both the critics and proponents of the "transformation") keep focusing on "rounding with clinicians" is a mistake. Most of us have bad memories of time wasted staring at our navels on hugely inefficient walking rounds as medical students. The suggestion that we return to doing this is absurd. It makes the whole concept of the transformation seem ridiculous, and I think that's unfortunate.
In my mind, the main idea of the "transformation" is this: Pathologists should make themselves visible members of the health care team, both to clinicians and patients. As I see it, the reason we'd like to do this is that, as a profession, we'd like to avoid the commoditization of our services and avoid giving the impression to clinicians, patients, and bureaucrats that pathologists are interchangeable parts. Rounding with clinicians and doing other similarly visible activities give us a face, both to the patients and to the clinicians.
As another example, take the currently hot concept of the "medical home" that people think may end up being the new model of government-influenced health care. Most people think of the general practitioner as being the gatekeeper of the system, controlling referrals, etc. The "transformation" perspective would be that, as the keepers of lab data, pathologists are uniquely positioned to take a leadership role in the overall care of the patient.
A third reason would be the rise of molecular testing in cancer diagnosis. There is a lot of fear out there that molecular testing could significantly diminish histopathology's traditional central role in cancer care. Cancer diagnosis and prognostication would become the realm of the PhD and the oncologist, and pathologists would get cut out of the loop. I don't see this happening in the near future, but twenty or thirty years from now, I guess it could.
In general, I think the transformation is a valuable initiative. However, I guarantee you I won't be doing walking rounds with the ****ing internists while I have a mountain of slides waiting for me in my office.
