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COVID-19 has confronted us with our own humanity – now let’s take pathology forward

For some time now, I’ve been an advocate for pathologists to step out of the lab and into patients’ lives. We track the course of cancer in each of our patients and for some patients – those that want to know what they are dealing with – the insights we hold can really help them.

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Dr. Gardner

Dr. Gardner

I talk a lot about this in my chapter in The Future of Pathology report, and I also talked about it in a TEDx talk earlier this year.

As we launch the report to healthcare leaders, I want to emphasize how important these connections are, now more than ever. COVID-19 has split us apart from one another in many ways, but in many ways, it has also brought us closer together.

We’ve become accustomed to seeing each other’s homes in the background of video calls, and professionally, I think we’ve all become a little more authentic. I’ll bet that most people have had at least one interaction where they’ve met someone for the first time via video conference and, by the end of the call, felt that they’ve made an unexpected connection. We’ve realized the value of our collective humanity in a literal way, and we’ve been reminded that what we do has an impact on others.

When it comes to pathology and cancer diagnostics, this is a time like no other.

In The Future of Pathology, I talk about the ‘unseen wall’ with pathologists on one side and other healthcare professionals, healthcare administrators, patients, and members of the public on the other. Because we pathologists are not patient-facing, it’s so easy for us to be hidden behind this wall. And because many are unaware of the role of pathology in the delivery of healthcare, it can be more challenging for us to maximize our contribution and develop our services.

There have, of course, been some significant changes to our pathology services during the pandemic. As non-emergency doctor visits and surgeries decreased, so too did the volume of tissue biopsy and excision specimens. However, as healthcare adapted to the “new normal” of life with COVID-19, patients who had delays in getting in to see a doctor are now able to do so, and specimen volumes have rebounded swiftly. In some places, the volume of specimens currently is greater than before the pandemic. Another change in pathology is a change that most people have experienced: adaptation to virtual forms of meeting, interacting, and teaching. The technology to meet and teach virtually has been around for a while now, but many pathologists and other doctors have been hesitant to embrace it. COVID-19 has forced us to use these virtual technologies and to become comfortable with them. While perhaps not as enjoyable as face-to-face meetings, the widespread acceptance of virtual meeting tools has enabled us to interact, meet, and teach on a more diverse and far reaching scale than ever before. The availability of free online pathology educational seminars, videos, and meetings has exploded during the pandemic, which is perhaps one of the greatest silver linings of this overall awful experience. Even once we move past the pandemic in the future, I am hopeful that this new acceptance of virtual tools for teaching and meeting will continue. But we are not past this yet, and now is an opportunity like no other to reconfigure and rebuild our services by drawing on the insights and expertise of pathologists, so our services are fit for purpose as we step into an unknown future.

Given that we are now better able to connect with each other as pathologists, are we also connecting with others outside the walls of our own laboratories? It’s clear that healthcare leaders and pathologists need to engage with one another to make the improvements that pathology needs to stay one step ahead, with cancer cases set to significantly increase in the years ahead – plus trying to catch up with an ever-growing backlog of cases. It is easier for us to not engage, to keep to ourselves, to let someone else handle it for us. But no one else will advocate for the field of pathology (or for the pathology services that our patients and our colleagues need)…we as pathologists must do it.

A key factor in reconfiguring pathology services is to attract and retain a pathology workforce. This starts with education. My fellow panel member, Dr. Tiffany Graham, talks about this in her chapter of the Future of Pathology report. Given that the number of students training as pathologists is going down, promotion of pathology should start earlier to ensure our future pathologists realize that this is the perfect career option for them.1 This needs to continue throughout med student training, and Dr. Graham offers some practical suggestions for how the promotion of pathology as a specialty might be achieved.

What should we be doing next? Perhaps we should reach out to administrators or other non-pathologist healthcare leaders in our institution to volunteer our input and assistance if and when they need it. COVID-19 exposed the danger of creating healthcare system policies and public health strategies without input from pathologists. Developing new tests and making them available on a massive scale is not as simple and easy as some people thought it might be; pathologists can help avoid errors and oversights like these from the start. Administrators and leaders need to have pathologists at the table when looking toward the future for healthcare organization strategy or public health planning.

We can also help by having a strong positive online presence, whether on Twitter, Facebook, Instagram, or other platforms. COVID-19 uncovered a disturbing and widespread anti-science/anti-medicine sentiment in our society. It showed us that now more than ever, people need to hear a trustworthy voice when there are conflicting messages related to health and science. Pathologists who share unbiased and accurate medical information online can be beacons of light that shine through the fog of false information that can confuse and even endanger members of the non-medical public. We have no agenda aside from wanting to help and educate others, and that is a position of integrity that engenders trust. We can use that position to help. If each of us helps just a little when and where we are able, the end result can be a powerful force for good that reaches far beyond the walls of our laboratories.

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1. Robboy SJ, Gupta S, Crawford JM et al. The pathologist workforce in the United States II: an interactive modeling tool for analyzing future qualitative and quantitative staffing demands for services. Arch Pathol Lab Med. 2015;139(11):1413–1430.

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