UBMD

Almost everyone who has ever provided a blood, tissue or other sample to a doctor at a hospital or one of several hundred private practices in the Buffalo area has done business with a UB pathologist.

Yet few people ever think about where their test results come from—let alone the names of those who interpret their sample and return crucial diagnoses to their personal physician.

The group that oversees all this is UB Pathologists Inc. (UBP), one of the 18 practice plans under UBMD, which provides pathology services to Buffalo General Hospital, Millard Fillmore Gates Hospital, Millard Fillmore Suburban Hospital, DeGraff Memorial Hospital, Women and Children’s Hospital of Buffalo and Erie County Medical Center—and to the Center for Laboratory Medicine at Flint Road in Williamsville.

“We have 18 people who are practice plan members, eight people who are employees and six who are associated with the plan, but aren’t part of it,” says Samuel Goodloe Jr., MD, chief of service for pathology and laboratory medicine for UBP. “We provide pathology services to Kaleida, specifically laboratory directors and medical directors, as well as the laboratory director and medical examiner at ECMC and a director for the regional lab at Flint Road.”

Also a member of UBP is the Erie County Medical Examiner, a local government position that the county contracts out to UBP to fill.

New York State regulations require that each hospital have a licensed medical professional to oversee the operation of its labs, Goodloe adds, although the lab technicians and other staffers who perform most tests and manage other administrative functions at each site are employees of the Kaleida Health System.

Overall, 435 employees of Kaleida laboratories, with oversight by UBP, performed 4.32 million billable tests for the year ending Dec. 31, 2006.

“It’s a symbiotic relationship,” Goodloe says of the complex connection between UBP and Kaleida. “They need us and we need them.”

Also complex is the process by which samples are analyzed and returned to a physician. Different procedures are followed based on the type of sample being analyzed and the urgency of the case. Urgent samples—such as when a surgeon removing a cancerous tumor keeps a patient on the operating table until a UB pathologist completes the tissue analysis—are handled in-house in order to keep turnaround time under an hour. Non-urgent anatomic samples, which typically involve physical samples such as a skin or organ biopsy, are analyzed by technicians and pathologists in the lab at Buffalo General Hospital; non-urgent clinical samples, which typically involve bodily fluids, including blood, urine, feces and sputum, are handled by technicians and pathologists at the regional laboratory. UBP’s residency training program—consisting of 16 medical residents—is also housed at Buffalo General Hospital.

Goodloe says anatomic samples are generally more likely to require interpretation by a trained UB pathologist than clinical samples, which usually only require a chemical analysis—performed by a machine—under the supervision of a lab technician.

“Our process is basically a Kaleida process,” he adds. “The sample gets to us from the doctor’s office by our picking it up and bringing it back to the regional laboratory where the assays that they requested are performed. This generates a report that’s either mailed to the office or is available electronically.”

He adds that the greatest challenge facing his practice right now is exploring a system by which UBP can connect to the electronic record systems being used by local medical practices. Electronic medical records (EMRs) are not only increasingly being used by the private practices who contract out to UBP for pathology services, he says, but are also an important part of the effort to merge all 18 of UB’s independent practice plans into a single unified plan under UBMD.

“A large number of local practices are actually using EMRs already,” says Goodloe. “We don’t want to end up being behind the eight ball.”

—Kevin Fryling