Pathologists As Consultants

Pathologists do not spend their entire days holed up in laboratories and morgues. As experts on disease processes, they are always communicating with their colleagues. Whether in person, on the telephone, through a written report, or at a conference, pathologists discuss patients with other physicians all the time. For instance, a pathologist receives telephone consultations from doctors wondering about the meaning of a lab value or pathologic finding. Keep in mind that every specimen arriving in the pathology department carries an accompanying clinical question. Whether the patient has an unusual neck mass or a surprising laboratory result, clinicians turn to pathologists for the answer. Sometimes the questions are not as clear, and pathologists have to sort out the relevant clinical inquiry. Is it cancer? What type, grade, and stage? Are there additional features that help assess the patient's prognosis and potential response to therapy?

The famous physician Sir William Osler once referred to the pathologist as "the doctor's doctor." Every aspect of their clinical care is essentially a consultative service. Because of this advice-giving role, good communication skills (both oral and written) are of utmost importance. While making the best diagnosis, pathologists often struggle to state their findings in a clear, concise manner. They

vital signs formulate comments that convey the relative significance of individual findings but never understate or overstate their degree of certainty. It is a challenging art form. "Communication skills are my currency with the clinicians," a senior faculty member in pathology remarked. "Other doctors cannot tell how good a pathologist is diagnostically. So, they only judge us on our ability to communicate the relevant information."

Because of this consultative role, pathology is a perfect specialty for medical students who appreciate precision in written and spoken language. Pathologists have to produce the most accurate and clearly written reports. They have to dictate each observation succinctly and in the proper format. For cases in which a diagnosis cannot be made, they must enumerate the relevant findings and the significance of each. If a possible diagnosis exists, the pathologist has to be careful about overstating their conviction. Like all fields of medicine, pathology is fraught with gray areas. Thus, in some cases, pathologists walk a fine line between under- and over-interpreting the findings. It is quite a challenge to submit final reports that are clinically useful yet do not over-imply diagnostic certainty. Word selection and order become critical factors. As such, pathologists tend to be good writers, striving to develop precise and accurate reports.

PATHOLOGY

EMPLOYMENT DATA

• Distribution among all physicians: 2.3%

• Practice type: 64.4% in private practice; 22.8% in academics

• Median number of patient care hours per week: 44.1

• 23.5% experienced difficulty in securing their preferred employment position

• 58.6% report that their salary is equal or higher than expected

Source: American Medical Association

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