Digital Pathology Blog

Is There a General Pathologist in the House

Almost 3 years ago I wrote a piece for Advance for Administrators of the Laboratory in their "Perspectives in Pathology" entitled Death of the General (Surgical) Pathologist.

This piece discussed the issues surrounding what is perceived by many as the increasing (and necessary) sub-specialization in pathology.  The model of "everybody doing everything” has evolved into “everybody doing one thing".

Historically, practicing pathologists were solid general surgical pathologists, often times with their own expertise/interest in a particular area, but they prided themselves on being "surgical pathologists" rather than "liver", "hemato-" or "dermato-" pathologists as in today’s world. A number of factors have driven and resulted in this trend.  

First and foremost, the needs of the market.  Dedicated specialists in breast or gastrointestinal diseases are commonplace in medicine including the radiologist, surgeon, oncologist and radiation therapist.  Pathology appropriately responded accordingly. Secondly, pathologists have driven some our own marketing and needs.  The resulting potential problems are paramount and based on many fallacies.

The State of the Pathology Union

Dr. Keith Kaplan, Chief Medical Officer for Corista, LLC, offers his thoughts on “The State of Pathology Today” and some strategies for facing today’s challenges. 

Today, the state of pathology, along with our national leadership and organizations, seems fragmented and without direction. I attended the College of American Pathologists (CAP) and House of Delegates meetings earlier this month, and there seem to be a few issues which we cannot deal with as a group:

  • Needs of academics vs. community-based hospitals: From the need for AP/CP generalists in some settings to the need for sub-specialists in others, how do we best practice our specialty? We seem to be an increasingly heterogeneous group with loss of identity.  

Are There Any Medical Personnel On Board?

As I was trying to sleep, sitting upright in seat 11C, this question came over the public address system. 183 of us were traveling from LA to Boston and it was 4 AM, in whatever time zone is home to Kansas. This was the final leg of a quick halfway around the world trip. Our itinerary started in Charlotte on Friday, then to Shanghai, and finally to Boston by Monday morning. We had already traveled nearly 15,000 miles by car, bus, train and air. Now, just a few hours from completing 6 flights in less than 3 days, we may have hit a snag in our travel plans.

Telepathology and Inspection Readiness

Telepathology and the use of whole slide images (WSI) are becoming accepted in the practice of pathology on a clinical level. While the use of WSI has not been approved for primary diagnosis, it is now a part of many diagnostic applications such as remote specimen evaluations (i.e. frozen sections and assisted fine needle aspirations), quality assurance activities, tumor boards and consultations.

To that end, regulators for laboratory accreditation acknowledge the role this technology plays in the laboratory and are now assessing telepathology and whole slide imaging activities accordingly. The attention and focus of inspections is similar to all other laboratory services; the critical elements of well-defined policies and procedures, documented training, and system validation are all expected of digital pathology/telepathology services.

Crossing the Digital Divide

Hospitals and pathology practices must often consult with colleagues and specialists at other centers on difficult cases. This has traditionally required mailing glass slides and reports to the consultant, and then waiting for the results to be returned. Today, digital pathology networks are dramatically reducing the turnaround time for consults while providing collaborative discussions between physicians reviewing the case images in real time.

The Big Miss

Several years ago Tiger Wood’s former golf coach wrote a book with the above title. Among providing glimpses of Tiger’s personal life, his work ethic, practice routines, diet, interaction with his wife, etc… the author of course talks about Tiger’s presence on the golf course, his swing mechanics and level of focus on the course.

A Spotlight on Second Opinions After Rita Wilson’s Diagnosis

News of Rita Wilson’s announcement that she had breast cancer and underwent a double mastectomy has been spreading across media and social media outlets. Anytime a celebrity, vis-à-vis Angelina Jolie or Suzanne Summers or Edie Falco (who played the fictional wife to Tony Soprano) makes public their diagnosis and treatment, the popular media has an opportunity to share their stories with millions of women. Their support promotes breast cancer awareness and early diagnosis and treatment via their publications or on air.

Internal & External Consults: Streamlining the Process

Cut Waste and Increase Quality of Care with New Technology

I’m sure you’ve thought about it. Every time a package arrives at your pathology practice, it represents a patient anxiously waiting for results at the other end. 

What would happen if you could significantly reduce the time it takes to return an opinion? How would your practice benefit if you could reduce the costs involved? 

Dread prepping for Tumor Boards? This might be why. [Infographic]

Tumor boards are a critical component of a patient's diagnostic and treatment processes, and pathology participation in these discussions is vital. However, the traditional process required to prepare pathology data and images can be laborious and time consuming.   

Pathology Challenges in the Era of Subspecialists

As a medical student/intern/resident in the early to mid-1990s, most of the pathologists I was exposed to in a university/medical center setting were pathologists who were-first and primarily-general pathologists, general surgical pathologists and clinical pathologists. Everyone did everything in terms of surgical pathology subspecialties, with a few notable exceptions (bone marrow examinations and liver biopsies, depending on the nature of the case and the particular pathologist assigned the case). In addition, the staff pathologists I worked with also covered some area of the clinical laboratory and were responsible for any issues referred from house staff during evening and weekend call.

Subscribe via E-mail

Connect with Us