In today’s healthcare environment, a major emphasis is placed on cost containment and the rapid return of information from the laboratory to the clinical setting. This places a heightened emphasis for pathology laboratories to provide a rapid return of laboratory results. To promote an awareness to our health care colleagues and the general public about the importance of pathologists and the practice of pathology in the delivery of high quality, cost effective health care, we must be creative, resourceful, and to some extent, self-promoting.
Our goal must be to communicate clearly and convincingly that in addition to our role as generators of information, we are not solely data generators but are members of the health care team. We are in fact both “gait” and “gate” keepers. The strategy in health care is for the rapid turnaround of out-patients and shorter in-hospital stays for in-patients. As gait keepers, the speed at which these events occur depends largely upon the ability of the laboratory to process the specimen and return the appropriate information to the correct clinical setting. As gatekeepers, in those activities mandated by external agencies, we must work with our clinical colleagues to ensure compliance with state and federal agency requirements for medical necessity and work with them to ensure compliance and proper resource utilization. Our focus needs to be that our contributions lie in problem solving, information dissemination, and how to improve our role in decision making.
Pathology is a medical specialty that provides the scientific foundation for medical practice. The practice of Pathology, more than any other specialty, is rooted in the understanding of the disease process. We serve as the backbone of hospital medicine, as both a knowledge base for consultations, in-patient management, and in the continuing education of physicians. The pathologist is the PHYSICIAN’S PHYSICIAN, indulging in frequent discourse with virtually every doctor in the hospital. Therefore, interpersonal skills are necessary in our specialty. The workday must also include the necessary time to keep current in a variety of fields including knowledge of the current pathology literature, and laws that govern the practice of medicine and pathology.
With new highly complex tests increasing in recent years, our clinical colleagues rely on us for guidance and direction in the proper use of the clinical laboratory. To sharpen the precision of our diagnoses, the use of sophisticated techniques utilizing molecular biology, monoclonal antibodies, image analysis, and flow cytometry to the patient’s specimen are routinely applied. Each diagnosis is made utilizing clinical information, pertinent information supplied by the patient’s physician and the results of examinations performed in both anatomic and clinical pathology.
Autopsy pathology provides unique insights into the natural history of disease and the influence of the therapeutics used in treating the patient. As pathologists, we must remember that performance of the autopsy and timely dissemination of the findings is an important aspect of quality assurance. The findings in a given case may be simply documentation of the clinical suspicion or the discovery of new and unsuspected pathological changes. The autopsy should be regarded as an important part of our mission of providing useful information to the health care team for current and future patient care. To be successful autopsy interpretations should not be performed in a vacuum. The findings should always include pertinent clinical and literature references.
We are committed to excellence in all areas of pathology. Pathology is a dynamic and rapidly evolving field encompassing all area of medicine and plays a pivotal role in diagnosis and utilizes standard methodologies and new developments in molecular biology and diagnostic biotechnology.
Marsha C. Kinney, M.D.