From the President’s Desk: Are we there yet?, 12/14

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Gene N. Herbek, MD

December 2014—At this time of year, when we are inclined to reminisce, I often recall holiday travel with small children. I mention this to explain my headline—an existential question also relevant to our work at the CAP.

When those around the table begin to debate a point (say, for example, during a CAP Board of Governors meeting), I sometimes recall voices. I suspect that’s true for many of us. The choral voices of the past can tell us a lot.

Dr. Herbek

I started this column by scribbling the names of some pathologists in my private glee club because I wanted my message to celebrate the durable harmonies that good mentors create. I have space for just a handful—those I need to name in order to tease out what they continue to teach me. As in life, my mentors will appear in no particular order. I hope these recollections will awaken memories of your own.

My back-of-the-envelope list consists of pathologists who emerged as leaders during a time of great cultural support for American physicians. Each was superbly educated, intellectually powerful, and supremely confident about the specialty of pathology. Each embraced the future and was fully engaged by the science. Each understood that the real rewards of our specialty have little to do with its material returns.

As chair of the CAP Immunohistochemistry Committee, Raymond R. Tubbs, DO, was a respected and respectful force of nature with a deep belief in patient-centered medicine. A pathologist at the Cleveland Clinic who had served as a member of the Surveys Committee and vice chair of the Molecular Oncology Committee, Dr. Tubbs was fundamental to our success in making cutting-edge, esoteric proficiency testing challenges widely available. Countless hours and rare expertise enabled him to build those Surveys; few could have so creatively synthesized so much new knowledge in such an accessible way. Dr. Tubbs, who died in April, was an energetic mentor whose students and peers learned to internalize his insistence that day-to-day patient care comes first.

Although William B. Hamlin, MD, and Loyd R. Wagner, MD, were very different people, I rarely think of one without the other. They were the best of friends and a formidable tag team on legislative testimony, one as boisterous as the other was reserved. Drs. Hamlin and Wagner, who died in 2004 and 2012 respectively, had intimate knowledge of the CAP infrastructure and an exceptional ability to get things done. Dr. Hamlin, who chaired the Council on Scientific Affairs and the Commission on Laboratory Accreditation, was forthright and fearless. His passion for the Laboratory Accreditation Program was exactly what was needed to shepherd our 1994 transition to deeming authority under CLIA. Dr. Wagner, our 1989–1991 president, was more the sage—deeply collegial, open to all opinions, well suited to his role as senior editor of the 50th anniversary CAP history. It was during Dr. Wagner’s presidency and at his urging that residents began to be appointed to CAP councils and committees.
Herbert Derman, MD, our 1983–1985 president, came into office just as TEFRA was being implemented. It was our good fortune he took the helm when he did, because Dr. Derman’s political skills were pivotal during a challenging time. He recognized the external pressures we would soon confront and pressed for changes that made our leaders and advocates more nimble. Dr. Derman, who drove formation of a lobbying operation that has protected the interests of pathologists and patients for years, remains a role model.

Our 1987–1989 president, William B. Zeiler, MD, a wonderful doctor and entrepreneur, oversaw controversial developments during his tenure. Dr. Zeiler was a zealous advocate for the then new CAP TODAY and a steady hand that guided consolidation of our staff activities in Illinois. Some who opposed the staff consolidation liked to point out that the construction site in Northfield, Ill., was a swamp, but Dr. Zeiler held true, as he always does, and that swampland now supports beautiful gardens. Dr. Zeiler is still active in the College and the CAP Foundation.

Many CAP members and staff lobbyists credit our 2001–2003 president, Paul Raslavicus, MD, MHA, with much of what they know about the ever-changing landscape of health care economics and public policy. A born mentor and expansive personality, Dr. Raslavicus was deeply involved in CAP review and comment during development of the resource-based relative value scale for Medicare reimbursement. He also signed our agreement with the National Library of Medicine to make SNOMED CT freely available to all health care professionals in the United States. Dr. Raslavicus now chairs the World Association of Socie­ties of Pathology and Laboratory Medicine International Liaison Committee.

Jerald R. Schenken, MD, was one of my first role models; I knew him when I still thought I was going into family practice. Today, I work in the laboratory founded by his father (John R. “Rudy” Schenken, a CAP founding fellow). Jerry, who died in 2001, chaired the CAP Council on Government and Professional Affairs and served, with his father, as a trustee of the American Board of Pathology. Jerry was later ABP president. He became a highly regarded leader within the AMA, serving as secretary-treasurer in 1988. I learned a lot from Jerry, most notably that politics is important work, challenging, honest, and fun. He taught me there is no such thing as a permanent adversary and that we owe it to one another to deal with political issues that affect our practices.

I felt honored when Donald A. Senhauser, MD, who died in 2004, chose to mentor me. Dr. Senhauser, our 1991–1993 president, would periodically sit me down to explain what he knew I should know about how the College worked. He saw the skills I needed to improve and showed me how to develop them. And he made me believe I could be someone in organized medicine long before anything of the sort had crossed my mind. That’s what a mentor does; it’s what each of us should be doing in our practices whenever we identify a younger colleague who would welcome our encouragement.

Paul Bachner, MD, although he later moved on to chair the University of Kentucky Department of Pathology and Laboratory Medicine, shares my community-practice background. As our 1999–2001 president, Dr. Bachner drove home for me how effectively respectful leadership can guide a ship. As immediate past president, he advocated successfully for our first Council on Education. Dr. Bachner, who now chairs the Accreditation Committee, is universally respected and beloved.
These CAP leaders made thoughtful choices that continue to enlighten my own and I treasure their example. When we honor those who have smoothed our path and mentor those who will follow, we’re on the right track.

As each of these pathologists has understood, it’s all about the journey. So, are we there yet? Let’s hope not.
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Dr. Herbek welcomes communication from CAP members. Write to him at president@cap.org.