The Armed Forces Institute of Pathology Should Consider Limiting and/or Charging User Fees for Civilian Consultations

GAO surveyed the policies and procedures of the Armed Forces Institute of Pathology (AFIP) regarding consultations submitted by civilian pathologists for study and diagnosis.

The mission of AFIP is one of education, research, and consultation in the field of pathology for the military, other Federal agencies, and the civilian sector. In recent years, the greatest share of staff time has been spent on consultations. Although civilian consultations more than doubled during the period from fiscal year 1971 to fiscal year 1982, the number of staff assigned to AFIP has not increased to handle the additional workload. GAO found that: (1) the large number of consultations leaves little time for pathologists to pursue education and research projects, and (2) many of the consultations are routine cases which are poorly documented and of little value to the AFIP registries. Diagnostic services are currently provided free of charge and, although AFIP officials have discussed charging user fees, no detailed cost-benefit analysis has been conducted to determine the effects of such a move. Most pathologists and AFIP officials do not support charging a user fee for all civilian consultations. GAO believes that AFIP should look into the effects of charging user fees, both from a program and an economic point of view. Another alternative, that of rejecting requests for routine consultations, needs to be evaluated in light of the apparently unsuccessful recent attempt to place a voluntary restraint on civilian consultation submissions.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: Robert A. Peterson Team: General Accounting Office: Human Resources Division Phone: (202) 275-6905