Becker's ASC Review

38 Executive Briefing Sponsored by: T e work of a pathology laboratory is immensely critical, as patients anxiously wait to hear word of a disease or clean bill of health. During that time, histotechnicians and pathologists are hard at work to produce an accurate, and potentially life saving, report and diagnosis. To ensure physicians deliver accurate diagnoses, histotechnicians and pathologists must work closely to provide this precise and timely information: • Histotechnicians prepare thin slices of human tissue working with precision equipment, dyes and chemicals to make abnormalities visible for microscopic examination by the pathologist. • Equipped with slides prepared by histotechnicians, pathologists study the lab samples of body tissue to discover the causes and effects of diseases. • Pathologists then relay their findings to physicians to make diagnoses. While some pathology labs deliver diagnoses within multiple specialties, others, such as Boston Scientific, hone in on a single specialty. Located in Alpharetta, Ga., the GI-specialized pathology lab is certified by the College of American Pathologists. "The things that we do everyday at Boston Scientific Pathology, including efficient turnaround time, high diagnostic quality and quality customer service, are in my opinion, things that should be the industry standard. Unfortunately, they're not," says Jeremy Miller, MD, Boston Scientific Pathology medical director. The pathologist's diagnosis influences how physicians approach the patient's treatment plan, so it's vital to deliver a high-quality analysis for every test. What sets a GI-specialized pathology lab apart Although similar to multispecialty labs, a GI-specialized pathology lab promises expert clinical value because all staff members are specifically trained in the specialty. "For that ASC clinician who is solely focused on the GI tract, there is a level of confidence when you have specialty-trained pathologists and histotechnicians," says Torey Andrews, pathology lab manager at Boston Scientific. "They are going to give the best care to make the proper diagnosis and treatment plan for patients." The specially trained staff continuously enhances their skills as they are only dissecting and orienting tissue from one area of the body. Histotechnicians and pathologists specializing in gastroenterology examine diseases of the liver, gallbladder and pancreas. "Having continued handling of a particular tissue type allows for every member of the team to become experts in that area," says Ms. Andrews. "In multispecialty labs, you open the window for mishandling of certain tissues, and there can be a mix-up." The specific knowledge GI specialty-trained histotechnicians bring to the table results in a close working relationship between histotechnicians and pathologists in a specialty lab. "There's a need for communication and that relationship builds that skill set and knowledge of histotechnicians, and why there is such a reliance on histotechnicians," she adds. Histotechnicians know exactly what a specimen looks like upon receipt and understand how to properly dissect it. "Diagnostic quality stems from the fact that our pathologists are GI specialized, and equally important, our histotechnicians that make the slides are GI specialized as well," says Dr. Miller. GI-specialized pathology makes a difference when diagnosing sessile serrated adenomas, a premalignant flat lesion of the colon, for instance. "This lesion is very difficult to diagnose and recent publications have shown that GI-specialized pathologists have a higher rate of diagnosing these lesions," Dr. Miller explains. A pedunculated polyp with a stalk attached to it is another instance where GI-specialized pathology can be a game changer. Histotechnicians must orient this specimen properly in order for the pathologist to not just provide an accurate diagnosis, but also provide definitive margin analysis. "If a specimen is not oriented properly at embedding, the pathologist will not see that specimen properly, especially when it comes to tumors," explains Ms. Andrews. "You want to have a team that is very cognizant in the specimen they're handling." This confidence among the lab staff yields definitive diagnoses and consistent margin calls. Additionally, the relationship between the pathologists and the gastroenterologists plays an important role. This relationship is a two-way street, requiring clinical staff to offer as much patient and procedure information as possible to the pathologist. Demand more: What GI physicians should expect from their pathology lab

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