Dear Michelle,

We had a similar situation here about 5 or 6 years ago.  The adjective
"painful" is appropriate indeed in describing this problem.  I don't know
how many pathologists you have on staff but the greater the number the worse
the problem is.  We had 5 at the time and an additional (conditional)
part-time pathologist thrown into the mix.  We also had recently hired a PA
so he was factored in as well.  Obviously, not to read out slides, but for a
calculation of grossing bench time for the pathologist "du jour".
We ended up with 4 pages of instructions that basically laid out about a
dozen various scenarios.  These scenarios were divided into thirds with 5
steps of special instructions for each third.  Once you determined which one
of the 12 (or the closest variation thereof) scenarios existed for that day,
you then had a 2 page worksheet to complete with the calculations (number of
slides) and to which pathologist they were to go.
This became so cumbersome and ridiculous that we did what we had to
do...gave it back to the pathologists.  Not only was this a valuable waste
of our tech time every day, the pathologists for the most part were unhappy.
The histotechs conveniently became the "scapegoats" as well in all of this
as any unhappiness about the division of labor was squarely placed on their
shoulders.  After all, they had "divvied" the work up!  We have made
dramatic increases in production volumes since then and now have 8
pathologists to serve.  I can't imagine having to divide the work up for
them again.
Every service is different and obviously I do not know the philosophy or
flow of yours.  But with all the variables thrown in (frozen sections,
intra-operative consultations, specific case assignments of special
interest/specialty, etc., etc.) it is beyond reasonable expectation to have
anyone other than the pathologists calculate their division of labor.
When we initially met to discuss this with the pathologists a couple were
adamantly opposed to doing the division themselves.  It soon became apparent
that this was not for any practical or process improvement reasons.  It was
simply because they did not want to do it.  Someone had been doing it for
them and if they didn't like the way the day shook out it was never their
fault.  Fortunately, logic and reason ruled the day and we've never looked
back (thank the Lord).
I'm certain it's apparent that I believe you should put the ball in the
pathologists court and have them take this over.  I do provide production
numbers daily to the pathologists and they take it from there.  I don't know
what their exact system is but they seem to be doing just fine with it.
If your pathologist group is reasonable this may be a solution for you.  I
hope this is helpful.  If you have any questions feel free to contact me.
Good luck.

Thomas Jasper HT(ASCP)BAS
Anatomic Pathology Coordinator
SMDC Clinical Laboratory
Duluth, MN
tjasper@smdc.org


-----Original Message-----
From: Michele_Marggi@ssmhc.com [mailto:Michele_Marggi@ssmhc.com]
Sent: Wednesday, April 06, 2005 8:37 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] who reads what?


Hello all:

I am hoping that I can get some help.....

I am wondering what system people are using  to divide up cases/slides to
your pathologists.  We currently have a very "painful" process of dividing
up cases to our pathologists.  Trying to make it fair in terms of numbers,
types of cases, and even trying to accommodate personal interests or
specialties.  All of this consideration means a lot of time added to the
process.   I would really appreciate some response and ideas for a better
and more efficient process.

Thanks,

Michele Marggi
Surgical Pathology Supervisor
St. Marys Hospital Medical Center
707 S Mills Street
Madison WI  53715
Telephone: 608.258.6930
Fax: 608.258.6268


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