NICE JOB missing Cervical Cancer

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Anonymous said:
There are other labs with similar problems. Quality is only an after thought when it comes to turn around time and pushing down costs. Speed not only kills but is error prone. Many of the ThinPreps read there are labeled, but don't have patient names on them. How this passed inspection is a mystery. Techs do not get monthly tissue correlation reports, that is, unless they had false negatives. Heaven help if you mention anything to anyone about stuff like this. You are immediately jacketed as a trouble maker and there will be retaliation. You have to be made an example of. How else will the rest of the troops understand the codes/standards of behavior?

Want a few suggestions? Start encouraging cytotech participation in professional organizations, attending seminars for real continuing education.The occasional CAP tests are good, but are no substitute for lectures with lab sessions from pros who not only read the books but wrote them. There are cases have been missed because the abnormal cells were seen but misdiagnosed. Put people in technical positions who are experienced and skillful. It is suck a waste to underutilize gifted employees. Especially when some insecure opportunist feels threatened by them. To place a person in this type of position because the soulless tool is a mere opportunist who meets the minimum legal requirements to hold the position, shows a deep contempt and disrespect of the profession. It makes the thought of peer review, quite frankly, a joke.
As far as the Image Guided methodology goes, it would be fine if used as an assistant, but as long as it is used as a primary screener, there will continue to be the problems of procedure over content. In the criminal justice system, there is a rule which implies that procedure is more important than truth in the sense that we are only promised "due process." and truth of guilt or innocence is not promised. When one uses the Imaged Guided Scope, one accepts the same principle . To follow the manufacturer's recommendations is to satisfy the lab's standard of care. Hopefully, this will soon change.

There is nothing wrong with color coding cases as stat or priority one. However, priority cases should mean what they say, take priority, and must be read and signed first without the time restriction. This will not cost a cent but will enhance quality.

Become well known for quality test results and not how quickly you can turn out a result.
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Oops! Should have said "....shows a deep contempt and disrespect FOR the profession." Wouldn't want tight ass's head to explode.
 






Anonymous said:
There are other labs with similar problems. Quality is only an after thought when it comes to turn around time and pushing down costs. Speed not only kills but is error prone. Many of the ThinPreps read there are labeled, but don't have patient names on them. How this passed inspection is a mystery. Techs do not get monthly tissue correlation reports, that is, unless they had false negatives. Heaven help if you mention anything to anyone about stuff like this. You are immediately jacketed as a trouble maker and there will be retaliation. You have to be made an example of. How else will the rest of the troops understand the codes/standards of behavior?

Want a few suggestions? Start encouraging cytotech participation in professional organizations, attending seminars for real continuing education.The occasional CAP tests are good, but are no substitute for lectures with lab sessions from pros who not only read the books but wrote them. There are cases have been missed because the abnormal cells were seen but misdiagnosed. Put people in technical positions who are experienced and skillful. It is suck a waste to underutilize gifted employees. Especially when some insecure opportunist feels threatened by them. To place a person in this type of position because the soulless tool is a mere opportunist who meets the minimum legal requirements to hold the position, shows a deep contempt and disrespect of the profession. It makes the thought of peer review, quite frankly, a joke.
As far as the Image Guided methodology goes, it would be fine if used as an assistant, but as long as it is used as a primary screener, there will continue to be the problems of procedure over content. In the criminal justice system, there is a rule which implies that procedure is more important than truth in the sense that we are only promised "due process." and truth of guilt or innocence is not promised. When one uses the Imaged Guided Scope, one accepts the same principle . To follow the manufacturer's recommendations is to satisfy the lab's standard of care. Hopefully, this will soon change.

There is nothing wrong with color coding cases as stat or priority one. However, priority cases should mean what they say, take priority, and must be read and signed first without the time restriction. This will not cost a cent but will enhance quality.

Become well known for quality test results and not how quickly you can turn out a result.
Click to expand...
I don't get it. What is priority one? Aren't slides read in the sequential order they entered the lab's system IT? I can see the need for the stat cases, but what makes some client's patient results more important than others? Does LCA have a rule that all paps have to be resulted within 24 to 48 hours? So why the rush? Can someone explain what the deal is?
 






Anonymous said:
I don't get it. What is priority one? Aren't slides read in the sequential order they entered the lab's system IT? I can see the need for the stat cases, but what makes some client's patient results more important than others? Does LCA have a rule that all paps have to be resulted within 24 to 48 hours? So why the rush? Can someone explain what the deal is?
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I asked around, and was told that some clients are targeted as priority in order to make a good impression. They are supposed to be resulted before all other clients and by noon each day.
 






























Anonymous said:
the CDC has made these recommendations regarding workload limits:

http://www.cytopathology.org/wp-content/uploads/2013/05/6429.pdf
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Thanks for the information. Finally. here are some propositions that makes sense. The ASC is doing the workload survey now. For the health of patients, I hope these guidelines will soon become law. 70 slides in a 24hr period is a a vast improvement when you count in the 15% to 20%+ that are imaged with a full manual review. This is the first time that fatigue has been considered. Great work!

It would be so edgy and intelligent if LH would make the guidelines policy before they are forced to do so. It would at least give the impression that they give a shyt. The missed cases that resulted in the death of that woman is bad news for LH's reputation.
 






Thanks for the information, Poster #45. Finally. here are some propositions that makes sense. The ASC is doing the workload survey now. For the health of patients, I hope these guidelines will soon become law. 70 slides in a 24hr period is a a vast improvement when you count in the 15% to 20%+ that are imaged with a full manual review. This is the first time that fatigue has been considered. Great work!

It would be so edgy and intelligent if LH would make the guidelines policy before they are forced to do so. It would at least give the impression that they give a shyt. The missed cases that resulted in the death of that woman is bad news for LH's reputation.
 












This situation will soon take care of itself and a lot of your revenue. The College of American Obstetrics/Gynecology has now recommended pap smears only be performed on most patients every five years. If a patient has had multiple normal smears, there won't be another pap performed for five years. Volume and revenue will decline as a result. Most of my clients order HPV with the pap. If the pap goes, so does the HPV. I'm sure we will be challenged to recoup the revenue.
 






Anonymous said:
This situation will soon take care of itself and a lot of your revenue. The College of American Obstetrics/Gynecology has now recommended pap smears only be performed on most patients every five years. If a patient has had multiple normal smears, there won't be another pap performed for five years. Volume and revenue will decline as a result. Most of my clients order HPV with the pap. If the pap goes, so does the HPV. I'm sure we will be challenged to recoup the revenue.
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Those recommendations make sense. However, they are only guidelines and it is up to the woman when and if she gets a Pap and there are millions of women and a few thousand cytotechnologists. HPV testing is helpful, but it is not everything. The semi automated imaging scope is helpful also, but under present daily slide limits it has serious limitations. Although the rules state that it is up to the lab director (just higher paid tools) to establish daily slide limits for each cytotech, as if that gives it some kind of credibility, everyone knows that you won't have a job if you don't do the max, no matter how excellent or poor your stats look. High volumes may increase revenues but lower accuracy for a number of reasons that I won't go into now. I will say that the Imager is no where near perfect and there are a high number of false positive HPV gen probe test results. The HPV test is used best when used to confirm if an ASCUS + pap result is High Risk Hpv positive.
You really have to work in the field to see the reality of the situation. When you sell, you only believe what you are told. The new daily slide limits are lower and much safer for patients. No one likes hearing about patients dying because of false negative Paps read at Pap mill sweat shops. Who wants to go back to the 1980's? But if something is not done soon, it is going to be worse than the 80's.

By the way, I would just like to ask one question. What happened to pathologists who were born in the USA, graduated from a university and then went to medical school, etc. and had real integrity? Are there any around. I have seen ambitious, but never seen such diabolical
behavior in a person with MD after the name. I often as myself, what kind of enviroment does a person like this come from?
 






There was a time when this company recruited American trained, reputable pathologists through a corporate department. That department no longer exists and the local lab managers hire the pathologists based on how cheap they can get them. Does this answer your question?
 






Anonymous said:
There was a time when this company recruited American trained, reputable pathologists through a corporate department. That department no longer exists and the local lab managers hire the pathologists based on how cheap they can get them. Does this answer your question?
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Yes, thank you. Corporate should really rethink this. Do you know that foreign doctors do not go to college? They just go from secondary school directly into medical school. Some have the good fortune of landing a fellowship at an American university. Most others take the time to study for the exam here, and if they pass, they are allowed to practice medicine. They get through Immigration by using the scarcity within the field excuse.

What happened to the idea of America first? Born in the USA means nothing anymore. And as was pointed out to me, having a diabolical nature is a large portion of the charm necessary to make someone like this stand out in the crowd,This economy sucks, especially for those BORN in the USA. Lab managers may get over by making decisions on the cheap now, but everyone will sooner or later pay up in more ways than one. But then, how many Lab Managers were borm in the USA?
 






Anonymous said:
Listen idiot. HPV testing will never be a primary test so you can get over it and be happy that there is a Pap test. It is not perfect by any means but with the help of ancillary testing, is the best thing going. The biopsy is and will continue to be the gold standard, and it is not perfect either. If you want to know why, read some earlier posts to earlier threads. If the FDA was doing its job, how could labs that use the Imager force cytotechs to screen so many slides? There have been numerous complaints made and still the beat goes on.
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Actually your the idiot. The Pap test is a horrid screening tool for Cervical cancer with a positive predictor value of around 15%. There are a variety of test out there that are much better for predicting cervical cancer (regardless of HPV genotype). Just shows the lack of knowledge that runs around this place. The reps here are pathetic and have no idea of clinical knowledge, clinical sell or education. Its rather comical to be honest.
 






Anonymous said:
Actually your the idiot. The Pap test is a horrid screening tool for Cervical cancer with a positive predictor value of around 15%. There are a variety of test out there that are much better for predicting cervical cancer (regardless of HPV genotype). Just shows the lack of knowledge that runs around this place. The reps here are pathetic and have no idea of clinical knowledge, clinical sell or education. Its rather comical to be honest.
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Now you are worse than an idiot because you are an arrogant pretender clowning yourself. You have better tests? Name them. The Pap is a relatively inexpensive test that is meant to identify abnormal cells. That is, before they develop into cervical cancer which is the whole point. Most HPV never progresses because within 6 to 18 months, the body's own immune system gets rid of it. Predict that. So what do you suggest? Go straight to colposcopy/biopsy after one of your positive test results? Or just give her a hysterectomy?
 






Anonymous said:
Yes, thank you. Corporate should really rethink this. Do you know that foreign doctors do not go to college? They just go from secondary school directly into medical school. Some have the good fortune of landing a fellowship at an American university. Most others take the time to study for the exam here, and if they pass, they are allowed to practice medicine. They get through Immigration by using the scarcity within the field excuse.

What happened to the idea of America first? Born in the USA means nothing anymore. And as was pointed out to me, having a diabolical nature is a large portion of the charm necessary to make someone like this stand out in the crowd,This economy sucks, especially for those BORN in the USA. Lab managers may get over by making decisions on the cheap now, but everyone will sooner or later pay up in more ways than one. But then, how many Lab Managers were borm in the USA?
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Fkn A
 












Anonymous said:
There are other labs with similar problems. Quality is only an after thought when it comes to turn around time and pushing down costs. Speed not only kills but is error prone. Many of the ThinPreps read there are labeled, but don't have patient names on them. How this passed inspection is a mystery. Techs do not get monthly tissue correlation reports, that is, unless they had false negatives. Heaven help if you mention anything to anyone about stuff like this. You are immediately jacketed as a trouble maker and there will be retaliation. You have to be made an example of. How else will the rest of the troops understand the codes/standards of behavior?

Want a few suggestions? Start encouraging cytotech participation in professional organizations, attending seminars for real continuing education.The occasional CAP tests are good, but are no substitute for lectures with lab sessions from pros who not only read the books but wrote them. There are cases have been missed because the abnormal cells were seen but misdiagnosed. Put people in technical positions who are experienced and skillful. It is suck a waste to underutilize gifted employees. Especially when some insecure opportunist feels threatened by them. To place a person in this type of position because the soulless tool is a mere opportunist who meets the minimum legal requirements to hold the position, shows a deep contempt and disrespect of the profession. It makes the thought of peer review, quite frankly, a joke.
As far as the Image Guided methodology goes, it would be fine if used as an assistant, but as long as it is used as a primary screener, there will continue to be the problems of procedure over content. In the criminal justice system, there is a rule which implies that procedure is more important than truth in the sense that we are only promised "due process." and truth of guilt or innocence is not promised. When one uses the Imaged Guided Scope, one accepts the same principle . To follow the manufacturer's recommendations is to satisfy the lab's standard of care. Hopefully, this will soon change.

There is nothing wrong with color coding cases as stat or priority one. However, priority cases should mean what they say, take priority, and must be read and signed first without the time restriction. This will not cost a cent but will enhance quality.

Become well known for quality test results and not how quickly you can turn out a result.
Click to expand...

Isn't it convenient how all of a sudden certain supervisor/lab manager tools have this faux change of attitude toward productivity vs quality. What an act. For example, at a particular lab, cytotechs are ordered not to put difficult cases into Triage. Triage, they were told, is only for cases with atrophic vaginitis, trichomonas, Actinomyces, Herpes, and patients over age with endometrial cells present....types of cases that any tech worth his/her salt has not issue with. (SOP?) Perhaps these winds of lawsuits have created the fear of change. Like maybe LC will rethink its model of placing inexperienced, opportunistic yes men/ma'am in managerial positions because they are easily micromanaged and only motivated by personal gains. Perhaps they will actually recruit experienced, well trained, emotionally healthy professionals with integrity. How refreshing this could be.
These law suits have brought new meaning to "penny wise and pound foolish."
 






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