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From the President’s Desk: Embracing our future at CAP18

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December 2018—The CAP Curriculum Committee chaired by Sarah M. Bean, MD, follows a competency-based model to build an annual meeting program that is practical, prescient, and diverse. The committee is balanced demographically, experientially, and scientifically. Whatever the topic, there is someone who can speak to it.

Over two years, the group studies participant evaluations from prior meetings and debates the best-suited teaching tools for each topic. The goal is to provide utility, variety, relevance, and challenge. Their approach is thorough, thoughtful, measured. But as Kim Kruger, their longtime CAP staff person puts it, they’re not risk averse.

CAP18 covered 40 of the 51 potential subject areas identified for this year. The final faculty roster featured 130 of the brightest lights in pathology. We enjoyed breakfast workshops, roundtables on everything from digital pathology in community practice to changes in federal payment policy, small-group lectures, SAMs, and a buzzing exhibit hall featuring 91 industry representatives.

R. Bruce Williams, MD

A five-day immersion to learn from the best of the best in pathology makes for a lot of energy. Scientific content will always be the No. 1 reason to attend the annual meeting, but the event as a whole addresses our professional needs in new ways every year. Our House of Delegates had a successful meeting and the PathPAC reception was well attended. The CAP Foundation hosted an architectural boat tour of Chicago—a cold evening, warmly enjoyed. Our meeting began on Saturday this year to accommodate more of those whose weekday schedules are less flexible, and that experiment was a great success: Three of the four Saturday courses were among those best attended all week long.

As Dr. Bean explains it, the 15-member committee recognizes that CAP members rightfully expect learning that is dynamic and challenging. Courses are multidimensional. For example, an informatics course may emphasize communication if that aspect would be most useful to our members right now. Especially on hot topics, course content will cover preconceptions and misconceptions. And programming structured to make us think about how we are evolving as physicians, scientists, and, well, humans is on the short list.

Which brings me to the scientific plenary, a main event. This year’s topic, “Starting the Conversation: The Physician Burnout Crisis—Improving Resiliency and Wellness,” centered on the sometimes tenuous space where the personal and professional intersect. As I mentioned, the CAP Curriculum Committee is not risk averse. Still, its members were breaking new ground. They could not know how their audience would respond.

I’m sure that any misgivings were quickly dispelled when the meeting space began to overflow with attendees. First extra chairs were brought in. Then the staff abandoned their seats to watch the program via social media in the hallway. By the time we had welcomed everyone and introduced our speakers (James S. Hernandez, MD, a pathologist at Mayo Clinic, Bryan Bohman, MD, senior advisor to the Well MD Center at Stanford, and Timothy J. Bono, PhD, a psychologist at Washington University), standing attendees were lining the auditorium walls. Another 1,000 unique viewers watched the program online during the meeting. (The Oct. 21 plenary is among a number of Facebook Live videos broadcast at CAP18.)

Early on, the speakers explained, burnout was thought to relate to the stresses of training, which is no more true than the notion that physicians with burnout can heal themselves. This is a systemic problem with structural, institutional drivers, we learned, and resolution requires multidisciplinary collaboration. It’s everybody’s problem. All of us should be alert to signs of burnout in our practice communities; it can occur at any point in the professional lifespan and manifest in a variety of ways (most commonly exhaustion, cynicism, and reduced effectiveness). The CAP Board of Governors will talk about how we can help our members grow the skills to address this problem and bring this conversation to their institutions.

The Inspiration Stage featured three outstanding pathologists who make creative use of their skills. Colleagues of Lija Joseph, MD, send cancer patients to her laboratory, where she sits with them at a multiheaded microscope and explains what they see. Crystal Moore, MD, PhD, who faced and overcame significant losses and burnout early in her career, now talks and publishes on health, wellness, and disease for patients and families, and she volunteers with the CAP Foundation See, Test & Treat program. And Barbarajean Magnani, PhD, MD, who makes time in a busy practice to care for patients with addictions, showed how that work adds depth and dimension to all she does as a clinical pathologist.

Britt-Marie Ljung, MD, who led the first CAP workshops on fine-needle aspiration technique, and has done pioneering work to bring the technology to clinics across Africa, gave an outstanding special plenary. Dr. Ljung traced the history and explained the underlying science. In a personal note, she confessed that her spouse jokes that she has “failed at retirement.”
At the Spotlight Event, Kevin Pho, MD (of the KevinMD blog), gave a fine introduction to social media. We are all on social media already via online physician rating services, Dr. Pho reminded us, which is why even a minimal presence online can give patients a more accurate, nuanced view of what their pathologists do.

The CAP18 Abstract Program featured more than 640 posters representing clinical research and case-based experiences within 25 different areas. Five CAP junior members were recognized for their research as part of the Top 5 Junior Member Abstract Program. At the Residents Forum meeting, talks, roundtables, and brainstorming breakouts produced an ambitious to-do list. Our newest colleagues are an intrepid, bright, and welcoming group.

For space reasons, I can’t fully report on the many well-deserved awards and must ask you to visit the website to read about them. Two that I will mention are Pathologist of the Year, presented to our immediate past president, Richard C. Friedberg, MD, PhD, and the CAP Staff Outstanding Achievement Award, presented to Bryce Gilmore, who has been a pillar of the CAP information services division for more than 40 years.

CAP19 will be held Sept. 21–25 at the Gaylord Palms in Orlando, Fla. Please join us. 

Dr. Williams welcomes communication from CAP members. Write to him at president@cap.org.

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