CIHI resurfaces!

Those of you whose employers monitor performance, in part, by following workload will be pleased to hear that the application which I submitted in 2003 (!) has finally made it to the point where it, along with many others, is being discussed. As you know, virtually nothing that PAs do is accurately reflected in the the workload units. For example, each surgical case described, regardless of its complexity and regardless of how many specimens make up that case, earns 4 units. Fashioned somewhat after the model provided by the pathologists -- wherein they charge a larger and larger fee depending upon the complexity of the specimen -- the PAs will soon be able to claim workload units more commensurate with their efforts. For those PAs who do autopsies (ie. the history, the dissection, the interpretation and recording), units will soon be allocated for that too.

In many instances, the units generated will more accurately reflect how busy the PAs really are and may justify additional resources and personnel. Comparison form PA to PA and from PA to other staff will be enabled. This is the wish of the CIHI: that the units more accurately reflect the real-life situation in labs across the country. If the time studies are performed honestly and accurately, the resultant workload units will be accurate. Then, if the wording of the units is succinct and understandable such that there is no chance to claim duplicate, or additional units for the same task; and if those claiming the units use them in the manner intended, the resultant number will be a true reflection of per staff workload and the per unit workload.

It is encouraging to know that this issue is proceeding.

For those of you who will be attending the CAP AGM next weekend, I'd appreciate your consideration (and vote please!) as I shall be offering my services for several executive positions from Chair, to Vice Chair, to Secretary and several sub-committee chairs. Please make sure that you vote (whether you attend the meeting or not). I am told that a method for voting by proxy will be communicated to the CAP members very soon. Also, if you are unable to attend but would like to offer your services on a committee, please make sure that you let Lloyd Kennedy (interim Chair) know via the CAP Secretariat.

A permanent, full-time PA position at Kelowna General Hospital has been posted. I would welcome all applicants' resumes. Please apply within the coming week. The salary is at the Tech III level. You will be given advanced standing on the pay scale depending upon your past experience and a Qualification Differential is added to your salary for degrees which you have earned (eg. MSc = ~$100/month). Depending upon when the successful applicant can start, I may be able to hire a locum or two within the next month or so also (same salary, plus travel and accommodation). The bonus (of course) is the fantastic summer weather in the Okanagan combined with the resort atmosphere, the lake and all of the activities that take place on it and near it.

I will post a new picture within the next week. I am still working on adding the feature whereby the reader can click on the microscopic image and it will open Spectrum Webviewer. Your patience is appreciated.

At the CAP, one of the discussions will concern the listing of Key Competencies (of PAs). This is basically a job description; describing that which constitutes a PA. I am sure that the discussion will involve a large number of people who have differing ideas of what should be, and what need not be, included. The document was distributed by the CAP Secretariat earlier this week. Don't hold back. Make your feelings known. If you want to expand upon, or reduce, the scope of the list, make sure you say so.

most recent publications

A few things that some of you might be interested in:

1. Plasmacytoid Urothelial Carcinoma of the Urinary Bladder, Report of Seven Cases. K. T. Mai, P. C. Park, H. M. Yazdi, E. Saltel, S. Erdogan, W. A. Stinson, I. Cagiannos, C. Morash. Case Study of the Month, European J Urology 50 (2006) 1111-1114.

2. The 3-Dimensional Structure of Isolated and Small Foci of Prostatic Adenocarcinoma, The Morphologic Relationship Between Prostatic Adenocarcinoma and Prostatic Intraepithelial Neoplasia. K. T. Mai, B. F. Burns, W. A. Stinson, C. Morash. Research Article, Appl. Immunohistochem Mol Morphol 15(1) 2007: 50-55.

And something a little older:

3. Proposed technique for sectioning of mastectomy specimens and submission of tissue for microscopic examination of breast carcinoma. K. T. Mai, H. M. Yazdi, B. F. Burns, D. G. Perkins, D. Mirsky. Correspondence, Histopathology 39, 2001: 323-327.

Spectrum Webviewer

With Quorum Technologies' able assistance, I'm going to try to allow access to a web-based version of Aperio Technologies' software called Spectrum Webviewer - simply by clicking on the image. The images that I have been posting are far too small to appreciate anything even remotely subtle. This will enable manipulation of the images, zooming in and out, etc. Wait 'till you see it! It's pretty neat.

Much ado

You may notice that a couple of my previous posts have been edited and re-posted.

I regret that my comments may have caused some consternation.

New Image

The images illustrate an interesting case that I saw recently. This young male patient had a long history of recurrent pancreatitis of unknown etiology. He was otherwise healthy. A Whipple's procedure was performed and we found an area of thickening in the wall of the duodenum adjacent to the Ampulla of Vater (gross image) which turned out to be ectopic pancreas (micro image). Notice in the gross image that the pancreatic tissue is between the mucosa and serosa. The bile and pancreatic ducts were markedly ectatic and the pancreas was diffusely fibrotic.

Professional Extenders?

Many of you have no doubt read with interest the one-page article in the Winter, 2007 CAP Newsletter entitled Professional Extenders for Pathologists, authored by Dr. Raymond Maung. Dr. Maung states that he intends to discuss this issue at the CAP AGM in June. There are many points within the article with which I could take issue but in the interests of brevity and diplomacy, I will make just one comment: there are so many pathologists across this country whose practice depends upon PAs that I think raising this discussion at the CAP will be enlightening.

It is refreshing and encouraging that an attempt is being made to measure the portion of the pathologists' workload traditionally dedicated to grossing. If the numbers are anywhere near accurate, they will further validate the practice of PAs. I support the thinking that up to 1/3 of a pathologist's time at a tertiary-care facility is, or ought to be, dedicated to grossing. PAs and Histotechs who perform gross descriptions have never been given the recognition that they deserve. All provincial ministries have been essentially unaware, for over 30 years, that someone other than pathologists have been doing all of this work.

I am so glad to see that the CAP has included a day-long session specifically for PAs at this year's meeting. I regret that I will likely not be able to attend but want to send my best wishes to all those who will be there.