Stepping Out From Behind the Microscope
Sitting Down With… Blair Holladay, CEO of the American Society of Clinical Pathology (ASCP), Chicago, Illinois, USA.
How did you get to where you are now?
Upon finishing my PhD in pathology at The Ohio State University, I began work at the Medical University of South Carolina, both as a professor teaching cancer diagnostics, and running a cytopathology and molecular diagnostics clinical trials research center focusing on translational medicine. Later, I was recruited to the ASCP as Executive Director of their Board of Certification, and appointed as Vice President of Scientific Activities. Five years after that, I interviewed and was chosen for the open position of CEO of ASCP.
Your career has seen you wearing “multiple hats”; how has this benefited you?
My work with various organizations, in different capacities, has helped me understand the ecosystem of our profession. I think it’s important for us to stand together and have an organized voice. To that end, the ASCP works with multiple organizations in pathology and lab medicine to build bridges and leverage our different areas of expertise.
For example, at one point I was acting as both CEO of ASCP, and interim chief executive of the United States and Canadian Academy of Pathology (USCAP), and that was an opportunity to look at how the organizations could work together. This resulted in a Memorandum of Understanding between the USCAP and the ASCP. So I think wearing “multiple hats” has helped find ways for organizations to collaborate, such as developing residency engagement programs and enhancing our ability to create forward-thinking science education for practicing pathologists and residents.
What have been your biggest successes?
I greatly enjoy my work with the ASCP, especially being able to take important and sometimes risky steps to help our profession advance, and to address issues that are near and dear to my heart. This includes substantial international outreach – we’re now working in 70 different countries, with offices around the globe, bringing education and certification to parts of the world that need it, and helping to improve standards of care while building a laboratory infrastructure that is sustainable. We work in places where many patients don’t have access to diagnostic medicine, such as bringing communicable and non-communicable disease diagnostics to Sub-Saharan Africa.
Another area of passion for me is health services research, which is unusual for the ASCP, yet we’ve been very successful in getting grant funding from federal, industry and international sources to support this. Our aim is not just to improve diagnostics but to help educate clinicians – we need to raise awareness that pathologists and laboratory professionals are the experts in getting the right test, to the right patient, at the right time.
How big an issue is unnecessary testing?
Right now, it’s huge. In the US, there’s a great deal of overutilization; some reports indicate as high as 30 percent. A lot of time and money could be saved by working with clinicians to trim unnecessary test ordering and therefore costs.
The clear solution is to work with clinicians, and support pathologists and laboratory professionals serving as the consultants on which tests should be ordered. Pathology and radiology represent the majority of diagnostic medicine, and diagnostics is set to become the pivot point that determines patient treatment. I believe it’s possible that in the future, diagnostic medicine will be the center where patients enter the healthcare system, and then proceed to be triaged to clinicians. So as pathologists and laboratory professionals, we have to get out from behind our microscopes and clinical testing and take on a more active, consultative role in patient care.
Another area that demands pathologist input is personalized medicine. New diagnostic assays must be validated to ensure they are adding value and evidenced-based outcomes, and not just expense. More work needs to be done to assess them – are they truly improving outcomes? If not, we shouldn’t be performing these tests. It’s important for our profession to play a larger role in informing patients and clinicians, and to help them make the best diagnostic choices possible.
What do you say to those who feel that pathology is just for pathologists?
You can’t just divide your lab into physicians and non-physicians, in particular, as our future unfurls. We should bring diverse professionals who make up our lab teams closer together in order to meet the unique diagnostic needs of each patient. ASCP is the largest pathology and lab medicine organization in the US, with around 120,000 members; however, our most important differentiator is that we represent the entire laboratory team – not just pathologists and laboratory medicine professionals, clinical scientists, medical laboratory scientists, histologists, phlebotomists, microbiologists, and many, many more.
Instead of simply stating “pathology ought to be represented by pathologists,” it’s important that everybody recognize the diversity of professional leaders in our medical laboratories and encourage proactive communication and cooperation. We have always promoted this team-based approach to patient care, and I think our inclusive policies and relationships with our myriad sister organizations have been a key part of our success. Working together can only bring diagnostic improvements for our patients and enhance the future network of our professionals, a team that ultimately has the same goal—together we will ensure the best possible outcome for each patient. Every team member plays a crucial role.
I have an extensive academic background in the life sciences, having studied forensic biology and human medical genetics in my time at Strathclyde and Glasgow Universities. My research, data presentation and bioinformatics skills plus my ‘wet lab’ experience have been a superb grounding for my role as an Associate Editor at Texere Publishing. The job allows me to utilize my hard-learned academic skills and experience in my current position within an exciting and contemporary publishing company.