The use of Pathology Assistants to do virtually all of the grossing
of even complex pathology specimens, under the supervision of a
pathologist is becoming commonplace in larger practices, and many are
convinced it provides a more consistent, higher quality gross
dissection and sampling, as long as the PAs are properly qualified,
trained and supervised and have pathologist back-up.
Conversely, in most pathology training programs, the residents do
most or all of the grossing as part of their training (sometimes with
the exception of small biopsies). However, this is counter-intuitive
from a patient safety standpoint: i.e. your least experienced people,
who are interrupted by other concurrent responsibilities and rotate
in and out on a scheduled bases are doing the part of pathology which
is most critical to patient safety and can't be replicated if done wrong.
We are considering tweaking our program in some ways to improve
patient safety in the gross room and reduce errors and would like to
see what others do and think. The concept being tested is that more
of the grossing of complex specimens should be done by PAs and
experienced residents (not fresh trainees who are trying to learn all
aspects of pathology and lab at the same time and are prone to
errors) and the training of residents should also include aspects of
directing a gross pathology lab (which requires knowing how to gross,
but also other things), rather than just grossing alone.
Could you help with the answers to these questions if you have a
residency training program in pathology:
* Do PAs gross complex specimens?
* Are PAs involved in training residents or vice-versa?
* What is the salary for PAs who gross complex specimens?
* Do you have any other innovative ways to reduce gross room
errors by residents in training or to teach gross pathology to same?
Luke A. Perkocha, MD, MBA
Associate Professor of Pathology and Dermatology
Associate Director of Surgical Pathology
UC San Francisco
Helen Diller Family Comprehensive Cancer Center
1600 Divisadero Avenue, Box 1785
San Francisco, CA 94143-1785
office: 415 885-7254
cell: 415 509-6442
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