By JOHN REID BLACKWELL
TIMES-DISPATCH STAFF WRITER
From the moment the courier arrives at Bostwick Laboratories, around 6
a.m. most days, the clock is ticking.
Around the United States, and around the world, people are waiting on
a diagnosis -- do they have cancer or not?
The answer lies in the packages that are delivered to Bostwick's
laboratories and offices in the Innsbrook Corporate Center each
morning.
Thousands of tissue samples come to the medical laboratory company
every day -- many of them prostate biopsies sent by the company's
client physicians. Bostwick Laboratories' job is to analyze those
samples and provide a diagnosis.
In a first-floor laboratory in one of the company's two Innsbrook
buildings, a team of histotechnologists trained to prepare slices of
body tissue for examination by pathologists goes to work preparing the
tissue samples. The samples, so tiny they are barely visible, are put
through a highly technical, multistep process, including dyeing them
and placing them on slides, before going to the company's 25
pathologists -- medical doctors specializing in diagnosing diseases --
for examination.
The aim is to provide a diagnosis to the physicians, and thus to
patients, within 24 hours.
"From a patient's standpoint, you want to know as a soon as possible,"
said Leroy Mell, the company's chief laboratory officer. "You don't
want to be sitting around for a week or two waiting for results. The
patient comes first."
And when it comes to diagnosing cancer, speed can't mean sacrificing
precision. "Our goal is 100 percent accuracy," Mell said.
With those kind of demands, the company's operations are suffused with
what Dr. David Bostwick calls "a sense of urgency."
"That's a phrase we use a lot," said Bostwick, an internationally
acknowledged expert on prostate cancer who founded the company that
bears his name in 1999.
The same phrase could be used to describe the growth of Bostwick Labs.
In only eight years, it has expanded from just a handful of employees
to a company with 560 employees. In addition to its main offices and
laboratories in Henrico County, the company has opened labs and
offices in Florida, Arizona, New York and London.
"We receive specimens from as far as Russia, South Africa, Japan,
Thailand, and of course, the United States," Bostwick said.
Bostwick came to Richmond to work for a urology practice while he got
his business off the ground. The company has stayed here, he said,
because of the Richmond area's central location on the East Coast, its
low cost of doing business, and the skilled work force.
In March, the company announced a three-year expansion plan that
includes investing $4.6 million to expand its laboratories and
offices. The company also announced it was hiring about 600 people
(about 150 of whom it has hired this year). The expansion plan would
bring total employment to around 950.
"We're probably the biggest company in Richmond that you have never
heard of," said Gary S. Levine, the company's chief financial officer.
He is only half joking -- most people who get biopsies probably don't
think much about what happens to their samples, or who is involved in
the diagnosis.
While hospitals -- including the major hospitals that serve the
Richmond area -- have their own pathology departments, many physicians
at urology centers or other practices rely on outside laboratories for
diagnostics.
The laboratory-services industry is anywhere from a $45 billion to $60
billion business in the United States. Two big, publicly traded
companies, LabCorp. and Quest, dominate the industry, but there are
also about 3,500 smaller players around the country, Levine said.
"It's a highly fragmented industry," he said. "But there is a growth
boom. That's driven by two things. Number one, payers are willing to
pay more for diagnostics," Also, as baby boomers age, they need more
medical tests. "That is what has driven a lot of our growth," Levine
said.
Bostwick said the privately held company is on track to reach or
exceed $100 million in revenue this year. The company has focused on a
niche market within the laboratory services: anatomical pathology,
specifically urologic pathology. Most of its business still comes from
analyzing prostate biopsies, although the company is expanding into
other areas including kidney, gastrointestinal and gynecological
diagnostics. The company also has a division that works with major
pharmaceutical companies on clinical trials.
Unlike much larger labs, "we don't try to do all things for all
people," Bostwick said. "What we have tried to do is narrow our focus
into those areas where we have core competencies."
While hospital pathologists often analyze biopsies from about 24
organs in the body, "we focus mainly on urologic pathology," Bostwick
said. "With that focus, we are able to maintain a very high level of
productivity, accuracy and a quick turnaround time."
That emphasis on focused markets and efficiency enables the company to
generate higher profit margins. As a privately held company, it puts
its money back into its operations. Also driving its growth is the
company's introduction of new types of diagnostic tests that are
faster and more accurate than conventional methods.
The company's expansion around the United States and in other
countries also has come through an ambitious sales effort driven by
Jed D. Fulk, vice president for sales and marketing.
Fulk, a West Point graduate and former U.S. Army officer who joined
the company in 2003, is leading the company's charge into new regions
and new specialties. He keeps maps in his office marking the areas
where the company is introducing sales reps and finding new clients. A
self-described workaholic who is usually sending out his first e-mails
by 4 a.m., Fulk has a desk full of r�sum�s.
"I'm hiring sales reps," he said. "We have doubled the number of sales
reps to over 70 in the country, and by the end of September, we will
have over 100."
A lot of the company's growth, Fulk said, can be attributed to
physicians' admiration for the man at the top, David Bostwick. Some
local physicians confirm that.
"He is trading on his name, which is a well-respected name," said Dr.
Sam Graham, co-founder of Urology Specialists of Richmond, who has
used Bostwick Labs for diagnostics. "If you ask most urologists around
the country, 'Do you know who David Bostwick is?' They will say yes."
Before founding the company, Bostwick was a professor of pathology and
urology at the Mayo Clinic from 1991 to 1999. He has written 16 books
-- including the best-selling textbook on urologic pathology -- and
more than 400 papers.
Bostwick had the idea of starting a laboratory with a 24-hour
turnaround in 1985 when he was a doctor at University of Chicago
Hospitals. His colleagues there, however, thought the idea was
impractical. But Bostwick, who later moved on to the University of
Maryland, didn't let go of the idea.
While earning an MBA in the early 1990s, Bostwick wrote his thesis on
setting up a laboratory with same-day results reporting.
"We have had the technology for 25 years," but it was never utilized
that way, he said.
Graham and Dr. David Wilkinson, chairman of the pathology department
at Virginia Commonwealth University, said the company has thrived on
providing specialized lab services to physicians who often don't have
access to that kind of service in their own communities.
"I think the demand for highly specialized knowledge is growing, and
that is where Bostwick Labs has found its niche," Wilkinson said.
In the Richmond area, Wilkinson said, the biggest impact the company
is having is driving job demand for workers such as histotechnologists
and medical technicians. Those kinds of workers are already hard to
find.
"The good news is that should help the salaries of those people, who
are very highly trained, very skilled people and probably have been
underpaid in many ways," he said.
Although many patients may not recognize the name, Bostwick Labs has
earned recognition in the business community. In 2005, the company was
named by the Greater Richmond Chamber of Commerce as the
fastest-growing privately held business in the Richmond area.
"We grew 95 percent last year, and are on target to grow 100 percent
this year," Bostwick said.
"We expect to grow at doubleor triple-digit rates in the near future."
With that kind of growth, the company is sure to attract investor
interest. Executives say the company is considering a public stock
offering.
Growing players in the industry also tend to attract buyout offers.
While acquisitions might be on the table, Bostwick said a buyout is
not.
"I have told the employees we are not for sale," he said. Contact John
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