Patrick Godbey, MD
December 2019—This time of year, it’s easy to find ourselves caught up in holiday planning and the challenges of managing a busy team’s hectic vacation schedule. But it is also the appropriate time to look ahead to the coming year and think about the opportunities as well as the challenges we should expect.
Dr. Godbey
Here’s what I can say for sure about next year and the years after that: The importance of pathologists and the laboratories that we direct will increase. Already, the majority of diagnoses and therapies are greatly influenced, if not outright dictated, by pathologists and our laboratories.
I have often heard various people in medicine say that 70 percent of all medical decisions are made owing to the laboratory. That may have been true at one time, but I strongly believe that number is too low. Many of the advances in modern medicine have taken place because of what has happened in pathologist-driven laboratories. We can generate more information, with more accuracy, that is more important to the care of the patient than ever before.
Much has come our way in the form of new technology. New systems can be intimidating, but it is essential that pathologists embrace them. Pathologists need to not only guide the performance of these technologies but also participate in the decisions on their use. We must not shy away from new advances—and there will always be new advances. More and more, we choose the pharmaceutical treatment for malignancies. Companion diagnostics make it possible to match the right patient to the right therapy through genetic analysis. In the future, our laboratories will continue to have the opportunity to bring in new assays. This is an exciting time to work in this field.
Our embrace of new technologies and tests means we have a real opportunity to embrace our increasing responsibility in health care and to be recognized for it also. It is no longer enough for pathologists to just diagnose patients. We can and must do so much more. Our role now involves the diagnosis, management, and treatment of the patient.
My fear is that pathologists will not take this opportunity and run with it. I remember interviewing a candidate whose career goal was to “name the meat and hit the street.” To say this is inadequate is being kind. Our increasing responsibilities in patient management push some pathologists out of their comfort zone. But the new technologies at our disposal offer real benefit to our patients and our decisions should be based on what is best for them.
If we can build on the momentum that’s giving laboratories more influence today, we will find that administrators will take more interest in our laboratories. They will be more inclined to direct more resources to them and to us. This is because the laboratories for which pathologists are responsible increasingly direct the way health care dollars are spent. We should champion our laboratories and our team’s capabilities. We should anticipate that because of the dollar amounts involved, forward-thinking hospital CEOs and CFOs will spend a larger percentage of their budgets in our laboratories. Our increasing role in the determination of how health care dollars are spent should also mean that pathologists will need to play an important role in alternative payment models.
That’s why I am looking forward to a new year where pathology and the laboratories that pathologists direct will continue to grow at a rapid pace, and where our influence over not just diagnosis but also treatment selection will increase. I am looking forward to our growing importance in the health care team, with the ultimate beneficiary being the patient.
I’d like to sign off by wishing all CAP members, and everyone involved with the CAP, a happy holiday season. To me, the most important part of the holidays is being able to spend quality time with loved ones. I am looking forward to spending time with my family, who will be gathered on an island off the coast of South Georgia, accompanied by some reasonably friendly alligators and one 300-plus-pound wild boar that has never liked me. I hope everyone who reads this will be able to do the same—minus the boar, of course. Happy holidays to you and yours.
Dr. Godbey welcomes communication from CAP members. Write to him at president@cap.org.