PathologistsPathologists’’ Assistants and Their Role in the Assistants and Their Role in the
Practice of PathologyPractice of Pathology
2011 ASCP Annual Meeting/ WASPaLM XXVI World Congress2011 ASCP Annual Meeting/ WASPaLM XXVI World Congress
Las Vegas, NevadaLas Vegas, Nevada
October 22, 2011October 22, 2011
Panel MembersPanel Members
Anne WalshAnne Walsh--Feeks, MS, PA (ASCP) Feeks, MS, PA (ASCP) CM CM
Director Physician & Ambulatory Program Development
North Shore-LIJ Health System
Manhasset, New York
Mamoun Younes, MDMamoun Younes, MD
Professor of PathologyProfessor of Pathology
University of Texas Health Science Center at Houston
Houston, Texas
Pamela S. Younes, MHS, HTL(ASCP), CPC(AAPC), PA (ASCP) Pamela S. Younes, MHS, HTL(ASCP), CPC(AAPC), PA (ASCP) CMCM
Assistant Professor
University of Texas Health Science Center at Houston
Houston, Texas
ProgramProgram
10:0010:00--10:30 AM 10:30 AM History of the Pathologists’ Assistant Profession History of the Pathologists’ Assistant Profession
andand
The Role of the Pathologists’ Assistant in Different The Role of the Pathologists’ Assistant in Different Practice SettingsPractice Settings
Speaker: Anne WalshSpeaker: Anne Walsh--Feeks, MS, PA (ASCP)Feeks, MS, PA (ASCP)
10:3010:30--11:00 AM11:00 AM The Relationship between Pathologists and Pathologists’ The Relationship between Pathologists and Pathologists’ 10:3010:30--11:00 AM11:00 AM The Relationship between Pathologists and Pathologists’ The Relationship between Pathologists and Pathologists’ AssistantsAssistants
Speaker: Mamoun Younes, MDSpeaker: Mamoun Younes, MD
11:0011:00--11:30 AM 11:30 AM The Training of Pathologists’ AssistantsThe Training of Pathologists’ Assistants
Speaker: Pamela Younes, MHS, PA (ASCP)Speaker: Pamela Younes, MHS, PA (ASCP)
11:3011:30--11:50 AM11:50 AM Questions & AnswersQuestions & Answers
Program: Part 1Program: Part 1
�� History of the Pathologists’ Assistant ProfessionHistory of the Pathologists’ Assistant Profession
�� The Birth of the ProfessionThe Birth of the Profession
�� Training ProgramsTraining Programs
�� The American Association of Pathologists’ The American Association of Pathologists’ �� The American Association of Pathologists’ The American Association of Pathologists’
Assistants (AAPA)Assistants (AAPA)
�� CLIA ‘88CLIA ‘88
�� ASCP CertificationASCP Certification
What is a Pathologists’ Assistant?What is a Pathologists’ Assistant?
“A pathologists' assistant is an intensively “A pathologists' assistant is an intensively trained allied health professional who trained allied health professional who provides anatomic pathology services provides anatomic pathology services under the direction and supervision of a under the direction and supervision of a under the direction and supervision of a under the direction and supervision of a pathologist.”pathologist.”
Source: AAPA Scope of Practice
The Role of the Pathologists’ AssistantThe Role of the Pathologists’ Assistant
Under the direction of a pathologist:Under the direction of a pathologist:
�� Grossing of all specimen typesGrossing of all specimen types
�� Autopsies Autopsies
�� Training of peers & pathology residentsTraining of peers & pathology residents
�� Frozen section preparationFrozen section preparation�� Frozen section preparationFrozen section preparation
�� QI/ QC/QAQI/ QC/QA
�� Laboratory managementLaboratory management
�� Regulatory RequirementsRegulatory Requirements
�� Tissue banking / researchTissue banking / research
The First Training ProgramThe First Training Program
�� 1969: The first training program was 1969: The first training program was
started at the Veterans Administration (VA) started at the Veterans Administration (VA)
Medical Center in Durham, North Carolina Medical Center in Durham, North Carolina Medical Center in Durham, North Carolina Medical Center in Durham, North Carolina
in conjunction with Duke Universityin conjunction with Duke University
Others Followed….Others Followed….
�� Additional training programs followed at:Additional training programs followed at:
�� The Veteran’s Administration Hospital of the The Veteran’s Administration Hospital of the
University of AlabamaUniversity of AlabamaUniversity of AlabamaUniversity of Alabama
�� Quinnipiac College, an affiliate of Yale University, Quinnipiac College, an affiliate of Yale University,
in Hamden, Connecticutin Hamden, Connecticut
Current Training Programs
Drexel University
Philadelphia, PA
Duke University
Durham, NC
University of Maryland
Baltimore, MD
Wayne State University
Detroit, MI
Indiana University
Indianapolis, IN
Quinnipiac University
Hamden, CT
Rosalind Franklin
Chicago, IL
University of Western Ontario
London ON Canada
West Virginia University
School of Medicine
Morgantown, WV
Training Programs
� Accredited by NAACLS (National Accrediting National Accrediting
Agency for Clinical Laboratory Science ) since Agency for Clinical Laboratory Science ) since
1993. 1993.
� All are two year MS/MHS degree programs
except Wayne State which is currently a two year
BS degree program .
The American Association of Pathologists’ Assistants The American Association of Pathologists’ Assistants
(AAPA)(AAPA)
�� Founded in 1972, notFounded in 1972, not--forfor--profitprofit
�� Premiere professional organization for Premiere professional organization for
pathologists’ assistants pathologists’ assistants pathologists’ assistants pathologists’ assistants
�� Provides education and advocacyProvides education and advocacy
�� Current membership 1,484Current membership 1,484
AAPA HistoryAAPA History
�� 1969: First training program began1969: First training program began
�� 1972: AAPA founded1972: AAPA founded
�� 1975: First Annual AAPA Convention Atlanta, GA1975: First Annual AAPA Convention Atlanta, GA
�� 1993: AAPA established an affiliation with the 1993: AAPA established an affiliation with the �� 1993: AAPA established an affiliation with the 1993: AAPA established an affiliation with the
National Accrediting Agency for Clinical National Accrediting Agency for Clinical
Laboratory Science (NAACLS) to accredits PA Laboratory Science (NAACLS) to accredits PA
training programstraining programs
�� 2004: ASCP (BOR) 2004: ASCP (BOR) –– National certification for National certification for
pathologists’ assistants through the ASCPpathologists’ assistants through the ASCP
AAPA Mission StatementAAPA Mission Statement
TheThe AAPA,AAPA, asas anan independent,independent, notnot--forfor--profitprofit volunteervolunteerorganizationorganization ofof alliedallied healthhealth practitioners,practitioners, isis dedicateddedicated totothethe advancementadvancement ofof thethe pathologists’pathologists’ assistantassistant professionprofessionandand ofof individualindividual pathologists’pathologists’ assistantsassistants throughthroughadvocating,advocating, promotingpromoting andand sustainingsustaining thethe highesthighesteducationaleducational andand professionalprofessional standardsstandards forfor thethe profession,profession,educationaleducational andand professionalprofessional standardsstandards forfor thethe profession,profession,forfor itsits professionalprofessional credentialingcredentialing partner,partner, forfor allall associatedassociatededucationaleducational trainingtraining programsprograms andand forfor individualindividualpathologists’pathologists’ assistantsassistants;; providingproviding allall AAPAAAPA membersmembers withwithhighhigh quality,quality, targetedtargeted continuingcontinuing educationeducation (CE)(CE)opportunitiesopportunities asas wellwell asas professionalprofessional developmentdevelopment andandleadershipleadership activities,activities, includingincluding networkingnetworking andand supportsupport..TheThe AAPAAAPA strivesstrives toto promotepromote andand supportsupport highhigh qualityqualitystandardsstandards withinwithin thethe scopescope ofof practicepractice forfor pathologists’pathologists’assistantsassistants inin anatomicanatomic pathology,pathology, therebythereby ensuringensuring thetheprovisionprovision ofof highhigh qualityquality patientpatient carecare..
AAPA Member BenefitsAAPA Member Benefits
�� The premier source of continuing education for The premier source of continuing education for
pathologists’ assistants.pathologists’ assistants.
�� The AAPA is an approved provider of continuing The AAPA is an approved provider of continuing
education programs in the clinical laboratory education programs in the clinical laboratory
sciences through the ASCLS PACE programsciences through the ASCLS PACE program
�� Job Listing and HotlineJob Listing and Hotline
�� Group malpractice insuranceGroup malpractice insurance
�� Career and professional networkingCareer and professional networking
AAPA Member BenefitsAAPA Member Benefits
�� Annual educational conference offering CMEAnnual educational conference offering CME
�� Workshops including:Workshops including:
�� Pediatric PathologyPediatric Pathology
�� OffOff--site gross lung pathology site gross lung pathology
�� Teaching residents and medical students surgical & Teaching residents and medical students surgical &
autopsy prosectionautopsy prosection
�� Upcoming meetings Upcoming meetings
�� 2012 Miami, Florida2012 Miami, Florida
�� 2013 Portland, OR2013 Portland, OR
�� 2014 New York City, NY2014 New York City, NY
AAPA Member BenefitsAAPA Member Benefits
Quarterly journal Quarterly journal
“The Cutting Edge”“The Cutting Edge”“The Cutting Edge”“The Cutting Edge”
AAPA Contact InformationAAPA Contact Information
American Association of Pathologists’ AssistantsAmerican Association of Pathologists’ Assistants
1711 W. County Road B1711 W. County Road B
Roseville, MN 55113Roseville, MN 55113
11--800800--532532--AAPA or 651AAPA or 651--697697--92649264
http://www.pathasst.org
Clinical Laboratories Improvement Clinical Laboratories Improvement
Amendments of 1988 (CLIA 88)Amendments of 1988 (CLIA 88)
�� CLIA sets standards designed to improve CLIA sets standards designed to improve
quality in all laboratory testing and including:quality in all laboratory testing and including:
�� Specifications for quality controlSpecifications for quality control
�� Specifications for quality assuranceSpecifications for quality assurance�� Specifications for quality assuranceSpecifications for quality assurance
�� Patient test managementPatient test management
�� Personnel and proficiency testingPersonnel and proficiency testing
Clinical Laboratories Improvement Clinical Laboratories Improvement
Amendments of 1988 (CLIA 88)Amendments of 1988 (CLIA 88)
�Personnel and proficiency testing
� PAs: Must meet educational
requirements for high-complexity
testing testing
� Associate degree minimum
American Society of Clinical Pathology (ASCP)American Society of Clinical Pathology (ASCP)
� Celebrating 83th anniversary (1928-2011)
� Over 130,000 laboratory members in the
following fields:
� Technician Certification Technician Certification
� AT, DPT, HT, MLT, PBT
� Technologist Certification
� BB, C, CT, H, HTL, MT, M, MP
� Specialist Certification
� SBB, SC, SCT, HP, SH, SLS, SM, PA
� Diplomate Certification -DLM
� International ASCPi Certification
� MT, MLT, MP, PBT
American Society of Clinical Pathology (ASCP)American Society of Clinical Pathology (ASCP)
�� Fall, 2004: Memorandum of Understanding Fall, 2004: Memorandum of Understanding
(MOU) formed between the ASCP Board of (MOU) formed between the ASCP Board of
Certification (BOC) and the AAPACertification (BOC) and the AAPA
�� Only professional certification for pathologists' Only professional certification for pathologists'
assistants: PA(ASCP)assistants: PA(ASCP)
�� To date >95%To date >95% of AAPA members are ASCP of AAPA members are ASCP
certifiedcertified
�� Contact information:Contact information:
www.ascp.orgwww.ascp.org
ASCP Board of Certification (BOC)ASCP Board of Certification (BOC)
�� What is certification?What is certification?
�� ASCP recognizes an individual as having the ASCP recognizes an individual as having the
necessary competence and having met necessary competence and having met
predetermined qualifications to perform the predetermined qualifications to perform the predetermined qualifications to perform the predetermined qualifications to perform the
medical laboratory roles they seek medical laboratory roles they seek
�� Pathologists’ Assistant (PA) certification Pathologists’ Assistant (PA) certification
requires:requires:
�� Successful completion of NAACLS accredited Successful completion of NAACLS accredited
PA programPA program
ASCP Certification Maintenance Program (CMP)ASCP Certification Maintenance Program (CMP)
�� PAs must participate in the BOC CMP to renew PAs must participate in the BOC CMP to renew
certificationcertification
�� Certification is timeCertification is time--restricted to 3 yearsrestricted to 3 years
�� Requires 45 points of continuing education over three Requires 45 points of continuing education over three
year period:year period:year period:year period:
�� 1 point in safety1 point in safety
�� 20 points in anatomic pathology20 points in anatomic pathology
�� 24 points in the areas of anatomic pathology, 24 points in the areas of anatomic pathology,
management, education, or other clinical specialtiesmanagement, education, or other clinical specialties
State Licensure & Regulatory IssuesState Licensure & Regulatory Issues
�� The AAPA’s Legislative Committee monitors The AAPA’s Legislative Committee monitors
legislative & regulatory issues of interest to PAs.legislative & regulatory issues of interest to PAs.
�� The AAPA is working with the American Society of The AAPA is working with the American Society of
Clinical Laboratory Science (ASCLS) to draft Clinical Laboratory Science (ASCLS) to draft
language specific to Pathologists’ Assistants for language specific to Pathologists’ Assistants for
inclusion in their “ Licensure Guide Bill”, a template inclusion in their “ Licensure Guide Bill”, a template
bill used by individual state ASCLS chapters to bill used by individual state ASCLS chapters to
create state licensure for clinical laboratory create state licensure for clinical laboratory
professionals.professionals.
Part 2: The Role of the Pathologists’ Assistant Part 2: The Role of the Pathologists’ Assistant
in Different Practice Settingsin Different Practice Settings
�� Role of the Pathologists’ AssistantRole of the Pathologists’ Assistant
�� Scope of Practice Scope of Practice
�� Practice SettingsPractice Settings
University Medical CentersUniversity Medical Centers�� University Medical CentersUniversity Medical Centers
�� Community HospitalsCommunity Hospitals
�� Commercial LaboratoriesCommercial Laboratories
�� Medical Examiner/ Forensic FacilitiesMedical Examiner/ Forensic Facilities
�� StatisticsStatistics
Role of the Pathologists’ AssistantRole of the Pathologists’ Assistant
Under the direction of a pathologist:Under the direction of a pathologist:
�� Grossing of all specimen typesGrossing of all specimen types
�� Autopsies Autopsies
�� Training of peers & pathology residentsTraining of peers & pathology residents�� Training of peers & pathology residentsTraining of peers & pathology residents
�� Frozen section preparationFrozen section preparation
�� QI/ QC/QAQI/ QC/QA
�� Laboratory managementLaboratory management
�� Regulatory RequirementsRegulatory Requirements
�� Tissue banking / researchTissue banking / research
Scope of PracticeScope of Practice
Section A. DefinitionSection A. Definition
�� A pathologists assistant is qualified by academic A pathologists assistant is qualified by academic
and practical training to provide, under the and practical training to provide, under the
direction and supervision of a licensed, Board direction and supervision of a licensed, Board
certified, or Board eligible pathologist, the certified, or Board eligible pathologist, the
following services:following services:
Scope of Practice: Surgical PathologyScope of Practice: Surgical Pathology
Preparation, gross description and dissection of Preparation, gross description and dissection of
human tissue surgical specimens including:human tissue surgical specimens including:
a) Assuring appropriate specimen accessioning.a) Assuring appropriate specimen accessioning.
b) Obtaining pertinent clinical information and b) Obtaining pertinent clinical information and b) Obtaining pertinent clinical information and b) Obtaining pertinent clinical information and
history, including scans, xhistory, including scans, x--rays, laboratory data rays, laboratory data
etc.etc.
Scope of Practice: Surgical PathologyScope of Practice: Surgical Pathology
c. c. Grossing
� Describing gross anatomic features of surgical
specimens
Preparing tissues for histological processingPreparing tissues for histological processing
Scope of Practice: Surgical PathologyScope of Practice: Surgical Pathology
c. Grossing
� Obtaining biological samples such as blood, tissue
and toxicological material for studies such as flow
cytometry, image analysis,
immunohistochemistry, etc.
� Performing special procedures including faxitron
imaging and tumor triage
Scope of Practice: Surgical PathologyScope of Practice: Surgical Pathology
d) Preparing and submitting appropriate tissue sections for:
� light microscopy (routine processing)
� frozen section
electron microscopy� electron microscopy
� immunoflourescence microscopy
Scope of Practice: Surgical PathologyScope of Practice: Surgical Pathology
e) Photographing all appropriate gross specimens
and microscopic slides.
Scope of Practice: Surgical PathologyScope of Practice: Surgical Pathology
f. Performing duties relating to the administrative
maintenance of surgical pathology protocols,
reports and data:
� filing of reports, protocols, photographic data or
slide, microscopic slides
� assisting in the completion of specimen coding
and billing
Scope of Practice: Surgical PathologyScope of Practice: Surgical Pathology
g. Assuring proper maintenance of equipment,
provision of adequate supplies and cleanliness of
the surgical pathology suite.
Scope of Practice: Surgical PathologyScope of Practice: Surgical Pathology
h. Assisting in the organization and coordination of
anatomic pathology conferences.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
Preparation of human postmortem examination,
including:
a. Ascertaining proper legal authorization for
autopsy.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
b. Obtaining patients medical record/ chart and
other pertinent data for review with the
attending pathologist.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
c. Conferring with the attending pathologist(s) to identify any special techniques and procedures to be utilized in the completion of examination (e.g. cultures smears; histochemical, immunofluorescence, toxicological, viral or immunofluorescence, toxicological, viral or electron microscopic studies, etc.), and notifying all personnel directly involved.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
d. Notifying the physician in charge, the funeral
home, and all other appropriate authorities prior
to the beginning of the autopsy; and coordinating
any requests for special specimen sampling (e.g.
organ transplantation, research, etc.).organ transplantation, research, etc.).
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
e. Performing postmortem examinations which may
include: external examination; in situ organ
inspection; evisceration; dissection and dictation
or recording of data such as organ weights,
presence of body fluids, gross anatomic findings, presence of body fluids, gross anatomic findings,
etc.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
f. Selecting, preparing and submitting appropriate
gross tissue sections for frozen section analysis as
well as electron microscopy and
immunofluorescence.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
g. Obtaining biological specimens such as blood,
tissue and toxicological material for studies
including flow cytometry, image analysis,
immunohistochemistry, etc.;
and performing special procedures such as
coronary artery perfusion, central nervous system
perfusion, enucleation, inner ear bone dissection,
spinal cord removal, etc.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
h. Photographing the body, organs, microscopic
slides and other pertinent materials.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
i. Gathering and organizing clinical information and
data pertinent to the preparation of the
preliminary summarization of the clinical history.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
j. Preparing the body for release, (including
indicating the presence of biohazards such as
contagious diseases, radiation implants, etc.) and
releasing the body to the appropriate mortuary or
funeral home representative.funeral home representative.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
k. Performing duties related to administrative
maintenance of anatomic pathology protocols;
photographic and microscopic slides; and
assuring the completion of coding.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
l. Assisting in the organization and coordination of
anatomic pathology conference.
Scope of Practice: Autopsy PathologyScope of Practice: Autopsy Pathology
m. Assuring the proper maintenance of equipment,
the provision of adequate supplies.
The Role of the Pathologists’ Assistant in The Role of the Pathologists’ Assistant in
Different Practice SettingsDifferent Practice Settings
The Role of the Pathologists’ Assistant in The Role of the Pathologists’ Assistant in
Different Practice SettingsDifferent Practice Settings
� PA Practice Settings
� University Medical Centers
� Community Hospitals
� Commercial Laboratories� Commercial Laboratories
� Medical Examiner/ Forensic Facilities
Pathologists’ Assistant Practice SettingsPathologists’ Assistant Practice Settings
� University Medical Centers
� Teaching of residents, PAs, medical student
and others
� Management responsibilities� Management responsibilities
� Staffing
� Scheduling
� Budgets
� Committee responsibilities
Pathologists’ Assistant Practice SettingsPathologists’ Assistant Practice Settings
�Community Hospitals
� Surgical & autopsy pathology
responsibilities
� May be involved in teaching� May be involved in teaching
� May cover multiple sites
Pathologists’ Assistant Practice SettingsPathologists’ Assistant Practice Settings
�� Commercial LaboratoriesCommercial Laboratories
� Often more than one PA in practice
� May cover multiple sites
� May work different shifts� May work different shifts
� Usually no autopsy responsibilities
Pathologists’ Assistant Practice SettingsPathologists’ Assistant Practice Settings
� Medical Examiner/ Forensic Facilities
� Less common practice site
� Autopsy only
Pathologists’ Assistants in the United States Pathologists’ Assistants in the United States
Current StatisticsCurrent Statistics
� Current membership: 1,484
� # Respondents: 540 (36%)
� Respondent Membership Status:
� Fellow 92%� Fellow 92%
� Associate 2%
� Student 6%
� ASCP Certified:
� Yes 94%
� No 6%
Source: 2010 AAPA Membership SurveySource: 2010 AAPA Membership Survey
Practice SettingsPractice Settings
�� Community HospitalCommunity Hospital 43%43%
�� Academic/University HospitalAcademic/University Hospital 25%25%
�� Private Group Private Group 26% 26%
�� HMO HMO 1%1%�� HMO HMO 1%1%
�� Other Other 5% 5%
Approximately how many surgical specimens are Approximately how many surgical specimens are
processed in your practice setting per year?processed in your practice setting per year?
� 1-20,000 37 %
� 20,001-30,000 23 %
� 30,001-40,000 13 %
40,000+ 27 % � 40,000+ 27 %
What is the total number of surgical cases What is the total number of surgical cases
you gross per year?you gross per year?
� 0-5,000 18%
� 5,001-10,000 29%
� 10,001-15,000 32%
15,001-20,000 12% � 15,001-20,000 12%
� 20,001-25,000 5%
� 25,001+ 4%
On the average day, how many hours per day On the average day, how many hours per day
do you spend grossing tissue?do you spend grossing tissue?
� 0-2 8%
� 2-4 11%
4-6 30 % � 4-6 30 %
� 6-8 47 %
� 8+ 4 %
What percentage of your time is spent What percentage of your time is spent
grossing tissue?grossing tissue?
�� 00--25% 25% 9% 9%
�� 2626--50% 50% 9% 9%
�� 5151--75% 75% 26% 26% �� 5151--75% 75% 26% 26%
�� +76% +76% 56% 56%
What are your job responsibilities?What are your job responsibilities?
� Grossing 94%
� Gross photography 80%
� Frozen Section 67%
� Prosecting 44%
� Non-resident teaching 38% � Non-resident teaching 38%
� Resident teaching 32%
� Administration/ management 32%
� Tissue banking 31%
What are your job responsibilities?What are your job responsibilities?
� Supply maintenance 30%
� Preparing autopsy reports 23%
� Conference preparation 18%
� Research 16% � Research 16%
� Photomicroscopy 8%
What areas do you manage or supervise?What areas do you manage or supervise?
� Cytology 7%
� Histology 12%
� Gross Room 77%
� Autopsy 36%� Autopsy 36%
� QA/QC 19%
� Frozen section room 39%
� Other PAs 29%
� Other 20%
Are you involved in a pathology residency Are you involved in a pathology residency
program?program?
� Yes 30%
� No 70%
Are there other Pathologists' Assistants at Are there other Pathologists' Assistants at
your workplace?your workplace?
� Yes 75%
� No 25%
Are you satisfied with your career as a Are you satisfied with your career as a
pathologists' assistant?pathologists' assistant?
� Yes 95%
� No 5%
What is your base salary in US dollarsWhat is your base salary in US dollars
(EXCLUDING benefits, bonuses)?(EXCLUDING benefits, bonuses)?
� Average Salary : $ 85,000 – $90,000
� Range: $50,001 - $150,000
� 2011 starting salary for new graduates 2011 starting salary for new graduates
$85,000 (range: $70-90K)
Note: Factors that influence a PA’s salary
include experience, workload, setting and
regional cost of living.
Future Outlook for PA ProfessionFuture Outlook for PA Profession
�� Promising outlookPromising outlook
�� Increasing number of available positionsIncreasing number of available positions
�� New training programs New training programs
Questions?Questions?
�� Contact Information:Contact Information:
Anne WalshAnne Walsh--FeeksFeeks
email: email: [email protected]@nshs.eduemail: email: [email protected]@nshs.edu
Phone: (516) 823Phone: (516) 823--83398339
The relationship between
pathologists and pathologists’
assistants
Mamoun Younes, M.D.Professor of Pathology
University of Texas Health Science Center at Houston
Houston, TX, USA
PA in Anatomic Pathology
• FS
• Biopsies
• “Routine” surgical pathology
• Autopsy• Autopsy
• Teaching
• Quality assurance/management
• Billing, coding, compliance
• Administrative duties
In the Frozen Section RoomIn the Frozen Section Room
PA First thing a.m. …
• Review OR schedule
• Highlight cases with potential FS
• Search computer database for relevant previous path
• Writes case # and DX on OR schedule next to pt. • Writes case # and DX on OR schedule next to pt.
name
• Calls Histology lab: send slides and copy of path
reports to FS room
Pathologist first thing …
• Copy of the OR schedule already has the previous path case numbers, dates and diagnoses written next to each patient name, and previous slides ready for review.
• on occasions, we have alerted the surgeon for potential mishaps
PA most helpful when ..
• 3 or more specimens come in together or within minutes of each other
• surgeon walks in, wanting his/her specimen to be done first
It is not practical or cost-effective to have several pathologists come help in FS room
The PA appropriately grosses specimens, takes pictures, correctly identifies and labels margins, pictures, correctly identifies and labels margins, identifies potential lesions and submits appropriate sections for FS.
• Cut and stain frozen sections when the histotech
is overwhelmed.
• After the frozen section is done, may gross large • After the frozen section is done, may gross large
specimens in FS room
• specimen photography
• freezing tissue samples for tissue banking
The PA on BiopsyThe PA on Biopsy
• Train residents on grossing biopsies, how
to submit larger polyps, skin ellipses, ..
• Some may have PAs do a lot of biopsies;
in other practices only help if needed
“Routine” surgical pathology“Routine” surgical pathology
• Initially the PAs train the residents and Fellows
• Later, they gross side by side, different
specimens; PAs provide help when neededspecimens; PAs provide help when needed
• Search for additional lymph nodes
• re-examine the specimen and submit
additional sections, as needed, if findings additional sections, as needed, if findings
in sections submitted by resident do not
match or correlate with gross or history
• Help draft grossing room and frozen
section room procedures, help with
grossing manuals, ..grossing manuals, ..
Autopsy
• performing the prosection themselves
• teaching and assisting • teaching and assisting
• In most instances, the pathologist goes to
the autopsy suite after prosection is
completed to examine the findings, review
the organs, and do on site clinical the organs, and do on site clinical
pathological correlation
Teaching
• Grossing, autopsy, photography, quality
assurance, coding and compliance to all
incoming residents and fellows.
• In some institutions, PAs are given Faculty
positions, starting at the “Instructor” level.
Quality assurance (QA)
• Select cases for review: random selections and targeted selections
• Distributing cases for review by • Distributing cases for review by subspecialty
• Collect and report results and track performance.
• At end of review, results are given to pathologist
in charge of QA for further action
• QA results are forwarded to our clients as • QA results are forwarded to our clients as
aggregate statistics.
Billing, coding, and compliance
• review ALL path reports for billing errors and corrections before they go out to the billing company.
• Also check these reports for errors in diagnosis, typographical errors, omissions, inappropriate typographical errors, omissions, inappropriate sampling, uncommon diagnosis rendered by a generalist without consulting a specialist, or diagnosis unexpected from history or contradict previous DX: cases picked up for QA review (targeted review)
Integrating PAs into pathology
practicepractice
Before a PA starts working for you
• make sure he/she received adequate
training.
• Know their strengths and weaknesses
When they start working for you
• Observe them carefully when they start the job
• Go over their gross description • Go over their gross description thoroughly
Team work:
• be open minded to learning from their • be open minded to learning from their
experience, but also tell them how you like
them to do things according to the way
you practice (if necessary).
• have them sit with you at the microscope if
they express interest to correlate with the
gross.
• If interested but have no time to sit at the
microscope, give feedback
• the more you educate your PA, and the
more he or she feels part of the team, the
better job they will do for you and your
patients.