Inadequate number of anatomic pathologists is a factor in lengthy delays in pathology test reporting
Even as the Province of Manitoba deals with some highly-publicized issues in anatomic pathology, over in the neighboring Province of Saskatchewan, a sizeable backlog in anatomic pathology cases earlier in the year caused the Saskatoon Health Region to refer pathology cases to another region within the province.
As happened in Manitoba, journalists are reporting regularly on the problems with Saskatechwan’s anatomic pathology service. That has made the public aware that a shortage of pathologists in Saskatoon played a significant role in lengthening the time required to process tissue specimens and deliver a completed pathology report to physicians.
Pathology Laboratory Issues in Saskatoon During 2011
In fact, since the beginning of the year, residents of Saskatoon have read different news stories about:
- a pathologist-whistleblower;
- lengthy delays in anatomic pathology reports; and,
- the shortage of pathologists in Saskatoon which contributed to the backlog in the timely reporting of tissue specimens from the region.
Things did not turn out well for the whistleblower pathologist. Identified in Saskatoon’s newspaper, The StarPhoenix, as Dr. Kirk Ready, he was dismissed without cause in May after earlier contacting the provincial government, and then leaking to the news media, that the laboratory in the Saskatoon Health Region was not under the direction of a physician, as called for by provincial regulations. For the past five years, Dr. John Krahn, who holds a Ph.D. in biochemistry, had run that laboratory.
The public also learned that, for five years, the anatomic pathology division had gone without a head director. During that time, it was Krahn who served in that role, even though his training in clinical chemistry did not include anatomic pathology.
Ready’s dismissal caused the Professional Association of Interns and Residents of Saskatechewan (PAIRS) to comment publicly. It was noted in a story published last month by The StarPhoenix that PAIRS considered the dismissal of Ready to be a “political firing” and that his loss would put “the training of pathologists in jeopardy at the University of Saskatchewan.” In its prepared statement, PAIRS said that “A loss of one pathologist worsens a severe shortage of pathologists in Saskatoon and affects the training received by all residents moving through pathology.”
Lengthy Turnaround Times for Anatomic Pathology Test Reports
The issue of overly-long turnaround times for anatomic pathology testing came to the public’s attention when The StarPhoenix published a story on March 21, 2011. Reporter Hannay Scissons wrote “Some lab test samples are being shipped to Regina during the next few months as Saskatoon experiences a shortage of pathologists. A backlog of 1,300 cases has built up as the Saskatoon Health Region tries to fill two vacancies in its anatomical pathology department.”
From the fall of 2010, when turnaround time for anatomic pathology reports had averaged 11.01 days, there was a modest increase for the first five months of 2011, to 12.14 days. Turnaround time was measured as the “time between when a tissue sample is received and a final written report is completed.”
On August 2, it was reported that the backlog of cases, reportedly as many as 1,300 in March, had been whittled down to 992 cases. Officials at Saskatoon Health Region have been referring tissue specimens to pathologists in the Regina Qu’Appelle Health Region (RQHR), in what they describe as a “short term measure.”
Sandra Blevins, Vice President of Clincial and Operations Support Services for the Saskatoon region, noted that approximately 3,290 tissue specimens originating in Saskatoon have been sent to Regina for testing since March. Also, officials have prioritized the testing of tissue specimens for more serious cases.
Meanwhile, staffing an adequate number of anatomic pathologists continues to be a challenge in Saskatoon. In the July 12, 2001 issue of the Canadian Medical Association Journal (CMAJ), it was reported that the Saskatoon region is four pathologists short of the total number of funded positions, which Blevins said is 15.
How quickly Saskatchewan’s health region can recruit the pathologists needed to achieve authorized staffing levels remains unclear. Earlier this month, Blevins told The StarPhoenix that the first search for a new medical director to head up the pathology and laboratory division had failed to identify a candidate with the right qualifications.
Pathologists and experienced clinical laboratory administrators can recognize that it is likely that Saskatoon’s health authority has several major challenges in its division of pathology and medical laboratory services. After all, over the past year, officials have been unable to achieve full staffing of pathologists for Saskatoon, despite concerted efforts and a watchdog press that regularly reports about how short-staffing is affecting the quality of patient care in that region.
Does Underfunding of Clinical Pathology Testing Play a Role?
At a minimum, the press and the public in Saskatoon should ask whether sustained underfunding of anatomic pathology services in the region is a factor in the current set of issues that confront the division of pathology and clinical laboratory testing. In fact, underfunding of medical training positions for pathologists and laboratory physicians is identified as a national problem in Canada, according to a research study recently published in the Canadian Journal of Pathology (CJP).
In the next issue of The Dark Report, there will be an intelligence briefing about the findings of this study and Canada’s long term gap in the declining number of new pathologists and lab physicians coming out of training programs versus the number of pathologists and laboratory physicians retiring or leaving the field.