No Longer Just the Doctor’s Doctor

No Longer Just the Doctor’s Doctor

When attempting to dispel the myth of the pathologist locked in a basement – friend only to the microscope and the tissue section – many of us turn to examples of patient interactions. It’s certainly true that there is a place for us in face-to-face conversations with patients, just as there is a place for us in medical education, and in community outreach. But these interpersonal interactions aren’t the only place outside the laboratory where our skills have value – and one oft-overlooked arena is, in my opinion, among the most important places where we can make a contribution; I see us as curators of health – not only for individual patients, but for entire populations.

The population’s doctor

In healthcare today, there are two somewhat parallel tracks, each focused on the same elements of the value equation – improving quality, access to care, and patient safety, while simultaneously reducing costs. On the one hand, increasingly personalized care narrows the focus down to the individual patient; this “precision medicine” uses genetic tools to tailor treatment protocols to improve the chances of a successful outcome and reduce unnecessary side effects. On the other hand, “population health” aims to manage and improve quality healthcare outcomes – not for specific individuals, but for groups in a community or a region. Population health also makes increasingly frequent use of genetic tools, such as genomic registries, to accomplish its healthcare goals.

Population health management offers us, as pathologists, a wonderful opportunity to use not only our diagnostic abilities, but also the teaching, administrative, and leadership skills that we have honed during our medical practice. It allows us to extend our sphere of influence well beyond our traditional “institutionalized” domains (in the hospital or private laboratory setting) into regional communities of care. It is an excellent opportunity to work collaboratively with other healthcare providers to ensure that at-risk populations are properly and regularly screened for diseases such as diabetes, cervical cancer and heart disease. As healthcare administrators and government decision-makers increasingly shift resources out of traditional acute care hospitals and into ambulatory care organizations (such as standalone surgi-centers, endoscopic clinics, or mother–child wellbeing centers), how can pathologists avoid becoming marginalized – both in terms of their remuneration and their interactions with other medical colleagues?

The answer: by stepping up to the plate – demonstrating our value to our healthcare ecosystem and by helping to lead the way through the digital transformation of our healthcare enterprise. As resources for healthcare continue to shrink and demand continues to soar, pathologists can show how targeted test utilization management (using sophisticated “big data” analytics) and clinical decision support tools, along with emerging artificial intelligence technologies, can save money and improve care for patients across the board.

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