Help from invisible hands

Heather Hebior

Director of Laboratory Services, Froedtert South

I lead a team of approximately 85 people, including phlebotomists who collect blood and other non-blood samples such as urine and throat/nasal swabs, as well as medical technicians and laboratory scientists who perform tests on these samples. We staff the labs at Froedtert Kenosha Hospital and Froedtert Pleasant Prairie Hospital 24 hours a day, seven days a week. .

Most of us are people no one knows much about. Patients see their doctor. They see the phlebotomist who takes their blood or other non-blood samples. But the lab staff is not a face typically seen by patients. Yet we are very important to patients because we provide doctors with the laboratory results they use for more than three quarters of their patients to diagnose diseases, determine the best ways to treat them and monitor the progress of these treatments. .

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The test that most patients recognize is called a lipid panel. This is a common blood test that measures cholesterol and triglyceride levels that increase the risk of heart disease and stroke in patients. We also do complete blood counts which measure red and white blood cells, looking for cancer, anemia and other conditions. Additional tests include urine samples to detect kidney disease and urinary tract infections. We also perform tests that measure blood clotting prior to surgery and are used to assess liver disease or to monitor patients on blood thinners.

These are just a few of the approximately 274 different tests we can perform, and it seems like new tests are coming in every day. One of the biggest advances right now is gene sequencing, where we detect certain genes to predict diseases that may not even show symptoms yet.

When I was younger and thinking about a career, I knew I wanted to be in healthcare. I found that I really liked medical laboratory science because of the role these test results play in helping patients by giving doctors the essential information they need to diagnose and treat disease. It’s been a fantastic career that has allowed me to go from working ‘on the bench’ to being a lab manager. I love my work. I’ve been doing it for 21 years and I wouldn’t change a thing.

Pathology is for the living

Kenneth Wind, MD

Medical Director of Pathology, Froedtert South and Assistant Professor, Medical College of Wisconsin (MCW)

My role in patient care largely involves working behind the scenes to help ensure that every patient at Froedtert South receives an accurate diagnosis. Healthcare is a team effort, and I consider myself an essential member of the Froedtert South team that has a significant impact on the lives of patients.

The art and science of practicing pathology as a medical specialty is widely misunderstood by patients, who often think that performing autopsies is how most pathologists spend their time. Rather, my job is to examine and analyze blood, urine and tissue samples from living patients to help accurately diagnose and treat their illnesses.

Often, I do this alongside surgeons and other physicians in the operating or exam rooms to bring my expertise to the bedside and help expedite diagnosis and treatment decisions. For example: one of the procedures I help perform is called the Rapid On-Site Assessment, or ROSE. Here’s how it works: An interventional radiologist uses a minimally invasive procedure to take a sample of a patient’s suspicious tumor or lesion. Then, right there in the room where the sample is taken, I examine it under a microscope. I do this to ensure the sample is large enough and appropriate for the lab tests we need to perform. If the tissue sample is not suitable, the interventional radiologist can immediately take another sample. This means that the patient does not have to undergo the same procedure at a later date or experience additional worries while their diagnosis is delayed.

In the operating room, I use a procedure called “frozen sectioning” to examine tissue samples obtained during surgery under a microscope and make a diagnosis, which may include cancer. This helps surgeons immediately ensure that they have removed a malignant tumor in its entirety, determine if cancer has spread, or better understand the progress of a patient’s cancer. Determining that a tissue sample is not cancerous can make a larger operation unnecessary.

I am also increasingly involved in personalized medicine, which targets treatments at the molecular characteristics of a patient’s cancer. My role is to ensure that tissue samples taken from the patient are appropriate to determine if they are eligible for a clinical trial, or to help the patient’s physician determine the best course of treatment – which may include immunotherapy to enhance a patient’s immune system and target molecular abnormalities on tumor cells.

When I have a difficult diagnostic question, I can collaborate with my fellow pathologists at MCW who have advanced training in their areas of expertise. Patients benefit from their expert opinions to ensure they receive the best treatment.

Cancer treatment that gets personal

David Knight, MD

Hematologist/Oncologist, Froedtert Sud

As an oncologist, one of the most dramatic ways in which laboratory services move us is in the area of ​​personalized medicine.

In the past, cancer treatments were more of a shotgun approach: chemotherapy drugs that killed cancer cells, but also damaged normal cells and caused side effects. Today, molecular biology has identified hundreds of abnormalities in the proteins and genes of certain cancer cells. Drugs have been developed to target these weaknesses and kill cancer cells more effectively, while leaving more normal cells intact.

Biopsies are performed on virtually every patient we treat to look for these abnormalities so that we can customize treatments to attack their cancer as effectively as possible. Our partners at MCW and Wisconsin Diagnostic Laboratories (WDL) help us do this all day, every day. Let’s say we’re testing a patient with gastric cancer. During a biopsy, or in the operating room during surgery, the pathologist can process and examine a tissue sample with enough precision to determine whether or not cancer cells are present. The answer can determine the surgeon’s next steps and provide information for making treatment decisions that ultimately help achieve the best outcome for the patient.

Similarly, when a surgeon removes a tumor, the pathologist looks at the margins around the tumor to make sure it is indeed normal tissue. Knowing at the bedside that the margins are clean lets the surgeon know that all of the tumor has been removed, that no cancer has been left behind.

My specialty, hematology/oncology, is one of the most complex and evolving fields in healthcare. The combined reliability and expertise of Froedtert South, MCW and WDL is unique and sets us apart from other institutions that do not have a relationship with an academic medical center. Make no mistake, the places where academic medicine happens — places like Froedtert and the Medical College of Wisconsin — are the thought leaders who treat the patients. All hematologists/oncologists like me talk to people in their area and across the country every day for help in diagnosing cancers and analyzing molecular biology and genetics. Having the professional and one-on-one relationships we have with the experts at MCW and WDL gives us a connection to the experts who are helping to move this whole area of ​​medicine forward.

This sets us apart and helps our patients.

World-class care near you

Steve Serota

President and Chief Operating Officer, Wisconsin Diagnostic Laboratories

As a subsidiary of Froedtert Health, WDL is one of the few laboratories to have pathologists board-certified in the subspecialties in which they interpret lab results. For example: if you have kidney disease, your tests are reviewed by a pathologist who has expertise and is board certified in that specialty. Having someone with the full breadth and depth in a particular specialty translates to better diagnoses and, in turn, the most appropriate patient care and treatment plans.

We are doctors of doctors. Patients come to their doctor with questions, and their doctors come to us to help provide the answers. Think of it this way: you have a physician interacting with a patient, but behind that physician is a team of 56 WDL board-certified subspecialty pathologists. And behind these pathologists is a team of 500 specially trained clinical laboratory professionals who support these pathologists.

Our testing capabilities are on par with the world’s leading laboratories, giving Froedtert South physicians access to any diagnostic tool available in the industry – diagnostic tests that are at least comparable, if not superior. , at any academic medical center anywhere in the world. .

During the COVID-19 pandemic, WDL provided approximately one quarter of all COVID-19 testing performed in the state of Wisconsin. While most other labs had COVID-19 test turnaround times of four to seven days, the WDL averaged less than 12 to 24 hours, allowing Froedtert South to make faster decisions for their patients. and their communities.

The relationship between Froedtert South, MCW and WDL provides residents of Kenosha County with access to advanced diagnostics that are not readily available in many other communities. For all of us at WDL, every tube, every slide, every piece of tissue is a patient. We see ourselves as direct members of each patient’s care team with the sole purpose of ensuring that each patient receives the most accurate treatment possible.

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