Cost-Based (Part A) Pathology Physician Services: Origin, Current Spectrum, and Future

Critical leadership and management skills for pathology practice

CONTEXT

Managed care has changed the nature of medical practice. The practice of pathology has also changed and is likely to undergo further modification. Additional skills in leadership and management are needed to perform optimally in the current medical marketplace.

OBJECTIVE

To determine whether pathologists view business and informatics skills as being important and valuable in their practices.

DESIGN

A survey was sent electronically (via e-mail) to 2566 pathologists and pathology administrators.

RESULTS

Two hundred sixteen survey recipients (8.4%) responded to the survey. The response rate to individual questions ranged from 86% to 99% (186 to 214 of 216 total respondents). Most who took the survey ranked communication (203/209; 97%), leadership skills (165/209; 79%), and systems thinking skills (155/209; 74%) as either "very important" or "essential." Fewer respondents were willing to offer salary premiums for marketing (108/196; 55%), business or finance (92/196; 47%), or staff leadership (95/196; 48%) skills unless the candidate had a track record of measurable achievement using these skills. Those practicing in academia as well as those making hiring decisions by themselves were more likely to value leadership and management skills. Fewer than 1% of respondents in any category considered current pathology residency training in leadership and management to be adequate.

CONCLUSIONS

Prospective employers value leadership and management skills. Pathology residency programs must include meaningful training in pathology practice management and informatics to satisfy the demand for these skills in the modern pathology marketplace.

Assessing resident competency in laboratory medicine

Validation of the competence of laboratory medicine (LM) residents for independent practice and to sit for the examination in clinical pathology rests with the program director. Assessing knowledge and basic skills were the primary measure of residents until 2000. The Accreditation Council of Graduate Medical Education and the ABMS launched the Outcome Project in 2000 as a response to the public. A shift in emphasis from "process" to a more "outcomes driven" assessment came with the Outcome Project. As of July 2006, the training of LM residents must incorporate the six competencies of the Outcome Project within each resident experience (rotation). In this article, comparison of historic and current methods of assessing residents is noted. Current and future outcomes and the pivotal role of consultation in LM are noted.