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ADASP President’s Letter

Teri A Longacre M.D.
President, ADASP

ADASP continues to expand membership and is beginning to branch into a number of exciting new areas. Our collaboration with ASCP has developed into an additional ADASP short course at the annual ASCP meeting. Last year, the course at the annual meeting in Las Vegas was entitled “The Second Opinion in Pathology…Nothing but the FAQ’s Ma’am” given by yours’s truly. The course addressed the importance of second opinion in pathology and the equal importance of transparency to our colleagues and to our patients concerning the grey areas in pathology. Several years ago, former members of Council developed a series of patient-centered FAQ’s about common diagnoses in pathology (shout out to Jonathan Epstein et al) that were ultimately endorsed by the American Cancer Society (ACS) and are located at the ACS website as well as that of the ADASP. It is now time to revise and add to these FAQ’s. There is little or no information about molecular tests – there were few at that time. There are no mentions of the shades of grey – the borderline diagnoses - that we all know are subject to interobserver (including expert) disagreement.  Many times, patients get second opinions in these areas and don’t understand why they have carcinoma in one report and atypical hyperplasia in another or melanoma in one report but atypical melanocytic proliferation in another or atypical ductal hyperplasia in one report and ductal carcinoma in situ in another…and so on. I believe we can provide a tremendous service to health care delivery in this country by pulling back the curtain of the wizard (as it were) and clearly identify those areas where we cannot agree and why we cannot.  This project is large scope and will take significant engagement from membership but, at least in my opinion, is one of the more worthwhile services that we can provide. 

As many of you are aware, ADASP awards the Autopsy Award and Diagnostic Surgical Pathology Award at the annual USCAP meeting to an outstanding abstract/poster presented by a young trainee at the Stowell-Orbison Monday morning poster session. Judges are drawn from Council but we welcome volunteers from the Society at large. The awardees are listed on the ADASP website and honored at the annual USCAP business meeting. Awardees (who also receive a certificate and stipend) for 2017 were as follows:

Best Autopsy Poster:  The Value of Autopsy in Solid Organ and Stem Cell Transplant Patients
Jeremy Shelton, Margaret Compton, Robert Hoffman. Vanderbilt University Medical Center, Nashville, TN

Best Surgical Pathology Poster: Predictors of Metastatic Disease in Testicular Seminoma: Clinicopathologic Study of 406 Cases Aylin Sar, Kiril Trpkov, Tina Cheng, Asli Yilmaz. University of Calgary and Calgary Laboratory Services, Calgary &Tom Baker Cancer Centre, Canada

The Annual Meeting program addressed several novel topics suited to our novel times. This year the program was split into three components entitled “Pathology Leadership”, “Communication with Patients, Families and Others”, and “Emerging Technology and Practice Trends”. The diverse and outstanding panel of experts included Sharon Weiss (Emory University), Carol Farver (Cleveland Clinic), Vinita Parkash (Yale University), Jeff Myers (University of Michigan), Suzie Dintzis (University of Washington), Jerad Gardner (University of Arkansas), Ulysses Balis (University of Michigan), Lynette Sholl (Brigham and Women’s Hospital), Gary Tearny (Massachusetts General Hospital), and David Rimm (Yale University). The speakers were all outstanding! We learned about social media & the role it can play in our profession; the increasing move towards subspecialization and the issues it engenders including workload distribution, equity, mentoring and physician well-being; physician burnout – yes, it is now affecting pathologists in a big way; pathologist/patient communication; and physician error. The emerging new technology speakers provided concise but highly informative information about the liquid biopsy, PD-1/PD-L1 testing and in vivo microscopy, each of which I suspect will continue to develop and occupy a niche in diagnostic and theranostic testing.

The ADASP continues to work closely with other major pathology societies and physician groups including ASCP, CAP, and USCAP. In 2016, ADASP became an associate member of the Intersociety Council for Pathology Information, Inc. (ICIP). ADASP is developing a leadership development focus for future medical directors of anatomic and/or surgical pathology and its subspecialties that includes faculty mentoring and work/lifestyle balance and communication. One formal survey concerning subspecialization and staffing was successfully conducted amongst the ADASP members and another on Urgent Diagnoses is in development. The results of the former survey were presented at the Annual Meeting.

I sincerely hope that this New Year finds you all well and that you will continue to support the Society with your membership and activities. Please consider taking a more active role by encouraging other directors to become members, suggesting topics for meeting or surveys, or volunteering for subcommittee work. I have already received several volunteers for the FAQ’s upgrade and will be sending out a sign-up sheet for the rest of you to participate.

Warmest regards to all,