Pathology Associates Inc. PS, the medical practice here that examines tissue samples for separately owned Pathology Associates Medical Laboratories Inc. (PAML) and several hospitals, is considering hiring Sacred Heart Medical Centers five pathologists and taking over the hospitals pathology department.


It also plans to rename the practice to avoid the long-time confusion that has existed between Pathology Associates and PAML.


Tom Allerding, president of Pathology Associates Inc. PS, says the expansion would give the practice 18 pathologists, allowing it to reach a size and work-volume level that could attract specialized pathologists from elsewhere and thereby help the practice remain competitive with bigger, more specialized pathology practices located elsewhere.


We believe this will allow us to provide a higher level of service, Allerding says. Were basically moving the practice to the next level.


Allerding hopes that the expansion could be completed late this summer or this fall, but he says that the practices pathologists and the hospitals pathologists still are discussing several details, such as the new name, staffing and personnel issues, and logistical issues.


This is a big process, Allerding says. The larger you get the more complicated issues such as staffing and vacation time become. I dont think any of the issues are insurmountable, but there still are many details to work through yet.


If the expansion proceeds, Pathology Associates would arrange a medical-director contract with Sacred Heart, which basically means that employees of the practice would provide pathology and related consultation services at the hospitals laboratory, Allerding says. Pathology Associates already has such arrangements with Holy Family Hospital, Valley Hospital & Medical Center, Kootenai Medical Center, and other outlying hospitals, he says.


Pathology Associates currently has a similar, limited arrangement with Sacred Heart, Allerding says. He says that Sacred Heart is unique in that it employs its own pathologists, while most hospitals contract with Pathology Associates or other pathology groups.


In the past year, however, Sacred Heart has contracted with Pathology Associates to provide a medical director to head its lab. That medical director, Dr. David Hoak, is employed by Pathology Associates, unlike the five pathologists who work with him and are employed by Sacred Heart. Hoak says the Sacred Heart pathologists have voted in favor of joining Pathology Associates.


Other benefits of the expansion would include the possibility of gaining new types of technology, standardizing pathology practices throughout the city, and developing a computer system to coordinate pathology information, Hoak says.


In anticipation of the expansion, the pathologists already are discussing the possibility of buying an automated Pap smear screening device, which would have been too expensive for Sacred Heart and Pathology Associates each to buy separately, but now appears more affordable for a combined group to acquire, Hoak says. He says that eventually the group hopes to connect Pathology Associates computer with Sacred Hearts to improve data sharing and coordination. He adds, however, that such a project likely would take at least two years to accomplish.


Pathology Associates, which was formed in 1958, is separate from PAML, which is a much larger operation and is owned by Bourget Health Services Inc., a for-profit subsidiary of Sisters of Providence, which also owns Sacred Heart. While Pathology Associates mainly examines tissue samples, such as skin and breast biopsies, gall bladders, and lung tissue, PAML performs tests on all types of bodily fluids, including blood, serum, spinal fluid, and urine.


During the last 15 years, Pathology Associates has grown from five pathologists to 1311 of whom have an ownership interest in the practice. Adding another five pathologists would make Pathology Associates a big pathology practice by Spokane standards, Allerding says. Pathology Associates already is the largest pathology practice in Spokane, he says.


Still, he says that pathology has been changing a lot in the last year, and pathology practices of 20 to 25 physicians arent uncommon in bigger metropolitan areas, such as Los Angeles. The reason pathology groups are growing is because theyre adding specialists. Allerding says that as medical information increases, the need for specialists grows so that they can stay on top of the most current information.


Also, national labs have begun specializing and advertising those specialties to hospitals and clinics. For instance, one lab will specialize in screening only for prostate cancer, Allerding says. Already, when Pathology Associates receives a tissue sample that is more complicated and requires a higher level of expertise, that sample is sent to a lab elsewhere.


We want to keep those cases in Spokane, Allerding says. To examine those tougher samples, though, local pathology groups have to be able to attract specialists who can perform work with higher levels of expertise, he says. To attract specialists, the practice has to have a high enough volume of work, and by adding Sacred Heart to the list of hospitals it serves Pathology Associates will reach that added work volume, Allerding believes.


We already can provide most of what the national companies currently are providing, Allerding says. Our intention is to make sure that we have the expertise we need to stay competitive.