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  • Michael Misialek, MD

The Pathologist’s Role in Diagnosis, Quality and Patient Safety


Pathologists are physicians and diagnostic experts. As a pathologist, our work touches every patient, in every stage of life. Situated at the intersection of all medical specialties, pathologists provide the link between the science and practice of medicine. All treatment begins with a diagnosis. Whether it be the results of a common blood test, tissue biopsy or esoteric molecular analysis, pathologists give direction to the work up of patient problems. A pathologist is a key member of the care team.

Diagnosis

All treatment begins with a diagnosis

It is a pathologist that makes this diagnosis. Any specimen that comes from a patient will be seen by a pathologist. Whether it is a tissue biopsy from a doctor’s office, the operating room or a pap smear, your pathologist will be the first to see it. Even samples for chemistry tests, blood counts, microbiology cultures and testing for transfusions…these are all overseen by the pathologist.

Accurate diagnoses

Errors can result in misdiagnosis, delay in diagnosis and be a cause of patient harm. Almost 70% of information in the medical record is said to come from the lab. Pathologists manage this tremendous amount of information and help ensure providers have access to the right information, for the right patient at the right time.

Diagnosis cycle

Pathologists are integral members of the diagnosis cycle. The recent Institute of Medicine (IOM) report on diagnostic accuracy lists several important recommendations that are of particular interest to pathologists.

The Society to Improve Diagnosis in Medicine recommends that the CDC should support:

  1. Failsafe communication of lab test results

  2. Funded clinical liaison pathologists in every hospital

  3. Funded autopsies at special centers

  4. Second opinions on surgical pathology

Diagnostic errors are a significant but underappreciated challenge to health care quality. Getting the right diagnosis is a key aspect of health care. It provides an explanation of a patient’s health problem and informs subsequent health care decisions. Diagnostic errors persist through all settings of care and harm an unacceptable number of patients

Quality

Pathologists ensure the accuracy and precision of laboratory testing to deliver the highest quality results for your care. The field of pathology was among the first in medicine to use the principles of quality assurance and quality control. Pathologists have developed quality control programs for critical and routine testing.

Pathologists help create cost effective algorithms for the testing of many diseases. They monitor lab test utilization, adding to the value equation by lowering cost of care and helping improve outcomes. They help address problems of both over-utilization and under-utilization.

Aiding in the creation of clinical decision support tools to guide prevention of complications such as thrombo-embolic events and infections, pathologists help prevent adverse events while in the hospital, including blood clots and hospital acquired infections.

The management of complex medical conditions of patients in the hospital and ICU is made possible through the input of pathologists by assisting in the creation of testing algorithms. They provide expert interpretations to manage complicated conditions, such as fluid and electrolyte imbalances

Patient safety

Through accurate diagnoses of tissue samples and overseeing the quality testing of blood samples, pathologists are crucial to patient safety. Pathologists provide leadership in the blood bank. They oversee the safe donation and transfusion of blood products, and in so doing, ensure the safety of America’s blood supply.

Pathologists are key members of the infection control team. They help monitor infections within the hospital, helping to minimize hospital acquired infections and limiting the spread of antibiotic resistant bacteria.

Take time to learn about the other doctor involved in your care: The Pathologist.

#diagnosis #quality #safety #pathology

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