Barbara A. Crothers, DO, ASC President Joint Pathology Center Silver Spring, MD
I aspire to be a farmer. I’m already a gardener who enjoys the fruits and flowers of my labors and now you, the members of the American Society of Cytopathology, have entrusted me with a great landscape to sow the seeds of change. It is a great privilege! I am honored to serve you, the profession of cytopathology, and our patients. I am sincerely grateful for your vote of confidence. But I will need your help.
Farming and gardening are cooperative activities that rely on an interconnected ecosystem for success, so I will use that analogy this year to chart our way. New gardeners and farmers plan for the future, but also evaluate the present and reflect on the past. The ASC grows stronger and more stable each year; a thick trunk springing from a strong root system.
During my 30 years as an ASC member, I have been constantly amazed at how the Annual Scientific Meeting improves every year, and at the growth and outreach of our organization. Most of all, I am impressed with the welcoming warmth of the members and the Executive Board. Our organization is like a family that continues to embrace new members and get them involved. Without the encouragement and opportunities provided to me as a member, I would never be standing in these shoes as your President. You are the organization, and each of you has a significant role to play.
THEME: Grow Your Garden with 100 Years of Color
Every incoming President selects a theme or focus for the year, and I chose “Grow Your Garden.” Gardeners focus on their own habitat, their own little worlds of color; a patchwork of gardens endows the world with beauty. Gardeners tend to work alone (aren’t most pathologists and cytotechnologists introverts?), looking at the big picture, but also getting down in the dirt and details. You are gardeners every day; we all influence things in our environment and impact outcomes, no matter how small our actions or how small our sphere. When you are a gardener, you go around looking at what is in your garden, what is doing well, what is not, and make some changes: Weed-pull it out! Flourishing- plant more! Languishing- relocate! I ask each of you to work within your sphere of influence – whether that is in your workplace, on an ASC committee, in your community or internationally – to forward our goals as a profession.
This year we celebrate “100 years of color,” George Papanicolaou’s research based on Papanicolaou staining to color cervical epithelial cells. Without color, Dr. Papanicolaou would not have been able to differentiate between cellular changes. The foundation of cytopathology is morphology, the examination of colored cells. Our gardens thrive on color, and there are innumerable cell blossoms that we view daily. It works well with a garden theme, don’t you think?
The ASC has already laid the groundwork for many changes we’ll be working this year. We have a strategic plan in alignment with the quality and safe practice principles of the Institute of Medicine, thanks to Dr. Eva Wojcik. I can’t say enough good things about the ASC/ASCP Working Group for the Future of Cytopathology spearheaded by Kalyani Naik, MS, SCT(ASCP), Maria Friedlander, MPA, CT(ASCP)CMIAC, Lynnette Pineault, SCT(ASCP), Amy Wendel-Spiczka, MS, SCT, MP, HLT(ASCP)CM, Sandra Giroux, MS, SCT(ASCP)CFIAC, and A. Janie Roberson, BS, SCT(ASCP)CMIAC, focused on emerging cytopathology roles and re-invention of the profession, particularly the transformation of cytotechnology. They’ve done a lot of heavy lifting to move us forward towards team-based cytopathology practice. Most importantly, we continue to collaborate with our sister organizations towards common goals: the College of American Pathologists, the American Society for Clinical Pathology, the American Society of Cytotechnology, the Papanicolaou Society of Cytopathology, the International Academy of Cytopathology, and the United States and Canadian Academy of Pathology.
But sometimes you have to do some weeding. Looking at our committee list, I “pulled up” the Continuing Education Oversight Committee, Position Statements and Guidelines Review Committee, Website Committee, and the Paris System Website Task Force to make room in the garden for some new initiatives. Committees should have a lifespan too – that’s a good thing; it means they have achieved their purpose. Two other committees are soon to see a shovel come their way – The ASC/IAC Milan System for Salivary Terminology and the Milan System Website Atlas Committee, but they still have a bit of work to do this year.
PLANTING NEW SEEDS
Once you make a space in the garden, you are inspired to fill it in. The ASC/ASCP Working Group will be restructuring to work through some of their recommendations for future growth. I’ve transplanted many members of the Website Committee to the Product Innovation Committee to conceptualize and design new products to help sustain us financially. There are two new Task Forces – CELL and CLIA – to work on special projects I’ve chosen to focus on this year. There are 69 new committee member “seeds” to help with these efforts. After you appoint and plant, it’s important to nurture the seeds, so… I have maintained or appointed seasoned leaders to act as advisors for these efforts. They include Mohidean Ghofrani, MD for the Product Innovation Committee; Kara Hansing, BS, SCT(ASCP) and Robert Goulart, MD for the CELL Resources Committee; David Wilbur, MD, George Birdsong, MD, Carol Filomena, MD and Swati Mehrotra, MD for the Government Affairs and Economic Policy Committee; Lydia Howell, MD for the Public Affairs and Advocacy Committee; and Patricia Wasserman, MD for the Social Media Committee. I want to recognize, in particular, the critical work that they have all done in the past and continue to do for the Society. It doesn’t happen without all of you; all of you who volunteer, who attend Annual Scientific Meetings, or even who advocate for cytology on a daily basis at your places of work – your sphere. YOU make the difference.
What is this meant to grow? Every President can only accomplish a few things during his or her year, and I chose the following areas of emphasis.
Transform, Re-energize and Recruit for New Cytology Professional(s)
I am deeply concerned about our dwindling cytotechnology schools and workforce. We cannot function effectively without cytotechnologists. They are the canaries in the coal mines – where they go, cytopathologists follow. We all must reinvent ourselves, and help each other do it. I’m asking the ASC to consider sponsoring an ASC University to develop a Master’s Program in Cytology for a new Mid-level Practitioner. It may involve a consortium of universities. In addition, we’ll double our contributions to the Cytopathology Education and Learning Laboratory (CELL) Website through the CELL Task Force to provide on-line education both nationally and abroad. The Cytotechnology Programs Review Committee (CPRC) and the Cytopathology Program Director’s Committee will collaborate on curriculum for a mid-level pathology professional Master’s program. The Social Media Committee and others have been charged to invent new ways to recruit and retain individuals in our profession.
Improve underserved US population access to cervical cancer screening with Pap tests
To this day, it is still primarily unscreened and under-screened women who get cervical cancer. We’re in a climate where healthcare is becoming unaffordable, more confusing, and less accessible, while at the same time we are advocating less screening with a molecular test that doesn’t detect dysplasia. We have to reach these women with an understandable message of the importance of screening, and preserve the Pap test as a scientifically valid screening test. The Public Affairs and Advocacy Committee is charged with coordinating with local patient advocacy groups and other organizations to create and investigate ways to make the messages clearer, and the ASC has begun discussions with the College of American Pathologist’s See, Test and Treat program to become a sponsor.
Prepare for changes in government regulations for cytology laboratories
We currently have a President, Donald Trump, who has stated that for every regulation passed, two must go, and we should be prepared. I’ve created a CLIA Task Force under the Government Affairs and Economic Policy Committee to partner with sister organizations and to examine current regulations for scientific validity and draft “ideal” regulations that consider the changes in cytology and technology.
Ensure financial solvency of the ASC through development of new products
The new Product Innovations Committee is charged with taking ideas from an ASC Executive Board Task Force, headed by Dr. Liron Pantanowitz, and coming up with new products that can help boost our revenue. In addition, the Budget and Finance Committee will be performing a 5-year review of the financial health of our organization and determine future projections for solvency.
Support cytopathology research through continued grants
The Scientific Program Committee, ASC Foundation, and Research and Current Concepts Committees will collaborate to foment new research in cytopathology. That may include perpetuating the Shark Tank or finding other inventive ways of encouraging new investigators.
Not everything in the garden is beneficial–we are faced with many threats, primarily our diminishing workforce, the changing medical climate, and currently, loss of our vote at the AMA in the House of Delegates. We require 20% of our medical members to be AMA members to have a seat, and we rely solely on this position for influence in billing and reimbursement in Congress, so it is a critical position. I urge you, as a member, become an AMA member as well.
However, we are a strong organization, and we are capable of anything. What did President Barack Obama say? Yes, we CAN. And next year in Washington, DC, at this time, I hope to be able to tell you about the fruits of your labor and dedication. So the theme, “Grow Your Garden,” is an appeal for each of you to work within your garden, your sphere of influence; to grow your garden. Look around you. Evaluate your garden, your environment. That means capitalizing on what works, avoiding what doesn’t, and planting new ideas into the soil. You are a little dot, a grain of soil, in a large garden called the ASC. We are your support network- your soil, your nutrients, and your opportunity for growth. It’s easy to start small, coming to the ASC Annual Meeting, volunteering to sit on a Committee, posting to the blogosphere. I’m going to call on you, in the words of President John F. Kennedy, to ask not what ASC can do for you, rather ask what you can do for ASC!
You have my heartfelt thanks for all you have done in the past, present and future. GARDENING IS A HAPPY EXPERIMENT. This is your garden – go and play in it!