CAP Foundation Chat - Connecting Pathologists and Patients

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Lisa Tomcko:

Welcome to the latest episode of the College of American Pathologist CAPcast. I'm Lisa Tomcko, content specialist with the CAP. In honor of the season of giving, we're spotlighting the CAP Foundation, the philanthropic arm of the College of American Pathologists. The CAP Foundation aims to develop tomorrow's pathology leaders through awards for advanced training, research and education, as well as to mobilize pathologists to expand health equity in medically underserved communities both within the US and globally. Joining me for this episode, our CAP Foundation board President, Dr. Eva Wojcik, Foundation Board member Sara Herbek and CAP board member Dr. Diana Cardona, they're going to discuss navigating your health and the health care system as a patient, the work the Foundation is doing for patients and ways to support that work. And on that note, Dr. Wojcik, I'll hand things over to you.

Dr. Eva Wojcik:

Thank you very much, Lisa, and again, welcome everyone to the special CEP Foundation Comcast episode. As Lisa said, I'm Eva Wojcik, I'm the president of the CAP Foundation, and joining me today is Sara Herbek, CAP Foundation board director. Hello, Sara. I'm so happy that you were able to join us today.

Sara Herbek, Esq:

Good morning, Eva. I'm happy to be here.

Dr. Eva Wojcik:

And Dr. Diana Cardona, CAP Board Governor. Welcome, Dr. Cardona. Happy to see you and hear you.

Dr. Diana Cardona:

Likewise. Thanks for inviting me to this discussion.

Dr. Eva Wojcik:

Today. We'll be discussing the Foundation's legacy through our own personal stories, the importance of being your own health advocate and addressing barriers to care. So let's start it. Sara, what would be the first thing you would tell someone who haven't heard about CAP Foundation?

Sara Herbek, Esq:

I think the first thing that I would tell people about the Foundation is the Foundation really works to highlight the impact that pathologists play within health care within hospitals. And I think most importantly with patients,

Dr. Eva Wojcik:

Thank you. And especially I think it's very important because you are not a pathologist and talking about pathology, that's a great opportunity. And of course talking to your friends and your community, it's really expanding people's knowledge about who we are and what we do and what Foundation is doing.

Sara Herbek, Esq:

Yeah, whenever I can be a champion for pathologists, I am, it's, I've been given the unique opportunity as my dad was a pathologist, to understand how important you all are. And if I can ever be a cheerleader, I will be.

Dr. Diana Cardona:

I think what Sara just said was spot on. But I also view the Foundation as just a natural extension of the CAP. It really is almost like the effector arm in some aspects of all the work that we do. And it helps provide real world evidence of the value we pathologists provide our patients worldwide, really as well as ways that we help promote young pathologists to advance their careers. And so I just think it works so synergistically with the CAP that it really is just a natural extension and just does tremendous amount of work.

Dr. Eva Wojcik:

Well, this is such a great description. Exactly what we do. And I'm sure you heard me so many times, CAP Foundation, it's our Foundation. And I think this is really for all of us in pathology, we should realize and that this is our Foundation.

Dr. Diana Cardona:

Agree more.

Dr. Eva Wojcik:

So Sara, your last name is Herbek. For many of us, this is a very familiar name close to our hearts, and anyone who has anything to do with CAP Foundation understands that there wouldn't be See, Test & Treat without Dr. Herbek. So is there any connection? Is it a coincidence?

Sara Herbek, Esq:

It's not a coincidence. He is my dad, my father, the pathologist who trained me to have my own voice with doctors. The CAP Foundation has always had a special place in my heart. One, I grew up with the CAP. I would go to meetings with my parents. I would have the luxury of going out to dinners and meeting the pathologist. I'm sure my dad had a different career path in mind when he was bringing me to all of these events. But instead of medical school, I went to law school. So there we are. But I think that with his passing and with the opportunity to join the board, I was compelled to do it. I remember when my dad put together the first See, Test & Treat in South Dakota. I think the first See, Test & Treat was about 25 years ago. Why they chose South Dakota, why they chose the Native American reservation outside of Rosebud, South Dakota.

Why this place? Why this location? And through the help of the CAP, they did a lot of statistical research. Where were women were most impacted, where was it most likely that women would put everyone else first? And they found this Native American reservation. The tribal elders agreed to allow the CAP Foundation to come on or the See, Test & Treat program to come on to the reservation and care for their women. My dad, as many of you recall, was a tall man. And given my dad's tall stature, they basically told him to sit down when they were meeting the tribal community. And as many of you know, my dad doesn't like sitting down. He really likes being in the mix and really likes talking to people and was really excited about kicking off this program. And one woman came up to him and started up a conversation and basically said, what are you doing here in maybe less kind terms.

And then my dad explained what the See, Test & Treat program was than it was, what is it going to cost us? What's going to happen if you diagnose a woman with a condition or an infection or disease that needs further treatment? And he explained what the process was going to be. Well, he didn't know this at the time, but the woman that he spoke to was the tribe elder. And just by having that conversation with her, I think they saw twice as many women because she gave her blessing. And that was sort of the pinnacle of kicking off what See, Test & Treat has become. It's such an impactful program that I know in the back of my mind, my dad surrounded by women, my mom, my sister, and myself growing up. And I think that understanding how critical women's health care is and how sometimes women don't always put themselves first or some of the foundations why he started the program, making sure women were put front and center, making sure women's health care was accessible and understandable and brought to the women who are most underserved and deserve that extra touch to let them know that they matter to.

Dr. Eva Wojcik:

Thank you Sara, so much for talking about Dr. Herbek whom we all admired and miss. And just the See, Test & Treat is the best example. What one person. One person with a passion, one person with a vision can do one person. Okay. Let's continue with Diane with you. So how has the Foundation open doors affected impact your career?

Dr. Diana Cardona:

So I would say I probably wouldn't be speaking with you right now actually, if it wasn't for the Foundation, it was the Foundation that gave me the first opportunity to recognize the work that the CAP does and get involved. Back in 2006 when I was a trainee, I was given the opportunity and I applied for the Young Leader Award and I got it, which was a surprise as a young resident. And that award, I think now it's called the Leadership Development Award, but back then it was the Young Leader Award and I was able to go to two Resident Forum meetings, attend my very first Annual Meeting for the College, and I was hooked. And because of that opportunity, I then learned about other ways that I could get engaged and involved even as a resident. And so I applied to join an advocacy related committee and was selected to be a junior member. And honestly since then I haven't looked back.

Dr. Eva Wojcik:

Look at you now.

Dr. Diana Cardona:

Yeah [laughs]

Dr. Eva Wojcik:

The Governor!

Dr. Diana Cardona:

Now I'm on the Board. So honestly, I wholeheartedly give the Foundation credit for opening my eyes to all the opportunity and ways to get involved, but also learn things that you don't typically learn and practice all the advocacy related issues, patient education type opportunities. When you're a trainee, you're just so focused on I need to learn pathology so that I can get a job. And there's just so many other tangential elements to practice that are so critical and actually help provide satisfaction. For me, I thrive in being able to advocate for our profession and for our patients and being successful in that provides me joy. And so it really is just very synergistic for me personally to actually be able to be a pathologist, but also be as engaged as I am within the college.

Dr. Eva Wojcik:

This is a really great story, and believe it or not, I heard this story so many times that because of the Foundation, that was this first introduction to CAP and that's how we hook people on CAP. And of course, I have my own personal story because of the CAP Foundation, I have been able to lead See, Test & Treat for eight consecutive years. And this is, as we all know, amazing program give us such an opportunity to show what we pathologists can be, that we can be true leaders of health team and to show to our clinical colleagues. It's priceless. And of course, we are providing this amazing care for those who cannot otherwise have opportunity to be screened for breast or cervical cancer and all of this just because of Foundation. But let's switch gears. Let's talk about us being our own health care advocate. So Sara, what have you learned about health care by having a pathologist in your family?

Sara Herbek, Esq:

I think probably foundationally, because my dad was a pathologist, I learned to have a voice, to ask questions and to really make sure that when I left the doctor's office, I knew exactly why a doctor would say something to me. I think it became very clear as I grew up and was no longer going to the doctor with a parent. And then once you go to college and even before that one moment sticks out very clearly in my head. It was the winter I was at the doctor and the doctor called and read the blood tests that you all read and determine and he was like, oh, your vitamin D is great. And then just moved on. And I thought, well, why is that important? And I didn't ask the doctor, I just picked up the phone and called my dad. And unfortunately I don't have that luxury.

But I do have a few friends that I bother who are pathologists on occasion if I want more clarity. But usually when I'm in the room with the doctor, I make sure that I'm very clear with what my expectations are and get the answers that I need. So I walk away knowing what I need to do from a health care perspective, whether it's how I eat or exercising, just to generally taking care of myself in a day-to-day basis. But I'm informed and making sure, well, saying that you're the loudest voice in the room doesn't really quite cover what I want to say, but your voice is being heard and that you matter and you are the most important person in the room whenever you're seeing a doctor.

Dr. Eva Wojcik:

Thank you Sara so much. Dr. Cardona, what have you learned from being a pathologist and how does that knowledge then transfer to your personal care or your family and friends?

Dr. Diana Cardona:

Yeah, so I'll start with the latter half, like family and friends and just kind of tag onto what Sara was just explaining. And I think that when I have family members or friends call me and ask me questions about any personal medical concerns they have, obviously I try to answer their questions. But if they're going to go see their provider, I highly encourage them to go prepared, write your list of questions before you even get to your appointment. I mean even sometimes I'm guilty of it. You're there, they're rushed, they're trying to get through things and then you forget to ask something. And it's not until after you leave the office that you're like, oh man, I totally meant to ask that question. And so if you go prepared and that I've trained my mom now specifically, mom, go prepared, please. She has so many questions.

And then she gets frustrated afterwards when she didn't get the opportunity to ask. But at a minimum, just the simple question of why, if they're saying something like Sara just said about vitamin D or any other test results or any plan that they're having that's going to impact you and your medical care, just ask the question why. And I think that empowers the patient to feel more informed and feel that they're a partner in their patient care decisions as they should be. And then as far as personal care or for my daughter, she's probably the one that suffers the most is I try not to overreact. I think that most people's first reaction is like, oh my God, it could be this or that. And maybe too much about medicine that you think about the worst case scenario. And so I always have to reign myself back in and be like, well, no, it's probably just a cold. And so that piece is a constant dialogue in my head, but at the same time, I think it also obviously empowers me to have conversations with my provider or for my daughter's provider about next steps and what makes most sense for us as a family as well. So I think that's kind of the most important parts of that kind of interaction with our own personal health care.

Dr. Eva Wojcik:

Thank you again, Dr. Cardona. Yes. We have to emphasize over and over again to take care of ourselves. I know we are all very busy, but it's also applies to us pathologists and physicians. After all we are physicians. And you mentioned already those barriers because the next topic we'll be talking about is addressing the barriers to care. And you mentioned that everyone is busy. We are busy, our providers are busy, and so important to be prepared for that whenever we have any contact with our providers. But Sara, what do you think how the CAP Foundation are improving patient education to help in breaking down those barriers? What the Foundation does and or what we can do better?

Sara Herbek, Esq:

I think most notably is See, Test & Treat. That to me just took a wrecking ball to the normal hospital setting that was even further reestablishing the system, so to speak when ask a doctor through the See, Test & Treat program came up where there was direct interaction with patients and pathologists where they get that one-on-one attention in a more informal setting where they're not only there to get absolutely critical and essential health care for free, but they're also communicating and sort of the myth behind doctors. You're approachable, everybody's human. It just does everything to help bridge the gap between individuals who may be nervous going to see a doctor. That's just not something that I ever have been being raised with a father as a doctor.

So I've always felt comfortable with physicians and doctors, but there are individuals where they may not have seen a doctor every year throughout their entire lives. So having that be so personalized, that personalized touch, I think just shatters all the barriers and really connects pathologists to their communities, not only professional communities, but also the individuals that they're impacting on a day-to-day basis, which I just think is such an amazing See, Test & Treat is amazing in and of itself, but really bringing the doctors together with their patients is just, it's the perfect symbol for what See, Test & Treat is supposed to be that connection.

Dr. Eva Wojcik:

Thank you very much. Of course. I'd love to hear all those great things about citizen treat very well. That what I think about this program, the most amazing program possible, practically speaking, and that's exactly showing that we pathologists can provide direct patient care and we can even talk to patients directly, Dr. Cardona, what else? How we pathologists can address those barriers in other way besides just See, Test & Treat?

Dr. Diana Cardona:

I love what Sara just described. I mean, I know that I personally love speaking with patients and when they actually reach out and say, Hey, can you show me my pathology? Can you explain that to me? I'm trying to make a decision. Do I get radiation? Should I not get radiation? Things like that. And although it doesn't happen a lot, because it doesn't happen a lot, I actually do have the luxury of time to spend with the patient and I will set up an appointment, they'll come to my office, I'll show them their slides under the microscope and being able to see that light bulb moment that they have when they can put a name to the face or a face to the name of what they're fighting against and just getting a deeper understanding of what we mean by having skip lesions and how that might impact their prognosis or risk of recurrence and things like that.

And they just have that opportunity to actually see it and it makes so much more sense to them. I know that it's helpful for them to make more informed decisions, but honestly, it's so rewarding for me personally as well. It's kind of like a win-win for me. And so being able to do that I think is just another way that we try to remove those barriers. But I also think there's lots of other things that pathologists are doing that we probably don't even recognize that you're doing, trying to deal with health care disparities and addressing issues with EGFR and calculations on how kidney damage is really being assessed in the entire population, not based on race right now. The CAP is looking at how do we improve our reporting, potentially moving, knowing that patients have ready access to their reports now by law. How do we ensure that what we are writing in our reports not only meets the needs of our clinical colleagues, surgeons, oncologists, other things like regulatory billing, compliance and et cetera, but also meets the needs of our patients. That's a lot of ask for one piece of paper, and I think we need to start thinking more innovatively on how we address that. Again, keeping the patient at the center of everything that we do, I think ultimately benefits everybody.

Dr. Eva Wojcik:

This is great. This is exactly what Foundation is all about. It's about elevating us pathologists and our position within the health care system altogether, kind of showing that we, well, not showing but reminding that we pathologists are also medical doctors, we are physicians. We are more than capable to talk to our patients. And for us, pathologists kind of reminding us that the pleasure and the satisfaction of that, talking to people. I had this experience, the See, Test & Treat when I discussed the results with patients and seeing the relief on their faces, it's priceless being hacked by those patients, showing their appreciation for what we do. Priceless.

Dr. Diana Cardona:

Yeah. Actually, I'm going to probably cry, Eva, because you just reminded me of one where I did, I had the opportunity to talk to a young patient regarding one of their tumors and fast forward a couple of months and it was Thanksgiving and their family had a tradition where everybody would put one thing that they were thankful for in a jar and then pass it around and somebody would pull it out and just read what they pulled out of the jar that somebody in their family had put in there as what they were thankful for. And that year, somebody in the family put in that they were thankful for Dr. Cardona being able to help them come to the right diagnosis because the patient had a long story and had been to a lot of different facilities, but they snapshotted that picture and they emailed it to me and I literally sat in my office and cried because it was just so touching. And you don't recognize at the time the impact that you have on patients. And I remind our trainees all the time behind every single glass slide, there's a patient in a family that's relying on your work and what you are going to say. And so things like that, to your point, being able to have that interaction, to have a hug, which was essentially like a virtual hug for me on that day, is just so rewarding.

Dr. Eva Wojcik:

This is so amazing and so needed for us pathologists to hear, to listen to this. And because let's face it, sometimes we are becoming a little bit more detached that we supposed to be. And I keep always reminding our trainees, residents, fellows, medical students, behind each and every glass slide, there is a human being. There is somebody's father, mother, child. These are not glass slides. These are our patients. But I think this is time to conclude our session. Thank you so much. Thank you Sara and Dr. Cardona for joining me today to share your stories and work with the CAP Foundation. I would also like to thank our listeners. We hope you learn more about this incredible work of the Foundation through this discussion. Last but not least, thank you to all our donors. Without your support, none of this great work would be possible.

Lisa Tomcko:

Well, a big thank you to all of you for the great conversation about patients, pathologists and the CAP Foundation. And thank you to all of our listeners for tuning into this special Foundation episode of CAPcast. To learn more about the CAP Foundation and donate visit foundation.cap.org, the link is in the description. Keep up with the Foundation stories and grants and awards opportunities by following them on social media at CAP Foundation, which is at CAPFndn. As always, stay tuned for future episodes of CAPcast and for more information about the CAP visit cap.org.

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