Pathologists at the Table: Keeping Our Place After COVID-19

The COVID-19 pandemic put pathologists, laboratory professionals, and testing front and center. It reminds me of a favorite, albeit paraphrased, quote by William Osler: “There are three phases of treatment – diagnosis, diagnosis, diagnosis.” We must not allow health system leadership to forget that it was through engaged laboratory leadership that frontline providers had the best testing available – not to mention that this was achieved in an evidence-based manner and under extreme, unprecedented conditions.

If the importance of the laboratory in the era of high-quality care fades into the background, we will have only ourselves to blame. Now is the time to push our way to “the table” if necessary and remind hospital leadership about what we bring, what we can bring, and what we have already delivered. We cannot, however, rest on the laurels of our performance during COVID-19. Instead, we must turn our attention to improving the healthcare delivery issue du jour at our institutions. I know these words may not be for every pathologist, but they are a battle cry for health system leaders to arise from within our ranks.

Regarding the “winding down” of COVID-19, the relaxation – and reimposition – of precautionary measures now and in the future must be evidence-based. They must consider viral transmissibility, disease prevalence, population density, and more. There have been many appropriately critical after-action reports regarding the national response to this pandemic. It is a hope – one unfortunately not likely based in reality – that the US could review these findings and use that learning to devise an evidence-based response strategy, separate from politics, that has a chance of working. I have faith in the expertise and professionalism of our community and believe that, at some point in the future, we will find our standing in the house of medicine better than ever.

That said, the uncertainties that lie ahead concern how we secure our place in that house of medicine. Are we viewed as important colleagues and key contributors to healthcare delivery (as became evident during the COVID-19 pandemic) or are our services viewed as commodities that can be outsourced and performed remotely? I am convinced that healthcare delivery is improved when pathologists and laboratory professionals are at the table and engaged in systems-level issues – and I’m sure my colleagues in the field are, too.

But, for that to happen, we have to be at the table in the first place. We must obtain positions on our health systems’ decision-making committees and maintain them by being more than just great pathologists. The surgeons, internists, and pediatricians who are currently CEOs and CMOs of health systems began by excelling in their craft while learning new skills in management, leadership, and large-scale healthcare delivery. Pathologists need to do the same, and we are fortunate to have some great pioneers in this regard whose example we can follow. Consider, by way of example, Jeffrey Myers from the University of Michigan; he is not only a world-renowned pulmonary pathologist, but also Vice Chair of Clinical Affairs and Quality at that institution and the Chair of the Patient Champions Steering Committee for ASCP. Leaders such as these, as well as pathologists in mid-level leadership positions, have opportunities to underscore the value of high-quality, on-site pathology and laboratory medicine services that benefit both the individual patient and the healthcare system in its entirety.