PAs are all the buzz in BC these days. Fraser Valley Health Authority and The Interior Health Authority are both 'looking.' It seems that the Pathologists are reducing or nearly-eliminating their level of service in the two regions and the hospitals are scrambling to find some experienced individuals capable of dissecting more complex surgical specimens. Histotechs are currently handling the less-complex specimens.
The Interior HA has a really novel idea (has been done in a few centres; mostly in the USA) about using telepathology to perform frozen sections. It's a natural (if it works well) for multi-site hospitals which may not have Pathologists on staff. The scenario is one where a PA (possibly accompanied by a Histotechnologist) will go to the frozen section room (in the OR usually) instead of the Pathologist, who may be many miles away. Via a secure web cam, the PA will describe and dissect the specimen under the watchful eye of the Pathologist. Either the PA or the Histotech will perform the frozen section and the slide will be reviewed remotely by the Pathologist; manipulated on the stage at her/his direction. The PA will write (and sign on behalf of the Pathologist) the microscopic description and the diagnosis. Pretty neat, eh?! For the hospitals, this presents an opportunity for a significant saving in that the PA, rather than the Pathologist, will be travelling (and waiting if necessary); will be present at the F/S and will be paid substantially less per unit time. For the majority of cases wherein there is a single slide, the healthcare system stands to save substantially. There will be no discernable reduction in turnaround time or quality control.
I haven't discussed how autopsies will be handled yet but will soon learn what their plans are.
Fraser Valley HA is in a slightly less frantic situation wherein the Pathologists are reducing their level of service. As a result, they are looking at starting from the grassroots level and plan, in full consultation with the BC health ministry, to set-up a PA training program. It is my understanding that they hope (unlike Winnipeg which has a Masters-level program) to set-up a BSc-level program, probably with a 1-year post-grad practicum. I think they hope to do this at UBC.
Needless to say, the PAs will justifiably achieve a higher standing than MLTs; I believe their intent is to pay the PAs at least two levels higher on the same (unionized) pay scale. All of this is in its infancy and subject to considerable change as time progresses. The time line, however will seem to go at the speed of light compared to anything that has happened elsewhere in the country over the last 30+ years.
I sincerely hope that the organizers in BC keep the CAP apprised of their progress, especially in regards their training program. The CMA Accreditation Office can provide important direction in the formulation of a curriculum based upon the core expectations (essentially the job description) of PAs. As a result, BC may have the first nationally-accredited PA training program.
I may have more to say on the subject of telepathology in a week's time. A demonstration is being held in Kelowna in a few days' time and I'll be there with the Director of The Interior HA. I'll be able to consider trying to 'sell' my own Director at The Ottawa Hospital on the idea of telepathology as we too are a multi-site hospital with numerous client hospitals at a distance from Ottawa.
It has been good to make contact with several PAs across the country recently. I feel a slow re-kindling of enthusiasm for the certification issue. I am very very appreciative of the CAP's efforts thus far. Please remember to ask every PA who you know whether or not they have received and replied to the letter from Dr. Cook (Pres. of the CAP).
Friday, April 01, 2005
Sunday, March 06, 2005
Spreading The Word
Surprise! All hospitals and referral centres have yet to hear of Pathologists' Assistants (and their merits). It seems there are still some places where Pathologists are spending hours (and their employers paying their salaries) performing tasks which can easily be handled by PAs. Interestingly, the Pathologists are complaining about how hard they're working; are threatening job action unless additional resources are provided, and yet they have not considered delegating significant portions of their work to PAs and Technologists.
I have come to the conclusion (much like London HSC) that a fully-trained PA ought to spend most of her/his time handling the more complex surgicals and performing medical autopsies. The less-challenging surgicals (eg. GI biopsies) can easily be handled by Technologists. I also believe (again, London's way ahead on this one) that PAs ought to have a minimum of a BSc (whereas obviously, MLTs are college-trained).
I have a meeting with a representative of a British Columbia hospital pathology department in a week's time. They have never used PAs and are investigating their value. My job, based on The Ottawa Hospital's 30 year experience (and London's), will be to convince them that they should hire PAs with a BSc and to save the small surgicals, etc. for their Junior Prosector (rather than training the Junior Prosector to be a PA). Time is of the essence; the province is pushing for a major revision in the structure of healthcare and managers are mandated to cut costs.
I have to wonder how many other major centres continue to have highly-paid MDs performing the tasks which, at many centres, are delegated to PAs? Please let me know if you are aware of any by submitting a comment to this post.
I have come to the conclusion (much like London HSC) that a fully-trained PA ought to spend most of her/his time handling the more complex surgicals and performing medical autopsies. The less-challenging surgicals (eg. GI biopsies) can easily be handled by Technologists. I also believe (again, London's way ahead on this one) that PAs ought to have a minimum of a BSc (whereas obviously, MLTs are college-trained).
I have a meeting with a representative of a British Columbia hospital pathology department in a week's time. They have never used PAs and are investigating their value. My job, based on The Ottawa Hospital's 30 year experience (and London's), will be to convince them that they should hire PAs with a BSc and to save the small surgicals, etc. for their Junior Prosector (rather than training the Junior Prosector to be a PA). Time is of the essence; the province is pushing for a major revision in the structure of healthcare and managers are mandated to cut costs.
I have to wonder how many other major centres continue to have highly-paid MDs performing the tasks which, at many centres, are delegated to PAs? Please let me know if you are aware of any by submitting a comment to this post.
Tuesday, February 22, 2005
I Stand Corrected
I received an interesting call yesterday from the CSMLS. I was informed that, in fact, they had not 'dropped the ball' on the PA certification issue (ie. did not fail to retain the mailing list). I was set-straight and informed that this was not what they were mandated to do. The mailing list was actually, I was told, received from the CAP.
This mailing list referred to was (and is) the mailing list for the Pathologists, not for PAs and, yes, it would be improper to retain same.
To not compile (and retain with permission) a mailing list for Canada's PAs however, while carrying-out the questionnaire (at considerable expense) was rather short-sighted. This may not have been the mandate of the CSMLS but, had PAs been involved at the outset, this would have been pointed-out as being, at the very least, rather important. It is unfortunate that the CAP are having to re-do this important step.
Also discussed during the telephone call was the fact that it is more appropriate for the CAP (and the CMA) to be carrying the certification issue forward. This was actually my thinking from the start.
The fact that the credentials and the expectations (learned in the responses to the questionnaire by the CSMLS) put upon PAs is 'all over the map' simply serves to illustrate the crying need for at least SOME regulation. Pick an issue if you will: will it be minimun educational standards? How about expectations of PAs based upon those, or other, standards? What about a nationally-recognised curriculum? Fellowship exams? Continuing medical educational standards? Equivalency criteria for foreign-trained PAs? Grand-mothering/-fathering criteria? Who is going to decide such weighty issues as these? Who knows the answer, if no one is asked in the first place? Clearly, someone lost sight of the real purpose of the process; the real 'mandate' if you will.
I find myself repeating myself (yet again; please forgive me). The Pathologists (at least those at The Ottawa Hospital) have become SO dependent upon the support provided by PAs, that if PA numbers are depleted (through sickleave, vacation, etc.) and the routine work doesn't get done at quite the usual pace, the Pathologists complain. They do this rather than recognizing that the PAs are doing THEIR (MDs') work. The PAs are not regulated, licensed or insured to perform these tasks. The volume (of surgical specimens, for instance) increases; necessitating re-prioritizing some of the traditional, routine tasks performed by PAs, and the Pathologists complain about poor turnaround times; about 'lack of support.' They will even on occasion enlist the support of various clinicians to help argue the need for PA support of their service. Some will even threaten to seek-out greener pastures if the situation doesn't change! Maybe the PAs should be flattered by all of this. Unfortunately, they don't see in all of this that their excellent work is appreciated. The PAs are doing MDs' work! What would happen if suddenly there were NO PAs? Would the Pathologists sit and wait for THEIR work to get done? Is this only obvious to ME?! I'd like to hear an opinion or two from the Pathologists.
I realise that many physicians appreciate the work of their support staff a great deal and that a special relationship is often created over the years that they work together. It is interesting to me to see, in different areas, the different ways in which this relationship 'appreciated' by the physician. Some physicians will passionately argue that their support staff deserve more; higher classification; more money; etc. Other physicians simply demand more. I wish I knew how to lobby the pathologists to argue passionately in favour of the advancement of PAs.
ALL of the jobs that PAs perform do not (since they are MDs' jobs) have workload unit values (through the MIS Guidelines maintained by the CIHI). This way, an employer cannot use units to justify hiring additional PAs. Instead, the few units that they do produce go into justifying the hiring of (usually) Histotechnologists. This isn't necessarily a bad thing but if one thinks about it for a second...if the Histology Lab is busy, who was busy first? Answer: the PAs (and their trusty support staff -- Technicians and Clerical staff).
It is HIGH time PAs were recognized. I am getting impatient. Now that I sit in the manager's seat, I see even more clearly the necessity for progress on this front. I can't believe that it has been 30 years and that virtually nothing has been done. Ontario's Anaesthetists are suggesting that Assistants would help their cause. I'd bet that if they are successful, they will set-up a curriculum, exam, certification process, clearly-defined job description and even suggest appropriate levels of remuneration BEFORE ever allowing an AA (Anaesthetist Assistant) to set foot in an OR. Why the heck wasn't this done for PAs? Do PAs perform tasks any less valuable to patient care than would AAs? I think not. Why the heck can't it be done NOW? Good for U of Manitoba for starting. Thank goodness they didn't listen to all of the nay-sayers who believed that it wouldn't be worth their time or money.
As I said to the representative of the CSMLS, going as far as they did and not continuing is like climbing 3/4 of the mountain and giving up. It is lamentable that direction was not (or so it appears) sought when it was clearly needed. I can only pray that the CAP / CMA does not get bogged down but rather forges ahead with a clear view to the reason behind furthering PA regulation: that is, the protection of the public, the patient, the institution, themselves, and yes, the Pathologists.
This mailing list referred to was (and is) the mailing list for the Pathologists, not for PAs and, yes, it would be improper to retain same.
To not compile (and retain with permission) a mailing list for Canada's PAs however, while carrying-out the questionnaire (at considerable expense) was rather short-sighted. This may not have been the mandate of the CSMLS but, had PAs been involved at the outset, this would have been pointed-out as being, at the very least, rather important. It is unfortunate that the CAP are having to re-do this important step.
Also discussed during the telephone call was the fact that it is more appropriate for the CAP (and the CMA) to be carrying the certification issue forward. This was actually my thinking from the start.
The fact that the credentials and the expectations (learned in the responses to the questionnaire by the CSMLS) put upon PAs is 'all over the map' simply serves to illustrate the crying need for at least SOME regulation. Pick an issue if you will: will it be minimun educational standards? How about expectations of PAs based upon those, or other, standards? What about a nationally-recognised curriculum? Fellowship exams? Continuing medical educational standards? Equivalency criteria for foreign-trained PAs? Grand-mothering/-fathering criteria? Who is going to decide such weighty issues as these? Who knows the answer, if no one is asked in the first place? Clearly, someone lost sight of the real purpose of the process; the real 'mandate' if you will.
I find myself repeating myself (yet again; please forgive me). The Pathologists (at least those at The Ottawa Hospital) have become SO dependent upon the support provided by PAs, that if PA numbers are depleted (through sickleave, vacation, etc.) and the routine work doesn't get done at quite the usual pace, the Pathologists complain. They do this rather than recognizing that the PAs are doing THEIR (MDs') work. The PAs are not regulated, licensed or insured to perform these tasks. The volume (of surgical specimens, for instance) increases; necessitating re-prioritizing some of the traditional, routine tasks performed by PAs, and the Pathologists complain about poor turnaround times; about 'lack of support.' They will even on occasion enlist the support of various clinicians to help argue the need for PA support of their service. Some will even threaten to seek-out greener pastures if the situation doesn't change! Maybe the PAs should be flattered by all of this. Unfortunately, they don't see in all of this that their excellent work is appreciated. The PAs are doing MDs' work! What would happen if suddenly there were NO PAs? Would the Pathologists sit and wait for THEIR work to get done? Is this only obvious to ME?! I'd like to hear an opinion or two from the Pathologists.
I realise that many physicians appreciate the work of their support staff a great deal and that a special relationship is often created over the years that they work together. It is interesting to me to see, in different areas, the different ways in which this relationship 'appreciated' by the physician. Some physicians will passionately argue that their support staff deserve more; higher classification; more money; etc. Other physicians simply demand more. I wish I knew how to lobby the pathologists to argue passionately in favour of the advancement of PAs.
ALL of the jobs that PAs perform do not (since they are MDs' jobs) have workload unit values (through the MIS Guidelines maintained by the CIHI). This way, an employer cannot use units to justify hiring additional PAs. Instead, the few units that they do produce go into justifying the hiring of (usually) Histotechnologists. This isn't necessarily a bad thing but if one thinks about it for a second...if the Histology Lab is busy, who was busy first? Answer: the PAs (and their trusty support staff -- Technicians and Clerical staff).
It is HIGH time PAs were recognized. I am getting impatient. Now that I sit in the manager's seat, I see even more clearly the necessity for progress on this front. I can't believe that it has been 30 years and that virtually nothing has been done. Ontario's Anaesthetists are suggesting that Assistants would help their cause. I'd bet that if they are successful, they will set-up a curriculum, exam, certification process, clearly-defined job description and even suggest appropriate levels of remuneration BEFORE ever allowing an AA (Anaesthetist Assistant) to set foot in an OR. Why the heck wasn't this done for PAs? Do PAs perform tasks any less valuable to patient care than would AAs? I think not. Why the heck can't it be done NOW? Good for U of Manitoba for starting. Thank goodness they didn't listen to all of the nay-sayers who believed that it wouldn't be worth their time or money.
As I said to the representative of the CSMLS, going as far as they did and not continuing is like climbing 3/4 of the mountain and giving up. It is lamentable that direction was not (or so it appears) sought when it was clearly needed. I can only pray that the CAP / CMA does not get bogged down but rather forges ahead with a clear view to the reason behind furthering PA regulation: that is, the protection of the public, the patient, the institution, themselves, and yes, the Pathologists.
Saturday, February 12, 2005
CAP's Address?
It would appear that the CAP neglected to include a return address on the letter mailed out to all of the pathology departments in the country. The Ottawa Hospital PAs are going to put all of theirs together and will mail their names, addresses, signatures, etc. to the CAP office (774 Echo Drive, Ottawa, ON.).
Tuesday, February 08, 2005
Workload
Alright! I've had it!
On behalf of myself and the dedicated PAs with whom I work, I submitted an application for workload units to the Canadian Institute of Health Information (CIHI) in 2003 and I have yet to hear from them (despite diplomatic reminders, by yours truly, and inquiries since that time). I see my colleagues suffering under the weight of many, many complex, important surgical specimens while having to deal with insufficient space, insufficient technical assistance, insufficient staff, insufficient time and insufficient patience to get the work done in good time.
I see The City of Ottawa free-up the substantial money to hire 28 new Paramedics. Good idea; let's get more patients into the institution so that their presence can have a ripple effect upon every other department within the hospital. But don't bother to ask us! I see tons of Registered Nurses being romanced into seeking employment at The Ottawa Hospital. At the same time, I see the Anaesthetists taking a job action on Feb 11th as a result of the increased OR volume being inflicted upon them by the provincial government -- primarily as a result of not being consulted. Right on! Good for you! I don't see anyone asking if there should be more Lab Technologists or PAs to handle the additional volume of surgical specimens. What the heck is the point of doing the surgery if there's no diagnosis (FYI - for the uninitiated - the 'diagnosis' comes from Pathology ... nowhere else)? If all the government is doing is rushing a bunch of sick patients in one door; having the surgery performed; then shoving them [prematurely] out the other door, they're not helping health care one bit. They are, in fact, hindering good health care by 1. overwhelming the PAs, the Lab Med Technical staff and the Pathologists and 2. shortening post-op length of stay and thus risking a certain percentage of post-op deaths (which they are evidently willing to accept on your behalf -- nice of them eh?). To what end? I'll tell you why: to dupe the voting public into thinking that shorter waiting lists for surgery = better health care. Neither the politians nor the public know. Healthcare workers know. Too bad they don't ask.
I submit that if the CIHI would get off there duffs and process the application for workload units for PAs, the amazing volume of work that PAs perform could be easily tracked such that additional resources, including staff, could be easily justified in the next budget. As it is, the PAs are forced to console themselves in the knowledge that they are doing the best they can, for their patients, in spite of what seems to be the entire system ignoring them, if not taking advantage of them. I don't blame them at all for being 'irritable' from time to time. I'm talking about people who, more than anyone I know, have their hearts in the right place. Collectively, they have the highest work ethic of any group I know.
PAs, unlike Nurses of the 21st century, have the very lucky advantage, when it comes to patient care, of being separated from what is becoming a truly ugly situation. If you have had the misfortune to partake of the services of an ER, or heaven forbid, an in-patient ward, recently you know all too well that Canadian healthcare has taken on a completely different colour than when we were kids. I would not want to be a Nurse working in an ER. Pain aside, unless you are dying, you get 'stabilized' and then flushed out the door (and sometimes even if your ARE dying). This must be a real eye-opener for Nurses who started out with a more traditional idea of what nursing was all about. I'm glad I don't have to succumb in such a way to the immediate constraints of funding; I'd rather just supply the very best care that I can. I'm glad I'm a PA.
I see a number of PAs are less than glad however; and I don't blame them at all. We're having to really scramble to continue to provide even a reduced level of care to that which we have been accustomed. The ever-present, and growing, mountain of specimens is truly daunting. I don't blame the PAs for looking like they're caught in the headlights. I don't blame them for looking for a temporary change of venue. It's difficult to maintain your dedication to the patient under circumstances like these.
Rest assured however that your profession is a truly honorable one. You are set apart by what you do; by what you know; by how you do it. This is not BS. You are perceived by your fellow Technologists with respect, awe and envy. You deserve more and WILL receive it; it is just a matter of time. Be patient (this too sets you apart). It will come. In the meantime, I know you will continue to do the best you can for your patients; because that's part of what sets you apart from the rest.
Hang in there. You're the best.
On behalf of myself and the dedicated PAs with whom I work, I submitted an application for workload units to the Canadian Institute of Health Information (CIHI) in 2003 and I have yet to hear from them (despite diplomatic reminders, by yours truly, and inquiries since that time). I see my colleagues suffering under the weight of many, many complex, important surgical specimens while having to deal with insufficient space, insufficient technical assistance, insufficient staff, insufficient time and insufficient patience to get the work done in good time.
I see The City of Ottawa free-up the substantial money to hire 28 new Paramedics. Good idea; let's get more patients into the institution so that their presence can have a ripple effect upon every other department within the hospital. But don't bother to ask us! I see tons of Registered Nurses being romanced into seeking employment at The Ottawa Hospital. At the same time, I see the Anaesthetists taking a job action on Feb 11th as a result of the increased OR volume being inflicted upon them by the provincial government -- primarily as a result of not being consulted. Right on! Good for you! I don't see anyone asking if there should be more Lab Technologists or PAs to handle the additional volume of surgical specimens. What the heck is the point of doing the surgery if there's no diagnosis (FYI - for the uninitiated - the 'diagnosis' comes from Pathology ... nowhere else)? If all the government is doing is rushing a bunch of sick patients in one door; having the surgery performed; then shoving them [prematurely] out the other door, they're not helping health care one bit. They are, in fact, hindering good health care by 1. overwhelming the PAs, the Lab Med Technical staff and the Pathologists and 2. shortening post-op length of stay and thus risking a certain percentage of post-op deaths (which they are evidently willing to accept on your behalf -- nice of them eh?). To what end? I'll tell you why: to dupe the voting public into thinking that shorter waiting lists for surgery = better health care. Neither the politians nor the public know. Healthcare workers know. Too bad they don't ask.
I submit that if the CIHI would get off there duffs and process the application for workload units for PAs, the amazing volume of work that PAs perform could be easily tracked such that additional resources, including staff, could be easily justified in the next budget. As it is, the PAs are forced to console themselves in the knowledge that they are doing the best they can, for their patients, in spite of what seems to be the entire system ignoring them, if not taking advantage of them. I don't blame them at all for being 'irritable' from time to time. I'm talking about people who, more than anyone I know, have their hearts in the right place. Collectively, they have the highest work ethic of any group I know.
PAs, unlike Nurses of the 21st century, have the very lucky advantage, when it comes to patient care, of being separated from what is becoming a truly ugly situation. If you have had the misfortune to partake of the services of an ER, or heaven forbid, an in-patient ward, recently you know all too well that Canadian healthcare has taken on a completely different colour than when we were kids. I would not want to be a Nurse working in an ER. Pain aside, unless you are dying, you get 'stabilized' and then flushed out the door (and sometimes even if your ARE dying). This must be a real eye-opener for Nurses who started out with a more traditional idea of what nursing was all about. I'm glad I don't have to succumb in such a way to the immediate constraints of funding; I'd rather just supply the very best care that I can. I'm glad I'm a PA.
I see a number of PAs are less than glad however; and I don't blame them at all. We're having to really scramble to continue to provide even a reduced level of care to that which we have been accustomed. The ever-present, and growing, mountain of specimens is truly daunting. I don't blame the PAs for looking like they're caught in the headlights. I don't blame them for looking for a temporary change of venue. It's difficult to maintain your dedication to the patient under circumstances like these.
Rest assured however that your profession is a truly honorable one. You are set apart by what you do; by what you know; by how you do it. This is not BS. You are perceived by your fellow Technologists with respect, awe and envy. You deserve more and WILL receive it; it is just a matter of time. Be patient (this too sets you apart). It will come. In the meantime, I know you will continue to do the best you can for your patients; because that's part of what sets you apart from the rest.
Hang in there. You're the best.
Sunday, February 06, 2005
CAP's PA mailing list
It has been a couple of weeks since the CAP sent out it's first correspondance asking that Canada's PAs respond with their mailing address (and written permission). Please take a moment to think of a PA who you know who may not have received this letter. Include even those who work at large centres. There are a number of reasons why the letter, addressed to "The Director" may not find its way to the PAs. If these people are examining surgical pathology specimens, rendering Gross Descriptions and/or performing autopsies (at a level above Morgue Attendant or deiner), they are performing duties which are those generally considered within the job description of Pathologists' Assistant.
Give her/him a call to enquire. If they got one, that's great, if they didn't, please make sure that they do. This is a very important first step. The CAP must have everyone's permission to proceed to the next step.
More on the issue of what constitutes a PA: let there be no misconception; a Morgue Attendant is NOT a PA. For the Morgue Attendants out there, please understand that I am in no way denigrating you, your occupation or the much-valued assistance that you provide. Generally speaking, the prerequisite for employment as a Morgue Attendant include a Grade 12 (in Ontario) high school diploma. Currently, the minimum prerequisite for employment as a PA is a Medical Laboratory Technologist diploma and registration with the appropriate provincial college. It is very important that at this juncture PAs force themselves to take the hard line and, at the risk of alienating the MAs with whom they work day in and day out, clearly define to themselves and to their colleagues, Pathologists included, the criteria which define "Pathologists' Assistant."
Another problem which will need to be addressed is that concerning PAs who are not involved in all aspects of Pathology. Consider PAs working at a forensic science centre, assisting at autopsy; performing the dissection on behalf of the Forensic Pathologist. They never see or handle surgical pathology specimens yet they are, as much as the Forensic Pathologists are Pathologists, PAs. To clarify, these are not Morgue Attendants. They are performing the dissection of the organs, examining tissues, interpreting their findings and communicationg these to the Pathologist. On the other hand, there are PAs who never do autopsies, but who handle surgical pathology specimens. Same story; just like the Pathologists who they assist, they too are PAs.
Give her/him a call to enquire. If they got one, that's great, if they didn't, please make sure that they do. This is a very important first step. The CAP must have everyone's permission to proceed to the next step.
More on the issue of what constitutes a PA: let there be no misconception; a Morgue Attendant is NOT a PA. For the Morgue Attendants out there, please understand that I am in no way denigrating you, your occupation or the much-valued assistance that you provide. Generally speaking, the prerequisite for employment as a Morgue Attendant include a Grade 12 (in Ontario) high school diploma. Currently, the minimum prerequisite for employment as a PA is a Medical Laboratory Technologist diploma and registration with the appropriate provincial college. It is very important that at this juncture PAs force themselves to take the hard line and, at the risk of alienating the MAs with whom they work day in and day out, clearly define to themselves and to their colleagues, Pathologists included, the criteria which define "Pathologists' Assistant."
Another problem which will need to be addressed is that concerning PAs who are not involved in all aspects of Pathology. Consider PAs working at a forensic science centre, assisting at autopsy; performing the dissection on behalf of the Forensic Pathologist. They never see or handle surgical pathology specimens yet they are, as much as the Forensic Pathologists are Pathologists, PAs. To clarify, these are not Morgue Attendants. They are performing the dissection of the organs, examining tissues, interpreting their findings and communicationg these to the Pathologist. On the other hand, there are PAs who never do autopsies, but who handle surgical pathology specimens. Same story; just like the Pathologists who they assist, they too are PAs.
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