CAPcasts

It's one thing to talk about the advocacy pathologists engage in, but it's another to get started in that advocacy, especially in a time where getting in contact with elected officals can be more difficult than ever. Bekra Yorke, MD, FCAP, Houston Methodist Hospital Pathology invited three residents: Chiraag Gangahar, MD, FCAP, Ashley Holloman, MD, and Lukas Cara, MD, to participate in their first virtual fly in. We sat down with the four of them to discuss their experience and how other pathologists can work with the CAP to get involved in effective advocacy.

If you are a pathology resident (or a CAP fellow teaching residents), and would like to experience teachable moments like this, make sure you register for the Pathologists Leadership Summit which culminates with the CAP’s Hill Day on May 3. This year’s Hill Day is taking place virtually, so you can participate alongside colleagues, from the convenience of your home or office.

In this recap, we review the final Medicare fee schedule regulations, updates from Cigna, and more.

Distinguishing between type 1 and type 2 diabetes is critical, because delayed diagnosis of type 1 diabetes is associated with 20% or more risk of diabetic ketoacidosis, a major cause of death in children. Differentiating between type 1 and type 2 diabetes is also extremely important for choice of appropriate therapy. While the clinical presentation of a patient may not allow an unambiguous discrimination between type 1 and type 2 diabetes, the presence of one or more islet autoantibodies can support the diagnosis of type 1 diabetes, according to William Winter, MD, FCAP, the director of the UF Health Pathology Laboratories' Endocrinology Unit. Because islet autoantibodies can also predict the development of type 1 diabetes, once safe and effective therapies are available to prevent this disease, islet autoantibody testing will become routine in medical practice, as Dr. Winter explains in this CAPcast. Dr. Winter led the development of a Clinical Pathology Improvement Program or CPIP course on this topic.

The CAP’s Accreditation Services is launching its Online Deficiency Response on December 20. This will impact the way the CAP’s accreditation customers send the necessary documentation for any deficiencies cited during their inspection. In this CAPcast, Amy Daniels, the CAP’s Technical Director of Accreditation Services, describes the new process for responding to deficiencies and how it impacts laboratories during the transition to the new process.

For more information on this new CAP Accreditation Services Online Deficiency Response, please visit the Accreditation section of CAP.org (https://www.cap.org/laboratory-improvement/accreditation).

In the latest episode in our series commemorating the CAP's 75th Anniversary, we talk with past presidents Thomas Sodeman, MD, FCAP, and Bruce Williams, MD, FCAP, about discovering and nurturing the next generation of pathologist leaders. Dr. Sodeman was president from 2005 to 2007 and Dr. Williams was president from 2017-2019. Dr. Sodeman appointed Dr. Williams to one of his first leadership roles in the CAP.

Precision oncology in the treatment of solid tumors is a rapidly growing field which involves testing for molecular biomarkers. Molecular biomarkers can be used to confirm a diagnosis, provide prognostic information, and select targeted therapies. Pathologists need a working knowledge of these biomarkers and assays used for their evaluation to optimize patient care, explains Jennifer Yoest, MD, FCAP, a pathologist at UH Cleveland Medical Center, in this CAPcast.

Dr. Yoest, who led the development of a Clinical Pathology Improvement Program course on this topic (https://capatholo.gy/3187OsM), will also discuss how this knowledge will also help pathologists triage specimens and prioritize testing in situations where limited tissue is available, which is also known as tissue stewardship.

During this years' annual CAP meeting, Dr. Emily Volk was formally inagurated. We sat down with our new president to discuss the clinical goals and advocacy priorities she has for the CAP during her tenure.

Amylase testing has long been used as a diagnostic tool for pancreatitis, despite amylase levels not being a definitive indicator of pancreatitis. Lipase offers a more useful diagnostic result, as its readings are a better indicator of inflammation of the pancreas, according to James Nichols, PhD, a member of the CAP Quality Practices Committee. Ordering a combination of amylase and lipase is a common practice, but the combination does not increase the sensitivity over a single test. Likewise, serial testing of lipase does not offer better monitoring or treatment. As part of the CAP Test Ordering Program, a new module (https://capatholo.gy/3Du78fr) provides information and resources for the pathologist to address unnecessary testing volumes in the laboratory while still providing effective patient care, as Dr. Nichols explains in this CAPcast.

Leading a laboratory involves both technical knowledge and softer skills: technical knowledge of testing and accreditation is needed along with the ability to manage people, perform risk assessment, and deal with finances and budgeting. Many pathologists leave training with the required technical knowledge but sometimes lack training and confidence in the “softer” skills. The CAP’s Laboratory Medical Direction course is led by experienced laboratory directors who can help correct gaps in your knowledge and improve your ability to function as a lab director. In this CAPcast, leading pathologists Elizabeth Wagar, MD, FCAP, and Richard Scanlan, MD, FCAP, discuss the benefits of attending the course, which will be held March 31-April 1, 2022 in Chicago: capatholo.gy/2mVcxrh.

Cancer immunotherapy has revolutionized oncology through dramatically increased survival rates, even in late-stage disease. Some biomarkers are already covered in what has become routine testing in many laboratories, affording pathologists an opportunity to play a central role in developing and implementing these biomarkers in ways to improve patient care, explains Eric Walk, MD, FCAP, Chief Medical & Scientific Officer and Senior VP of Medical & Scientific Affairs with Roche Diagnostics, in this CAPcast.

Dr. Walk recently wrote an article on this topic, which is posted on CAP.org under the Precision Medicine Resource Center: https://capatholo.gy/345u6dd.