The Laboratory Leader

Why did you pursue a career in laboratory medicine?
The story goes all the way back to high school, when I used to see old black-and-white films of healthcare workers delivering vaccines and other treatments to people in the heart of Africa. I became extremely interested in infectious diseases and pursued microbiology at undergraduate and Master’s level. Through the guidance of colleagues, I discovered pathology as a route to involvement in microbiology – and I’ve enjoyed a wonderfully rewarding career ever since.

You are the former Co-Chair of the Enterprise Laboratory Stewardship Committee – what did this aim to achieve?
Pathologists have traditionally focused primarily on the analytic phase of testing, which is obviously crucial when providing useful and accurate information to the clinician. Laboratorians today are extremely proficient in that regard – our tests are highly reliable, reproducible, and demonstrate all the quality data required. More recently, our work has expanded to pre- and post-analytics to encompass specimen handling and the meaningful reporting of results. The next step – which some people have termed pre-pre-analytics and post-post-analytics – is to provide guidance around why a certain test is required and exert some influence over how the test results are used. This is all part of our duty in the US under Clinical Laboratory Improvement Amendments regulations – and it encompasses the real nuts and bolts of test utilization. As laboratory medicine professionals, we must be able to participate in conversations with our clinical colleagues who order the tests to ensure that all decisions are evidence-based.

Our aim is to create a consensus around evidence-based, best practices for test use to ensure consistency between patients. I’m most proud of the way we have achieved this collaboratively; during my nine years at the helm of the committee, laboratorians and clinicians have worked together to agree on best practice. Moving forward, we must train residents and fellows to understand that their job is not just performing tests, but actively coordinating with the entire system. That’s why good interpersonal communication and systems-based practice skills are increasingly important for the laboratory workers of tomorrow.

What role have medical laboratories played during the COVID-19 pandemic?
There is one inescapable word that every radio and TV station has been repeating throughout the pandemic – testing. William Osler – widely regarded as the father of American medicine – once said that there are three stages to treatment: diagnosis, diagnosis, diagnosis. Our response to COVID-19 hinges on accurate and timely testing and diagnosis, meaning that those infected can self-quarantine and not transmit the disease. As the driving force behind those tests, the medical laboratory plays a crucial role – and I just hope that the public acknowledge laboratory medicine as a pivotal point of healthcare and that it drives the best and brightest of the next generation to consider it as a career.

How can we encourage people to pursue careers in laboratory medicine? 
I’m disappointed by the amount of exposure pathology currently receives in medical schools. I think many medical students don’t even know what a pathologist is or what the medical laboratory does when they choose their preferred subspecialties. I’d like to see greater exposure early on for students; for example, I visited my old high school this year to present pathology and laboratory medicine as an attractive career path and encourage bright young minds to consider a future in the laboratory. We also need much greater exposure in undergraduate communities and within medical schools to introduce our field as an exciting and rewarding opportunity.

How do you find time for your personal interests among all your professional endeavors?
I love to sail and own my own sailboat; that’s probably my biggest hobby and a great way to relax. We also have a cabin in northern Michigan that we often escape to and do things totally unrelated to work, such as chopping wood and taking long walks in the woods. I love getting out into the open air in general; unfortunately, I definitely don’t get enough of those things. I have to squeeze them in around the edges whenever I can! I probably over-commit myself sometimes – but I think it’s important to have scheduled activities away from work because it always helps to re-energize and come back refreshed.

What advice would you give to those at the start of their careers?
You have to follow the passion in your heart. My primary interest was always in infectious disease pathology and microbiology – but temptations have arisen along the way. For example, I was offered a staff position in urologic pathology early in my career at an institution where I really wanted to stay. I chose to turn it down because I decided to pursue the subspecialties that really interested me and – even though I had the option to stay at an renowned institution  – saying no was the best decision I ever made. When you do things that you really love, your passion will be sustained throughout your career and you’ll continue to love it many years later!