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About Pathology

What is pathology?

Pathology (from Greek “pathos” = suffering; “logos” = study of) is the branch of medical science that studies the causes, nature and effects of disease, by examining organs, tissues, cells and bodily fluids. In ancient times, pathologists did this through autopsy of patients who died of disease. In modern medicine, these organs, tissues, cells or fluids can be obtained from living patients by biopsy, at surgery or through pap smears, urine and blood samples, so the information can be used to guide the treatment of living patients.

Who are pathologists and how is a pathologist involved in my care?

Pathologists are physicians (Medical Doctors or Osteopathic Physicians) who specialize in the analysis of organs, tissues, cells and fluids obtained from patients. Pathology is considered a specialty within medicine, like surgery, internal medicine, cardiology, etc. You may not meet the pathologist who is involved in your care, but your own physician or another specialist such as a radiologist will request a pathologist to analyze the specimen they obtain from you. In some cases, the pathologist may obtain the specimen, such as a bone marrow biopsy or needle aspiration biopsy. In all cases it is the pathologist who either directly performs the analysis of your diagnostic specimen, or supervises other professionals, such as laboratory technologists, who do this. The pathologist communicates the results of this analysis to your physician to assist him/her in making decisions about your treatment.

Why is the pathologist’s diagnosis important to my care?

The basis for making decisions about your medical care lies with knowing the correct diagnosis, so the treatment that is most effective against your disease can be selected. Beyond just providing the diagnosis, the pathologist often also provides additional information which is helpful to your doctor, such as the severity of your condition, what organs are involved and which treatments are most likely to be effective. The pathologist may also provide information about the susceptibility of your family members to the condition and, importantly, can often tell your doctor when you DO NOT have a certain disease, or how well your condition has responded to therapy and whether adjustments or additional treatments are necessary.

How does a pathologist make a diagnosis?

Pathologists look at your tissues and cells under the microscope and are experienced in recognizing the unique patterns of the many thousands of diseases that may affect us. In addition, they use a number of sophisticated “ancillary” technologies or special stains and studies to learn more about your tissues and cells than can be determined using only a microscope. These include biochemical, immunologic and physical techniques and methods that provide additional information about your specimen and how you are affected by disease. Finally, because pathologists are also medical doctors, they consult with your other doctors to discuss your signs and symptoms and assist your medical team in putting all of this information together into a unified picture of your condition and state of health.

What kind of training and certification do pathologists have?

Like other doctors, pathologists are graduates of medical or osteopathic schools (usually 4 additional years of study after college). They then undertake additional intensive study of human health and disease, which may take from 3 to 5 more years of study in approved pathology residencies. Pathologists must also meet certain requirements for years spent in training and pass various certification exams before they are licensed to practice medicine by the state Medical Board and certified as specialists in pathology by the American Board of Pathology.

Are there specialists within pathology?

Yes. The “explosion” of medical knowledge in the last few years has made it difficult for one doctor, even a specialist in pathology, to know about all the diseases that affect all the organs. So some pathologists undergo training beyond that described above to become “sub-specialists” within the field of pathology. This additional training may last another 1 to 3 years and be focused in areas such as diseases of the gastrointestinal tract, liver, skin, cancer diagnosis, and a number of others.

About My Biopsy, the Results and Report

What steps are involved in processing and interpreting my biopsy or other specimen?

In order to get the most accurate and complete results on your biopsy or other specimen, the process often begins with consultation between your doctor and pathologist before the specimen is even obtained or before you go to surgery. The specimen must be the correct specimen and its integrity must be maintained while it is transported rapidly to the pathology laboratory. There it is labeled and tracked by computer so that it is not confused with specimens from other patients. The specimen is examined by the pathologist (or a laboratory technologist under the pathologist’s supervision) and then undergoes a complicated set of steps in chemical processing that takes several hours. A microscopic slide or slides are then made from your specimen and examined under the microscope by the pathologist. He/she may then consult by phone with your doctor and may also decide to order additional tests if needed to arrive at the correct diagnosis. A written report is then produced and delivered to your doctor.

How long does it take before a result is available?

Despite the large number of steps involved and the number of people needed to process your specimen (courier’s, lab technologists, pathologists, etc.), a final report is usually ready within 24 hours on most types of specimen. In some cases, when the need is emergent, your pathologist may come in to the hospital or laboratory after hours to provide immediate consultation or analysis for your doctor. In other cases, when more complicated testing is needed, the results may not be available for several days or a week or more.

What kind of information is present in a pathology report?

In addition to containing a diagnosis based on analysis of your specimen, your pathology report may also include other interpretive comments or recommendations based upon further research, discussion with your doctor and other specialists and the results of more specialized testing. Often it is not just the diagnosis that is important to your care, but this other information that is useful in “fine tuning” your treatment. As noted before, sometimes the most useful and important information to both you and your doctor is knowing what you DO NOT have.

How does my doctor receive my diagnosis?

Your doctor will receive a written report, which may come in paper format, or electronically over his/her fax machine or through his/her computer. He may receive the report in several “installments” as various results become available, so that he can begin your treatment as soon as possible. Finally, as noted, your doctor may speak directly with the pathologist about you and your medical care.

How can I get a copy of my results?

The best way to obtain your results is to ask your doctor or his/her staff to provide you with a copy. This is because it will give you an opportunity to discuss the meaning of the results with your doctor and to understand his/her recommendations and plans for your treatment. It will give you a chance to ask questions of the person who knows your particular medical situation the best. You can also obtain a copy of your results directly from Aurora Diagnostics Western Pathology, but you must come in or send us a signed release for medical records in order for us to give these to you. We do not release results over the phone or to anyone except the patient without a signed release. This is to protect the privacy of your medical information.

What if I have a question about my results?

The best person to discuss your results with you is your personal physician. This is the individual ideally suited to understand the meaning of your results in your particular situation. If your doctor has questions, he can contact one of our pathologists 24 hours a day to discuss your results. If you cannot reach your personal physician, our pathologists are willing to discuss your results with you, but we cannot provide medical or treatment advice because we do not know your complete medical history.

What about “second opinions?”

It is not uncommon, and is often a good idea, to obtain a “second opinion” about your diagnosis or results, especially if the interpretation or potential treatment plans are complicated or unusual. It is very common for pathologists at Aurora Diagnostics Western Pathology to obtain second opinions from other pathologists, both within Aurora Diagnostics Western Pathology and from specialists across the country. In addition, patients often see additional doctors or would otherwise like their pathology results reviewed for a second opinion. We are happy to arrange this and will mail your results and slides to consultants at your request and at no charge to you by us (the consultants will normally bill you for their second opinion, however). Remember also, that the pathologists at Aurora Diagnostics Western Pathology are highly trained and recognized experts and we are also happy to review your pathology results that may have been obtained elsewhere, and provide you with our second opinion.

About Costs and My Bill

Why did I get a bill from a pathologist, who I never met? Although you may never meet your pathologist, as you can tell from other information on this website, your pathologist is a highly trained physician who is expert in the diagnosis and understanding of disease and who works “behind the scenes” for you as a partner with your other physicians to make sure they receive the correct diagnosis and other information about your health status they need to make the best recommendations and decisions about your medical care.

Will I receive a bill from Aurora Diagnostics Western Pathology?

Yes. Like all other physicians, pathologists bill patients and/or their insurance companies for the services they render. Like other businesses, pathology laboratories have to pay their rent, buy expensive equipment and supplies and pay salary and benefits to their own employees.

Can I pay my bill online?

Not at this time. However, this may become possible in the future.

Will my insurance plan pay for the pathology services I receive?

In most cases, yes. Aurora Diagnostics Western Pathology has been providing services to patients in Nevada and parts of California for many years and we are on the approved list of providers for almost all insurance plans which operate in this area. If you have questions about whether insurance covers your pathology services, call our billing office at (775) 746-3412.

What if I don’t have insurance?

The most important thing to us is that you receive the pathology services you need so your doctor has the information necessary to provide you with the best medical care for your condition. If you are not covered by insurance, we will work with you to establish a payment plan and provide discounts as needed so that your health care needs are met.

About Aurora Diagnostics Western Pathology

How is Aurora Diagnostics Western Pathology chosen to test my specimen?

There are a number of laboratories that provide pathology services in our area. In most cases, you and your doctor have a choice of where to send your specimens for analysis. Many physicians choose Aurora Diagnostics Western Pathology because of our reputation for fast service and accurate results. Our pathologists are among the most highly trained and credentialed in Nevada and are known for their expertise in different areas of pathology and medicine. A pathologist is available to your physician 24 hours a day for consultation on your results. We also have a large laboratory staff working 6 days a week and also on call to provide testing services. It is this commitment to service, ready communication and accurate results that makes Aurora Diagnostics Western Pathology the laboratory of choice for many physicians.

Does Aurora Diagnostics Western Pathology provide a full range of diagnostic services?

Aurora Diagnostics Western Pathology provides a broad range of diagnostic services, but we do not do everything. In most cases, if you need a test or procedure we do not offer, we are able to locate a laboratory that does and arrange for this testing to be performed for you. At the current time, we do not offer gynecologic cytology (“Pap testing”) or outpatient clinical laboratory testing (blood and urine tests), though we do supervise this testing as it is done at a number of hospitals in our area.

Who works at Aurora Diagnostics Western Pathology?

Aurora Diagnostics Western Pathology and its affiliated company, Nevada Histology Laboratory, have a staff of about 30 full or part-time employees and 8 pathologists.

Where is Aurora Diagnostics Western Pathology located and where do they provide services?

Our main office and laboratory is located near the Keystone exit off Interstate 80 in Reno. We also have offices at St. Mary’s Hospital, Northern Nevada Medical Center and Tahoe Forest Hospital in Truckee. In addition, we provide services at sixteen hospitals or surgicenters throughout Northern Nevada and Northeastern California and have a courier network that services physician offices throughout this area.

How do I know the quality of the pathology services I receive from Aurora Diagnostics Western Pathology is high?

Aurora Diagnostics Western Pathology’s laboratory is fully accredited, licensed and inspected by all agencies or associations that do this, including the State of Nevada, and the College of American Pathologists. We meet all federal, state and local regulatory requirements, including CLIA (Clinical Laboratories Improvement Act). All of our physicians are university-trained Medical Doctors, licensed by the state of Nevada. All are Board Certified specialists in Anatomic and Clinical Pathology. In addition, several have additional training and certification in Cytology, Dermatopathology, Hematopathology and fellowship training in Gastrointestinal Pathology and Liver Pathology.

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