Chairman's Corner
Ronald J. Zabransky is New Division C Chair-Elect
Special Information Regarding the 98th General Meeting
New Poster and Presentation Format Minimizes Overlap and Facilitates Attendance
to a Variety of Sessions
Division C Business Meeting Reminder
ICAAC 1997 - Topics of Interest for Division C
Dr. Michael A. Pfaller to Receive the 1997 Becton Dickinson and Company
Award in Clinical Microbiology
Dr. Barth Reller is the 1997 bioMeriux Vitek Sonnenwirth Awardee
Variety of Activities Serve Interests of Clinical Microbiologists
American Academy of Microbiology
Board of Education and Training
Meetings Board
Membership Board
Charge to the Task Force on Clinical Microbiology
Publications Board
Public Communications Committee
Public and Scientific Affairs Board
ASM's Role in Assuring Professional Recognition of Clinical Laboratory
Scientists
ASM Council News
ASM Public Policy, What's Going On?
Overview of Sessions for the 1997 General Meeting - Miami - May 5 to May
8, 1997
- As you will see from this Newsletter, we have been extremely busy planning
sessions for both the General Meeting to be held in Miami, May 4 to May
9, and for ICAAC, which will be held in Toronto, September 28 to October
1, 1997. For the General Meeting 561 abstracts were reviewed and 468 were
programmed into numerous poster sessions (a summary of both oral and poster
sessions of interest to Division is provided at the end of this Newsletter).
Please Note that the Division C business meeting is scheduled for Tuesday
morning, immediately following the interactive session entitled 'Laboratory
Detection and Surveillance of Antimicrobial Resistance: Do You Know What
It Takes?'. I also encourage you to attend our two Award Lectures; the
Becton Dickinson Award presentation by Dr. Michael Pfaller and the bioMerieux
Sonnenwirth Memorial Award by Dr. Barth Reller.
I want to thank our Chair - elect, Dr. Michael Miller, for assisting in the Abstract review and programming process. Dr. Miller will assume responsibilities as Division C Chair as of July 1 1997. I also want to thank the Division C membership for providing me the opportunity to serve as Chair. It has been an honor and I look forward to seeing you in Miami.
As always, I welcome any comments or suggestions you might have regarding the Division and it's activities.
Daniel F. Sahm Chair, Division C
- The Division C membership has elected Ronald Zabransky, Ph.D. as the
new Chair- Elect. Ron will assume office July 1, 1997 at the same time
current Chair - Elect, Michael Miller, begins his duties as Division C
Chairperson.
- Dr. Ronald Zabransky received his B.S. degree in Biology from Rutgers
University (the State University of New Jersey) in 1956 and, following
a two year stint in the Army, his M.S. and Ph.D. in Microbiology from Ohio
State University, in 1961 and 1963, respectively. After serving for one
year as Assistant to the Staff in the Section of Clinical Microbiology
at the Mayo Clinic in Rochester, MN, he was appointed as a Consultant in
Microbiology in 1964. In 1969 he joined Mount Sinai Medical Center in Milwaukee,
WI as Staff Microbiologist and Epidemiologist and directed the Clinical
Microbiology Section in the Department of Laboratory Medicine, positions
he held for more than 20 years. During that same time period he held academic
appointments at the Medical College of Wisconsin (Microbiology), University
of Wisconsin Medical School (Pathology), and University of Wisconsin--Milwaukee
(Health Sciences), rising from the rank of Assistant to full Professor
at all three institutions. At Mt. Sinai Dr. Zabransky organized and was
the Director of the AAM/CPEP- accredited Post-doctoral Educational Training
Program in Medical and Public Health Laboratory Microbiology.
- In 1991 Dr. Zabransky was appointed Director of Clinical Microbiology
and Immunology and Professor of Pathology at the University of Texas Medical
Branch in Galveston, TX. In 1994 he accepted his current position as Chief
of Microbiology at the VA Medical Center in Cleveland, Ohio.
- Dr. Zabransky is an editor for the Clinical Microbiology Newsletter
and has served on the editorial boards of Diagnostic Microbiology and Infectious
Disease and Microbiology Letters. He has been an ad hoc reviewer for the
Journal of Clinical Microbiology, Antimicrobial Agents and Chemotherapy,
Clinical Microbiology Reviews, and Clinical Infectious Diseases.
- As an active member of the ASM, Dr. Zabransky has participated in many
symposia, seminars, and workshops at the ASM's general and ICAAC meetings
and local and regional laboratory science meetings. He has presented over
50 papers at national and international meetings and is the author or coauthor
of more than 70 peer-reviewed articles reviews, book chapters, and monographs.
His research interests have ranged from antimicrobial susceptibility testing,
particularly of anaerobes, to the identification of unusual organisms.
His publications have addressed his research as well as issues of education
and laboratory management.
- Dr. Zabransky is a Diplomate of the American Board of Medical Microbiology
(1969) and was elected a Fellow of the American Academy of Microbiology
in 1975. During his many years of membership in the ASM he has served on
numerous boards, committees, and subcommittees: National Registry of Microbiologists
(Chairman), AAM Board of Governors, Examination Committee (ABMM), Board
of Education and Training, Graduate and Undergraduate Education Committee
(BET), Professional Affairs Committee (Chairman and member) (PSAB), Laboratory
Practices Committee (PSAB), American Board of Medical Microbiology, and
the Quality Control and Microbiology Device subcommittees (Laboratory Practices).
He is the outgoing Councilor for Division C. Outside the ASM, Dr. Zabransky
has served as a member and consultant to the FDA's Office of Medical Devices
(Microbiology, Immunology, and Good Manufacturing Practices panels), member
of the Center for Disease Control and Prevention's Clinical Laboratory
Improvement Advisory Committee, member of the Accreditation Board of the
National Accrediting Agency for Clinical Laboratory Sciences, and as member
of and advisor to the National Committee for Clinical Laboratory Standards
Subcommittee on Antimicrobial Susceptibility Testing, member of the Microbiology
Area Committee, and as member its Board of Directors.
- ABSTRACT SUBMISSIONS. For the first time, ASM was able to accept
submission of abstracts electronically. Of all abstract submissions to
the General Meeting, 49% were submitted through either e-mail or ASM's
web site. Division C abstract submissions rose to 561. Of these 561, 169
were submitted electronically (30%). After review, Division C has scheduled
468 abstracts for presentation at the 97th General Meeting. Note: If you
don't know about electronic abstract submission, pay attention to the 98th
General Meeting Call for Abstracts. This piece will be available in Miami
Beach and will be mailed to all ASM members in June.
MICRO MARATHON. The first annual MICRO MARATHON will be held on Sunday, May 4. The SK race/walk will begin at 7:00 a.m. at the Fontainbleau Hilton. On-site registration fees are $15 and include a tee-shirt commemorating your participation. Call 202-942-9261 for further information.
SURVEY FORMS. ASM will be seeking our input on sessions, speakers, and the overall meeting. Session and speaker information will be collected in a survey form available on site. Overall meeting survey questionnaires will be mailed to attendees after the meeting. If you have an opinion, both good and bad, please share it. ASM staff and volunteers use this information to plan and program future meetings.
- Poster session times have changed in response to concerns raised by
the membership in 1996. Poster presenters will display their posters for
one-half day, either from 9:00 a.m. to 12:15 p.m. or from 12:45 p.m. to
4:00 p.m. Morning presenters will be available at their posters from 10:45
a.m. to 12:15 p.m., and afternoon presenters will be available from 12:45
to 2:15 p.m.
- A special poster session is being held in conjunction with the President's
Forum on Tuesday evening. Following the President's Forum, posters, presenters,
and refreshments will be available in Hall D from 7:00 to 9:00 p.m.
- Beginning with the 1997 General Meeting, seminars and symposia will
be scheduled from 8: 00 am to 11: 00 a.m. and from 2: 00 p.m. to 5: 00
p.m. While posters will be available for viewing all day, author attendance
is scheduled during two sessions around the noon hour (i.e. 10: 45 a.m.
to 12: 15 p.m. and 12: 45 p.m. to 2: 15 p.m.). This format should facilitate
visitation of posters while minimizing overlap with oral presentations
of interest, provide more time for lunch and conversation with colleagues,
and allow greater opportunity for attending exhibits.
- Seminars and Symposia of Interest to Division C Membership. Several
seminars and symposia have been organized with Division C interests in
mind. Several formats including the case studies, round tables, and the
new computer - based interactive session are being used to maximize benefit
to attendees. As always, membership feedback on the topics and quality
of presentation is important and desired. Dates, topics, and times for
presentations and poster sessions are provided at the end of the Newsletter.
- Several topics of interest to Division C members are planned for the
37th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC)
to be held from September 28 to October 1, 1997 in Toronto, Canada. Selected
examples of planned Sessions include:
- Antimicrobial Resistance: What Do and Don't You Know *
Back to the Basics in Laboratory Diagnosis of Infectious Diseases: Balancing the Costs and Benefits in a Managed Care Setting
Emergence of Group B Streptococcal Infections: New Patterns of Disease and New Promise for Prevention
Emerging Trends in Tick-Borne Diseases
Methicillin-Resistant Staphylococcus aureus: What Have We Learned and Where Do We Go From Here?
Update on Protozoal Infections
Vancomycin-Resistant Enterococcus: More Questions Than Answers
- Michael A. Pfaller has been selected as the 1997 recipient of the Becton
Dickinson and Company Award in Clinical Microbiology. Dr. Pfaller is being
honored for his research contributions that helped establish the role of
molecular typing methods in infection control and epidemiology and for
his pioneering efforts in antifungal susceptibility testing. Dr. Pfaller
has systematically adapted and evaluated numerous molecular techniques
for typing several nosocomial bacterial pathogens and expanded this expertise
to include typing of clinically important yeasts such as Candida spp. and
Cryptococcus neoformans. The development of these methodologies has provided
important tools to further expand our knowledge regarding the emergence,
spread, and potential control of bacterial and fungal nosocomial infections.
In the realm of antimicrobial susceptibility testing, Dr. Pfaller has been
actively involved in studies concerning both antibacterial and antifungal
agents where his insights and contributions have been invaluable. With
regard to the area of antifungal testing, Dr. Pfaller has been a principle
driving force behind the development and publication of the NCCLS reference
procedures for yeast susceptibility testing.
Dr. Pfaller received his MD degree in 1976 from Washington University School of Medicine, St. Louis, MO. As a medical student he was the recipient of the Bronfenbrenner Award for Outstanding Research in the Field of Infectious Disease. His post - doctoral training continued at Washington University School of Medicine and included a Fellowship in Laboratory Medicine, during which time he served as Chief Resident of Laboratory Medicine, and a Research Fellowship in Microbiology and Infectious Disease. In 1983 he was named Associate Director of Clinical Microbiology, University of Iowa Hospitals and appointed Assistant Professor of Pathology at University of Iowa School of Medicine. With the exception of two years in Oregon, Dr. Pfaller's entire professional career has been at the University of Iowa where he currently is Professor of Pathology, Co-Director of Clinical Microbiology, and oversees the Special Microbiology Laboratory.
Dr. Pfaller is certified by the American Board of Pathology and has been actively involved with the College of American Pathologist's Microbiology Resource Committee and with the National Committee for Clinical Laboratory Standards. In addition to his American Society for Microbiology membership, he is an active member of several other professional societies including the American Society of Clinical Pathologists, the Medical Mycology Society of the Americas, and the Infectious Diseases Society of America. Dr. Pfaller has served on the editorial board or as a reviewer for over 20 professional journals including the Journal of Clinical Microbiology, Clinical Microbiology Reviews, the European Journal of Microbiology and Infectious Disease, Antimicrobial Agents and Chemotherapy, and the New England Journal of Medicine. He has also served as a Section Editor and Volume Editor for the Manual of Clinical Microbiology and has authored or co-authored more than 40 books and book chapters.
Dr. Pfaller's research accomplishments have resulted in more than 250 publications, primarily in peer reviewed journals. While much of this work has focused on in-depth molecular epidemiology and antifungal susceptibility testing studies, his expertise has resulted in a number of publications concerning a wide array of topics significant to the field of clinical microbiology. His scientific productivity is also reflected in the fact that over the past 10 years Dr. Pfaller has secured funding for more than 90 research projects. The magnitude of Dr. Pfaller's enthusiasm for clinical research is equaled only by his unselfish nature and willingness to serve as a mentor for others. Since 1984 he has supervised the training and education of twenty six master students, doctoral students, and postdoctoral fellows. His unselfish nature is also evidenced by his consistent willingness to collaborate with and assist professional colleagues whenever possible. This most admirable trait has undoubtedly played a key role in Dr. Pfaller's scientific success.
As stated by Dr. Patrick Murray in his nomination letter, "Dr. Michael Pfaller has demonstrated remarkable productivity in a variety of arenas within the discipline of clinical microbiology." This fact, coupled with Dr. Pfaller's constant willingness to share and disseminate the knowledge and expertise he has gained, make him a truly deserving recipient of the 1997 Becton Dickinson and Company Award. Dr. Pfaller was nominated by Dr. Patrick R. Murray, Washington University School of Medicine, St. Louis, MO.
- Dr. Barth Reller has been selected as the 1997 recipient of the bioMerieux
Vitek Sonnenwirth Award. While Dr. Reller's outstanding research accomplishments
were recognized in 1991 with receipt of the Becton Dickinson award, the
bioMerieux Vitek Sonnenwirth Award is given in honor of his leadership
as a microbiologist, his promotion of innovations in clinical microbiology,
his dedication to the American Society for Microbiology, and his contributions
to the advancement of Clinical Microbiology as a profession.
Dr. Reller's leadership is amply evidenced by the guidance he provides through his substantial editorial involvement in the Journal of Clinical Microbiology and more than a dozen other professional journals focused on clinical microbiology and infectious diseases. Furthermore, Dr. Reller has been extensively involved in, and leader of, a number of national and international committees and organizations whose efforts impact our profession in numerous ways. These include the American Type Culture Collection, the American Board of Medical Microbiology, the National Committee for Clinical Laboratory Standards (for which he has served on four Subcommittees), the Food and Drug Administration Center for Drug Evaluation and Research (member of the Antiinfective Advisory Committee), and the Food and Drug Administration Center for Devices and Radiologic Health (member of the Medical Devices Advisory Committee). Additionally, Dr. Reller has provided expert consultation abroad for the World Health Organization with particular service focused on enteric infectious diseases and the epidemiology of infectious diseases in Singapore and Manila.
Dr. Reller's publications in the field of clinical microbiology and infectious diseases attest to his promotion of innovations in clinical microbiology. His contributions in this area are both numerous, with over 150 publications in peer - reviewed journals, and innovative. Dr. Reller is well recognized for his development and promotion of effective and efficient blood culture techniques. However, his insights regarding the utility of stool examinations and cultures on in - patients, the development of suitability criteria for endotracheal aspirate specimens, and the limited utility of antigen detection on cerebrospinal fluid specimens provide key examples of his additional innovations regarding the most appropriate use of laboratory resources for the diagnosis of infectious diseases.
Dr. Reller has been a Diplomat of the American Board of Medical Microbiology since 1974. Since that time he has not only served the Society indirectly by his national and international leadership and his publication record, but also directly through service on the editorial board of the Journal of Clinical Microbiology, as a member of the ABMM Oral Examination Committee ( 12 years), and as an organizer and participant in numerous presentations at the American Society for Microbiology General Meetings and Interscience Conference on Antimicrobial Agents and Chemotherapy.
Throughout his career Dr. Reller has been dedicated to the teaching and training of other health care professionals in the disciplines of Clinical Microbiology and Infectious Diseases. His teaching career began as a Clinical Instructor in Medicine at Emory University School of Medicine and, as Professor of Pathology and Medicine at Duke University School of Medicine, teaching continues to be a highlight of his accomplishments. Several of his trainees have go on to become notable contributors to the field of Clinical Microbiology and Dr. Reller has received numerous teaching honors including the Kaiser Permanente Award for Excellence in Teaching.
Dr. Reller's dedicated leadership and scholarship in Clinical Microbiology is in every way consistent with the qualities that the Sonnenwirth Memorial Award is intended to recognize. He is in every way a most deserving, recipient of this prestigious honor. Dr. Reller was nominated by Dr. James H. Jorgensen, University of Texas Health Sciences Center at San Antonio.
- The following article has been reprinted
with permission from the ASM News.
Clinical microbiologists form the largest single membership segment of ASM, with more than 7,300 full domestic and international members represented in Division C. ASM has developed many programs and conducts many activities on behalf of this constituency and is seeking additional means of serving these members at a critical time in the history of this profession.
"Significant changes are occurring in the clinical laboratory that are altering the practice environment," according to ASM President Kenneth Berns. "The introduction of new technologies and the increasing adoption of managed care programs, especially the latter, will have substantial effects on the careers of clinical microbiologists. ASM is committed to working with this important constituency to meet their needs at this critical time."
Managed care will have several influences in the clinical laboratory community, Berns noted, including effects on medical decision making, laboratory specialization, laboratory mergers and consolidations, delivery of training, numbers of diagnostic tests, reduced reimbursement for analysis and testing, and changes in employment prospects.
In response, the President is organizing an ASM task force to explore the needs of clinical microbiologists and the future of the clinical laboratory, and the American Academy of Microbiology is organizing a colloquium in this subject area. In addition to these individual ASM efforts, the Society is also undertaking a joint effort with the Infectious Disease Society of America to focus on problems faced by clinical microbiologists and their relationships with infectious disease specialists, Berns noted.
ASM has also joined a new coalition, the Laboratory Health Care Partnership, composed of several laboratory organizations. The Partnership has developed an initiative to convene a focus group of managed care organizations to help craft a strategic education campaign highlighting the value and benefits of laboratory testing and its critical link to diagnosis and treatment.
Of the 16 members of the Council Policy Committee, 4 are clinical microbiologists: Marie Pezzlo chairs the Membership Board, Judy Daly is an atlarge member representing the Divisions, and Roberta Carey and Marie Coyle are atlarge members representing Branches.
"Without question," Daly says, "the ASM leadership is committed to meeting the needs of and supporting clinical microbiologists. Currently the leadership is actively searching for the most effective means to gather and make available data, such as outcomes-based research, and then to publicize the highly positive impact clinical microbiologists have on quality and patient care," Daly notes.
As described below, the various units of the Society have current and future activities and programs for clinical microbiologists. These will be reviewed by the task force in developing a comprehensive approach.
American Academy of Microbiology
Of the 1,296 active Fellows in the American Academy of Microbiology (AAM), more than 16% are members of Divisions C (clinical microbiology) and V (clinical immunology). Combined, this group is the largest within the AAM. The Committee on Postdoctoral Educational Programs (CPEP) is the only accreditor of postdoctoral training programs in clinical and public health microbiology and immunology in the United States. The AAM also administers three professional certification programs. The National Registry of Microbiologists (NRM) certifies microbiologists at the bachelor's and master's degree levels in both clinical and nonclinical specialties. The NRM is working with the American Biosafety Association to develop a certification program for individuals who handle hazardous pathogens. The American Board of Medical Microbiology (ABMM) and the American Board of Medical Laboratory Immunology (ABMLI) certify doctoral-level scientists, who are then recognized under the Clinical Laboratory Improvement Amendment (CLIA '88) as capable of directing full-service diagnostic laboratories.
The AAM has recently added a full-time staff person to manage its certification and accreditation activities. "Having an ABMM certified professional heading a diagnostic lab is not a luxury but a wise investment in running a scientifically sound and cost-effective lab in the era of managed care," according to Carey. "Who knows better what is superfluous, like the unnecessary quality controls that ASM is working to eliminate, and what is critical for quality patient care?"
Of the 20 ASM awards administered by the AAM, 6 are targeted specifically to the clinical microbiology and clinical immunology communities. In addition, the Abbott ASM Lifetime Achievement Award and the Hoechst Roussel Award include clinical microbiologists among eligible scientists.
The AAM is organizing a colloquium on clinical microbiology in the age of managed care. Slated for 1997, initial planning will take place in
December at a meeting of the steering committee. The steering committee is co -chaired by John Matsen and Noel Rose. Other members are Patricia Charache, W. Michael Dunne, and Peter Gilligan.
Board of Education and Training
Through its Committee on Continuing Education, half of whose members are clinical microbiologists, the Board of Education and Training (BET) administers workshop programs at ASM meetings. About half of the workshops at the ASM General Meeting are specifically devoted to clinical microbiology topics, supplemented by workshops in management and communications that are substantially amended by clinical microbiologists. At the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), workshop topics are divided among management and laboratory diagnosis of infectious diseases. Each year attendees are surveyed, and their responses are used to make changes in the content of the workshops. Continuing Medical Education (CME) credits are available for all workshops.
BET also sponsors an audioconference program directed specifically at the clinical microbiology community. The program is sold to institutions that subscribe for up to 20 sessions per year. Topics are drawn from other meetings and workshops and reworked into shorter segments of no longer than 90 minutes. For the future, BET is studying site-based learning through distribution networks, such as satellite or cable networks and the Internet. A task group is being formed, and a pilot project is scheduled for 1998-99.
At the General Meeting, 25% of the 68 seminars available for programming by the Divisions are allocated to the divisional group that includes Division C. Division C establishes the topics and selects speakers for eight seminars (12% of all seminars). Clinical microbiologists also participate in the colloquium advisory committee that organizes 20 additional seminars under a general theme. Division C also conducts a business meeting and organizes a mixer. About 15% of attendees at the General Meeting are clinical microbiologists.
Six members of the ICAAC Program Committee are clinical microbiologists. Of the 25 invited sessions, half have direct relevance to clinical microbiologists. Among its activities, the Meetings Board is establishing consistent standards for both meetings and workshops and is creating a task force to assure that ASM retains its CME accreditation. The European Society for Clinical Microbiology at present co -organizes a session at ICAAC, and similar relationships with other societies are being explored.
The Clinical Microbiology Division comprises 16% of ASM members. The Membership Board continually collects demographic information about members in order to provide improved products and services. Branches, the independent affiliates of ASM, often have a significant number of clinically oriented programs and activities for their members. In addition, ASM provides a lectureship program that brings distinguished scientists to each Branch, more than 20% of whom are clinical microbiologists. In the future, Branches will be encouraged to organize meetings in conjunction with regional scientific organizations, including clinical microbiology societies.
The Membership Board also administers the Placement Service, which is dedicated to providing placement opportunities and career development training and information. The Placement Service offers workshops and round tables and forums at ASM meetings to help clinical microbiologists and others retrain for new careers. At the 1997 General Meeting, Sustaining Members will be supporting a symposium on the impact of managed care on the conduct of the clinical laboratory, entitled "Clinical Microbiology: Survival of Quality in the Managed Care Environment."
Charge to the Task Force on Clinical Microbiology
The charge to the Task Force on Clinical Microbiology is to assess the impact of changes in the health care environment on the clinical microbiologist and make recommendations for programs that ASM can expand or initiate that will enhance the value of ASM to clinical microbiologists at all levels of education and responsibility. Although not charged to implement the recommendations, the task force is asked to analyze data and prepare strategies for staff or member implementation. Among its efforts, the task force could:
- Use focus groups and surveys to better understand the needs and concerns
of clinical microbiologists and the field of clinical laboratory diagnosis
in order to inform its decisions
Review similar efforts by other clinically oriented scientific and professional societies and determine which programs or activities can be adapted by ASM
Recommend ASM programs to address the needs of clinical microbiologists
Recommend ways to educate prospective employers about the unique and essential role of clinical microbiologists.
ASM Press is the leading publisher of clinical microbiology books. The Press publishes the Clinical Microbiology Procedures Handbook, which is used by a vast number of clinical microbiologists, particularly those working at the bench level. Clinical microbiology titles comprise 40% of the titles and provide 35 to 40% of the revenue for the Press. Expected during the next year are major titles on food microbiology, drug resistance and antimicrobial agents, medical mycology, a medical microbiology textbook, and a 2nd edition of the computerized Cases in Medical Microbiology and Infectious Disease, which will be available on CD-ROM. Three ASM journals are directly relevant to clinical microbiologists. Two are peer-reviewed, the Journal of Clinical Microbiology and Clinical Diagnostic Laboratory Immunology. The third, Clinical Microbiology Reviews, is the major review journal in the field.
Public Communications Committee
The Public Communications staff works with the Public and Scientific Affairs Board (PSAB) in coordinating ASM's participation in National Medical Laboratory Week and distributes posters and other promotional literature. A major objective of the program is to communicate information about clinical microbiology to the press. The staff prepare press releases on new research or on demonstrations of diagnostic testing or quality assurance, keep clinical laboratory publications informed about ASM programs, and refer questions from the press about clinical laboratory issues to appropriate spokespeople.
Public and Scientific Affairs Board
In addition to representing ASM in the Laboratory Health Care Partnership, as noted above, the PSAB maintains two active committees on behalf of clinical microbiologists. The Laboratory Practices Committee has four subcommittees concerned with disinfection control, laboratory safety, medical devices, and laboratory regulation. The latter is active in reviewing the impact of CLIA and other regulations and legislation. The major issue this past year involved ASM communicating its support for CLIA regulations at all testing sites, including physician office laboratories.
The subcommittee also works with the Committee on Professional Affairs on CLIA quality control standards, examining Health Care Financing Administration (HCFA) regulations, and identifying quality control requirements that can be eliminated without compromising patient safety. Both committees recently surveyed a random sample of laboratories, asking respondents to indicate the type and frequency of reagent quality control failures. Results of the survey were presented as testimony to the CLIA Committee (see p. 627).
The Professional Affairs Committee also reviews federal and private standards for clinical laboratory personnel, including assessing employment ads in ASM journals that exclude qualified microbiologists from consideration for positions and grading of microbiology positions by federal government agencies. The Committee Chair represents ASM on the Health Care Finance Administration (HCFA) Laboratory Technical Advisory Committee, which will be examining clinical laboratory reimbursement issues, including competitive bidding. The Committee has also recommended three ASM members to serve on a HCFA panel revising the ICD-9 coding system for microbiology tests, which indicates the level of reimbursement allocated for such tests.
PSAB's Culture Collections Committee is working on federal regulations that affect the transfer and use of select microbial agents in the laboratory (ASM News, November 19 96, p. 580).
The Board works routinely with other organizations that represent clinical laboratory interests. These include the Coalition for Safe Patient Testing, which works to ensure minimum quality standards for clinical laboratories, and the Coalition on Laboratory Budget Issues, which focuses on Medicare reimbursement issues for clinical laboratory tests. PSAB also has a representative on the National Commission on Clinical Laboratory Standards, which sets instrumentation and diagnostic standards for clinical laboratories and tests.
PSAB also advises members on responding to state laws and regulations that affect clinical microbiologists. Currently the Board has been assisting clinical microbiologists in California, where there is an effort to write regulations recognizing Ph.D.'s as laboratory directors.
The Board is concerned with alerting clinical microbiologists to changes in health management and the impact on their career. A major survey of personnel needs of four employment sectors, including clinical laboratories, was recently completed. The results have helped employers establish a profile of clinical microbiologists. The Board annually organizes roundtables at the ASM General Meeting to bring issues to the attention of the clinical microbiology community. In 1996, there were roundtables on CLIA updates and on career issues.
ASM's Role in Assuring Professional Recognition of Clinical Laboratory Scientists
In 1967, the ASM gained the first foothold in the Clinical Laboratory Improvement Act of 1967, designed to regulate independent laboratories engaged in interstate commerce, by getting language amending the regulation to recognize ABMM-certified M.D.'s and Ph.D.'s as qualified to direct full-service laboratories. In 1988 and 1992, respectively, two developments occurred which significantly enhanced the role of doctoral clinical scientists working in the hospital laboratory setting. In 1988, the College of American Pathologists (CAP) changed their standard for laboratory director to include doctoral clinical scientists. In 1992, the Joint Commission on Healthcare Organizations (JCAHO) also recognized board-certified doctoral clinical laboratory scientists as being qualified to direct full service laboratories in hospitals. These two very important actions were the culmination of more than two decades of petitioning of CAP and JCAHO by ASM and AACC. In addition, current federal regulations to implement the Clinical Laboratory Improvement Amendment of 1988 include a provision requiring that directors of high complexity laboratories be either an ABMM/ABMLI-certified doctoral scientist or a qualified physician.
The elected representatives (Councilors) from each scientific division and each geographic branch, Group Councilors, Councilors-atLarge, the major elected officers of the Society, and the Chairs of the of the various Boards of the Society constitute the ASM Council, the major governing body of the Society. Even though there is only one Councilor for each Division, Division C has been fortunate over the past several years in having good representation from other members of Division C on both the Council and the Council Policy Committee which carries out the work of the Society during the year. In that regard you can be assured that our interests are being represented.
During the past year the Society implemented the plan to establish regional planning groups. These regional groups are designed to strengthen the activities of branches and their relationship to the national Society. A Regional Director has been appointed for each region and $10,000 has been allotted to each Director to carry out the objectives of the plan. The Regional Directors are empowered to facilitate communication with the national office, gather information about branch activities within their region, and distribute funds to the branches. For instance, branches can be given the opportunity to upgrade their annual meetings by providing funds for speakers or workshops. The plan will help to establish (i) leadership and direction to further support the goals and objectives of the, branches, regions, and national Society, (ii) establish a closer relationship between the branches and the national Society, and (iii) provide a mechanism whereby branches can request financial assistance for their needs. This plan has a sunset provision within five years unless it is officially established within the ByLaws of the Society.
A different dues schedule for recent graduates has been established. This will allow individuals progressing from student membership to full membership to retain their membership without a major financial burden. The lower rate will be available for qualifying members for up to two consecutive years.
Another major change that was implemented this past year was the opportunity to list an alternate Division (without vote) for membership. We know that our specialty of Clinical Microbiology overlaps with other scientific areas in the Society; e.g. antimicrobial agents, infection control, mycology, virology, etc. This will give opportunity for members of any one division to receive newsletters and other information and to participate in the planning and scientific activities of other divisions in the Society.
Serving as the Division C representative to the ASM Council has been a rewarding experience. My only regret is that I did not have the opportunity to serve a longer or second term. The infrequency of the Council meetings (once a year) and the time it takes to learn the responsibilities of the position does not permit one to develop a role or direction in the governance of the Society. Nevertheless, I thank you for the opportunity to have served the Division and the ASM in this way.
Ronald Zabransky, Ph.D.
ASM Public Policy, What's Going On?
The Professional Affairs Committee (PAC) has been working on a number of issues which we wanted to share with the larger clinical microbiology community. The ASM News publishes a monthly section "Public Affairs Update" which includes ASM related public policy news or events which affect clinical microbiologists. However, we would like to use this column to inform Division C about some of the committee's "works in progress" and hope to hear feedback from you on these projects and ideas for others.
l) The PAC is working with the ASM Membership Board to establish a clinical microbiology professional liability insurance program. If you would be interested in such a program, sponsored by ASM, please email Seemin Pasha, ASM Membership Department and let her know. She is trying to estimate the potential number of ASM members who would be interested in obtaining this type of coverage (spasha @ asmusa.org).
2) The PAC and the Committee on Laboratory Practices (Chaired by Mary Gilchrist), PSAB, have been working these past two years on revising the quality control (QC) requirements in the CLIA regulations. Two surveys of microbiology laboratories sponsored by ASM have been conducted to determine the amount of QC failures. The results of the survey led ASM to make the following recommendation to the Department of Health and Human Services (DHHS) in both written and oral testimony: "For commercial reagents surveyed with a 98% or greater success rate, test only new lots." This recommendation, if adopted, would lead to regulatory relief for clinical laboratories since QC frequencies could be substantially reduced thereby providing a cost savings without affecting patient care. CDC and HCFA have endorsed the ASM proposal. Judy Yost, Director, CLIA Program, HCFA will be a presenter at the CLIA Roundtable on Monday, May 5 at the ASM General Meeting in Miami and will be available for questions about the status of the ASM recommendation as well as other CLIA changes.
3) The PAC has been representing ASM on the Laboratory Health Care Partnership, a consortium of over 10 organizations (scientific/professional society's and commercial laboratories) interested in assessing the current health care environment and working collaboratively to communicate the importance of laboratory testing and diagnosis to patient care. Currently, the Partnership have sponsored focus groups of executive purchasers of health care, physicians and managed care medical directors, to research and determine the best way to communicate the value of laboratory testing and diagnosis to these audiences. The Partnership is considering producing a brochure explaining the benefits of quality laboratory testing for executive purchasers of health to help guide them when choosing among different health plans.
4) Members of the PAC have been working with a contractor on rewriting and revising the ID-10 codes for microbiology procedures to better reflect current microbiology practices. According to Vicki Basilisk, Member of PAC, the microbiology codes "will most likely quadruple in number and will be much more realistic. We won't have to make the tests we perform somehow "fit" into the outdated codes." If the new coding procedures are adopted by HCFA it is likely the CPT codes and reimbursement policies may also change. As this project progresses, the PAC will continue to inform Division C of any change.
The above issues are an example of the projects the PAC/PSAB/ASM are working on. We would like to hear your feedback concerning the current or potential activities of the PAC, or if you have any other questions regarding legislative or regulatory issues.
Alice Weissfeld
Chair, Committee on Professional Affairs, Public and Scientific Affairs Board, PSAB, ASM
Director, Microbiology Specialists Inc., Houston, TX (micro@netropolis.net)
and
Amy Melnick,
Manager, Office of Public Affairs, ASM amelnick@asmusa.org
MONDAY, MAY 5
Presentations
- 8:00 - l l :00 am;
- Division Group I Symposium: AIDS Updated; For Everyone There is Something
in the Basket.
- Clinical Microbiology: Survival of Quality in the Managed Care Environment
Medical Parasitology: Emerging Parasitic Infections and their Clinical Relevance
Epidemiology and Control of Medically Important Fungi
CLIA in the l990s: A Regulatory and Legislative Update (Public and Scientific Affairs Board)
- 10:45 am- 12:15 pm;
- Vancomycin-Resistant Enterococci: Surveillance and Detection
Molecular Methods for Bacterial Identification
Specimen Management: Collection, Transport, Processing, and Media Selection
Molecular Methods for Direct Detection and Typing of Bacteria
Quality Assurance and Cost Effectiveness
- Detection and Characterization of Emerging and Uncommon Pathogens
Detection and Quantitation of HIV and Agents of Viral Hepatitis
Antimicrobial Susceptibilities: Anaerobes and Miscellaneous Bacteria
Enteropathogenic Escherichia coli
Presentations
- 8:00 - 11:00 am
- Laboratory Detection and Surveillance of Antimicrobial Resistance:
Do You Know What It Takes ? (An Interactive Session)
Division C Business Meeting Immediately Follows
Identifying and Controlling Environmental Reservoirs of Nosocomial Pathogens (Division L)
- Becton - Dickinson Award and Division Lecture presented by Dr. Michael
Pfaller. Dr. Pfaller's lecture will be followed immediately by the Case
Presentations in Clinical Microbiology Session
Molecular Diagnosis and Infectious Diseases: Issues and Applications (Part of Genomics and Biotechnology Colloquium)
Evolution of Antibiotic Resistance (Co - Sponsored with Division A)
Challenges for the l990s: The Microbiology Laboratory's Response to Infection Control Needs (Division L)
- 10:45 am - 12:15 pm
- Laboratory Diagnosis of Cytomegalovirus
Microsporidia and Cyclospora
Laboratory Diagnosis of Enteric Bacterial Pathogens
Diagnostic Mycology: Molecular and Conventional Methods and In Vitro Susceptibility Testing
- Antimicrobial Susceptibility Testing: Staphylococci and Pneumococci
Mycobacteriology: Molecular and Automated Methods
Clinical Detection of Mycobacteria: Molecular Methods (Division U) Laboratory Detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and other Sexually Transmitted Agents
- Miscellaneous Topics in Clinical Microbiology and Epidemiology
Presentations
- 8:00-11:00am
- bioMerieux Vitek Sonnenwirth Memorial Award and Lecture presented
by Dr. Barth Reller. Dr. Reller's lecture will be followed immediately
by the Debates in Clinical Microbiology Round Table session
- Diagnostic Virology: Conventional and Molecular Methods
How Far Should We Go with Mycobacterial Identification ? (Division U).
- 10:45 am - 12:15 p.m.
- Laboratory Diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae
Bacterial Blood Culture Systems
Bacterial Identification: Non-Molecular Methods
Laboratory Diagnosis of Respiratory, Enteric, and Other Viral Pathogens
Mycobacteriology: Miscellaneous Laboratory Methods
Clinical, Epidemiological, and Microbiological Aspects of Vancomycin - Resistant Enterococcus and Methicillin - Resistant Staphylococcus aureus
Clinical Detection of Mycobacteria: Non-Genetic Techniques (Division U)
Antimicrobial Resistance Surveys and Studies (Division A)
- Giardia, Cryptosporidia, and Other Parasitic Agents
Antimicrobial Susceptibility Testing: Performance of Various In Vitro Methods
Nosocomial Infections and Molecular Epidemiology (Division L)
Presentations
- 8:00 - 11:00 a.m
- Update on Gram - Negative Rods: Taxonomy, Identification and Clinical
Significance
- Reemergence of Diptheria: Are We Ready?
- 10:45 - 12.15 p.m.
- Antimicrobial Resistance Vancomycin, Aminoglycosides, and Others (Division
A)