Lab Line by the Doctor’s Doctor
Blog Address: http://blogs.medscape.com/thomaswheeler
September 8, 2014

The Case for Case Reports

The case report has been considered one of the lowest forms of scholarship in academia.  It is typically the first publication for which a resident gets credit.  When I was a resident I remember a junior faculty person telling me "I don't do case reports anymore".  It was as if this could tarnish his reputation, doing a case report when he should have progressed to something more important.  Most journals seriously restrict the number of case reports, if they accept them at all. 
 
However, I would like to give a new perspective on this issue.  After over three decades in practice, there is little in the areas of surgical pathology that I practice that I have not seen or at least learned about at some point. 

However, what I...

Posted By: Thomas Wheeler  

July 16, 2014

RVUs for Pathology Workload – Good or Bad?

More and more academic centers (and many private groups) are going to an incentive-based compensation model with a base pay and the remainder of the compensation made up by indexing work productivity using the standard work RVU model.  RVU, short for “Relative Value Unit” was developed as an index of physician work in the 1980s by a work group at Harvard.  It has since bec...

Posted By: Thomas Wheeler  

June 4, 2014

Virtual Professors or Virtual Students? Both?

The physical presence of the medical students in didactic lectures is becoming a thing of the past.  In our medical school only about a third of students actually show up for the lecture.  The rest view the lecture material that is "streamed" on the internet for them to partake at their leisure.  They can speed up the boring lectures or slow down/repeat complicated lectures, all ...

Posted By: Thomas Wheeler  

April 11, 2014

The Pathologist’s role in Solid Organ Transplantation

Successful organ transplantation is one of the great success stories of modern medicine.  Most lay folks have little idea what a pathologist does, even less so concerning the role of the pathologist in evaluating organs for transplantation or assessing transplanted organs for rejection.  The former is the topic of this blog.

The United Network for Organ Sharing (UNOS) is the n...

Posted By: Thomas Wheeler  

February 7, 2014

Vanishing Thyroid Cancer?

Well, it had to happen to me eventually and it did last week.  I was moderating an important conference when I got an email on my smart phone from my assistant stating "Dr. X called to speak to you about a thyroid FNA you signed out as cancer.  He removed that lobe and the pathologist at his hospital said there was no cancer there.  The patient is an engineer and he is questionin...

Posted By: Thomas Wheeler  

December 30, 2013

What happened to 2013?

Wow, another year has passed! Years go by now faster than summers went by in my youth. 

Inevitably, year end brings an opportunity to reflect on the year just passed and to look forward to the New Year with new (or old recycled) resolutions for the year ahead.  The news media remind us of all of the celebrities who we lost this year for us to pause and reflect.  Professio...

Posted By: Thomas Wheeler  

December 30, 2013

What happened to 2013?

Wow, another year has passed! Years go by now faster than summers went by in my youth. 

Inevitably, year end brings an opportunity to reflect on the year just passed and to look forward to the New Year with new (or old recycled) resolutions for the year ahead.  The news media remind us of all of the celebrities who we lost this year for us to pause and reflect.  Professionally we had so...

Posted By: Thomas Wheeler  

November 25, 2013

Is Grossing Really that Gross?

The interview season for new residents for our 2014 class has been underway now for more than a month. I have been impressed by the number and quality of applicants this year. As a matter of routine I have lunch with the applicants (4-7 per interview day) where I present the strengths of our program and answer questions.

Although none of the applicants has specifically asked me about ...

Posted By: Thomas Wheeler  

September 16, 2013

How to Kill the Bleeding Time Without Shedding Blood

Although I have been a chair of an academic department for 9 years now, only this year did I take on the additional duties I had in a former academic life when I assigned myself the additional duties of being chair of the department of pathology and laboratory medicine at our large county hospital (Ben Taub) serving indigent patients.  As I became aware of the depth and scope of our clinic...

Posted By: Thomas Wheeler  

August 2, 2013

Is it cancer or a lesion?

This past week an editorial was published in JAMA "Overdiagnosis and Overtreatment in Cancer An Opportunity for Advancement"(JAMA -published online July 29, 2013) regarding overdiagnosis and overtreatment of cancer that has become an important public health issue in recent times.  This story has generated much interest and was picked up by several news services.  Most of thi...

Posted By: Thomas Wheeler  

 
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About This Blog

This blog will provide commentary on a broad range of pathology topics -- from anatomic pathology (surgical, autopsy, cytopathology) to clinical pathology (hematopathology and chemical pathology, transfusion medicine and blood banking, microbiology, serology, and immunology). Discussions will vary from medical knowledge, practice performance and improvement, ethical issues, and public policy, including reimbursement and political advocacy. Comments and suggestions are welcomed.

Disclosure: Thomas M. Wheeler, MD has disclosed no relevant financial relationships.

Poll: Case reports are 1|2|3|

  • Thomas Wheeler

    Dr. Wheeler is board certified in anatomic pathology, clinical pathology, and cytopathology and has served 30 years in academia. He received his medical degree from Baylor College of Medicine in Houston, Texas, where he completed his residency in anatomic and clinical pathology and was Chief Resident in Pathology. Dr. Wheeler serves on the faculty at Baylor in the Departments of Pathology & Immunology and Urology; he is the W. L. Moody, Jr., Professor of Pathology and is Chair of the Department of Pathology & Immunology.

The content of this blog does not necessarily reflect the viewpoints of Medscape.
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