Is it time to revisit your hospital's autopsy policies?
Primary certification criteria of the American Board of Pathology (ABP) for Anatomic Pathology Certification are a common requirement for obtaining autopsy privileges, according to Samuel Furci, MPA, principal at Furci Associates, LLC, a healthcare accreditation compliance consultancy in West Orange, New Jersey. The ABP's Anatomic Pathology Certification requires an applicant, among other criteria, to have completed at least 50 autopsies by the time the application for certification is submitted.
The ACGME also has a 50-autopsy requirement for post-graduate training. "Therefore, new grads applying for initial appointments as anatomical pathologists can meet the competency requirement. The problem for the hospital is how can they maintain an ongoing competency if the hospital performs very few autopsies?" Furci says.
Anatomic pathology privilege forms are often not specific about autopsy volume requirements. However, they include group criteria for several different procedures (for example, frozen sections, bone marrow biopsy, and aspiration). An applicant for privileges can select these group criteria to demonstrate proficiency in a minimum number of areas—for example, three of seven areas, says Furci.
"We looked at the pathology privileging sheets that we have available, and some of them don't specify the requirement for anatomical autopsy; it's grouped in with other criteria. So if you meet three criteria, you're good for anatomical autopsy privileges," says Furci.
"In other words, it takes 50 procedures to get certified, but what do you do to maintain certification?"
In addition, pathologists may be board-certified for a lifetime if they were originally certified before 2006. Continuing education requirements must still be met, but they may not have performed an autopsy in years, adds Patricia Furci, RN, MA, Esq., principal at Furci Associates.
Autopsies are no longer being done at many smaller hospitals, she says. "This impacts a lot of what regulators enforce, and [autopsy privileges] can be overlooked," she says.