The Pathologist as Wallpaper Inspector, Art Critic

In my book, The Life You Save: Nine Steps to Finding the Best Medical Care -- and Avoiding the Worst, here’s how I explained the potential for malpractice issues with pathologists and the importance of second opinions:

I explain to friends that a pathologist’s job combines being an inspector in a wallpaper factory with an art critic. The pathologist must inspect the entire specimen, many thousands of cells, that seem to run by forever in repeating swirls and loops under the microscope. The pathologist needs to make sure that a specimen that looks completely benign doesn’t have any hidden islands of cancer. And once a cancer is spotted, the pathologist’s job turns to art critic; he or she has to interpret subtle features of the cells to classify the exact kind of cancer and grade its aggressiveness, all of which makes a big difference in the planning of subsequent treatment. I pick the analogy to art critic for a good reason; you would think that in the study of disease, there are right answers and wrong answers, and everything should be clearcut. But it’s not. Pathologists can debate the diagnosis of a disease with as much passion as art historians debating whether an alleged Jackson Pollock painting is genuine.
Pathologists are important players in the medical care system, but most patients never meet one. Ironically, they can be very easy to reach on the telephone, since they don’t have patients crowding their schedules and thus don’t have phalanxes of nurses and secretaries to screen out patients trying to talk to them.

Patient safety tip for biopsies and pathology specimens

Getting a second opinion is how you can make sure that the most experienced eyes are looking at your specimen and making the right call of whether or not it’s cancer. The good news is it’s easily accomplished. Read more...

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