The Truth... What is it?


As to this file/page you have been directed to: it's @ Dr. Shaw's personal website

Since Pap smear screening is not a medical emergency (or even medically urgent), interest in getting a result quickly makes much less sense than an intense quality focus on optimizing the detection of cervical abnormalities & cancer. However, many patients are anxious and hyper-demanding and pressure their doctor for an answer. So, turn-around-time (TAT) had become a competitive business factor among labs during the days of independent physician practice. Average or current TAT may be easy to compare between labs. But quality is not. One key note: Sudden growth spurts in Pap smear volume or difficulty obtaining/retaining qualified cytotechnologists can profoundly affect TAT (especially if the lab is absolutely committed to highest quality...which is our position).

TAT factors:  

  • Quality of specimen sample and demographic information (TAT increases if either is poor): The lab can't "make up" for a poor sample. And insurance companies require very exact information or they won't pay for your test. It is sometimes many days before we can get the office obtaining the Pap sample to to get the info back to us [and they may have been delayed as they tried to find the patient and get her to respond with the missing info.). All such information...including that office giving us their assignment of various billing codes which we must copy onto our reports...goes into our correct submission legally required billing codes so that a "clean claim" is billed out by our billing company so that the patient's insurance might pay on your bill from the lab/pathologist.
  • accessioning: in order that we are always able to find your previous medical information AND so that this new Pap result can be correlated accurately with prior info AND that we can find other pertinent medical info that might be in LMC's electronic medical records on each specimen, our hospital has the Pap smear function staffed one shift per day, 5 days per week. A case is only accessioned into the electronic system AFTER the above federally-required correct information has been received. This involves Meditech pre-registration, Co-Path order entry, and Team IA requisition scanning on each and every Pap case.
  • Transport: Effectiveness and efficiency of the courier or specimen submission process system (specimen delays arriving to the lab increase TAT).
  • Clerical & Prep: Adeptness/efficiency of lab clerical and cytopreparatory personnel (slow or poorly trained/supervised or poorly equipped personnel increase TAT). Where a lab provides liquid-based Pap sample services, there is an entire preparatory process that did not have to be done in the "old days" of the "conventional Pap". All Paps are screened in our lab by professionally by skilled cytotechnologists (not true in many labs) searching for cell and other abnormalities (many labs only screen for cell abnormalities). And, if the test is also backed up by artificial-intelligence computerized screening (we do this on all cases that the instrument will "accept"...about 98%), this is an entire additional process.
  • Attracting employees: Inability of a lab (for whatever reason) to pay wages enough to get proper employees may lead to less-good personnel.
  • Supply of employees: A poor supply of personnel in a geographic area could lead to less-good, less efficient doctor office or lab personnel.
  • Work-hours restrictions: Inability (lack of funds, unwilling to spend the funds, employees unable to work overtime) to work personnel enough hours to reduce TAT. The Cytology Dept. at Lexington Medical Center cannot staff 24/7/365 and works one shift per day, the 5 weekdays per week. Increase TAT.
  • Adequate team #1: Inability to hire, retain, or work enough hours: cytotechnologists. Increases TAT.
  • Adequate team #2: Inability to hire, retain, or work enough hours: pathologists. Increases TAT.
  • Back-up: Inability to "farm out" excess workload (due to government restrictions, lack of "takers", inadequate capability of "takers", etc.) increases TAT.
  • Government Case Volume Restrictions: Inability to work cytotechnologist screeners as many hours and cases per week as some would like (governmental restrictions) increases TAT.

    If you are reading this file as a:

  • patient: hope that you get the sharpest-eyed, best-quality job possible done on your Pap sample...and let your doctor or us know of any special needs or expectations regarding TAT (see below).
  • lab manager: hope that you can afford a top quality Pap process and be spared unreasonable demands.
  • clinical doctor: provide the best Pap sample possible and let your lab know of any special needs or expectations regarding TAT (see below).
  • curious citizen: if you are female and are, or have been, sexually active, be sure that you make your annual appointment & get regular Pap smears!


Being set toward doing the best job we can do for the trusting patient (yet being realistic), our gold standard for TAT ( since this hospital opened in 1971) at Lexington Medical Center is to have a target TAT of 5 business days and consider ourselves in "problem territory" if TAT gets over 10 business days. In 2015, our TAT on normals is 2-3 days and abnormals about 5 days. Because of personnel vacation and sickness, a little fluctuation is unavoidable. Remember, it is always possible for pressured people and businesses to bend these factors so as to meet special needs/demands of a particular patient or patient situation (we welcome a "heads up" phone call or attached note to the requisition on any such case [803-791-2485]). May I take this moment to encourage reasonableness on the part of all parties.

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(posted 17 Feb. 2001; latest update 20 May 2015)