Pathologist lobbies congressman for local lab testing of Pap smear tests

Local lab makes its pitch when congressman comes calling.

Fredricksburg, VA

With a congressman in the house, Dr. Paul Hine lobbied for his laboratory.

His message: "The best practice is local practice."

Hine is chairman of the Department of Pathology and Laboratory Medicine at Mary Washington Hospital. Yesterday he and the laboratory staff hosted 1st District Rep. Rob Wittman, a Republican from Westmoreland County.

The Fredericksburg hospital officials talked with Wittman about federal funding for the Medicaid program, and about the testing requirements for laboratory technologists.

But the focus was on the benefits to patients of using a local, rather than national, laboratory. And to illustrate, the staff demonstrated for Wittman how it reviews Pap smears.

A Pap smear checks for cervical cancer and is usually part of a woman's annual gynecological exam.

Specimens are collected in doctors' offices and sent to laboratories such as Mary Washington's. There, slides are prepared and examined under high-powered microscopes.

A technologist peers through the microscope to find any abnormal cells. Hine compared it to hovering in a helicopter over a mall parking lot.

"Your task is to find which, if any, cars have left their doors open," he said.

Some of the slides are chosen randomly for a second look, and abnormal ones are checked by a pathologist.

"Over 50 percent of all slides are read by more than one person," Hine said.

The Pap test is seen as an effective way to identify abnormal cells that can become cancerous. Hine said it has been more than a year since he saw a slide from a patient with invasive cancer.

"The reduction in women's cervical cancer is phenomenal," he said.

Mary Washington's laboratory reviews 5,000 Pap tests each year. Yet that represents only 10 percent of the local market.

The rest are sent by doctors' offices to national laboratories such as LabCorp and Quest Diagnostics.

Patients have little choice in where the laboratory work is done. Health insurance companies, such as Anthem, believe they can get quality work at a lower price by contracting with national laboratories.

But Hine and Cindy Huffman, laboratory director, argued that patients and physicians benefit from the interaction that occurs at a local laboratory.

Huffman said it is common for a doctor to call or walk into Mary Washington's lab and ask the staff, "Can you pull this slide?"

"We believe quality is best measured by local knowledge," Hine said. "We're accountable to people in this community."

Wittman did not offer an opinion on the use of national laboratories, though he did appear comfortable in the hospital laboratory. He has an undergraduate degree in biology and worked for 26 years in the seafood safety division of the Virginia Department of Health.

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