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

HRD-82-129: Published: Sep 28, 1982. Publicly Released: Sep 28, 1982.

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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.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Surgeon General of the Army should conduct a cost-benefit study to determine the feasibility of charging user fees for civilian consultations. In the event that the cost-benefit study does not support the charging of user fees, the Surgeon General of the Army should instruct the Director of AFIP to follow up on the suggestions contained in the November 1981 Center for Advanced Pathology Consultation Committee Report for ways to improve the quality of cases submitted and to limit the number of civilian consultations.

    Agency Affected: Department of Defense


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