Summary
The CAP faces challenges such as laboratory consolidation impacting proficiency testing revenues and the need to modernize the accreditation process. However, these challenges present opportunities to innovate, such as developing new proficiency testing products and leveraging AI to streamline inspections and improve lab quality.
Challenges, and opportunities, abound
December 2025—When this column comes out, it will be nearly the end of 2025. It’s a good time to think about the challenges we have been facing—and the opportunities we will have in the coming years to address them.
The CAP is no stranger to challenges, and neither are its members. There’s a lot going on in the world and in the health care markets that directly affects what we do. I believe that if we face these challenges head-on, we can find ways to improve laboratory quality and our ability to care for patients, all while strengthening the CAP as an organization.
To get started: We’re all familiar with how hospitals have been eating each other across the United States, and the laboratory consolidation that follows these mergers. With fewer laboratories, there are fewer customers for the CAP’s proficiency testing products. Unfortunately, the cost of making the PT products is going up even as the market shrinks. Continually raising the price of these products is untenable. But PT revenues are critical for supporting the CAP’s many programs and advocacy efforts. I believe there is a good opportunity here to create new PT products to address new approaches in pathology practice and to make PT more affordable.
Another challenge stems from our laboratory accreditation process. Today’s lab quality inspections are conducted the same way they were decades ago—with the notable exception that the checklist just keeps getting bigger. Inspectors have actually complained about having to pack and carry those enormous checklists, so now the CAP ships them to the labs ahead of time. Printing and shipping these materials to the thousands of labs that have to be inspected each year costs millions of dollars. At a minimum, we could save a fortune by switching the checklist to a digital format.
But I think there’s a bigger opportunity to improve lab quality inspections while continuing to ensure that laboratories have the processes in place to deliver consistent, reliable results. What if we incorporated generative AI tools to streamline inspections, allowing inspectors to truly focus on quality while the AI tools handle the screening and filtering of paperwork? I have served as an inspector many times, and so much of the visit is spent asking to see papers and protocols. Wouldn’t it be great for inspectors and laboratories alike if we could pass the paperwork responsibility off to a thoroughly capable and carefully evaluated AI tool, so the time spent between inspectors and lab staff could be more valuable? We should prioritize increasing interaction among experts wherever possible.
Another critical challenge is to apply digital and AI technologies to pathology and laboratory medicine. On one hand, we worry AI will become too “smart,” that it will become smarter than our own brains and get out of control. On the other hand, in many areas AI holds so much potential to help pathologists improve the efficiency of our practices. To close this gap, we need to collaborate closely to validate these new tools.
I am an optimist. While the challenges I’ve outlined here are serious, and are just a selection of what’s facing us today, they present us with wonderful—and in some cases unprecedented—opportunities to make the CAP even more robust than it already is and to ensure a strong and successful future for pathologists and our profession.
Dr. Zhai welcomes communication from CAP members. Write to him at [email protected].