Summary: The electron microscope (EM) is a device which produces highly magnified images used in clinical diagnostic applications to examine the microstructure of thin sections of biological tissue. Individual EM's in Veterans Administration (VA) hospitals have cost up to $82,000, and a complete EM unit, including remodeled facilities, purchase and installation, darkroom, and photographic equipment and supplies may cost from $150,000 to $200,000. EM activities were reviewed at 15 VA hospitals in 8 of the 28 VA medical districts.
The VA central office has permitted the establishment of EM units in locations without adequately determining their need. VA has not followed its stated policy that specialized medical services, including electron microscopy, be planned and provided on a regionalized basis to avoid duplicating or overlapping these costly medical programs. Some of VA EM units are underused; from July 1974 to December 1976, 15 of 42 diagnostic EM units examined less than 250 specimens annually (the current use standard). Plans to install EM units have not been formally coordinated at the national, department, or medical district level. The current practice of assigning separate EM's to the Pathology Service and the Medical Research Service, both within the VA Department of Medicine and Surgery, impedes the most effective use of these instruments.
