Not bad; not too bad

I thought I should check in; just in case some of you were wondering whether I had dropped off the face of the earth.

I am pleased to report that I am alive and well, living in the Okanagan (I even spelled it right!). I have been working at Kelowna General Hospital for just over a month. I am now doing all of the gross descriptions of the surgical specimens and am filling my spare time with writing a policy and procedure manual for surgical pathology (autopsy to come next). Some time after the Interior acquires a permanent Medical Director and s/he gets settled, etc. I'll present the manual for her/his amendments and/or approval. The manual was originally written -- by me -- (in the 80's) using Ackerman/Rosai but has undergone many amendments and improvements since that time. This manual will of course encorporate BCCA requirements which are specific to this province.

I am very pleased to report that things seem to be running rather smoothly. At first, there were a few administrative hiccups which briefly hampered optimal operations but now that procedures have become somewhat more routine, I dare say that day-to-day operations seem to be going smoothly and the turnaround time, from the clinicians [and patients'] perspective, is at least as good as it was prior to the enactment of the contingency plan at the beginning of May.

I am slowly but surely making friends (I sincerely hope that they see it this way also) amongst the Histotechnologists and the MLTs in the other labs at least recognize me now. I think I am convincing the Techs, and hopefully the Pathologists (if not others) that Pathologists' Assistants are not the ogre that they may have been made out to be. It is regrettable I suppose that the PAs were perceived to be the 'instrument of change,' at least in the eyes of the Pathologists and Techs. I am very appreciative of the maturity, professionalism and restraint shown by everyone in giving this new wrinkle a fighting chance. PAs, with the tolerance and support of the staff of the hospitals making up the IHA have made the difference, at least from where I sit, between keeping the division of anatomical pathology open for business, and closing the service completely. The latter scenario clearly would have been enough to induce genuine panic amongst the entire community, not to mention the staff of the entire hospital. Although I still sense some resentment on the part of some of the staff, I feel that they are realizing that the PAs are there, like them, primarily for the patient.

I think that the IHA ought to thank Marty Woods and Jennifer Rice BIG time for their efforts on behalf of the population of the Okanagan. They have, with amazing calm, managed to piece together a plan which is actually working and which will see us through until the IHA acquires sufficient personnel to once again stand alone and move ahead to a bright future of superlative care, academia and research. I see great things for the IHA as in the future it becomes a centre of excellence in British Columbia; training medical Residents in other services and (I hope) laboratory medicine for UBC. The production of papers for publication in peer-review journals is what, in part, will move the IHA ahead in the future. The staff will benefit by their collaboration with Residents in the production of these papers, regardless of how basic the papers may be. The involvement of the Technical staff (resulting in acknowlegements and co-authorships) induces involvement amongst the other staff and, like a wave over the deparment, convinces other staff to behave in like fashion. The involved staff have a new, revived perspective of their profession and of their routine work.

I expect that there will be other PAs hired at the IHA within the next several months. Hopefully, an intersted Histotechologist or two will come forward and will express an interest in learning how to dissect and describe the more complex surgicals and how to perform autopsies, write clinical histories, take photographs, etc.

A medical autopsy has not been performed in the IHA for over a month; clearly, we need to re-start this much-needed service (before it takes another nail in its coffin). I personally lament how the autopsy service was considered 'expendable.' I am positive that there are enlightened clinicians in the IHA who feel otherwise (although I must admit that I am somewhat surprised that I have not heard any comments to that effect).

I hope that Pathologists, Technologists and Clinicians in the IHA (and for that matter, elsewhere in BC) do not view PAs as a threat, but rather as colleagues who can help to provide the finest level of health care that the population can possibly get.