Re: Grossing

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From:Jeff Silverman <peptolab@hamptons.com> (by way of histonet)
To:histonet <histonet@magicnet.net>
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Re: grossing by HT's
I have been regularly grossing for eight years for the pathologists in my
institution doing eveything from endoscopic biosies to hysterectomies,
lumpectomies, nephrectomies and colectomies and mastectomies, as well as
regrosses. All big cases and any skin lesion excision or anything with
complicated margins gets shown to the doc before or during the dissection.


There has been no formal credentialling by any hospital committee although
every day I interact with the surgeons and clinicians in this capacity as
well as lead histotech.  Twenty five years studying surgical pathology in
community hospital labs and at meetings make me well suited for this task.
It is we the mighty histotechs who must ultimately demonstrate the lesions
at the embedding and microtomy centres so who better to examine these
things grossly.I  always cut thin sections. I only wish the AAPA had an
alternate pathway or a subcategory such as "assistant in surgical
pathology".  Why?  I don't do autopsies, surgicals only!

CLIA says if I did a good job before 1995 or ?1996, I don't need an
associates degree to continue- thank God. I haven't been grossing for a
year though, the boss is too paranoid. My pathologist, who is going private
in 1999 and wants me to leave my union job and work for him for
"piecework", prefers to do it himself now and is ostracizing me to scare me
into his union busting- my hospital claims losses of 58 million dollars
over the last three years and is also trying to weaken the unions with
contract talks at a standstill.  They just merged with the two other small
regional hospitals out here in Suffolk, Long Island, NY and the three and
all their unions are enlocked in a classic labor/ management struggle and
I'm in the middle.  Mine is the first job they're going to try to
subcontract to an idenpendent contractor- the pathologist.  I've got
marketable skills, I think, so I'm enjoying the ride and just trying to
hang on- if not just for the movie script.

Jeff Silverman
peptolab@hamptons.com
Southampton Hospital NY USA
----------
> From: Robin K Ryan <ryanrk@gnv.fdt.net>
> To: HistoNet@Pathology.swmed.edu
> Subject: Grossing
> Date: Monday, November 23, 1998 7:06 PM
>
> Hi Don,
>
> At our institution the pathologists do all of the "grossing".  There are
> five histotechnologist and two pathologists.  Several of us have
experience
> in grossing but they prefer to do it themselves, although, if a biopsy
> comes in (endo., cx. bx., liver, etc.) we do put the gross description on
> the surgical requisition, place the tissue in the cassette and process it
> rather than holding it until the next day.  The pathologists do their
gross
> description based on what we write on the requisition and what they see
on
> the slides.  The only experience we have is what some other trained
person
> taught us-no formal schooling for grossing.  Hope this helps.
>
> Kaye Ryan




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