Choose Your Pathologist Wisely

Article about the importance of the Pathologist in the medical field. This specialty is often underrated and patients are not aware of the importance of having a great Pathologist.

Who’s your surgeon?  Who’s your cardiologist?  Who’s your ObGyn? Have you ever heard anyone ask – Who’s your pathologist? Never, right? Most people don’t even know what a pathologist is or does. It’s a pity, you know. Patients are often uneducated about the medical field in general, their disease and most importantly, their own diagnosis! Have you ever had a biopsy before? Any biopsy: skin, liver, lung? Major surgery? Minor surgery? Have you ever wondered what happens to that organ or piece of tissue that is being removed from your body? Where does it go? Who examines it? What do they do to it? If you haven’t thought about all of this, you should. Why? Because your organ and your piece of tissue will eventually reach the hands of a doctor who will study it, analyze it and ultimately give youyour final diagnosis. That physician is a pathologist.

Pathology is the most important specialty in medicine. I know it sounds a bit bold, but it’s true. Think about it. Pathology is the core discipline in medical school. It’s the foundation of the medical field. It’s the study of disease! Do you know who your pathologist is?  Is he or she any good at diagnosing diseases? This is something every patient should know, don’t you think? Why does it matter? Well, because your life could be at stake! The pathologist’s diagnosis may define what the next step in your care will be.

For example: let’s suppose you have a small lump on your breast, or a mole on your arm, or any lesion anywhere, and you are worried about it.  So, you go see a doctor and he/she examines you, but cannot be absolutely sure what the lesion is without “further studies” (a pathology report), and therefore, suggests a biopsy. You agree to the biopsy. Now, the doctor takes that piece of tissue from your breast, arm, wherever and sends it to “the lab”. Patients often don’t think about what’s going on behind the scenes. “The lab” is where technicians, nurses, histologists, physician assistants and physicians (pathologists) will be to receive your specimen and analyze it. It takes around 24 hours to process and prepare the stained glass slide with your specimen on it. Finally, the pathologist will get a chance to look at your biopsy under the microscope and give you a diagnosis. Do you know how much skill is involved in this? Some cases are easy and some are hard. Depending on the difficulty of the case, it could take a week before you get your result. Many times, additional stains are needed to help distinguish a malignant lesion from a benign one. The interpretation of the tissue on the slides is very subjective. Sometimes, a biopsy is interpreted as malignant by one pathologist and benign by another. Some cases are shown to several different pathologists and a consensus about the nature of the lesion is not achieved. This does not indicate incompetence, but it is a sign of how observer-dependent a pathology report can be. So, basically, this means that your diagnosis can vary depending on which pathologist signs it out! So now what? Well, think about it, in the end, perhaps that breast lump wasn’t malignant, and the mastectomy wasn’t necessary after all. Or, even worse, that mole you had on your arm, a few years ago, wasn’t benign and in reality it turned out to be a metastasizing melanoma. Get the picture? My point is: know who your pathologist is. Ask your doctor to whom he or she sends his specimens. Is your skin biopsy being sent to a skin pathologist or a general pathologist? It makes a big difference! Do your research. Request that your biopsy be sent to the pathologist of your (or your doctor’s) choice. Get a second opinion. Become more familiar with the doctor who is actually diagnosing your condition. These are questions that people usually don’t think about, but in the end, that pathology report, whether the diagnosis is right or wrong, is what your whole treatment will be based on. It’s your life, wise up!

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