More emphasis is placed on quantity rather than quality. Here the main
histology lab is responsible for cutting everthing but controls for
IHC/SS. Attempts to catch bad slides before staining were met with
contempt, even though my superior had directed me to check the slides.
Quite frankly I had to stop checking the slides, it just created too
[mailto:firstname.lastname@example.org] On Behalf Of Kemlo
Sent: Thursday, December 06, 2007 4:59 AM
To: Robert Richmond; email@example.com
Subject: RE: [Histonet] Re: Slide quality
You couldn't get the average pathologist, definitely including this one,
to even notice most of the folds and wrinkles that occur in sections.
We've become so used to ignoring them that when we teach
photomicrography to residents, we have to remind them not to photograph
areas in the slide with wrinkles in them - they look like hell when
I think that asking the pathologist to document wrinkles and folds is
In the various labs I do pathology in, the recurrent problem is GI
biopsies with shatter and "window-blind" artifact. My requests to
address the problem are usually ignored. Very few pathology services do
separate processor runs for small specimens, and I've never been able to
get a laboratory to even consider it.
If I ran the zoo, I'd have a double headed microscope (not permitted for
pathologists in small pathology services), and I'd look at the day's run
of slides with a senior histotechnologist nearly every day. That to my
mind might launch an effective quality assurance program.
I agree with you (before you argue with me!) that most pathologists in
this circumstance would be so abusive that the exercise would be quite
unendurable for the technologist.
I'm surprised that you don't look at the slides with the Tech; how does
he/ she know if they are doing a good job. In my experience when my
Pathologist was kind enough to teach me some smatterings of
Dermatopathology it was stunningly powerful in showing me the error of
my ways. I don't understand why Techs/ BMSs don't look at slides before
they go to the Pathologist and even take a crack at the diagnosis. On
one or two occasions I remember I've spotted CIN3 on a Lletz that wasn't
spotted by the Pathologist but then I was a Cytologist; wouldn't be any
good at anything non- cervical; but I could learn!!!
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