PLoS ONE (Jan 2021)

Evolution of anatomic pathology workload from 2011 to 2019 assessed in a regional hospital laboratory via 574,093 pathology reports.

  • Michael Bonert,
  • Uzma Zafar,
  • Raymond Maung,
  • Ihab El-Shinnawy,
  • Ipshita Kak,
  • Jean-Claude Cutz,
  • Asghar Naqvi,
  • Rosalyn A Juergens,
  • Christian Finley,
  • Samih Salama,
  • Pierre Major,
  • Anil Kapoor

DOI
https://doi.org/10.1371/journal.pone.0253876
Journal volume & issue
Vol. 16, no. 6
p. e0253876

Abstract

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ObjectiveQuantify changes in workload in relation to the anatomic pathologist workforce.MethodsIn house pathology reports for cytology and surgical specimens from a regional hospital laboratory over a nine- year period (2011-2019) were analyzed, using custom computer code. Report length for the diagnosis+microscopic+synoptic report, number of blocks, billing classification (L86x codes), billings, national workload model (L4E 2018), regional workload model (W2Q), case count, and pathologist workforce in full-time equivalents (FTEs) were quantified. Randomly selected cases (n = 1,100) were audited to assess accuracy.ResultsThe study period had 574,093 pathology reports that could be analyzed. The coding accuracy was estimated at 95%. From 2011 to 2019: cases/year decreased 6% (66,056 to 61,962), blocks/year increased 20% (236,197 to 283,751), L4E workload units increased 23% (165,276 to 203,894), W2Q workload units increased 21% (149,841 to 181,321), report lines increased 19% (606,862 to 723,175), workforce increased 1% (30.42 to 30.77 FTEs), billings increased 13% ($6,766,927 to $7,677,109). W2Q in relation to L4E underweights work in practices with large specimens by up to a factor of 2x.ConclusionsWork by L4E for large specimens is underrated by W2Q. Reporting requirements and pathology work-up have increased workload per pathology case. Work overall has increased significantly without a commensurate workforce increase. The significant practice changes in the pathology work environment should prompt local investment in the anatomic pathology workforce.