Opinions...Cytyc or Tripath(thinprep or surepath)

[Anonymous]

i have experienced the same problems, but what can anyone do about it?

Yes, especially when you are instructed that the imager is your friend because it picks up high grades. Oh, well, we all know that the imager misses sheets of low grade hpv. It's ok when the imager misses them but NOT if the tech misses them. Why that is a MAJOR Discrepancy and too many of those and you will be in serious trouble.After all, a missed low grade might actually be on tissue or become a high grade. Please. Will someone explain this logic to me because I am not feeling it. What I am sensing is that Hologic has a strong influence on management.

 

[Anonymous]

Yes, especially when you are instructed that the imager is your friend because it picks up high grades. Oh, well, we all know that the imager misses sheets of low grade hpv. It's ok when the imager misses them but NOT if the tech misses them. Why that is a MAJOR Discrepancy and too many of those and you will be in serious trouble.After all, a missed low grade might actually be on tissue or become a high grade. Please. Will someone explain this logic to me because I am not feeling it. What I am sensing is that Hologic has a strong influence on management.

Strong influence is a huge understatement, they are so in bed together it is not funny.
The only way that LC thinks it can make a few pennies on Paps is to max out every cyto out there, otherwise they lose money. PLus make sure that there are a lot of abnormals to trigger an HPV test, get it? LC is only concerned with the number of Imaged slides produced and Hologic dirbag reps are right there telling them that's the way to do it. You grease me and I'll grease you, sickening to know this goes on when dealing with patients.
Oh yah, and it's always the cytos fault if you haven't been told that yet, that's coming from both parties.

 

[Anonymous]

According to the Ms Hologic Douchebag, there are other labs who pass the abnormal FOV slides off to another tech who counts each as 1 FMR slide in order to enhance productivity.
More money for Hologic, more money for the lab. Tech is screwed.

Is this really happening now? LC or Q or both?
Do these techs also kick everything up to add an HPV test, or is that just the unspoken Pathologists rule?

 

[Anonymous]

Is this really happening now? LC or Q or both?
Do these techs also kick everything up to add an HPV test, or is that just the unspoken Pathologists rule?

No. Not everything. But there are games being played at times. For instance, if they want to cytot to quit, they will stop agreeing with his/her calls. Has nothing to do with how good the tech is. It is usually something political and this tech is being made an example of to scare everyone else. All of a sudden, all of the tech's ascus's become negative and all of the rest of that tech's calls are called up a step or down a step. If the tech stays on, the stats look like crap and is one of the first to get riffed. Now this is unspoken but understood. Dirty little secret, huh?

 

[Anonymous]

No. Not everything. But there are games being played at times. For instance, if they want to cytot to quit, they will stop agreeing with his/her calls. Has nothing to do with how good the tech is. It is usually something political and this tech is being made an example of to scare everyone else. All of a sudden, all of the tech's ascus's become negative and all of the rest of that tech's calls are called up a step or down a step. If the tech stays on, the stats look like crap and is one of the first to get riffed. Now this is unspoken but understood. Dirty little secret, huh?

Makes sense...pages and pages of the "disagree" sheet?? If u look closely many cases show up there and the final diagnosis is EXACTLY the same - but is the tech being called as a "disagree?"...hmmmm?

 

[Anonymous]

Makes sense...pages and pages of the "disagree" sheet?? If u look closely many cases show up there and the final diagnosis is EXACTLY the same - but is the tech being called as a "disagree?"...hmmmm?

I don't quite understand what you are asking. A diagnosis is entered on each case by the cytotech who did the initial screening. If the case is negative, the tech signs it out and it is reported to the client as negative. If the case is abnormal the tech enters his/her diagnosis and it is sent to the pathologist for review. If the pathologist agrees with the cytotech's diagnosis, it all good. If the pathologist disagrees with the cytotech's diagnosis, it is called a discrepancy, either minor or major. To the untrained eye, too many discrepant cases make the cytotech look bad for obvious reasons. HR doesn't really understand what is going on, and the HR at this company could care less anyway. The reality of the situation is that as a rule, cytotech's are much better at making a diagnosis on cytology than pathologists are and most everyone knows that. The wise pathologist relies on his tech. Stats are kept on the techs and the Pathologists. And yes, it is the cytotech who is discrepant, not the pathologist. That is unless the biopsy report supports the tech's diagnosis. And the lab actually provides tissue correlation to the cytotech and includes it in the stats.

How do you know if the tech is good? You know because most of the tissue biopsies correlate well with his/her diagnosis on cytology. On rare occasions a low grade intraepithelial neoplasm missed and will be picked up on the 10% negative quality control review. Seldom is an abnormal retro case missed/misinterpreted when a current case is found to be a high grade by cytology or biopsy and the 5 year retrospective review of all negative cases on that patient is done. The tech cares about the profession. keeps up with changes in the field, is knowledgeable, takes great pride in his/her work, and gives priority to the patient above all else.

Like many other professions,cytopathology has its sociopaths with psychopathic tendencies who for whatever reason, always seek power to rule over others. Face it, they are highly valued by Corporate America. Who else could smile in their faces while they lie on, set up, and stab co-workers in the back or take over a company just to get rid of a competitor and put fire all of the employees in the middle of one of the longest and deepest recessions since the Great Depression... and still be able to sleep at night?

Hopefully the lab is compliant and does retros and does tissue correlation and previous abnormal slide review.. I mean really reviewing the previous abnormal slides, not just saying they did on the report. Cutting corners doesn't seem to matter much anymore to whom it should matter.

It is a wise client who sends his paps to a different lab than where the biopsies are going to be interpreted.

 

[Anonymous]

Makes sense...pages and pages of the "disagree" sheet?? If u look closely many cases show up there and the final diagnosis is EXACTLY the same - but is the tech being called as a "disagree?"...hmmmm?

I was just pointing out that if a Pathologist changes ANYTHING from the initial CTs reporting (even if the diagnosis remains exactly the same) - like adding fungus or no LMP, etc - then sometimes those cases automatically go to the "disagree" report. I'm questioning whether those stats go directly to Corporate and makes the CT look bad. HR has no idea that the diagnosis was exactly the same, they just see a number of cases ending up on the disagree list. It was just FYI to check out.

 

[Anonymous]

I was just pointing out that if a Pathologist changes ANYTHING from the initial CTs reporting (even if the diagnosis remains exactly the same) - like adding fungus or no LMP, etc - then sometimes those cases automatically go to the "disagree" report. I'm questioning whether those stats go directly to Corporate and makes the CT look bad. HR has no idea that the diagnosis was exactly the same, they just see a number of cases ending up on the disagree list. It was just FYI to check out.

Yes. That's correct. QC too. Any change like fungus or excessive exudate or blood added or deleted will be reported as a change. Who on earth other than LabCorp uses stuff like this to decide what kind of raise you will get? This is idiotic. Who the hell cares about this useless stuff? Nobody wants to miss anything and a lot of the stuff is discretionary and subjective.

The only other time that I have seen stats used like this was for bonuses. If the cytotech read a certain number of slides and maintained a certain accuracy level (meaning the number or sils missed withing a year) a tech earned a maximum bonus of 5, 000 at the end of the year. What is going at LCA is asinine. Nobody has protested????

Obviously, what matters is if you are picking up abnormal cells and providing the clinician with accurate information in order to properly manage the care of his/her patients. What should matter to HR is that the cytotech is competent, licensed and qualiied for the job. Not on probation for missing too many sils. What are too many. Well that should be something that is written up in the rules so that everyone knows what the standards are. Bad behavior should be dealt with as it comes up. Conduct, attitude, skill set and skill level should be evaluated by the technical supervisor. WTF is going on at LCA? This is bull sht. Does LCA have a professional HR department?

 

[Anonymous]

Strong influence is a huge understatement, they are so in bed together it is not funny.
The only way that LC thinks it can make a few pennies on Paps is to max out every cyto out there, otherwise they lose money. PLus make sure that there are a lot of abnormals to trigger an HPV test, get it? LC is only concerned with the number of Imaged slides produced and Hologic dirbag reps are right there telling them that's the way to do it. You grease me and I'll grease you, sickening to know this goes on when dealing with patients.
Oh yah, and it's always the cytos fault if you haven't been told that yet, that's coming from both parties.

The FDA adverse reation site on the Imager is filling up with more and more misses "not on the 1-22 FOV". Keep sending in those complaints because it is the only way to pull that piece of crap off the market. Then the big lab's hands are tied and at least they can't make Cytotechs screen more than they are capable of.

I read on a patient complaint site (about a confusing LC bill) that many were being charged for an Imaged Pap and HPV test...$339?? Is that right?

 

[Anonymous]

Thanks for keeping up with this. I just came upon this site. I cannot agree with you more. The imager is some friggen crap. I hate that POS. It misses cases like crazy and n a daily basis. I just put a negative imaged slide on my regular scope to look for endocervical cells and found a big sheet of high grade. And don't be overworked and come upon an adenoca. A couple of times I saw just single glandular cells that looked like macrophages on a scant background. When I put it on my scope I found big bubbly clusters of Endometrial Adeno, completely missed by the imager. You can bet they would have blamed me for it if I missed it

Every cytotech I know has stories like this to tell. I did not know that you could report this to the FDA. I am going to tell everyone about it. Reporting it to cytyc went nowhere.

It makes no sense that patients are charged so much for what used to be and still can be an inexpensive test. We who actually do the work certainly don't see but a few dollars of what they are charging for these tests. Greedy SOBs. This is just another example of why medical costs are through the roof! Corruption is nearly everywhere these corporate types can conger up a way to get rich.

 

[Anonymous]

Thanks for keeping up with this. I just came upon this site. I cannot agree with you more. The imager is some friggen crap. I hate that POS. It misses cases like crazy and n a daily basis. I just put a negative imaged slide on my regular scope to look for endocervical cells and found a big sheet of high grade. And don't be overworked and come upon an adenoca. A couple of times I saw just single glandular cells that looked like macrophages on a scant background. When I put it on my scope I found big bubbly clusters of Endometrial Adeno, completely missed by the imager. You can bet they would have blamed me for it if I missed it

Every cytotech I know has stories like this to tell. I did not know that you could report this to the FDA. I am going to tell everyone about it. Reporting it to cytyc went nowhere.

It makes no sense that patients are charged so much for what used to be and still can be an inexpensive test. We who actually do the work certainly don't see but a few dollars of what they are charging for these tests. Greedy SOBs. This is just another example of why medical costs are through the roof! Corruption is nearly everywhere these corporate types can conger up a way to get rich.

This is exactly the case that NEED to be reported to the FDA! Not to your lab, not to Hologic - See FDA Adverse Reporting (MAUDE) under the ThinPrep Imaging System.

BTW, what is happening with the "rejected" Imager cases at your place? Is it coded and billed like a Manual Pap, or an Imager case? Do patients even know it was rejected? Can you run an HPV test on it if the md requests it and it has been rejected by the Imager?

 

[Anonymous]

In reading the blogs in this post I am dissapointed to say the least in the mis-information being displayed. For instance, doctor offices are well aware of the lubricant issues in the taking of a Pap sample. However, the habits of the patient population are dynamic in that there are women who use lubricants at home for w/e reasons and then come in for their Pap. OMG think people were supposed to be scientist here. As for the HPV DNA assay being appoved by the FDA...who cares? Everyone here should know that there are a battery of special stains and markers, in house, that are not FDA approved. Also, when there is an ASCUS or any abnormal findings on a Pap the HPV DNA assay is used to confirm what is seen on the Pap smear. The Pap is the standard and the follow up biopsy the gold standard. Besides when there is a negative Pap and HPV DNA assay positive test who cares weather its FDA approved or not. I have a ton more to say on this subject but i will add this and no more. When there is a Pap used with HPV DNA assay, FDA approved or not, this information is a benifit for the patient. Also, the liquid based Pap smear Thinprep or Surepath has been proven to yeild better result then the conventional smear and overall better care for the patients.

 

[Anonymous]

In reading the blogs in this post I am dissapointed to say the least in the mis-information being displayed. For instance, doctor offices are well aware of the lubricant issues in the taking of a Pap sample. However, the habits of the patient population are dynamic in that there are women who use lubricants at home for w/e reasons and then come in for their Pap. OMG think people were supposed to be scientist here. As for the HPV DNA assay being appoved by the FDA...who cares? Everyone here should know that there are a battery of special stains and markers, in house, that are not FDA approved. Also, when there is an ASCUS or any abnormal findings on a Pap the HPV DNA assay is used to confirm what is seen on the Pap smear. The Pap is the standard and the follow up biopsy the gold standard. Besides when there is a negative Pap and HPV DNA assay positive test who cares weather its FDA approved or not. I have a ton more to say on this subject but i will add this and no more. When there is a Pap used with HPV DNA assay, FDA approved or not, this information is a benifit for the patient. Also, the liquid based Pap smear Thinprep or Surepath has been proven to yeild better result then the conventional smear and overall better care for the patients.

It may be the case that doctors know about lubricant, but it still does not stop them from using a cheaper non-recommended brand that hides the cells. The rest of your post is right on target. However, you did not mention the imager and automated screening in your critique. I am curious about your take on this.

 

[Anonymous]

In reading the blogs in this post I am dissapointed to say the least in the mis-information being displayed. For instance, doctor offices are well aware of the lubricant issues in the taking of a Pap sample. However, the habits of the patient population are dynamic in that there are women who use lubricants at home for w/e reasons and then come in for their Pap. OMG think people were supposed to be scientist here. As for the HPV DNA assay being appoved by the FDA...who cares? Everyone here should know that there are a battery of special stains and markers, in house, that are not FDA approved. Also, when there is an ASCUS or any abnormal findings on a Pap the HPV DNA assay is used to confirm what is seen on the Pap smear. The Pap is the standard and the follow up biopsy the gold standard. Besides when there is a negative Pap and HPV DNA assay positive test who cares weather its FDA approved or not. I have a ton more to say on this subject but i will add this and no more. When there is a Pap used with HPV DNA assay, FDA approved or not, this information is a benifit for the patient. Also, the liquid based Pap smear Thinprep or Surepath has been proven to yeild better result then the conventional smear and overall better care for the patients.

Conventional slides have proven to be the equivalent of liquid based over and over again. So maybe you dont know very much afterall.

 

[Anonymous]

IT DOESNOT MATTER. LBC IS HERE AND OTHER TESTING IS BEING DONE FROM ITS VIAL WHETHER APPROVED OR INHOUSE VALIDATED.
PLUS IT DOESNT REALLY MATTER WHAT THE MACHINE OR ANYONE CALLS THE CELLS BECAUSE WHEN IT GETS TO THE PATHOLOGISTS.............THATS ANOTHER STORY.

 

[Anonymous]

This just in ..... LabCorp announces Lubricant to be supplied to all employees. Human Resources thinks this will go along way in the Morale of it's employees. That way when we get screwed again on our annual reviews, it won't hurt so bad.

 

[Anonymous]

IT DOESNOT MATTER. LBC IS HERE AND OTHER TESTING IS BEING DONE FROM ITS VIAL WHETHER APPROVED OR INHOUSE VALIDATED.
PLUS IT DOESNT REALLY MATTER WHAT THE MACHINE OR ANYONE CALLS THE CELLS BECAUSE WHEN IT GETS TO THE PATHOLOGISTS.............THATS ANOTHER STORY.

How did you learn about this? Are you in sales or pathology?

 

[Anonymous]

You have to work in pathology, probably a cytotechnologist. Nobody else would understand, and Sales wouldn't give a row of beans.

 

[Anonymous]

Unless it cost me a hard won client.

 

[Anonymous]

This just in ..... LabCorp announces Lubricant to be supplied to all employees. Human Resources thinks this will go along way in the Morale of it's employees. That way when we get screwed again on our annual reviews, it won't hurt so bad.

LMAO. Now that's hilarious! JULY IS HERE. Anyone got a raise yet? What is the rate of increase this time around? I hear it was 1% last year. Money to blow on lawyers and acquisitions, but nothing for you? No wonder they have the unions at their door.