Pathology Institute Defends Its Turf
We're Still Open, New Firm Is Told

By Steve Vogel
Washington Post Staff Writer
Monday, August 17, 2009

For nearly 150 years, from its origins during the Civil War, the Armed Forces Institute of Pathology in Washington has helped diagnose illnesses and solve medical mysteries.

The institute's unsurpassed repository of 95 million tissue samples helped researchers reconstruct the virus behind the notorious 1918-19 Spanish flu three years ago, providing clues on how to battle new pandemics such as the H1N1 virus. Earlier this month, the institute's DNA lab in Rockville identified the remains of Navy Capt. Michael Scott Speicher, ending nearly two decades of uncertainty over the fate of the pilot, shot down during the Persian Gulf War.

Despite the institute's renown, the Pentagon announced plans four years ago to shut it down as part of the closure of Walter Reed Army Medical Center in 2011 because of the federal base-closing program.

A private company revealed plans this month to fill the "critical void" left by the institute's closing. A news release Aug. 7 announced the formation of "AFIP Laboratories," made up of staff from "the soon-to-be-closed Armed Forces Institute of Pathology."

Company officials say they are hiring more than two dozen civilian pathologists from the institute. The company has leased space in Silver Spring, three miles from Walter Reed, and is set to begin operations on Sept. 8.

But the military institute insists that reports of its demise are exaggerated.

Last Monday, the private company, a division of Bostwick Laboratories, received a letter from the Defense Department requesting that it cease using the AFIP name. On Thursday, the company agreed, changing its name to "AIP Laboratories."

In addition, the military institute placed a scrolling notice on its Web site last week denying that the institute will be closing soon and will not be taking new cases.

"Unfortunately, it has come to the attention of the AFIP that some contributors are confused and under the false impression that the AFIP will no longer be accepting cases for consultation after August 2009," the announcement said. "This is not the case -- the AFIP has not closed."

"We're worried that there's been misleading information put out there," Army Col. Jo Lynne Raymond, deputy commander of the institute, said in an interview. "We want to set the record straight -- we are the AFIP."

Institute pathologists will continue to provide consultative services on behalf of the military, Veterans Affairs, other federal agencies and the civilian medical community, a number that typically reaches 50,000 cases or more a year, Raymond said.

Though it is still slated to close, the institute is hiring pathologists to replace the ones leaving for the private company, she said.

The controversy stems from the 2005 decision by the Base Realignment and Closure Committee (BRAC) to shut Walter Reed and consolidate military health care at an expanded National Naval Medical Center in Bethesda.

After concerns were raised within the military medical community over the loss of the institute, Congress in 2008 mandated that a "Joint Pathology Center" be established that would take on many of the institute's roles, including providing consultative review and maintaining and updating the repository of tissues.

Other divisions of the institute are moving. The armed forces medical examiners office, including the DNA lab, will go to Dover Air Force Base in Delaware. The National Museum of Health and Medicine, part of the institute campus and home to curious medical artifacts from the Civil War to the present, will relocate to the Army's Forest Glen annex in Silver Spring.

Congress also required earlier this year that no funds be used to close the institute until the Joint Pathology Center is established. "Right now, we're in a holding pattern," said Paul Stone, an institute spokesman.

Many of the basics about the new center have not been decided, including its location, staff level and amount of funding, officials said.

According to the institute's Web site, the center "will function as the reference center in pathology for the Federal Government and will, at a minimum, provide pathology services to the military healthcare system, Department of Veterans Affairs, and other federal agencies."

Military health-care officials are "committed to ensuring that DoD continues to have a one-stop shop for pathology consultation," the Web announcement said.

Evan Farmer, director of AIP Laboratories, said that although the Joint Pathology Center will retain the repository and have pathologists, "it's not AFIP by any stretch of the imagination."

Farmer, a dermopathologist who served as an institute fellow and is a part-time faculty member at Johns Hopkins and Virginia Commonwealth universities, said the private company will carry on much of the work of the military institute.

"What I see is [that] this incredibly unique institution was going to disappear," Farmer said. "The whole thrust is in the brains of these people."

In March, a group of institute pathologists met with David Bostwick, chief executive of Bostwick Laboratories, to explore whether a private company could be established that would keep the specialists together.

"Some of our pathologists approached David Bostwick, who said that he would love to have us, unlike DoD, which doesn't want us," said a longtime institute pathologist who will be joining the new company. He did not want to be identified because he is still with the institute.

In May, the company offered jobs to all civilian pathologists at the institute, and 25 accepted.

Company officials note that institute planning documents prepared in the spring tentatively called for the institute to stop accepting new cases by year's end.

"It's the reason we're acting now," Bostwick said. "We would have preferred waiting a year or two, but we wanted to get ahead of it."

Raymond, the institute's deputy commander, said, "That date is no longer valid."

As for the company name, officials say that they hold a trademark for AFIP and dropping it was a matter of being circumspect. "They got fussy about it," Farmer said. "You don't necessarily want to be engaged in a fight with the federal government."

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