From the President’s Desk

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In pathology, peer review comes naturally to us, so it has been a challenge for me to understand why other physicians don’t always embrace it the way we do. I believe it comes down to the availability of meaningful data regarding physician performance. For those of us who practice anatomic pathology, hematopathology, clinical chemistry (serum protein electrophoresis interpretation), and transfusion medicine (antibody panel reviews), we have a permanent record of what we looked at to form our diagnosis. We are accustomed to doing second reviews, look-backs, and comparisons between different types of tests that may require us to reinterpret our original diagnosis.

Other specialties lack that concrete evidence to show a patient’s pathophysiology at a particular moment in time and how that led to a specific diagnosis, treatment plan, or clinical decision. When there is a problem with the care or the outcome of a patient, there is less objective evidence to review as we look for opportunities for improvement. I think this is why classically patient-facing physicians tend to be more reluctant to participate in the peer-review process. But as I often tell my colleagues, if you don’t engage to figure out what happened, somebody else will. That is why we need to embrace the opportunities that peer review offers us, even when it’s challenging. That’s a lesson that comes easily for pathologists, and it’s one of the reasons we have so much to offer our health care colleagues beyond reliable patient test results.

Another thing I’ve come to appreciate in the CMO role is the complexity of operational issues, such as supply chain constraints. Too often, physicians get frustrated by the barriers they run into and leap to judgment that somebody isn’t trying hard enough. I have learned the importance of avoiding contempt before investigation. There are usually very good explanations, and it’s typically not because somebody is trying to get in the way of providing care. When confronted with a frustrating situation, the approach you take may determine your success in resolving it. I can tell you from experience that the leadership team is more receptive to the concerns of physicians who are pleasant to deal with and who offer the benefit of the doubt when they raise an issue. I’ve also learned that physicians who take the time to understand who can help them, rather than just complain to the first person they bump into, are more likely to get the tools they need to provide great care.

I am so grateful to have the opportunity to serve in a leadership role, and it would not have happened without the support and resources of the CAP throughout my career. If you are interested in learning more about how pathologists can become leaders, I encourage you to attend CAP’s Pathologists Leadership Summit, which will take place as a hybrid event April 15–18.

Dr. Volk welcomes communication from CAP members. Write to her at president@cap.org.