News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Second opinion dermpath business combines digital pathology, glass slides, and the Internet.

Telepathology, Federal Express, and internet technologies are the cornerstones of a flourishing second opinion business by dermatopathologists in Boston, Massachusetts. In just a few years, the practice has built a national and international clientele. This confirms that there is already overseas demand for access to expert pathologists with subspecialty skills.

Another unique twist to this pathology second opinion business is its use of a subscription arrangement. Referring pathology groups can pay sliding flat fee per case, based on a pre-agreed monthly volume. This arrangement has proved popular.

Artur Zembowicz, MD, PhD of

Artur Zembowicz, MD, PhD

Entrepreneur pathologist and melanoma expert Artur Zembowicz, M.D., Ph.D.,  left Harvard in 2008 and founded his company specifically to serve this market for expert second opinions of dermatology cases. His web-based business model is called  It provides second opinion dermatopathology services to pathology groups in the United States and around the globe.  While many pathologists and anatomic pathology laboratories have yet to adopt latest-generation technologies, Zembowicz’s company is continually investing to stay at the front edge of that curve.

“This unique dermatopathology business model is a response to the strong demand for dermatopathology expertise, ” Zembowicz said. “However, pathologists who need second opinion consultations for dermatology specimens must often contact academic centers or their competitors from specialty laboratories. Typically it is a cumbersome and expensive process to get a consultation on these cases. Often, days and weeks later, it is up to the referring pathologist to contact the academic center pathology group to track down whether the second opinion consultation report was signed out and is ready to deliver. The second opinion and technical charges can often cost hundreds of dollars.

“I saw an opportunity to apply latest-generation technology to make it simple for pathology groups anywhere in the United States or abroad to refer their second opinion cases to us,” continued Zembowicz. “First, using a web-based process based upon all-digital communication, we can reduce the cost of a consultation with an expert dermatopathologist. Yes, glass slides are still shipped to us. But from that point, we are totally digital in our interaction with referring pathologists.

“Number two, we are organized to provide specialty expertise to those pathologists and anatomic pathology laboratories that don’t quite have enough volume of cases to hire a full-time dermatopathologist,” he added. “Also, our group can be used to provide additional capacity or to cover for vacations in cases where the pathology group has only one dermatopathologist, and temporarily needs extra help.”

As a virtual dermatopathology laboratory, there is no brick and mortar lab facility. The public face of the company is the web site at Three pathologist subspecialists review cases.

“Our pathology consultations currently center upon dermatopathology, ophthalmic, and head and neck,” explained Zembowicz. “As technology advances—particularly in digital scanning of pathology slides—we expect to expand both our fields of expertise and the number of institutions and pathology groups that we serve.”

Another unique twist to Zembowicz’s business model is how he prices his services. He builds relationships with pathology groups and hospitals by remotely offering his expertise on a subscription basis. If a laboratory only has a need for only five consultations per month, there is a subscription for that. The higher volume flat-fee subscriptions allows a hospital to refer hundreds consultations a month. It is a convenient staffing solution in lieu of locum tenens. Further, when special studies are required, Zembowicz will often send these to his referring clients’ laboratories. This allows them to retain the revenue from these procedures. demonstrates how innovative pathologists are stepping up to apply new information technologies to make it easier for local pathologists to refer cases to expert subspecialist pathologists. The fact that Zembowicz and his colleagues are getting second opinion case referrals from other countries outside the United States is an early sign that—when it comes to recognized pathology subspecialty expertise—borders won’t mean much. Physicians will want their specimens reviewed by the best pathologist subspecialist in the field, regardless of where that individual lives and works.

Related Information:

DigitalPathology blog looks at the increased use of “virtual slides” among dermatopathology residents

Wake Forest University digital Dermatopathology Library

Abstract from Journal of Cutaneous Medicine and Surgery: Incorporating Medical and Surgical Dermatology article “The Utility of Digital Clinical Photographs in Dermatopathology”