Aadil Ahmed

About Aadil Ahmed

Pathology is the cornerstone of diagnosis in modern medicine — yet too often, our field limits its own impact by stopping at the diagnosis. Making the correct diagnosis is, of course, fundamental and non-negotiable. But for pathology to reach its fullest potential in patient care, we must move beyond seeing diagnosis as the final destination and instead view it as a bridge to informed, patient-centered treatment.

A key change required is shifting our training and daily practice mindset so that pathologists not only know how to recognize disease under the microscope but also understand its practical implications in real-world treatment pathways. In medical training, we rarely focus on what happens to the patient after our report is signed out. This gap becomes especially problematic when a diagnosis is ambiguous or sits on a gray zone where standard guidelines are lacking. In such moments, clinicians look to us not just for a label but for meaningful guidance on next steps — and we can only provide that if we are prepared.

In my own dermatopathology practice, I see this daily. For example, when I diagnose an atypical endophytic squamous proliferation where the lesion base is not visualized and features do not meet the threshold for squamous cell carcinoma, simply reporting “atypical” is insufficient. Clinicians immediately ask: What should we do? Is re-excision needed? Can we observe? Should we treat topically? There is no single textbook answer — so the pathologist’s role evolves from diagnostician to consultant and guide, informed by clinical realities.

Another example is the management of widespread atypical lentiginous melanocytic proliferations. Relying solely on repeated surgical excisions can leave patients with extensive skin loss. In such scenarios, it is our responsibility to pick up the phone, proactively reach out to our clinical colleagues, and discuss whether topical treatments, monitoring strategies, or a multidisciplinary approach might be more appropriate.

To maximize pathology’s impact, our reports must also communicate clearly and effectively. Long, verbose reports risk burying the main message; short, precise comments — crafted in active voice — ensure that our guidance is seen, understood, and acted upon. When nuanced details do require lengthy explanatory notes, direct communication becomes even more vital. Picking up the phone to discuss a complex finding or ambiguous result humanizes the work, builds trust, and keeps the focus on the patient’s best interest.

In my work, I emphasize these principles daily. I teach my mentees and junior colleagues that microscopic descriptions can be detailed, but the comment must deliver the exact actionable message. This approach empowers clinicians and clarifies next steps. I make it a priority to reach out regularly to referring physicians — not just to answer questions but to anticipate them. By being proactive and informed about treatment pathways, we become true partners in patient care rather than passive report generators.

I also believe these small but intentional communication practices — clear, active-voice reports, timely phone calls, and collegial dialogue — help humanize pathology in an environment where our interactions with patients and even with colleagues can be limited. In doing so, we elevate both the impact and the respect for our specialty.

Ultimately, if pathology is to maximize its contribution to patient care, we must recognize that our job does not end at diagnosis. It extends into the realm of guiding treatment decisions, communicating clearly, and being an accessible, trusted collaborator in the patient’s journey. This is how I practice every day — and how I hope to help shape the future of our field.