Pap Smear

This word has been much in the news lately, oh so many experts.  Lots of money.  I wonder what the bill is for this?  It helps to think of the doctors in the US as one giant doctor with one giant wallet.  Then if he makes one dollar for each pap smear, you stick it in the wallet, and you will see the wallet xplode.  To avoid this scene you change the $ones to $fives and if the wallet still xplodes, then we have to jump to tens .... until we go to $millions.  Honk if you think $billions.

Before we make this about money, lets make it about people.  Lets go back in time a few years to my beloved state of Texas.  Once upon a time there was little if any legislation, and apparently there were no ethics either.

The doctors would bring the women into their laboratory, scrape the vaginal wall and make slides.  The slides would go to the histologist and they would read them.  The results were reported positive if any cancer cells or precancerous cells were observed.  The results were reported negative if no cancerous cells were observed.

You have to understand that the smears have to be mounted on a big microscope, the histologist adjusts the magnification, removes the slides and completes the report.  The report eventually got back to the doctor, oh, there were no computers then, so it went by snail mail or carrier.

So many pap smears, so few histologist, so little time.  Not a problem, the technologist began to throw away the slides and report negative results. It was the path of least resistance ..... they were paid by the slide.

As you have guessed lots of women were dying of cervical cancer, there were law suits, congressional investigations ..... all of those bureaucratic happenstance that people engage in to keep the public happy, like finger pointing.   None of this brought back those women whose lives had been wasted by criminal minds.  But there was legislation, the histo techs could no longer take the slides home and throw them away....they could no longer read an infinite number of slides, they could only read so many a day.

Now imagine yourself, in a lab coat, in a room in the back, with a table and a scope for a companion.  You read the slide, make a report, if the slide is iffy you call the pathologist.  Now the histologist has a degree in laboratory science and a year of training to get the specialty.  Making life and death decisions, now ask yourself....would my child make a good histologist?

Now the plan is to cut the number of pap smears a women gets from annually to once every five years.  The research supports this plan.  So if your child would not make a good histologist, go for five years, but if your child grows up with a back ground in biological sciences, loves microscopes, has a degree, speaks English, and has the makings of a competent histology technicians, than take it annually.

See, I told you it wasnt about the money.  Now when you see your gynecologist and your legs are in the stirrups, before he inserts that k-y smeared disposable speculum, you have something to work with.

You can understand that without Quality Control, and supervision, there is no way that this will work.  Lucky for us this is all in the past and we have nothing to worry about .....