Leadership beyond the lab
Donald S. Karcher, MD
August 2025—I’ve written in this column many times that pathologists should be leaders of the laboratory. But all of the leadership skills we develop through that role also make us a good fit for many other leadership positions in our health care institutions and beyond. I have met CAP members who are chief medical officers, chief quality officers, presidents of their medical staff, and even CEOs of hospitals and health care networks. The current commander of one of the largest military medical centers in the U.S. is a pathologist.
With the stereotype that pathologists hide in the basement, diagnosing cases in isolation and dodging human contact, it may be surprising to some that we pathologists are so well prepared for leadership roles. But our specialty makes us a natural fit for leadership beyond the laboratory. Pathology touches pretty much all areas of medicine, and the diagnoses we make and the information we provide impact essentially all patients. We interact closely with most areas of medicine and, as a result, our knowledge of medicine must be quite broad. That’s intrinsic to what we are trained to do. In fact, we are likely more knowledgeable about things going on in other specialties and branches of medicine than pretty much any other type of physician. That arguably makes us more qualified than most other specialists to have leadership roles in the hospitals and health care systems we serve.
Another trait that gives us an edge: More so than any other medical specialist, pathologists are formally trained and have extensive experience in maintaining quality services. We are steeped in quality principles and well prepared to manage quality beyond the laboratory. Those same skills translate effectively to ensuring quality across health care services and operations within and outside of medicine.
We also tend to have more experience in personnel management from our daily responsibilities. At one point I had a staff of 130 people reporting to me as a laboratory director, and some pathologists have teams much larger than that. More than most other physicians, we have to develop skills to deal with managing large and complex teams: human resources, personnel dynamics, training, competency assessment, conflict mediation, and more. These skills can help us in leadership positions at hospitals and health care networks, and even well beyond that.
Many of us don’t think about career paths beyond the laboratory. But if you find yourself aspiring to a different kind of leadership position, I encourage you to build on your unique expertise as a pathologist. The executive roles I’ve mentioned here can be a natural fit for a pathologist looking for a perch outside the lab. Some pathologists even find rewarding career paths in industry, where we offer substantial value to the companies developing instruments and tests designed for clinical laboratory use. In addition to the leadership skills we possess, we also bring our medical and scientific knowledge to executive positions in health care not traditionally held by physicians.
There’s another area where our backgrounds are useful: political office. Pathologists have a lot to offer in policymaking and legislation—related to health care, obviously, but also more broadly than that. With our backgrounds in one of the most heavily regulated parts of medicine, we have to know a lot about policy, government agencies, and what it takes to become and remain compliant with a wide array of regulations. Dealing with the various agencies and rules that apply to pathology and clinical laboratory practice can be excellent preparation for a career in politics. And the perspective we can provide is much needed at all levels of government. I would love to see a pathologist become a member of Congress someday.
I’m certainly not the first to observe the natural link between pathologists and leadership roles. The CAP designed the Pathologists Leadership Summit, which takes place each year in the spring, to help pathologists further develop their leadership skills and prepare for positions within and beyond the laboratory. For anyone considering a leap into politics, the meeting also coincides with the CAP’s Hill Day, which facilitates meetings between pathologists and their elected representatives. I’ve attended several times and it’s a great opportunity to get a peek into the world of elected office.
If you’ve been wondering what’s next in your career, I encourage you to consider pursuing some kind of leadership role outside the laboratory. We pathologists have so much to offer in hospitals, health care networks, industry, and beyond. And if you aspire to political office, you can count on my vote and that of many of our fellow CAP members!
Dr. Karcher welcomes communication from CAP members. Write to him at president@cap.org.