Laboratory medicine: a team sport
Donald S. Karcher, MD
April 2025—If you read my monthly column often, you probably know that leadership among pathologists is one of my favorite topics. And one of the most important leadership roles we play as pathologists is as leaders of the laboratory diagnostic team. Our years of training prepare us to view a patient’s health holistically and to interpret test results in the context of the patient’s full clinical picture.
One of the privileges any leader enjoys is being able to shine a light on the hard work and many contributions of the other members of their team. In that spirit, I want to take a moment to celebrate the many members of the laboratory team who make such a difference for our patients. There are the dedicated pathologist assistants, who handle gross examination and dissection of the specimens we look at under the microscope. And the histology technicians, who make an art form of cutting tissue sections and producing beautifully prepared and stained slides. Medical technologists, now more properly called medical laboratory scientists, operate increasingly sophisticated instruments and perform myriad tests that run the gamut of laboratory technology, from flow cytometry to next-generation sequencing to GC mass spec. The phlebotomists who collect specimens for our laboratories are often the public face of the clinical laboratory, as they interact directly with our patients and ensure specimens are collected properly and with the least possible discomfort. And then there are the PhD laboratory scientists, whose work and expertise contribute immeasurably to the high quality of testing in our laboratories. Every individual brings so much value to the effort. Laboratory medicine is truly a team sport: Without question, a highly functioning diagnostic team will result in the best outcomes for our patients.
While we pathologists lead these teams, the art of leadership is often not included in our early medical education. For most of us, learning the tools of laboratory leadership and administration begins in residency and lasts well into our years of practice. The CAP, working with other organizations, has conducted a series of surveys dealing with pathologists’ familiarity with the many facets of lab administration. We’ve heard from group leaders who hire pathologists and from new-in-practice pathologists, and both have repeatedly said that our early-career colleagues don’t always have confidence in their ability to execute this aspect of their work as pathologists.
Fortunately, leadership skills can be learned. I see this in my own involvement with residency training, where I teach important elements of laboratory administration and leadership to our residents, including quality management, laboratory finances, personnel management, and much more. I consider this a very important aspect of pathology practice and am honored to serve as a coeditor of a book on this topic published by CAP Publications. (It’s called Laboratory Administration for Pathologists in case you’re curious.)
The CAP offers a number of resources to help us pathologists hone our leadership skills. By the time you read this, the CAP’s annual Pathologists Leadership Summit will be right around the corner. It takes place in Washington, DC, April 26–29, and while there is an emphasis on government policy and advocacy, the leadership skills taught in this meeting are also valuable for laboratory administration.
If a trip to DC isn’t in your plans, the CAP also offers a series of useful online leadership courses. These are available to all CAP members and can be found on the CAP’s education webpage at cap.org under the “laboratory management and leadership” heading. I highly recommend these courses to all CAP members. Whether you’re new in practice or a more seasoned laboratory leader, these resources can help you master critical skills to keep your lab—and your team—operating as effectively and efficiently as possible.
As you can see, the CAP has your back when it comes to leading a clinical laboratory—and that’s both in teaching essential leadership skills and in helping you staff that lab. We all know there’s a shortage of pathologists, and an even more severe shortage of medical laboratory scientists and other laboratory technical staff. The CAP is working on both issues, devoting resources and advocacy efforts to raise awareness among students of these rewarding career paths and to expand the educational opportunities to help fill these roles.
I’d like to leave you with a simple request: The next time you walk through your lab, take a minute to thank the other members of your laboratory team. It’s not an exaggeration to say that we couldn’t do the work we do for our patients without all members of the laboratory diagnostic team doing their part.
Dr. Karcher welcomes communication from CAP members. Write to him at president@cap.org.