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Mark Pool

Thanks, Bruce, for another provocative post on the autopsy. I guess I'll take the bait! The subject of this post reminds me of a saying I used to hear as a boy: "Two can live as cheap as one, if one don't eat." We talk the talk of wanting to improve quality, but the fact of the matter is that the autopsy (as it is currently) is a time- and energy-consuming endeavor whose value to medicine (as measured by its compensation) it exactly: zero. Encouraging more autopsies without reforming how our time is reimbursed is reckless and feckless--no matter what it contributes to education and/or quality. While I'm doing the autopsy for Dr. Gompf, she is likely seeing patients in clinic--meanwhile after I drag myself back to my office from the morgue, I still have trays of slides left that I have to sign out. Since I stand astride community and academic practices, I can also attest to the fact that autopsies are equally discouraged and demeaned even in teaching centers. If I hear any hue-and-cry for the autopsy (as things stand now), I'm running for the hills! With that being said, I agree that the virtopsy would be a brilliant alternative that actually would address several different problems and deficiencies (which can be deduced from your last enumerated points). This could be a ax-handle for our College to use if we seriously want to promote evidence-based medicine and improved patient care. As things are now, we get what we pay for.

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