Digital Pathology Blog

I read with interest a recent article entitled “If A Computer Can Diagnose Cancer, Will Doctors Become Obsolete?”. The discussion in the article has several purely economic points and focus, but what caught my eye of course was being made obsolete by a computer!  

Today, Keith Kaplan posted the following blog on his tissuepathology.com site. We are reposting here because we couldn’t agree more. The honest, candid response to client issues, listening hard, takes courage. Making amends, moving forward more forcefully addressing that which was missing, takes leadership and enormous courage. We have to ask it of ourselves, for the benefit of clients and patients. That courage can be inspirational, for us all. Thanks Keith.

An old (-er, I mean experienced) pediatric cardiothoracic surgeon once told me, “The heart is not a music box, it is a pump, why should I use a stethoscope to listen to it?” An experienced neurosurgeon once told me, “Neurologists are the tool we used to use before the CT scan” and a critical care intensivist friend has reminded me several times of the value of a stethoscope when you have arterial blood gases, central venous pressure monitoring, and ventilator settings you can adjust for optimum care.  

I arrived for my away rotation early. I was scheduled to be at the Office of The Chief Medical Examiner (OCME) in Baltimore for the month of July. My first rotation of second year of residency would be spent away from the gross bench and chemistry analyzers. The month was actually fine with me – the OCME office handled deaths from all over the state of Maryland including Baltimore city and county, so there would be a mix of the usual inner city homicides, suicides, drug-related deaths, as well as farming, motor vehicle, and boating accidents at the peak of summer in Maryland. And the OCME was walking distance to Oriole Park and Camden Yards and the Orioles were scheduled to play nearly 20 games that month at home. One of the best smelling ball parks in the country would offset the smells of decomposing bodies pulled from the water or burning buildings. 

In medical school, the pathologists would come to lecture during second year, and while they had their own subspecialty or research interests, they would often tell us “Pathology is a lot of fun. All of the interesting cases in the hospital wind up under the microscope and you are respected among your peers.”

Healthcare leaders in 2014 have a plethora of critical issues to tackle. A key challenge is how to cut costs to offset dwindling reimbursements without compromising patient care. There are an increasing number of hospitals taking a hard look at variations in care: using retrospective patient data to chart which protocols produce the best outcomes. These data-driven initiatives are producing an exciting intersection of quality and cost savings that improve patient outcomes and cut down on unnecessary prescriptions, tests, and procedures. 

A few weeks ago, the Journal of the American Pediatrics Association published a new study showing substantial diversity in how hospitals treat and manage tonsillitis. The study showed that in some facilities, as many as 13 percent of children suffered complications, whereas in others the rate was only 3 percent. Why the difference?