By Barbara J. McKenna, MD, FASCP

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We must not, in trying to think about how we can make a big difference, ignore the small daily differences we can make which, over time, add up to big differences that we often cannot foresee.
—Marian Wright Edelman
    President and Founder of Children’s Defense Fund

What is the American Society for Clinical Pathology all about? The answer to this question depends on whom you ask.

Two Different Perspectives

Many members perceive the Society as an education organization offering a variety of workshops, educational courses, and assessment activities. Others focus on the publications—two professional journals, this magazine, and a variety of superb textbooks. Others identify with the ASCP Board of Certification because they are proud of their certification. Still others appreciate the Society’s extensive advocacy efforts and its foreign and domestic humanitarian activities.

In contrast, members who are active as volunteers— those serving on and perhaps even chairing ASCP committees, commissions, task forces, or boards—give yet another answer. It is one that comes from having the broader perspective of those actively involved in leadership. These individuals state that ASCP is a not-for-profit organization that exists to serve the public good. These views can be seen as two different perspectives. One perspective is of ASCP as a membership organization that exists primarily to serve members through education and certification. The other perspective is that the Society’s primary purpose is defined by what is in the best interests of the public health. There is a similar duality in the perspectives of pathologists and laboratory professionals regarding their professional lives.

The Unexpected Dichotomy

In more than 20 years as a practicing pathologist, I have worked beside scores of dedicated pathologists and other laboratory professionals. Again and again I have seen their willingness to go the extra mile, take the extra step, stay late, arrive early, or continue to be available from home when a patient’s well-being is at stake. There are little thanks for those who work with such dedication and compassion. Clinicians are sometimes aware of the extra efforts, but patients certainly are not. Thus, the motivation of these tireless professionals appears pure. It seems their primary motivator is, in fact, to help patients. To test this hypothesis, I asked a number of current and former colleagues, including pathologists, medical technologists, cytotechnologists, and histotechnologists, the following questions:

• Why did you choose your profession? For pathologists this question had two parts: Why did you decide on medical school, and then, why did you choose pathology?
• What part of your profession drives you, gives you the greatest satisfaction, and makes you want to get up and go to work?

Given my observations on laboratory professionals’ exquisite attention to patient care, I thought the answers would center on a desire to help people. Instead, 80% of the pathologists I talked with cited an interest in science and a desire for intellectual stimulation as their reasons for going into medicine and pathology. The remaining 20% cited a desire to help people. Interestingly, most of the latter group consists of international medical graduates. The technologists were more evenly split, with about half of them listing an interest in science and half of them expressing a desire to help people.

In response to the second question, 80% of everyone I asked cited intellectual satisfaction and the opportunity to face new challenges and learn new things as their primary motivators. How can this apparent contradiction be reconciled? On the one hand there is the strong focus on quality patient care, and on the other hand there are the stated motivators—an interest in science and a desire for intellectual stimulation.

I believe it is precisely the joy of meeting scientific challenges and searching for knowledge that drives most pathologists and laboratory professionals to achieve excellence in patient care. Were they not interested, curious, alert to the unusual, and hungry to learn more, pathologists and laboratory professionals would probably deliver no more than mediocre, uninspired care.

How do the responses of my colleagues relate to ASCP? ASCP is an organization of 130,000 members. If my colleagues reflect the attitudes of the average ASCP member, then the ASCP comprises people who are driven by a keen interest in science, a love of learning, and an appetite for new challenges. In addition, if my colleagues’ dedication to quality patient care can be generalized to all ASCP members, then this is an organization that consists of people who strive to serve patients and therefore the public to the best of their ability.

ASCP’s Ultimate Focus: The Patient

Returning to the original question, What is the ASCP all about? What is the ultimate reason for its existence? Does it exist for the purpose of education or advocacy? Is it a certification organization? Are its humanitarian activities in accord with its underlying mission? Or does ASCP exist primarily for the public good, as its leadership contends?

I believe the answer to all these questions is “Yes!” ASCP educates pathologists and laboratory professionals so that patients and the public can receive the best health care possible. ASCP certifies laboratory professionals to ensure that well-trained, qualified individuals are available to provide needed laboratory services. Likewise, ASCP advocacy efforts focus on issues that ultimately affect the public good. A natural extension of these patient- and public-focused activities is ASCP’s participation in training and certifying laboratory professionals around the world.

In the end, it is each member’s own particular perspective that determines what ASCP is. For the technician or technologist who wants verification of his or her professional qualifications, ASCP is all about certification. For those who join ASCP for its educational programs and products, the Society is all about education. When laboratory professionals respond to an eAdvocacy Alert and write to their state or federal representatives, ASCP is all about advocacy.

On the other hand, taking a step back and looking at everything ASCP does on so many fronts, it becomes clear. Ultimately, the Society’s broad range of activities focuses on ensuring quality health care through uncompromisingly high standards of laboratory medicine. ASCP helps real people in real laboratories help real patients. And that is something about which we can all agree.

Dr. McKenna is Associate Professor of Pathology, University of Michigan Medical School, Director, Surgical Pathology Fellowship Program, and attending physician, University of Michigan Hospitals, Ann Arbor, MI. This column is based on a speech Dr. McKenna delivered at the ASCP Annual Business Meeting and the Opening Keynote Session at the ASCP Annual Meeting in Baltimore on October 16, 2008.