Talking to Our Customers

David Novis, MD FCAP, Peter Perrotta, MD FCAP, Barbara Blond MBA, Thomas Long, MS

In any service industry, gaps between what services customers expect from providers and what those providers actually deliver to their customers may undermine perceptions of service adequacy and quality. In the field of pathology, there is no robust market research that addresses potential discordance between customers’ expectations and actual delivery of pathology services. 

Through the College of American Pathologists, we conducted a short, “back of the envelope” survey of the perceptions of oncologists and laboratory directors regarding the delivery of molecular diagnostic services. We chose to inquire about molecular pathology testing because it is a burgeoning field of pathology in which service demands might not yet be crystalized. We chose to survey oncologists because they are regular patrons of these services who would necessarily rely on pathologists to steward them through ordering and interpreting the results of these complex tests.  And we chose to survey laboratory directors because they are responsible for ensuring that the scope and quality of pathology services meet the needs and expectations of physicians who use pathology services. 

To launch this study, we asked 12 volunteer laboratory directors who were Fellows of the College of American Pathologists to complete a questionnaire and to send an identical questionnaire to one oncologist customer who they believed to be knowledgable about the clinical use of molecular pathology testing practices. The questionnaire asked participants to grade on a 5-point scale their perceptions of the importance of 8 common molecular pathology services, and on a three-point scale, the frequency with which pathologists provided those services. The survey questions are listed below.

Molecular Pathology Services Questionnaire

1. Pathologists select suitable tissue for testing related to targeted cancer therapies.
2. Pathologists select which laboratory samples are sent to the reference laboratory for testing related to targeted cancer therapies.
3. Pathologists identify surgical pathology cases that may benefit from testing related to cancer therapies where such testing has NOT been ordered.
4. Pathologists assist oncologists with testing related to targeted cancer therapies issues.
5. Pathologists review orders for testing related to targeted cancer therapies to ensure test appropriateness.
6. Pathologists incorporate result of testing related to targeted cancer therapies into final and/or amended surgical pathology reports.
7. Pathologists are involved in ensuring institutional criteria and protocols for utilizing testing related to targeted cancer therapies are followed.
8. Pathologists attend multidisciplinary conferences where testing related to target cancer therapies are discussed for patient management.

What these 8 services are is less important than whether or not laboratory directors and oncololgists agreed on the value and delivery of these services.  This was not an assessment of the nature of  molecular pathology services, but rather an assessment of customer service in which we molecular pathology services was an arbitrarily chosen example.