Dr. Carlynn Collins This is Me

Education

 Web References

1. 1. CYTOPATHNET-EN- October 1997 Newsletter

   www.cytopathnet.org/newsletter - [Cached]

   Published on: 11/29/2001   Last Visited: 8/28/2002

   A colleague recently loaned me a tape recording of a remarkable speech given in Philadelphia at the fall meeting of ASCP/CAP by CDC Director of Laboratories, Dr. Carlynn Collins, M.D. Dr. Collins is apparently a pathologist, although I am told she has never really practiced gynecologic cytology where she actually rendered diagnoses and was the responsible pathologist. Nevertheless, she is the individual now tasked by the authorities to tell everyone else how to do quality Pap smear work! Well, the remarkable part of the speech was that she was there to present to her colleagues (at a major scientific meeting) the results of a CDC "scientific study". I am sure the audience was as eager as I was to hear the results of a tight, well designed scientific study orchestrated by the director of laboratories at the CDC. We all know that the CDC is in the forefront in stamping out disease worldwide, from Ebola in Africa to t.b. in urban America. You can imagine my shock when I learned that what she was presenting was the results of a SECRET STUDY! No methods and materials were presented. These were still confidential and couldn't even be safely shared with the leading scientific experts in the field who were gathered. No telling what harm to the public welfare could ensue if the details leaked out! Furthermore, not even the actual data could be released. Apparently, it was still being "analyzed" and was also too sensitive for distribution. It would be irresponsible to release it, I guess, sort of like shouting "fire" in a theatre. Thank goodness for our cautious and ever prudent public servants at the CDC!
   ...
   None of that would matter any more, since we would now be quality-controlled by Dr. Collins and the CDC!! I could even imagine Dr.Collins on Larry King Live telling women all about how she was going to make things so much better!
   
   Only later did I learn that there were a few flies in the ointment. Apparently, the study design had been severely criticized at the outset by the American Society of Clinical Pathologists, probably the country's largest expert professional organization with cytopathologist and cytotechnologist members. Instead of altering the design, however, CDC simply turned the study over to ASI who was willing to "play ball" without any annoying scientific criticism. It seems the CDC doesn't like critical review, which is why I suppose Dr. Collins only presented the conclusions without the methods or the data. (I could feel the cold wind of the Gulag or was it the Dakotas blowing over my shoulders?) It also turned out, much to my shock, that ASI had no expertise in cytology, not even Dr.Collins' residency training credentials in cytology ( 1-2 months?). I figured they would have signed on some big name cytopathologist experts to honcho this study. Right? Wrong! They apparently signed up an unemployed pathologist who had mainly done clinical pathology as the "expert" for this important taxpayer-funded study. Now I was really beginning to worry why Dr. Collins had failed to release the study method and details and the actual data. She couldn't even "recall" (in her lilting reassuring Mississippi accent) how many little old pathologists were among the 85 tested study cytologists. This seemed especially wierd to me, since the study pathologists all screened their own Pap smears, a relatively unusual practice. These were likely pathologists from small centers where their low volume wouldn't pay for the services of a cytotechnologist. Would these results of a few unusual pathologists be extrapolated to the rest of the pathologists in the country? I began to get nervous, thinking of the lack of cytopathology expertise in ASI and being evidenced by Dr. Collins. Many other slights of hand heightened this anxiety. Any time a scientific group or individual had said anything encouraging, this was roudly repeated in a slanted way in order to show something Dr.Collins called "public-private partnership". Apparently she even showed a slide of hands shaking. (I thought a picture of someone holding a gun to someone's head might have been a more appropriate illustration!) The facts didn't matter. The CDC tanks were rolling!
   
   This was, to my ears, a landmark speech. Even CDC had fallen to politically-driven psuedoscience in pursuit of a political agenda. Either the CDC director of laboratories had no idea what reasonable science consisted of, or she was willing to bend to political pressure from above and stand in front of her colleagues with this bizarre presentation. CDC and HCFA and perhaps elected political figures were now to be setting the "standards" and not the expert scientific professional organizations. At least, not unless they were willing to tow the line and do exactly what they were told by "the authorities" (just like ASI). To me, it sounded like the death of scientific methodology in this one small arena, unnoticed outside of our field but with wide ranging implications. We cytopathologists were now expected to act as lap dogs, ever attentive to our master's (CDC/HCFA's) whistles. Hi ho! Hi ho!