Don’t forget the background check, he added. "I’m always amazed at how many people will hire without doing a background check."
Wage and Benefits
To attract and maintain the best person, the physician has to be prepared to offer a competitive wage, an attractive benefits package with health care and retirement, and the promise of continuous training. "An intensive 4-day course is fine, but even the best is not enough to go back and start cutting good slides. Find somewhere to get hold of pig skin – a pig’s foot from a market is fine and will last a whole day – and let the person practice cutting and sectioning 40 hours a week for a couple of weeks. If you let them take one course and expect to start surgery the next week, I can tell you the stress on both of you is going to be unimaginable."
Communication
Good communication is the foundation of success, he said. "This bears repeating. You want to speak diligently to the tech about what’s happening in surgery, and have that person in the surgical suite with you if possible. If you’re doing anything out of the norm of what they usually see – eyelid with a conjunctival margin, ear wedge with cartilage – you have to let them know, or they can mess up the slides."
Don’t expect a tech to make a silk purse out of a sow’s ear, he said. "They need good sections to make the kind of slides you need for diagnosis. Give them sections with complete margins, with beveled edges and clean cuts and at least 1-2 mm of epidermal rim. Specimens with jagged epidermal edges are difficult to lay flat and tend to pull out of the medium much more than a nice circular or oval cut with a 30- to 45-degree bevel."
Training
Pay a lot of attention to training. "Send them to courses as much as possible so they can hone their skills." Included in training should be courses on cryostat maintenance and adjustment. "Let your techs adjust the cryostat themselves. Don’t be afraid to let the tech learn to do that, to recondition the microtome. That way if there’s a maintenance issue, you won’t be dead in the water. Get them the education they need so if there is a problem, they know what to do to solve it."
Finally, he said, as soon as the new tech is competent, have him or her train another person in the office. This might make some people nervous about job security, but it’s a matter of practicality for everyone. "If that person ever wants to go on vacation, he’ll need someone good to cover for him."