CLSI eNews - 1 September 2006 (Plain Text Version)Return to Graphical Version | Search back issues | Print all articles In this issue: Volunteer FocusValerie L. Ng, PhD, MD
Tell me about your career path and how you got started in the healthcare field. I started my career very interested in doing research. In college, I was given the opportunity to work in a basic research laboratory. From that time on, I was really hooked on the “new discovery” thrill of working in basic research. After college, I applied to graduate school and got into a PhD program. I was working in retroviruses at that time. When I was finishing graduate school, NCI, the major financial resource for retrovirus research, cut funding in this area. I decided to change my course; and, I applied and was accepted to medical school. After two years in medical school, the AIDS epidemic hit and the the field retrovirus research saw a major resurgence. After medical school, I thought about future career paths and was still drawn to the opportunity to do research. Pathology was the obvious field of postgraduate specialization because it is where research and clinical medicine are closely intertwined. Once I completed residency, I stayed on as faculty at the University of California. Currently, you are Principal, Paragon Pathology Medical Associates, Inc; Chairman, Pathology and Director, Clinical Laboratory, Alameda County Medical Center/Highland General Hospital; and Professor Emeritus of Clinical Laboratory Medicine, Department of Laboratory Medicine, School of Medicine, University of California (UCSF). Can you describe your responsibilities in each of these positions? Paragon Pathology is a small, private pathology group that I formed in which I am one of only two principals. In addition, at my current job at Alameda County Medical Center/Highland General Hospital, I work in a small pathology department with three other pathologists. My practice is devoted entirely to the clinical laboratory. The other three pathologists do primarily anatomic pathology and cover for me in the laboratory when I am not there. Professor Emeritus of Clinical Laboratory Medicine is an honorary title from the University of California. I am retired; however, they can count on me if they need input from time to time. Describe a bit about your involvement in professional societies other than CLSI. I remain very active in one society that is most in line with my professional interests: Academy of Clinical Laboratory Physicians and Scientists (ACLPS). This organization represents academic laboratory medicine, which was my role for the first 20+ years of my career. When I attended the ACLPS annual meeting this year, I came in with a different perspective. I still find it an extraordinarily valuable organization that covers all aspects of laboratory medicine. What I like about the group is they are academicians with incredible depth and expertise in every area of the lab, ranging from bench practice to the most archaic, esoteric research related to what we do in the clinical laboratory. My recent, increased involvement with CLSI really represents the exact opposite, which is user application. It’s nice to participate with two groups that represent opposite ends of the spectrum and find my happy middle ground. You have a strong commitment to teaching and mentoring. What drives you to continue to stay passionate about education? A lot of what is done in the laboratory could be better communicated to our users and our colleagues. From the feedback I get from my lectures, it seems that many think I am an effective communicator. If true, I can hopefully bridge the gap between the lab and our colleagues . If our colleagues gain a deeper and better appreciation for what is done in the laboratory, then they understand how laboratory professionals can help them improve their patient care. That is really what is driving me to stay passionate about education. Do you find that medical professionals are aware of CLSI resources? I mentioned CLSI to some of the bench Clinical Laboratory Scientists (CLS) at my current job and they have not heard of the organization. I was shaken by this observation because my opinion of CLSI documents is that “CLSI documents are the bible” for good laboratory practice. In my previous job, my technical CLS group was quite aware of and involved with CLSI. I am in a different environment now in which the majority of the CLSs are foreign trained. It is clear to me that CLSI is still probably not heavily emphasized outside the United States in training programs. I know the whole globalization movement at CLSI has been gaining strength over the years and needs to continue. What benefits do you feel CLSI documents bring to medical education programs? I think there are huge benefits that CLSI documents bring to all kinds of medical education programs in every area that CLSI touches. CLSI stands out as a globally recognized consensus body. It is the central forum for medical professionals who have questions or issues that need to be addressed. In terms of medical education programs, I see the benefits of using CLSI documents ranging all the way from the very beginning—medical student or allied health student programs—to practicing, experienced professionals, as well as for pathologists, CLSs, and our clinical partners in specialty areas (pulmonologists, respiratory therapists, etc.) Before I left UCSF, there was a major desire to instill within the students the concept and practice of life-long learning. The idea was to teach the students how to use available resources to continue their education without sitting in a lecture room. Once the students graduate and are in residency, they are very busy taking care of patients and do not want to violate the 80-hour work week regulation. As a result, conferences and other didactic teaching opportunities are the areas being short-changed. CLSI documents offer an alternative education resource and tool for students. You have been involved in CLSI for over 15 years, including a variety of committee and advisory positions. What first initiated your involvement in CLSI? UCSF Department of Laboratory Medicine had a very active role in CLSI, particularly in hematology. My direct boss for many years, Gene Gottfried, was really involved in CLSI. He ultimately became the chairholder for the hematology area committee. Gene participated in projects that needed real-world laboratory validation. As he got more involved, he sent proposed CLSI documents to me for review and comment. It was really Gene Gottfried’s direct, hands-on mentoring and guidance that initiated my involvement in CLSI. As my lab director, he valued and respected CLSI’s mission to the point that our policies and procedures had to be consistent. This made a big impression on me. CLSI provided the benchmark for everything we did in the laboratory. Another faculty member, Jack Levin, who was at the UCSF affiliated SFVA hospital, was also very involved in the hematology area committee. This was a man whose hematology experience I tremendously valued and respected. He constantly referred to CLSI documents as the clinical standard, and again, this made a huge impression on me. I “grew up” professionally believing CLSI was truth, goodness, the gold standard, and nothing has ever led me to believe any different. In my current position, in which I’ve only worked a year, my staff has become very familiar with CLSI. What do you feel are the main strengths and prime concerns in developing consensus documents for global use? What I have always felt is the main strength of CLSI is its unparalleled skills at forging consensus. That is just an unbelievable skill. To me, the prime concerns are the consideration of cultural issues, identifying and understanding professional differences, and adapting CLSI recommendations to assure the best quality of practice worldwide. In April 2006, you were installed to a three-year term on the CLSI Board of Directors, what led you to this position? I was asked to give a talk about the real-world experience of point-of-care testing at the 2004 CLSI Leadership Conference. From my perspective, I must have made an impression because I was nominated and selected for the Board of Directors. I am quite humbled and honored to have been chosen to serve on the Board. I will also serve as a member of the CLSI education committee. Susan Blonshine stated, in our first meeting of the education committee, that after hearing my lecture at the 2004 Leadership Conference, she thought I would have education-related attributes that would compliment the other members of the committee. What primary objectives do you hope to accomplish in this leadership role? I would like to further CLSI’s short-term goals and objectives, and I certainly hope that I will be able to contribute to the long-term goals. I have been told that my experience in education and my clear communication style are strengths that I can bring to this leadership role. You have written extensively in scientific publications, and have been an invited speaker for numerous presentations about AIDS, laboratory aspects of tuberculosis, and POCT, among other topics. Do you see any prevalent areas or emerging needs that require the development of CLSI standards and guidelines? My publications focus on many different aspects of the clinical laboratory. My passion is to be a generalist, as well as a laboratory medicine professional. Therefore, I can identify topics and issues that need attention across multiple areas of the laboratory. I would like to think that I am poised to be able to identify prevalent areas and emerging needs. As you know, through a CDC grant, CLSI is providing capacity-building assistance for global HIV/AIDS laboratory guidelines and standards development in Africa. As an expert lecturer on the topic of AIDS, what, in your opinion, are the key benefits of CLSI’s involvement in this educational and worthy cause? I think this partnership is one of the best things that ever happened, hopefully both for CLSI and for Africa. I will say that in my previous life at UCSF, probably for the last three to four years, we certainly saw a huge need to provide quality training for laboratories outside the United States through various international AIDS programs. In an effort to enhance their global health program, UCSF aligned with the WHO initiative on TD/AIDS/Malaria. There was recognition that quality systems in place in the United States could benefit other locations that didn’t have them. I was never able to further my interest in this area while at UCSF because of too many other pressing priorities. Meanwhile and related to this goal of improving global health, I think you could not find a better partner to help in the training than the CDC. In some of my past work, we had brief interactions with laboratories in South Africa. It was clear to us that the quality systems that we have in the United States did apply to these laboratories. Another exposure to global issues that I had at UCSF was with a huge group of professionals who visited once or twice a year from China. I would talk to them about laboratory issues, the treatment of HIV infection, how the laboratory data played a role, and what quality systems were in place to ensure that the laboratory data was correct. It was amazing to me that these participants had no idea about all the quality systems we had in place to ensure the answers we generated were, in fact, accurate. I think that making sure colleagues in various parts of the world are aware of these quality systems is definitely a role that CLSI can play. At your lectures, both nationally and globally, do you cite any CLSI documents as a practical reference? If so, can you elaborate on which documents? CLSI has always struck me as an incredibly committed group of volunteers who will do whatever it takes to promote the best quality practices. I think it is important to use the volunteer network to promote the CLSI documents. Whether it is providing the local on-site education course or supplying hands-on assistance with implementing procedures, CLSI’s volunteer network should serve as the overarching tentacles of the organization. This is certainly a topic that the education committee will be addressing in the future. There is no question that many of my lectures, if not all of them, refer to CLSI documents. I present at an annual continuing medical education course for laboratory directors, underwritten by Scientific Symposiums Inc., where one of my talks every year is regulatory updates. In the upcoming presentation, I will refer to the two quality control projects in development: Principles of Manufacturer’s Validation of Risk Mitigation Using Quality Controls (EP22), and Laboratory Quality Control Protocols Based on Manufacturer’s Risk Mitigation Information and the Laboratory’s Environment (EP23). In addition to EP documents in development, I also talk about precision, accuracy, and reference ranges and refer to the pertinent CLSI documents. Do you have any recommendations that you think are paramount for CLSI to address either in standards development or within the organization in general? I view my position on the CLSI Board as a new job. Watching my own performance over many years, my learning curve is very reproducible; it takes me about one and a half to two years to get a real good understanding of the organization and my role and to then bounce off with ideas and recommendations. "Volunteer Focus" is an eNews feature that highlights Clinical and Laboratory Standards Institute volunteers from different areas of the healthcare community and describes the contributions they are making to the patient-testing world through CLSI and their daily work. To recommend a volunteer to be featured in an upcoming issue, e-mail Communications. 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