RT Journal
A1 Ohrt DK
T1 The intraepithelial lesion: A spectrum of problems
JF JAMA
JO JAMA
YR 1989
FD August 18
VO 262
IS 7
SP 944
OP 945
DO 10.1001/jama.1989.03430070092039
UL http://dx.doi.org/10.1001/jama.1989.03430070092039
AB The Bethesda System described in this week's issue of The Journal is an improved approach to reporting cervical/vaginal cellular abnormalities.1 When abnormal, the "routine Pap smear" initiates a complex chain of events, judgments, and interactions. From a quality assurance perspective, it is necessary that each link be carefully performed if the clinical episode as a whole is to have any utility. The attending physician, cytopathologist, and the patient herself all have roles that will make or break this concatenation.2Backed by their office managers, attending physicians have too often sought the low-price competitor with the best turnaround time. Ironically, as the price of reading and interpreting cervical cytology samples has been leveraged downward by competition for contracts, the price to the patient or payer has been pushed upward. Some physicians have become much like brokers, all too often failing to concern themselves with the necessary balance of cost