Pod Labs

[trent05]

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Found this website advertising for pathologists on pathologyoutlines. What ever happened to the CAP/ASCP "effectively ending POD labs"? The website is pretty shameless. http://mypathlabs.com/program.asp

 

[Farles]

This isn't really a pod lab. They provide pathologists to work in-house at derm practices. I really enjoy the references to providing a microscope and office for the "pathologist of your choice". It kind of sounds like a Save the Children commercial. "...and every month, you'll receive a photo of your pathologist and a hand-written note telling you how much working for you is sapping their will to live."

 

[trent05]

I think it is essentially a POD lab that receives the biopsy specimen, makes the slides and sends them back to the office where a rotating pathologist comes and reads them. It seems like an attempt to find a loop hole in the regulations. They mention that dermatologists have been doing it for years. If you browse through the site you see they are marketing primarily to Gastros and Urologists. I think the derm market is already well infiltrated.

 

[DarksideAllstar]

I think it is essentially a POD lab that receives the biopsy specimen, makes the slides and sends them back to the office where a rotating pathologist comes and reads them. It seems like an attempt to find a loop hole in the regulations. They mention that dermatologists have been doing it for years. If you browse through the site you see they are marketing primarily to Gastros and Urologists. I think the derm market is already well infiltrated.

How exactly are they coming into "new-found" reimbursement money if they aren't stealing it by way of adding the path services?

Samples quotes from one of their brochures:

Did you know that you have given away hundreds of thousands (even millions) of dollars per year to pathologist groups or private laboratories

We have a program where your practice can partake in reimbursement for your referrals.

You should be able to bill and collect for pathology services for all financial classes of patients....

What a joke.

 

[pathstudent]

If clinicians want to try and run a histo lab and make money that's fine. But I find the notion of a group of clinicians salarying pathologists and then billing for the professional particularly distasteful.

First it is unethical, and it is fee splitting and any pathologist who takes that kind of a deal is a loser. Unfortunately it seems path has drawn quite a few losers.

 

[Doctor Zaius]

The sad thing is there will probably be lots of pathologists fighting over these jobs working for urologists and gastros. As has been noted here before, it's just another symptom of the large oversupply of pathologists.

 

[Gyric]

I did note the comment at the bottom of their web page about the Stark law … that should give a few of the less greedy clinicians pause. Dermatologists are different in my opinion, since dermpath is an established part of dermatology training and is a bonifide fellowship in part governed by their certifying body. Senior dermatologists routinely sign out their biopsies in many states and are not hiring pathologists as subservient employees to profit from (they hire dermpath trained people, usually dermies in partnership track positions).

It is naïve to think that malpractice attorneys will not pick up on this abusive business practice, with its emphasis on profit over quality. These practices would likely be financially devastated the first time they screw up…. they are after-all liable for any mistakes their “employees” make.

Lets say the local GU group pulls this ****, they do their 20 separate cores with ipox and their barely literate “pathologist” mistakes atrophy for cancer. They come over to my hospital and take his prostate out … hmmm no cancer. I call the patient and ask him to have his core biopsies sent to me … still no cancer. I send it off to my expert GU mentor … still no cancer … I call the patient and let him know that his impotence was totally unnecessary and pass on the number of my favorite plaintiffs attorney.

We still are incredibly important for delivery of quality healthcare and ought to take the gloves off when dealing with this sort of threat to our profession and to our patients. It shouldn’t have to come to that of course, ideally our professional societies would squash this sort of thing.

 

[yaah]

Heh, I think I posted about this before, but some guy in Texas had a poster at USCAP last year or the year before about how the quality of service at a (GU) pod lab was just as good as standard of care. His whole point was that the diagnosis of cancer was made in similar percentages (along the gleason spectrum) as nationally reported averages. That's rock solid evidence! 😉

In regards to taking prostates out based on bad diagnoses, most large hospitals (at least, academic ones) require review of outside diagnoses internally (as transfer cases) before the surgeons will operate. It doesn't always happen, of course, and mostly depends on the clinician requesting it to be sent. But one slip up and they never forget again. But on our rotations we see tons of transfer cases from outside labs, it's amazing to see the poor quality of a lot of material. There is one large megalab we see lots of cases from where the lab manipulates the slides and the cutting to put prostate cores from two different sites on the same slide, you differentiate them based on which part of the slide they are on and how they are inked. I guess if you are doing thousands a year every glass slide you can save helps, but it's also a little disturbing. I am sure that proponents of the system would be able to give you plenty of statistics on how effective they are, and even how their system improves results, but I'm still skeptical.