Stronger Together: A History of Non-Physician Members in the American Society for Clinical Pathology

By Karen A. Brown - February 02, 2021

Brown

The early years

In 1922, ASCP was founded as the American Society of Clinical Pathologists. Originally organized for educational, scientific, and charitable purposes as well as to promote clinical pathology as a distinct specialty among physicians,1 the Society has developed a unique position in the years since. Today, ASCP has inclusive membership and physicians and non-physicians work together to advance the practice of pathology and laboratory medicine. The general history of the ASCP is well-documented. However, the evolution of the role of non-physician medical laboratory professionals within the Society is less defined.

In the 1960s, ASCP recognized the important contributions of non-physicians, especially medical technologists, to laboratory medicine. The Society established the Associate and Affiliate member category in 1968 and by 1971, membership was fully opened to non-physicians to include medical technologists and technicians, PhD clinical scientists, other technicians, and students.2 Then ASCP created the Committee on Associate and Affiliate Member Activities (CAAMA) in 1977 to represent this new class of membership. Two important programs launched by CAAMA for medical technologists, which still exist today in revised formats and titles, were Tech Sample and Workshop Weeks for Technologists. Tech Sample, now the LabQ program, was developed in 1980. Workshop Weeks, now known as Workshops for Laboratory Professionals (WLPs), and offered typically over three days, originated in 1982.

Formation of the Associate Member Section

Laboratory professionals responded in such numbers to the opportunities to belong to the ASCP and attend or subscribe to high-quality continuing education that CAAMA evolved into the Commission on Associated Member Activities (CAMA) in 1983. Continued growth in the non-physician member category and the need to strengthen medical laboratory professional involvement in ASCP, as well as in continuing education and advocacy efforts, resulted in the development of the Associate Member Section (AMS) in 1986 (through a bylaws change approved by the physician membership vote at the ASCP Annual Business Meeting in Orlando, Florida).

The first AMS Administrative Board consisted of 12 members, with Barbara J. Minard, MT(ASCP)SH,SI, serving as the Chair. The AMS Chair initially also had a seat as a voting member of the ASCP Board of Directors. The AMS Board was charged to “plan and administer educational and related activities.”2 The original AMS was structured around nine committees that included, in addition to Tech Sample and Workshop Weeks, Plan and Scope, Finance, Products/Publications, AMS Teleconference, Government Relations, Membership/Awards, and Regional Advisory. In 1987, the Educators Committee was added. That same year, the Regional Advisory Committee launched the State Advisors Network, which becomes the grassroots hub of activity for ASCP non-physician members. The AMS Administrative Board and Committees constituted a completely separate governance structure from the ASCP pathologist (Fellow) members and organized uniquely distinct meetings, including a matrix meeting convened each February in Chicago.

The AMS continued to mature and define its mission and goals as well as to begin laying the groundwork for a strategic planning process. In 1991, another new committee, the Committee on Continuing Education (CCE), joined the Teleconference Committee to strengthen the AMS educational portfolio.

Recognizing the growing popularity of the AMS among non-physicians in ASCP, the Board of Directors added an AMS Member-at-Large position in 1992. This same year, the AMS evolved beyond offering continuing education activities for laboratory professionals to awarding scholarships for students in various medical laboratory programs. The AMS also finally adopted its Mission Statement in 1992. By 1994, membership in the AMS totaled 57,048 and yet an additional committee, Professional Affairs, was organized to address issues related to professionalism and image.2 The AMS Administrative Board expanded in number when the Chair of the Government Relations Committee becomes an ex officio member.

CAMA first honored laboratory professionals with the Technologist of the Year Award in 1983 and the Distinguished Service Award in 1985. The ASCP-AMS continued the legacy of recognizing its most valued members by introducing the Associate Member Lifetime Achievement Award and the Excellence in Education and Excellence in Management Awards in 1996. Though the format has shifted through the years from an AMS-exclusive awards presentation to a broader, all-inclusive ASCP-wide ceremony, these awards are still conferred today to exceptional laboratory professional members of the Society.

Transitions

Likewise, a slight transition in AMS and ASCP governance structure, and approach to continuing education, began in 1999. As public policies, government regulations, and legislation affecting pathology and laboratory medicine increasingly impacted all members of the Society, a single, integrated Government Relations Committee replaced the AMS Government Relations Committee. This new committee had equal representation from ASCP Fellow and Associate members. The following year, the AMS and the ASCP’s Commission on Continuing Education co-located their fall meetings and successfully planned educational programs to be offered by the Society. The team approach to structuring Society committees continued in 2001 with the merger of the AMS Professional Affairs Committee and the ASCP’s Communications and Public Relations Committee to form a new Communications and Public Relations Committee that, again, consisted of equal numbers of ASCP Fellow and Associate Members.

Although integration of AMS and ASCP committees was slowly permeating through the Society, there were still two completely separate administrative boards and duplicates of most committees for ASCP Fellow and Associate Members. In addition, for several years, AMS leadership had recognized that the name “American Society of Clinical Pathologists” no longer truly represented the growing number of non-physician members in the Society and advocated for a name change. Eventually, two significant transitions in the Society further shifted the pendulum to become a more inclusive organization, both in name and in governance.

First, at the ASCP Annual Business meeting in Philadelphia in October of 2001, the ASCP membership voted (and later ratified in a bylaws revision) to change the name to the American Society for Clinical Pathology. Though a simple alteration, the effect was significant in strengthening and integrating the Society and in recognizing the thousands of non-physician members and their important role on the laboratory team. The name change was effectively active on January 1, 2002.

Also in 2002, the second noteworthy transition occurred in the ASCP. John Ball, MD, JD, MASCP, MACP, was named the new Executive Vice President. Not a pathologist, but known for his strong leadership and organizational revamping skills, Dr. Ball readily identified the redundancies of governance within the Society. Therefore, in June of that year, the Board of Directors approved formation of a Task Force on ASCP Governance and President E. Eugene Baillie, MD, FASCP, appointed a six-person Task Force charged “to recommend a governance structure to enable ASCP to most effectively and efficiently provide the services, programs, and products that will allow the Society to remain vital to the membership throughout their professional lives.”3 AMS Chair, Susan R. Besaw, SCT(ASCP) joined Margaret G. Daniels, MA, MT(ASCP)SC, Chair of the ASCP Board of Registry Board of Governors, as non-physician members of the Task Force.

In June of 2003, the Task Force presented its major suggestions to the Board of Directors, which were unanimously approved. These recommendations were based on the ideas that governance of the ASCP should be integrated and “organized around its major programs and services, and that governance and management should be structured in parallel.”3 The functions of the Society, operationalized through various committees and councils, should be organized around five commissions. These five commissions: Membership, Education, Publications, Self-Assessment, and Public Policy, would be responsible for developing overall strategy for the Society and monitoring implementation in its specific content areas.4 The Task Force also considered two overarching facts in its deliberations and which would directly impact non-physician members of the Society: (1) integrated committees that include all classes of members would be more efficient and possibly more effective than the current separation of committees by Fellows and Associates; and (2) Associate members of the Society, although numbering approximately 130,000, were represented on the 18 member Board of Directors by only one member-at-large and one ex-officio member.4 Therefore, the Task Force recommendations included that the Board be restructured as well with an increase in voting Associate members to a total of five. Originally, these positions would be filled by three Associates-at-Large, the AMS Chair, and the AMS Chair-Elect. All officers would still be Fellows (physicians) and Fellows would still comprise a majority of the Board. It should be noted that the Task Force also reviewed the relationship of the Board of Registry (BOR) to the Society, affirming that the independence of the certifying function should be guaranteed and assuring its financial stability.3 The Task Force further believed the relationship between the ASCP and the BOR would be strengthened if the Chair of the BOR Board of Governors became a voting member of the Board of Directors.4 This position on the Board of Directors was eventually eliminated beginning in 2016 to ensure complete autonomy of the certifying agency.

The end of the AMS

The Task Force on Governance essentially recommended that the AMS Administrative Board and its committees be replaced primarily by a new Commission on Membership, which was charged to “ensure that each of the constituencies of the Society have a local, state or regional presence” as well as a defined mechanism of communicating with its constituents and providing appropriate benefits and opportunities for volunteering.3 The “constituencies” of the ASCP would be organized into councils to include the Fellow, Diplomate, and Resident Physician Councils and the Chairs of these councils would also sit on the Commission on Membership. The Commission on Membership would be chaired by a member of the Board of Directors and also include three members at large. Interestingly, the Task Force initially proposed that “Associate” members be called “Diplomates.” This suggestion was eventually rejected by the AMS Administrative Board for several reasons, but notably because of the potential for confusion by the Associates if both the Society’s governance structure and its name were both changed in the same year (would Associates think their membership category was also eliminated?). In addition, the BOR did not support the term “Diplomate” as it was a category of certification.5 Although originally only the Council Chairs sat on the Commission of Membership, once the Commission became completely functional, defined its goals, and had several face to face meetings, the Chair-Elects for each council were granted seats on the Commission as well to ensure continuity and overlap from the Council leadership since terms for each of the Council Chairs were only defined as one year. Once the Society’s new governance structure was fully implemented, the Chairs of the Councils also became ex-officio members of the Board of Directors, as did the Chair-Elect of the Associate Council.

The final recommendations of the Task Force on ASCP Governance were voted on and approved by the Fellow members of the Society at the Annual Business Meeting convened in New Orleans in 2003. The affirmation by Fellow members of ASCP demonstrated responsiveness to the needs of a large segment of the membership, the inclusiveness of the organization, and recognized the close relationship of pathologists and non-physician laboratorians as members of the healthcare team. Over time, the essential recommendations of inclusiveness and diversity have also proven to strengthen the Society.

The AMS Administrative Board continued to exist until 2004. During this time period of 2003-2004, the Board developed policies and procedures to effectively transition into the Associate Council. In essence, the old AMS Administrative Board gradually began to function more like the new Associate Council. A top priority was to define policies and procedures to elect a Chair and Chair-Elect, recognizing that these positions would also be additional representation of non-physician members on the ASCP Board of Directors.

The initial composition of the Associate Council consisted of a Chair, Chair-Elect, and members who represented the Society’s eight geographic regions. These regions were the basis of a grassroots state network designed to reach ASCP non-physician members at the local level and first organized from the Regional Advisory Committee of the AMS. These individuals not only represented their respective regions, but, over the years, also a variety of laboratory professionals as well, to include laboratory managers and directors, histotechnologists and technicians, cytotechnologists, MLTs, MTs (MLSs), program directors and education coordinators, pathologist assistants, and PhD scientists.

In the early days of the Associate Council, use of the descriptor “Associate” was discussed by the Council’s leadership and its members as well as non-physician ASCP members at the local level. In June of 2006, the ASCP Board of Directors approved a motion brought forward by the Commission on Membership proposing that the term “Member” be used to identify all ASCP members known as “Associates.” Unfortunately, this name proved to be confusing since all pathologists and non-physicians are “members” of the Society. In 2008, the Member Council became known as the Council of Laboratory Professionals, though the name “Member” is still used as a class of membership within the Society’s bylaws.

More Advancement for Non-Physicians

Additional advancements for the non-physician members in Society governance were initiated in 2012 when a second Task Force on ASCP Governance was convened. Although the original charge to this Task Force was to explore mechanisms defining domain specific knowledge categories instead of the product-focused committees in place at the time, this Task Force decided to step back and again take a broad look at the Society’s governance structure. 6Therefore, the Task Force reviewed and considered options whereby the ASCP bylaws could be amended to provide further rights to laboratory professional members. It was also important to extend these rights while still maintaining ASCP’s status in the American Medical Association (AMA) House of Delegates. The qualifications for membership in the AMA House of Delegates include that a majority of the voting members of a medical society must be physicians. The Task Force recognized, however, that in this context, “voting membership” encompassed voting only on officers and bylaws, not on various committees or the governing board of a society.6 The Task Force proposed that ASCP officer positions be redefined as “leadership track” which included President, President-Elect, Vice-President, and Past-President and “corporate” officer positions of Secretary and Treasurer.6 Only Fellow members would be eligible to serve in leadership track positions and to vote on candidates for these positions. Laboratory professional members would be eligible to serve as corporate officers as well as to vote on candidates for these positions. The current at-large positions on the Board of Directors would remain unchanged, with Fellow and Laboratory Professional members both having the right to vote on member-at-large positions. The Task Force recommended that the Bylaws Committee be charged with developing the mechanisms for their proposals while ensuring the ASCP’s membership status in the AMA House of Delegates be maintained.6 In time, Bylaws Committees were able to establish operating policies allowing Laboratory Professionals (“Member” class), as well as Fellows, the right to serve as the Board of Director Secretary and Treasurer. Likewise, additional bylaws revisions created a mechanism whereby a Laboratory Professional member, with specifically defined service to the Society, would have full voting rights (along with Fellows); in other words, could vote on all officer and at-large director positions for the Board of Directors.7

Summary

Ever since its organization in 1922, the ASCP has been true to its mission, providing excellence in education, certification, and advocacy on behalf of patients, pathologists, and laboratory professionals. This mission, in part, is advanced when all members of the Society are supported and recognized as vital, not only to the Society, but to the practice of pathology and laboratory medicine. Although other governance changes through the years have reorganized and revamped various commissions, committees, and councils of the Society, the basic composition of these entities has remained integrated. Leadership provided by Chief Executive Officer, E. Blair Holladay, PhD, MASCP, SCT(ASCP)CM, the current Board of Directors non-physician members-at-large, non-physician ex officio members, and the non-physician Secretary and Treasurer, have further strengthened the governance of the Society. These non-physician members of the Board of Directors are also supported by all Fellow members of the Board. Over many decades, the ASCP has transitioned to becoming inclusive and diverse, especially in its non-physician membership, and truly demonstrating that the Society is stronger together.

References

  1. Rodriguez Jr., F. and Ball, J. The American Society for Clinical Pathology: The Pathology Society of “Firsts.” LabMedicine. Volume 38, Number 10. October 2007.
  2. For the ASCP Associate Member Section 15th Anniversary. A History of the AMS. 15 Years of Advancing and Promoting Laboratory Professionals. 1986-2001.
  3. Task Force on ASCP Governance. Final Report (draft). May 21, 2003.
  4. Baillie, E. President’s message. Laboratory Medicine. Volume 34, Number 8. August 2003.
  5. Personal communication from Susan Besaw. August 5, 2003.
  6. Task Force on ASCP Governance. June 22, 2012.
  7. Addendum A. ASCP Bylaws. Presented at the ASCP 96th Annual Business Meeting. Baltimore, MD. October 5, 2018. 4-7-20; 4-23-20Kab

Karen A. Brown

Medical laboratory sciences professor