Cancer numbers are on the rise – only teamwork can turn the tide
Pathologists do far more than diagnosing cancer – our perspective brings value at many different stages in a patient’s journey. But we must engage more with our colleagues across the cancer care continuum, so we can provide the best possible patient care.
Gone are the days when the pathologist was only involved in the diagnosis of cancer. Now, the work of the pathologist starts with screening for some cancers and runs right through diagnosis and treatment choice to prognosis, checking for recurrence and monitoring treatment response. As someone who follows many cancer patients throughout their patient journey, I am certain that, due to this engagement, the pathologist’s participation in the tumor board – a multidisciplinary team meeting focused on the patient’s total story – has become crucial. The pathologist brings insights to this meeting that other members of the care team cannot. But more importantly, I think that key decisions are best made when all of our expertise is pooled. I am not alone in this belief. One of the people I interviewed at the beginning of the Future of Pathology project Dr. Stephanie Gardner, Provost of the University of Arkansas Medical School, said, “Pathologists need to be able to say not only that this is the stage or type of cancer, but here are the implications of that: let’s work together as a team.” I agree: real progress comes when we work as a team.
I am not only talking about the value of the multidisciplinary team in the tumor board, essential though that is. There are other teams also. The patient partners with the clinicians and staff working to treat their disease. I consider pathologists from my hospital, and even from centers in other countries, as a team, in the sense that we share our learnings and experiences so that our discipline can develop and hone its knowledge and skills. Teamwork between the pathologist and the hospital administrator is often overlooked, and yet both stand to gain.
In the forthcoming Future of Pathology report, I talk about how the pathologist can support healthcare administrators in decisions about diagnostic service provision by advising them on the most appropriate laboratory equipment and tests. In turn, healthcare administrators can support pathologists by raising awareness of the specialty, by letting other people in the hospital know what pathologists know and how to find one and by telling those outside the hospital of the new developments in the pathology service. Pathology is constantly changing and evolving, so there is a lot to say! You can read more about these changes in the chapters by Dr. Bethany Williams and Dr. Matthew Clarke in our upcoming report too.
Like some of the things we look at under our microscopes, pathologists can be invisible to the human eye. People often think of pathology as a report, rather than an actual department with individual physicians and other healthcare professionals who have chosen pathology as their discipline. We need to be known as the experts guiding our colleagues with accurate diagnoses and ongoing analysis. We need to be known for the role we play in optimizing patient outcomes as well as in minimizing costs associated with misdiagnosis and ineffective treatment.1,2 What’s more, we want to improve the perception of pathologists because it is easier to be part of a team when people know who you are. And as teams we can achieve more.
In the Future of Pathology report I go into detail about how we can improve the perception of pathologists, how we can reach out to build partnerships and get involved in team working. I hope my suggestions and experience are helpful and inspire people to action. But why not start thinking right here and now? If you’re a pathologist, you might reach out to your local healthcare administrators so you can show them the work you are engaged with and the value it brings to the hospital. Make sure your administrators know your name, know that you are a pathologist, know what you do and that you want to help them. And if you’re a hospital administrator, you might start to find out what your organization’s pathologists can do to help you run an effective and efficient institution with patient outcomes at its heart. Cancer numbers are rising3 but if we work as a team, we can provide the best care possible to our patients.
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1. Ho J, Ahlers SM, Stratmen C, et al. Can digital pathology result in cost savings? A financial projection for digital pathology implementation at a large integrated health care organization. J Pathol Inform 2014;5:33.
2. Department of Health. Report of the review of NHS pathology services in England. London, DH. 2006.
3. Centres for Disease Control and Prevention. Expected new cancer cases and deaths in 2020. www.cdc.gov/cancer/dcpc/research/articles/cancer_2020.htm Accessed 25 January 2020
This editorial is part of the Future of Pathology series sponsored by Leica Biosystems; it reflects the views of the authors, in their individual capacities.