Laboratory News

Future of Pathology Predicted by Incoming CAP President

What lies ahead for pathologists was a key theme in San Diego, California, this week at the Pathology Visions 2007 program produced by Aperio Technologies, Inc.  and the California Society of Pathologists (CSP). The keynote speaker was Jared N. Schwartz, M.D., Ph.D., who is the incoming President of the College of American Pathologists (CAP).

Under the title "Future of Pathology: Vision 2020," Schwartz laid out a few basic directions for the future of pathologists. His views will be instructive for Dark Daily readers, as they represent some of the strategic thinking now occurring within the College. Four key points capture the essential message that Schwartz shared with an audience of several hundred pathologists and other lab industry executives.

First, Schwartz pointed out that technology is advancing in ways that will allow growing numbers of patients to be diagnosed and/or treated without tissue. He described several of these possibilities, ranging from tissue-specific in vivo bio markers and virtual colonoscopies to tissue characterization and imaging based on such methodologies as virtual histology and microendoscopy. According to Schwartz, it is important to recognize that such technologies have the potential to dramatically reduce the overall number of tissue specimens submitted to pathologists. As that happens, pathologists need to position themselves to add value in the diagnostic and therapeutic areas of medicine.

Second, "resistance to train in new technologies opens the door for others to seize the opportunity," declared Schwartz, who recommended that pathologists proactively master new technologies and take the initiative to provide these technologies to clinicians. As this happens, it helps pathologists protect their role in the clinical continuum. It also fends off other specialists who might be interested in incorporating such technology and clinical procedures into their scope of practice.

Schwartz's third insight was for pathology to recognize how different it is from radiology, in ways that are highly valuable to referring physicians. "As a rule, when pathologists are referred a case, they make a specific diagnosis that generally leads to direct action," he explained. "By comparison, radiologists often issue a report, which before the physician can take further action, requires additional diagnostic steps." Because of these differences, pathologists contribute to patient care in a very powerful and direct way. "This is an opportunity for pathologists who are ready to step up their support for clinicians," advised Schwartz.

Fourth, Schwartz defined the choice that lies before the pathology profession. "The virtues of traditional pathology have not diminished," he noted. "But these simply are no longer sufficient [given the ongoing advances in medicine]. This puts pathologists at a crossroad. Pathologists can generate test results, or pathologists can provide answers that support the diagnosis and choice of therapy, as well as guide the care team," said Schwartz.

Schwartz offered a powerful closing remark. "Pathologists are not defined by the tools that they use, but by the knowledge that they share," he told the audience. "So what will it take for pathology in the future? Pathologists need to go back to being a physician!"

It was a receptive audience. Pathology Visions 2007 is a conference devoted to the full digitization of pathology, including images, reports, and other relevant data. There were more than 39 formal presentations, as well as an exhibit and sidebar sessions designed to showcase advanced technology solutions for image capture, archiving, and review. Many attendees are already incorporating digital products and systems within their pathology laboratories.