October 2022 Advocacy Recap

Alec Bose: 

Hello, and welcome to the CAP Advocacy Recap, a monthly podcast dedicated to catching you up on the top news for pathologists. I'm Alec Bose, here with your October recap. This month we'll highlight a grant awarded to the CAP to improve diagnostic excellence, key issues from this year's Advocacy Town Hall at the CAP'S annual meeting, and more. Later, we'll speak with Dr. Thomas Wheeler about the findings from this year's practice characteristic survey. 

We start with a win for the college. The Council of Medical Specialty Societies, or CMSS, a coalition of 48 specialty societies, awarded the CAP with a $100,000 grant to study how to make pathology reports more patient-centered and understandable. The CAP will use the grant to improve the patient experience of a cancer diagnosis related to the pathology report. These awards result from a competitive grant program, administered by the CMSS, for medical specialty societies to support the development of resources and programs to promote the topic of diagnostic excellence for clinician audiences. 

Medical specialty societies like the CAP are well positioned to educate and disseminate effective strategies that advance diagnostic excellence among their members through educational programs. The CAP welcomes the opportunity from the CMSS societies to help identify patient priorities in pathology reports, and create recommendations around patient-centered pathology reports. 

Next, we move to the CAP 22, which took place this past month. The Advocacy Town Hall happened during the annual meeting, where Dr. Kalisha Hill moderated a discussion about the CAP's advocacy agenda between CAP president, Dr. Emily Volk, and the CGPA chair, Dr. Jonathon Myles. Items discussed included how the CAP worked with the CMS to increase clinical labor rates for histotechnologists, and advocating successfully for 13 new digital pathology add-on codes for the 2023 Medicare physician fee schedule. Dr. Myles also reviewed proposed changes to CLIA authorized laboratory director personnel requirements, the current state of the VALID Act, and fighting to mitigate upcoming Medicare cuts and improve the Medicare physician fee payment system. 

We turn now to the nation's capitol, where CAP president-elect, Dr. Donald Karcher, urged the D.C. Council to reconsider laboratory personnel licensure and additional statutory fixes, in lieu of repeal within the personnel cleanup bill proposed by the Mayor's office in a public testimony. The law was initially enacted in 2015, but never operationally implemented. At this stage, the D.C. Council appears to be carefully weighing the concerns expressed by the CAP and other stakeholders, including the D.C. Hospital Association. 

Quote, "The CAP does not believe that local regulation of clinical laboratory personnel is necessary for, nor integral to, quality assurance in the clinical laboratory," CAP president, Emily Volk, said in a statement to the D.C. Committee on Health affirming. "Accordingly, our members in D.C. oppose the enactment of the original D.C. licensure law in 2015." End quote. The CAP will continue to work with D.C. Stakeholders and the D.C. Council to urge the repeal for laboratory licensure. 

We end today with a conversation about the CAP's Practice Characteristics Survey. The survey reveals key findings about laboratory practice trends, and how pathologists are reacting to them. We sat down with Dr. Thomas Wheeler, chair of the CAP's policy roundtable, to look at some of the highlights from this survey and how best to interpret the data it reveals. 

Okay, Dr. Wheeler, welcome to the CAPcast. Thank you so much for joining us. We really appreciate it. 

Dr. Thomas Wheeler: 

Good to be here. 

Alec Bose: 

To start us off, let's just jump right into it, and can you tell us what this Pathologist Characteristics Survey says about the pathologist job market, and how's it looking in 2022 compared to 2021? 

Dr. Thomas Wheeler: 

Yes, of course. Demand for pathologists seemed to be at least as strong as in 2021, if not stronger, and 2021 was a very tight pathology job market. This lines up with what we've been hearing from our members, and what recruiters say they're experiencing on the ground. We asked practice leaders about their plans for hiring in 2022, and 59% indicated they expected to hire at least one pathologist in 2022, compared to 56% in 2021, but those practices were hiring more pathologists. On average, practice leaders had 3.1 FTE pathologist positions open in 2022, compared to only 2.4 FTE positions for 2021. 

Practice leaders were less optimistic about their ability to fill open positions in 2022, reporting that, on average, they were able to fill, or intend to fill, only 68% of open positions, compared to 74% of positions in 2021. Interestingly, the survey results suggest that while there are more positions available in 2022, a smaller percentage of these positions were new positions, and by new I mean any position that isn't filling an existing vacancy, departure, or retirement. So, while 46% of positions were new in 2021, only 34% of positions were new in 2022. Put another way, a larger percentage of hiring in 2022 appeared to be replacement hiring. 

Alec Bose: 

So it seems more practice leaders are hiring for more open positions, fewer of which are new, and practice leaders are less confident they'll be able to fill those positions this year? 

Dr. Thomas Wheeler: 

Yes. We asked practice leaders to characterize their hiring experience relative to prior years, and 65% said it was more difficult to hire a pathologist in 2022 than it had been in the past. 30% of respondents said that they faced about the same level of difficulties the prior year, and 5% said actually it was easier to hire a pathologist in 2022 than in prior years. I wonder if those positions were in Hawaii or the US Virgin Islands. 

Alec Bose: 

Do we know why practice leaders are telling us the hiring process is more difficult? What's preventing them from filling more of these open positions? 

Dr. Thomas Wheeler: 

Well, the barriers are going to be unique in every practice, but the survey does provide us with some general insights. We asked those practice leaders, who reported they weren't able to fill positions, to select from a list all applicable reasons that prevented them from hiring or filling a position, that we asked them to check the box. These are the items that rose to the top. Number one, 67% of practice leaders said that they were unable to find candidates who met their specific needs. Number two, at 35%, was practice leaders said that they were unable to meet compensation requests of the applicants. And number three, at 31% of practice leaders, they said that geography and community did not meet the applicant's desires or requirements. 

Alec Bose: 

So over the past two years we've heard from members that visa issues have played a barrier to hiring, or even considering applicants for pathology positions. I know you've asked about the visa issue specifically for the first time on this year's survey, so can you tell me a little bit about what you found out, and what your thoughts are about this visa situation? 

Dr. Thomas Wheeler: 

Yes. Well, we asked practice leaders whether visa issues have prevented them from either considering or hiring candidates for an open position in the last two years. Overall, 25% of practice leaders reported that visa issues had an impact on their hiring decisions. 20% of practice leaders reported that visa issues prevented them from considering candidates for open position, and 10% said it prevented them from hiring a candidate. Of note, 5% of practice leaders reported that visa issues prevented their practice from both considering and hiring candidates. 

Alec Bose: 

We've heard from many members that they're having difficulty hiring laboratory staff. Can you share any insights from the survey, or from your personal experience? 

Dr. Thomas Wheeler: 

Sure. We asked practice leaders to rate how difficult it's been to hire various types of laboratory staff. With one exception, and that being PhD laboratory scientists, 60% or more practice leaders reported it was difficult to hire every category of laboratory staff that we asked about. The greatest level of difficulty was for medical technologists at 78%, medical laboratory technologists slash clinical laboratory scientists, 78%, histotechnologists and histotechnicians, 76%, and cytotechnologists at 72%. Even though 32% of practice leaders reported it was not difficult to hire a PhD laboratory scientist, 47% of practice leaders said they still found it difficult to hire a PhD laboratory scientist. 

Alec Bose: 

Well, great. That's about all I had. Was there anything else that you wanted to expound on before we let you go? 

Dr. Thomas Wheeler: 

No. Thank you for the opportunity to present the findings of our Practice Characteristics Survey. 

Alec Bose: 

No, thank you, Dr. Wheeler. We'll wrap up there. Thank you so much for joining us. We really appreciate it. 

Dr. Thomas Wheeler: 

You're quite welcome. 

Alec Bose: 

That's all for this edition of the Advocacy Recap. Thank you so much for listening. For more information on any of the stories you heard today, be sure to subscribe to our weekly advocacy newsletter, and follow us on Twitter @capdcadvocacy. Once again, for CAP Advocacy Communications, I'm Alec Bose, and we'll see you next month.

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