A question for actively practicing dermpaths: could you share some advice on how to improve efficiency?
I had a Eureka moment. The OP is a mid-manager type in some dermpath mill, looking for ways to squeeze the most 88305s from dermpaths.Could you elaborate more on what you're looking for? Is this efficiency in the lab? Efficiency in reading cases? Efficiency for ordering/resulting? There's lots of steps to consider. I suggest you check out pathologywatch.com to see how going digital can also help.
I can assure you I am definitely not this! I'm an MD path-trained dermpath. Thanks for your suggestions in the derm subforum, by the way.I had a Eureka moment. The OP is a mid-manager type in some dermpath mill, looking for ways to squeeze the most 88305s from dermpaths.
Could you elaborate more on what you're looking for? Is this efficiency in the lab? Efficiency in reading cases? Efficiency for ordering/resulting? There's lots of steps to consider. I suggest you check out pathologywatch.com to see how going digital can also help.
Basics to consider - barcode tracking and a good LIS system. EMR ordering with preset clinical info/impression choices. Good QA/QC procedures for the lab. If you want more info, PM me.I can assure you I am definitely not this! I'm an MD path-trained dermpath. Thanks for your suggestions in the derm subforum, by the way.
All of those.
We made some changes to our lab workflow that have helped tremendously, resulting in fewer slides per case. For instance we do 3 levels on a punch now rather than the 9 serials over three slides we used to do. We are still having issues with techs not being able to sample the entire epidermis on excisions, so getting full faced sections slows us down somewhat. It is annoying to have to revisit a case later that you've already examined because the last block wasn't sectioned full face.
Reading cases efficiently is always something that can be improved. When I get inflammatory biopsies from dermatologists it's pretty straightforward. When I get them from family doctors, it's challenging and these tend to take a lot of my time because I have no idea what the clinical impression is, and even if I do I don't know if I can trust it, so there's a lot of hedging on my part. What happens with these cases on your end? Anyone else too?
My neck and I wish we could go digital but that's not in the cards at this point. Cost ratio is too high and our practice skews vintage.
It probably varies from dermpath to dermpath and lab to lab. I know some dermpaths that stain anything even remotely brown. Although they are doing so to pad their bank accounts, not because they need the stain to make the diagnosis. I would say I get stains on anything melanocytic that I have the slightest doubt about, which likely works out to around 20% of those cases. I tend to stain lentigines on the head/face of elderly patients as I've seen some very subtle atypical proliferations that were nearly invisible on H&E. But obvious nevi, obvious MMIS, obvious melanoma I do not routinely stain unless it will assist in margin evaluation or I'm trying to rule out LVI or something. I'm fairly liberal with levels as there have been many times something has popped up on the deepers that wasn't there at all on the original slide. And my lab gets 3 levels per slide on all small biopsies which is convenient and uses less glass/time.Thanks for the tips I found here at this thread. I am less than 2 years into practice and I feel I need to work on my speed, I also tend to do lots of levels and stains. What percentage of your cases do you roughly do stains on, particularly melanocytic? I also hate these tough squamous lesions superficially sampled. any advice is appreciated.
I can assure you I am definitely not this! I'm an MD path-trained dermpath. Thanks for your suggestions in the derm subforum, by the way.
All of those.
We made some changes to our lab workflow that have helped tremendously, resulting in fewer slides per case. For instance we do 3 levels on a punch now rather than the 9 serials over three slides we used to do. We are still having issues with techs not being able to sample the entire epidermis on excisions, so getting full faced sections slows us down somewhat. It is annoying to have to revisit a case later that you've already examined because the last block wasn't sectioned full face.
Reading cases efficiently is always something that can be improved. When I get inflammatory biopsies from dermatologists it's pretty straightforward. When I get them from family doctors, it's challenging and these tend to take a lot of my time because I have no idea what the clinical impression is, and even if I do I don't know if I can trust it, so there's a lot of hedging on my part. What happens with these cases on your end? Anyone else too?
My neck and I wish we could go digital but that's not in the cards at this point. Cost ratio is too high and our practice skews vintage.