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Head of Pathology Service, Complejo Asistencial de Avila, SACYL-Health Service, Castilla y León, Spain; President of Asociación Territorial SEAP-IAP (Spanish Society of Pathology-International Academy of Pathology) in Castilla y León, Spain; Member of the Spanish SEAP-IAP

Biggest challenge in pathology? The challenge is to define and make visible our position in precision medicine. Pathology should be fully integrated in multidisciplinary work, leading diagnosis from macroscopic morphology to the molecular aspect of pathologies. Pathologists handle diagnosis from a structural basis, to the molecular detail of the structural alteration, integrating all aspects of pathological changes in the disease of a specific patient. We do not deliver a mechanized, automatic analysis; it is rather a pathological REPORT, combining knowledge, professional experience, and the latest scientific updates in our field. In using this, we work, among other tools, with digital visualization technology and AI. Combining all, we have a diagnostic, preventive, and prognosis aim, depending on the case.

Missing from the diagnostic toolbox? Universal digital pathology with AI tools for everybody. Use of international protocols in oncopathology reports, and also in other pathologies, in all the departments, using the same items and codes. Joining forces in molecular pathology, creating territorial areas and networks. Management making the pathologist’s job visible by reaching out to our superiors, the patient, and other specialists, using marketing and management tools for the funding and modernization of our field.

Controversial opinion? We are not known by the public, being an almost invisible speciality. Most people think that we make an automatic analysis that can be obtained from a machine, that we are just a paragraph in a surgery or oncology report. The reality is that diagnosis, in a perfect and complete pathology REPORT (not “analysis”) elongates and/or saves the life of the patient, as well as preventing diseases and complex surgeries in the descendents.

This is, in my opinion, one of our biggest challenges: TURNING VISIBLE for the people. 

Another problem is that most oncology therapies are very expensive. They are based on biomarkers identified in the pathology department. If the pathology biomarkers are wrong, the therapies will not be efficient. And they may be useless and even harmful if the pathology report is not complete and correct, which is why our job is key, and should be given more recognition.