Speaking of in-office labs

[lipomas]

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This website popped up on my gmail advertisement space today, I guess because I had a lot of ASCP emails and things like that.

http://www.iopathology.com/

Of particular interest are the testimonials and FAQ. Nowhere is there much of an acknowledgement that the pathologist is being exploited. The pathologist is barely acknowledged, and when they are, it's as a hassle or as an expense. There is one statement about "we like our local pathologists, can we continue to work with them?"

pretty apropos smilie.

 

[DrBloodmoney]

What a banner display for the total failure of our professional societies.

 

[pathstudent]

It is interested that they are located in lake forest il That is one of the richest burns in the USA. Basically the tiburon or white plains of Chicago 😍

 

[KeratinPearls]

I would think these in-office practices will eventually be illegal. These in-office labs give clinicians a financial incentive to perform more and more biopsies for profit. I don't know how these setups can be legal. Terrible for the patient and of course great for $$$$greedy$$$$ clinicians.

 

[yaah]

I would think these in-office practices will eventually be illegal. These in-office labs give clinicians a financial incentive to perform more and more biopsies for profit. I don't know how these setups can be legal. Terrible for the patient and of course great for $$$$greedy$$$$ clinicians.

They are legal because they are basically small clinics. They are not necessarily terrible for the patient, unless of course the pathologist is not good. They are terrible for the patient if their practice behavior is based on whatever makes more money, however. They would also argue that they are more efficient because everything is done "in house." They do, however, exist solely because of the desire to make more profit. While patient care is likely put forth as the main reason, it is in reality $$$ that is the main reason. But that's capitalism.

 

[Nilf]

They are legal because they are basically small clinics. They are not necessarily terrible for the patient, unless of course the pathologist is not good. They are terrible for the patient if their practice behavior is based on whatever makes more money, however. They would also argue that they are more efficient because everything is done "in house." They do, however, exist solely because of the desire to make more profit. While patient care is likely put forth as the main reason, it is in reality $$$ that is the main reason. But that's capitalism.

Just to clarify, these in-office establishments rack up 100% of technical component, right?

 

[yaah]

Just to clarify, these in-office establishments rack up 100% of technical component, right?

I would assume so. Basically, the way I understand it, they build a lab with processor, hire histotech(s), other staff as necessary, and hire a pathologist. They get 100% of both technical and professional component, minus whatever they pay out to their employees (pathologist included). I think there have been arrangements in the past where in office labs do not actually do the technical component, they send specimens out somewhere else and have it processed, and then they bill only for the professional component. As it says quite humorously on that site, "The regulations (regarding in office labs) have changed every year since 2004." Shouldn't that be a sign that it's at the very least unethical?

Basically though, it's kind of hard to see how regulations could make a business that process their own tissue and reads it, all in the same office, as truly illegal. I can see how it should be, but it's hard to see how it actually could be. Maybe the CAP should work harder to make it more difficult for these labs to become certified, or something.

 

[2121115]

Maybe the CAP should work harder to make it more difficult for these labs to become certified, or something.

BINGO. We control the certification process for these labs. If we wanted to bad enough, we could play that card and end this.

 

[exPCM]

BINGO. We control the certification process for these labs. If we wanted to bad enough, we could play that card and end this.

These labs do not have to be certified by CAP. There are other options such as CLIA/COLA/Joint Commission. CAP does not have a monopoly.

 

[lipomas]

These labs do not have to be certified by CAP. There are other options such as CLIA/COLA/Joint Commission. CAP does not have a monopoly.

I think you're right about that. I have seen a couple of larger in office labs (large practices with a lot of volume who have insourced all of their procedures and their pathology and some lab tests) and they have "CAP certified" certificates on their walls. But I have heard of others that went with someone else. I am not sure if that was because CAP didn't certify them, or because they didn't try. I think CAP has the most respect but I don't really know. I suppose it doesn't really matter to patients or other clinicians, so long as they are certified by someone.

 

[Pathwrath]

The in-house labs set up on a shoestring usually opt for quickie COLA inspections, which are as half-assed as the labs themselves.