Lab West Upper Management?

Like the previous post asked, got any ideas? Nothing much has changed with the recommended screening intervals and the recommendations do makes sense. There has always been a lot of burnout in cytology and many cytology schools have closed due to saturation, but the field will be around for quite a while to come. In terms of gynecological Paps, do the math. How many women are there in the USA and how many cytotechnologists are there? With the passage of the Affordable Care Act, we look forward to more hospital labs to employ non-gynecologic testing in house. And if and when a cost/benefit analysis is done on the cost effectiveness of gynecological testing automated with screening devices, Hologic, the manufacturer (as a result of an exceptional expert marketing plan by the former Cytyc corp.) is the only real winner.

Only with more competition in the lab business and some strong enforcement of antitrust laws will things improve for those in the diagnostic portion of the business.

I highly doubt many hospitals are looking to bring non-gyn work in-house due to the affordable care act. PATHOLOGISTS sign those out anyways. YOu can have a histotech or other low cost employee go make slides on FNAs. The only thing a cytotech can do is sign out negative pap tests. That is the only real skill the schools gave them and they should be ashamed. More schools should close.
If anything in-office labs (urologists etc) will continue bringing NONGYN testing to THEIR facilities as work migrates out of hospital settings. Guess what, cytotechs arent employed in those places. They have a histotech and some low-cost pathologist, who signs everything out.
The screening devices were about 20 years too late. They wont have much of a shelf life. HOlogic knows it and adapted by buying gen-probe.
 






I highly doubt many hospitals are looking to bring non-gyn work in-house due to the affordable care act. PATHOLOGISTS sign those out anyways. YOu can have a histotech or other low cost employee go make slides on FNAs. The only thing a cytotech can do is sign out negative pap tests. That is the only real skill the schools gave them and they should be ashamed. More schools should close.
If anything in-office labs (urologists etc) will continue bringing NONGYN testing to THEIR facilities as work migrates out of hospital settings. Guess what, cytotechs arent employed in those places. They have a histotech and some low-cost pathologist, who signs everything out.
The screening devices were about 20 years too late. They wont have much of a shelf life. HOlogic knows it and adapted by buying gen-probe.

Jeez, who are you, because you should know what you are talking about if you are going to sell a service.

FYI Pap is a staining process and a system of classification named for Papanicalou. It does not you the source of the specimen. Cytotechnolgists are NOT histotechnologists. Unlike histotechs who do not diagnose, cytotechnologist do participate in the diagnostic process.

Cytotechnologists are highly skilled laboratory scientists. Who do you think reads the non-gyn FNA's before the pathologist signs them out at LabCorp ????Cytotechs can do the prep work, but most often a technician preps the slides under the supervision of a cytotech. Cyotech's have always read non-gynecological specimens. They are trained in cytology school to prep and read them. In fact, you cannot take or pass the ASCP certification examination unless you have been trained to read non-gynecological specimens.

And yes, the pupose of the Cytotechnologist is to screen out the abnormal cases so that they may be reviewed by the Pathologist. This is a cost-effective time management solution. Only normal gyecological cases may be signed out by the cytotechnologist However, all non-gynecological specimens, whether normal or abnormal must be reviewed and signed out by the pathologist. By the time that abnormal gyn pap or the non-gyn sputum, urine, bladder washing, lymph node aspirate,salivary gland aspirates, Cerebral spinal fluids, thyroid aspirate, breast discharge or fine needle breast aspirate,anal smear, etc arrives on the pathologist's desk, it has been read: suspicious and neoplastic cells dotted, infectious agents dotted and noted, and diagnosed by the cytotechnolgist who has done most of the heavy lifting. I'll wager that you thought the pathologists were doing it all themselves, didn't you? Hater!
There will always be small labs who cut corners to make ends meet but you sound confused. In the first place, a urologist would not hire a cytotech any more than a gynecologist would hire a cytotech. The pathologist hires the cytotech to make his/her life easier, especially when there is a good volume of specimens.
Most of the major hospitals and many small ones employ cytotechs.And in most of these hospitals they spend more time doing non-gynecological screening than reading gyn Paps. Try UCLA, Little Company of Mary, San Pedro Hospital, Cedars Sinai,Kaiser Permanente, Long Beach Memorial, the St John's Hosipals, the VA hospitals,...etc..I could go on.

You sell for LabCorp and you don't know this and you have an attitude too??? OMG!!!
 






There is no regulation that says the Cytotech has to prep cytology specimens or pre-screen nongyns. Just because you are taught to do them doesnt mean anything. YOu can use a much lower cost employee to do prep work and just have the pathologist sign out the nongyns. They have a lot more training in ancillary techniques compared to cytotechs and its THEIR name that goes on the report. Like I said, the ONLY task a cytotech can really do is sign out 90 percent of negative pap tests on their own. With those going away, you better learn a new skill.

Histotechs are trained enough to look at special stains which is relied on much more than simple morphology nowadays. Histotechs have a lot more in demand skills nowadays. Their future isnt tied to the dying pap test.

Urologists and others are starting their own labs and keeping the specimens in-house, only hiring histotech(s) and pathologist(s). The nongyns are read out by the pathologist only. Go read up about it.
 






There is no regulation that says the Cytotech has to prep cytology specimens or pre-screen nongyns. Just because you are taught to do them doesnt mean anything. YOu can use a much lower cost employee to do prep work and just have the pathologist sign out the nongyns. They have a lot more training in ancillary techniques compared to cytotechs and its THEIR name that goes on the report. Like I said, the ONLY task a cytotech can really do is sign out 90 percent of negative pap tests on their own. With those going away, you better learn a new skill.

Histotechs are trained enough to look at special stains which is relied on much more than simple morphology nowadays. Histotechs have a lot more in demand skills nowadays. Their future isnt tied to the dying pap test.

Urologists and others are starting their own labs and keeping the specimens in-house, only hiring histotech(s) and pathologist(s). The nongyns are read out by the pathologist only. Go read up about it.

Look, you really ought to stop hating. It is not that serious. No one said that a cytotech has to process the slides. Do you comprehend what you read? I said that they are trained to process but usually a trained prep person does the processing. Less expensive than a Cytotech or Histotech.

Furthermore, it is the pathologist who wants the cytotech. For example, the cytotech often assists with the specimen collection in the hospital setting. For true patient centered care, it is important for the cytotech to see the specimen or have as much clinical info as possible about the patient before reading the smears.

Didn't you learn through your sales training that cytotechs read all of the urines before they go to the pathologists at LabCorp? Why do you think that this is so? In this way, pathologists have more time to read tissue samples. Of course the pathologist is responsible for the final report. The purpose of the cytotech is to assist the pathologist.The cytotech is a technologist. The pathologist is a M.D. OH. That's right. You have a comprehension problem.

And like the previous post inferred, there will be an increase in preventative health care, testing like mammography and Pap smear testing with the ACA.

So some urologists and other docs are opening their own labs with part-time staff and don't hire cytotechs. Wonderful. Trust me, if their volume gets to a certain level, they will beg for a cytotech. Most pathologists don't want to screen negative smears---gyn or non-gyn unless they need a job.

Now why don't you go into the LCA anatomical pathology lab and ask the pathologists why they hire cytotechs because pathologists may legally screen gyn Paps the same way they screen urines. In fact some pathologist do.

So what is your story? Why the focus on urologists? Is that your specialty? Losing your client base? Must be frustrating for you.

Would you have a surgeon cut into you based on a positive gen probe? It is ancilary testing. Read up on that. What happened to rational thinking nowadays? The Pap will be around for a while to come.
 






Hologic bought Gen Probe to get their technology and increase market share by eliminating a competitor. The Imaging device could not have come any sooner than it did because it costs too much. The only reason that labs use it now is because it allows them to get around CLIA and the slide screening limit regulations. It makes money by eliminating jobs. The cytotech ends up working twice as hard for the same pay. You can go to other message boards to read what the cytotechs really think about the imaging device.

Genetic testing for HPV does not work as a stand alone test because it is an unreliable diagnostic tool. It only tells you if a patient has the virus which is a very common virus. Most often, the immune system takes care of it and it is out of the body within 6 to 18 months. The test says nothing about viral load or the viral load necessary to cause cellular changes. The new guidelines for Pap Smear testing are informed by this and tries to help to eliminate some of the unnecessary treatments and procedures that take place. Now there are always exceptions to the rule and that is what medicine is all about. The exceptions.That is the job of the clinician.
 






Hologic bought Gen Probe to get their technology and increase market share by eliminating a competitor. The Imaging device could not have come any sooner than it did because it costs too much. The only reason that labs use it now is because it allows them to get around CLIA and the slide screening limit regulations. It makes money by eliminating jobs. The cytotech ends up working twice as hard for the same pay. You can go to other message boards to read what the cytotechs really think about the imaging device.

Genetic testing for HPV does not work as a stand alone test because it is an unreliable diagnostic tool. It only tells you if a patient has the virus which is a very common virus. Most often, the immune system takes care of it and it is out of the body within 6 to 18 months. The test says nothing about viral load or the viral load necessary to cause cellular changes. The new guidelines for Pap Smear testing are informed by this and tries to help to eliminate some of the unnecessary treatments and procedures that take place. Now there are always exceptions to the rule and that is what medicine is all about. The exceptions.That is the job of the clinician.

You must be stuck in the past or something. This isnt 1999 anymore. Digene aint the only test out there. Go read some articles about the new generation hpv tests. The Gen-probe and roche hpv tests show high specificity for CIN3 and it looks like at least one of them (roche) is gonna try to get FDA approval for primary screening. Dont keep lying to yourself about the pap test. Its on its way out.
 






You must be stuck in the past or something. This isnt 1999 anymore. Digene aint the only test out there. Go read some articles about the new generation hpv tests. The Gen-probe and roche hpv tests show high specificity for CIN3 and it looks like at least one of them (roche) is gonna try to get FDA approval for primary screening. Dont keep lying to yourself about the pap test. Its on its way out.

LOL. And you still don't get it. Half the population has carried HPV at some time in life. So the test is more specific for some viruses that may cause high grade. Wonderful. If the gen probe is positive, this means you are carrying the virus and it does not mean that you have a neoplasm (meaning tumor, or precancerous leasion). If it is negative, it will not mean that you don't have a neoplasm. A positive Hpv test with a negative Pap means that further testing may be necessary. This is what is meant by the test being unreliable The test may correlate well with known cases of cancer or high grade neoplasia, but what about unknowns. What kind of sensitivity rate are your talking about? What do you want to do, give biopsies and/or hysterectomy based on positive gen probes because they are better able to detect some viruses that are high risk for cervical neoplasia. This has been tried. It does not work. As said previously, at some time in almost everybody's life they have carried the virus? The body rids itself of the virus like a case of the flu. But as with the flu, some go on to develop pnuemonia or other complications and die. Are you following the analogy?

If you think that this test is going to replace the Pap anytime soon, you are delusional. However, if we are fortunate, in the near future we will have single payer health care. Maybe you should follow your own advice. Btw, who are your representing anyway... Hologic or LCA ? Why do you care?
 






God, do you not read or what? Specific for CIN3, not HPV. Hell any HPV test can tell you that. CIN 3 is the endpoint. Read the data. Roche and possibly genprobe are going to try to get fda approval for primary screening.
 






God, do you not read or what? Specific for CIN3, not HPV. Hell any HPV test can tell you that. CIN 3 is the endpoint. Read the data. Roche and possibly genprobe are going to try to get fda approval for primary screening.[/QUOTE

Don't make me laugh.All that is helpful if it works. However,the whole point of screening is catching the disease in its EARLY stages and BEFORE it progresses to Severe Dysplasia/CIN3/CIS/Invasive Carcinoma, buddy. So what do you think is supposed to happen? Pap testing will be discarded because there will no longer be a need for early detection? A patient wll go straight from a positive Roche test to the to the LEEP or hysterectomy table? Get real.

Well why don't you just shout it out? No more pap smear testing will be necessary because as soon as Roche gets FDA approval of a test to for CIN3...ROFLMAO....
 












God, do you not read or what? Specific for CIN3, not HPV. Hell any HPV test can tell you that. CIN 3 is the endpoint. Read the data. Roche and possibly genprobe are going to try to get fda approval for primary screening.

LOL Mr. Cutting Edge in technology...Are you talking about Athena trials for the Cobas HPV test?..Hello! It IS just another HPV test. It uses PCR if my memory serves me. Please take some time to educate yourself before showing your ignorance on this board. Ignorance with an attitude. That is such an attractive characteristic. As stated in the earlier post, it is persistent HPV that causes cancer. Yes the Cobas test is specific for Hpv 16 and HPV 18 as well as the other high risk Hpv viruses which are known to be associated with high grade neoplasia.

Do you even understand what you are reading? And do you know what endpoint in a clinical trial actually means because it obviously does not mean what you think it means. It is a good thing. The test may be used with normal cytology or for reflex testing. It is still ancillary testing to enhance the effectiveness of Pap smear testing and early detection/prevention of cancer. It changes nothing. Like the other HPV tests, it supports the current guidelines for cancer screening.

You need to get up on the technology yourself. Why don't you take a statistics class while you are at it. It will make you a better sales rep. Take a chill pill and relax. You cannot stop progress. Who would want to, but everything in its time.
 






I think he might have been talking about the the San Diego company Hologic just bought. It uses a different technology. Instead of using DNA, it uses RNA in its probe. No FDA approval on it yet. I am sure they would like it to be used for primary testing, but ithas the same problems the other tests have......sensitivity.
 






I think he might have been talking about the the San Diego company Hologic just bought. It uses a different technology. Instead of using DNA, it uses RNA in its probe. No FDA approval on it yet. I am sure they would like it to be used for primary testing, but ithas the same problems the other tests have......sensitivity.

The RNA tests are much more specific. Its highly likely they will try to get FDA approval for primary screening. Roche wants that very much. Not so sure about gen-probe though.

THe pap will be the reflex test if its lucky.
 






The RNA tests are much more specific. Its highly likely they will try to get FDA approval for primary screening. Roche wants that very much. Not so sure about gen-probe though.

THe pap will be the reflex test if its lucky.

Dream on.RNA may be more specific, but it has the same sensitivity problems that all of the other tests have. The supposition that RNA was found to be more specific than DNA is on its face exciting. It is helpful that the test is specific for hpv 16 and 18. Awesome. But they have already tried it as a primary screener and it does not work . Want to know what happened? The women who tested positive on the Hpv test were sent directily for colposcopy/ biopsy. Most of the histology results came back negative. This is because you can be a carrier and be asymptomatic,or the virus can lie dormant and express itself later or much later,or the immune system could be doing its job, or the test could be a false positive. One can only imagine the litigation could stem from something like this.

Roche has a profit motive but what is in it for you and where is all of your hate coming from? The current guidelines are perfect at this stage of the game. The work just fime.
 






Someone update the rest of us as to how Monrovia is doing.
Heard it is the same sweatshop they all are, but I LOVED hearing about the "Adventures of SK"!!
Please, I'm bored-

Speaking of sweatshop. I hear that a pathologist missed a case recently and it's let's play "lets accuse a tech" again. My question is: what do expect? Why are screeners being blamed when under the current conditions, it is inevitable. Heard that Monrovia fired a bunch of long term techs and then increased the workload on the ones who were left. They have techs screening 100 slides that include Fluids and FNA's when 80 are way too many to be read reliably?

A friend tells me the techs are forced to do around 100 slides a day and this can include specimens like breasts, urines, thyroids, etc. Can you imagine screening 60 non gynecological slides that are mostly thick bloody thyroids and then given another 40 slides to screen on that automated microscope which include prior abnormal Paps that are to be correlated with current tissue reports. Think how hard would you have to push yourself to get through this stuff? Then the pathologists, who have slides stacked to the ceiling, are expected to rush out the reports in order to maintain some ridiculous TAT. These jerks obviously could care less about patient care. Yes, it is a business, but it is not piece work in a garment factory even though it seems to be run that way. And what is even worse is that they don't even have a supervisor who is competent in FNA's and Fluids in a lab of that size. Why? To save a few pennies?

I am grateful to work for a lab with a different ethic. When we report that we have reviewed the patient's previous slides, we actually review the slides with the current slides and document any discrepancy and count them in our workload.

I can tell you this. I know where my tests or for anyone in my family will NOT go.
 






Blaming and accusing is a tactic of divide, conquer and distract. It will pit pathologists against techs and distract from the serious issues. It is always easier to blame than it is to deal with the real problems by fixing the system.
 






I am confused. Aren't the Non-Gy cases equally distributed among the cytotechnologists each morning? If not, why not? This works to enhance turn-around-time and keep the cytotech's skills fresh and tight. It also takes some of that gratuitous unnecessary pressure off the system and why most other labs do it this way. Good grief! What a no brainer.
 






God, what physician would be stupid enough to send NOn-gyns and fnas to labcorp. LOL. Get ready to lose your jobs cytotechs. New pap intervals have killed your field. Retrain.