Webinar on the "Insourcing" of Pathology Specimens by Clinical Practice Groups

In my opinion, one of the greatest threats to the specialty of pathology is the "insourcing" of pathology specimens by large clinical practice groups, usually urologists and gastroenterologists. I have posted previous notes about this practice in which I have referred to the construction of in-office histopathology labs (see: Pathologist Satisfaction with "Pod Lab" Positions; Corrected Definition for a Pod Lab and a Look at In-Office Labs). The basic concept is that the clinical groups processes their own tissue specimens and then contract with a pathologists to generate the interpretive reports. Fees for both the technical and professional components are collected by the group.

The Pathology Business Institute is offering a webinar entitled Fight Back Against the Insourcing of Pathology Specimens on Monday, June 14, at 3:00 - 4:00 p.m. EST. with three faculty members. Registration is limited to 50 participants. I very much like their adoption of the term "specimen insourcing" and will use it myself in the future. Obviously, building an in-office lab is the means by which the clinical groups are able to pursue this business model.

By the way, I have the distinct sense that our various national pathology societies have been curiously and conspicuously quiet on this issue. I would very much like to be disabused of this idea. Can any of the readers of Lab Soft News point me in the direction of high-level, broad-impact policy statements or seminars by our societies devoted to specimen insourcing? If none are to be found, can someone explain to me why this is the case?

Comments

[S]

PATHOLOGIST ARE TRYING TO OBTAIN THE MULTIPLE BIOPSIES FOR OUTSIDE PROCESSING.

NOT EVERY PATHOLOGIST IS ABLE TO OBTAIN ACCURACY AND QUALITY OF DIAGNOSIS IN TAKING THIS ROAD.

ERRORS WILL BE ABUNDANT BUT THE PATHOLOGIST AS WITH THE SPECIFIC SURGEONS ONLY SEE DOLLARS

[Bernie Ness]

Dr. Friedman,

Local pathologists lost the local GI, derm, and GU biopsy business originally when DIANON started marketing AP services almost 20 years ago. Local pathology groups could not or would not keep up with the marketing investments of the pathology specialty laboratories (CBLPath, AmeriPath, Caris Dx, GIP, etc.) They also were not interested investing 10% of their revenues in professional sales representation to be competitive. With the in-sourcing of pathology specimens by specialty groups, which we started in 2004, the local pathology groups are getting back some of the work they lost 20 years ago. All this without investing in computer interfaces, sales representatives, marketing promotions, etc. This is why each time we set up a new specialty practice with an in-office pathology laboratory (we have done 25 so far) we replace the national specialty pathology laboratories or Quest and LabCorp with local pathology group coverage. We have seen independent pathologists in this environment make $1,500,000/year with no expenses and still have time to work at other practice pathology laboratories! I see no need for CAP or APF or Mick Raich to denounce in-office pathology laboratories based on our experience. Independent pathologists who understand the new economics at play have done very well. If there is any overutilization it is in the area of special and IHC staining which is increasing at three times the rate of biospy specimen increases using CMS data. Only pathologists order these stains not the specialists.

[derm]

My name is Dr. G. I am a dermatologist. I am not a board certified dermatopathologist. However, I am board certified dermatologist and proficient in dermatopathology. I use to purchase the TC and bill global( legal in Geogia). Due the new medicare law, I decided to set up my own laboratory. I opened last month. I process my own specimens on-site AND read them. I think that pathologist were happy about the new law but it may back-fire if dermatologist start doing what I just did. I use to purchase the TC but labs started going up on the fees. Has this been the trend in California?

[Grahame Grieve]

Why is it a "threat to the specialty of pathology"

[Mick Raich]

Dr. Friedman:
This is exactly why I started PBI. I was involved with several societies and they failed at keeping abreast of the business issues effecting pathologists. So I started this society to bring issues like this to the forefront.

Please feel free to comment on anything that you think we need to discuss. We are currently working on our agenda for our next meeting in California in the fall and our first national show in the spring.

Thank you for you comments and thoughts.

Most Sincerely,

Mick Raich