CAPcasts

The laboratory director has a legal obligation to follow-up with all recalls that impact any test components or blood components used in the laboratory. While blood bankers are already on high alert for all blood component recalls, the impact from a medical device recall can be just as serious as a blood component recall. Per the CAP laboratory general checklist (GEN.20340), the laboratory manages notifications from vendors of defects or issues with reagents, supplies, instruments, equipment, or software that may affect patient care/client services. For example, there was a recent recall on waived blood lead testing lot numbers. The recall was classified as level I because use of the impacted lot numbers might have led to falsely low lead results.

In this CAPcast, Matthew Krasowski, MD, FCAP, Chair of the CAP Toxicology Committee, discusses the laboratory’s role in medical device recall, such as this recent incident, and how both CAP accredited laboratories and inspectors should respond to recalls.

Insufficient health plan networks and surprise medical bills have had a substantial impact on patients through the years. The No Surprises Act of 2020 aimed to address surprise bills by taking patients out of medical billing disputes between physicians and insurance companies. In part, the law set up an independent dispute resolution, or IDR, process that was supposed to be fair and impartial. However, the regulations implementing the law now favor insurance companies. The CAP is advocating to make the IDR process truly independent and fair to all participants. We spoke with Dr. Theresa Emory, chair of the CAP’s Payment Policy Subcommittee, to learn more.

February 4 is World Cancer Day, an international initiative focused on raising awareness of the importance of preventing, detecting, and treating cancer. World Cancer Day is led by the Union for International Cancer Control to support the goals of the World Cancer Declaration. This year, the focus is on Closing the Gap. In this CAPcast interview, CAP President Emily Volk, MD, FCAP, talks with Joseph Khoury, MD, FCAP, who is chair of the CAP’s Cancer Committee and Mary Edgerton, MD, PhD, FCAP, Chair of the CAP’s Pathology Electronic Reporting Committee about how the CAP and pathologists are working to improve access to quality care.

For more information on CAP Protocols, please visit the Protocols & Guidelines section of CAP.org: https://www.cap.org/protocols-and-guidelines.

Evolving molecular technologies and genomic knowledge has significantly changed the diagnosis and management of T-cell malignancies. More and more clinical laboratories have adopted next generation sequencing platforms to assess clonality and to identify diagnostic and predictive biomarkers. However, current standard testing practices to diagnose T-cell lymphomas use clonality assessment by fragment analysis. This approach has low sensitivity and low specificity, among other limitations, explains Jinjuan Yao, MD, FCAP, a pathologist at Memorial Sloan Kettering Cancer Center and a member of the CAP Personalized Health Care Committee. Dr. Yao has written an article (“The Updates of Molecular Testing in T-Cell Malignancies", https://capatholo.gy/3tOznDY) about how using next generation sequencing techniques allows more accurate initial diagnosis, as well as high sensitivity for detecting minimal residual disease and therefore improving post treatment outcomes, as she’ll explain in this CAPcast interview.

What are some common challenges that pathologists face when they are transitioning from training to practice? This CAPcast features a panel discussion recorded during the 2021 Fall Residents Forum meeting, when Abdul Abid, MD, vice chair of the Resident Forum moderated a discussion on this topic with three pathologists who are early in their careers—Elizabeth Rinehart, MD, FCAP; Marcos Lepe, MD, FCAP; and Juanita Evans, MD, FCAP. The panelists share their insights about how they are navigating the early stages of their pathology careers.

For more information about the CAP Residents Forum, please visit CAP.org and click on the Residents section located under the Member Resources tab.

This month we’ll look at a lawsuit involving the implementation of the No Surprises Act, the efforts of Congress to mitigate Medicare cuts, and more. We'll also be speaking with Michael Giuliani, Senior Director of Legislation and Political Action, about the status of the Build Back Better act and other legislative priorities Pathologists should look out for.

Document review is a critical component of any laboratory accreditation inspection. Driven by the need to innovate due to the ongoing pandemic, the CAP now offers laboratories a choice on whether they want to share documents in advance of their inspection whether it be in person or virtual. In this CAPcast, Adrienne Malta, the CAP’s Director of Inspection Services will describe options for laboratories to share documents in advance of an inspection. Adrienne also provides insight into how her team of Inspection Assignment Specialists help the inspection team and laboratory navigate the laboratory’s preference for document review during the inspection.

For the latest information on CAP accreditation, please visit the Laboratory Improvement section of CAP.org: http://www.cap.org/laboratory-improvement.

Medical errors happen to all pathologists, and every pathologist wants to make sure that they never happen. Indeed, there are whole books on identifying and correcting errors that should be part of every lab's quality management plan and CAP accreditation is there to help pathologists prevent, catch, and correct errors. However what is often missed is the worry, mental effort and stress that pathologists who are new in practice feel regarding mistakes when they first started their careers.

In this CAPcast, Drs. Richard Owings, Juanita Evans, and Yasmeen Butt discuss medical errors--how to confront and move on from them, as well as how to avoid them. Drs. Owings, Evans, and Butt are all members of the CAP's New in Practice Committee.

Additional resources for pathologists who are early in their career are available on the New-in-Practice section of CAP.org: capatholo.gy/3btuncz.

There’s a gap in the instructional texts for surgical pathology, such that residents preparing for pathology board exams or even practicing pathologists who need a refresher/reference texts lack sufficient information. In this CAPcast, Daniel Mais, MD, FCAP, discusses his recently published book, Surgical Pathology Review, which is focused on addressing these gaps.

Visit the CAP's estore to purchase the book: https://capatholo.gy/3bLFLks.

One of the challenging aspects of transitioning from a pathologist in training to one who is new in practice is how to organize your workday. In this CAPcast, Yasmeen Butt, MD, FCAP, and Neha Varshney, MD, FCAP, discuss this topic from both a private practice and an academic practice perspective.

For more resources for pathologists early in their careers, visit the New in Practice section under the Member Resources tab on CAP.org (https://capatholo.gy/3btuncz).