How Pathologists Help Diagnose Disease & Find The Best Treatment

A pathologist is a vital part of any patient’s care team. Despite this, the pathologist may be almost unnoticed by the patient. That’s because much of a pathologist’s work is conducted in the lab. They use medical expertise and a detective’s interest in solving mysteries to piece together the image of a disease. 

What’s the traditional role of a pathologist?

The pathology department is both a basic science department and a clinical department. Almost a third of the faculty just do basic science research, and the other two-thirds do clinical work that ranges from everything from overseeing the clinical labs and all the associated tests to anatomic pathology. They process specimens from the operating room, look at slides and make the diagnosis for biopsies and resection specimens. They do some autopsies as well, but that’s a very small component of their job.

What's the traditional role of a pathologist
What’s the traditional role of a pathologist

So traditionally in a hospital-based setting, pathologists have been viewed as people who make a diagnosis based on just looking at the specimen slides. But now they do a lot of other things like immunophenotyping studies and molecular genetics studies. They run all those laboratories, not only to make the diagnosis but to provide the information that can help with targeted therapy and prognosis for the patients. So, pathologists work closely with surgeons, oncologists, hematologists and all the medical specialists.

How to describe the pathologist’s role?

As other areas have been specialized throughout medicine, the treating physicians understand diseases very well, and then they demand that the pathologists sub-specialize as well. They have to have people who are experts in just about all the organ systems to make sure they’re up to date and they’re providing the same information to the treating physicians.

The pathologist's role
The pathologist’s role

At what point do pathologists become involved in a patient’s care?

One is if they’re having a biopsy of a tumor, it automatically comes to the pathologists. Then they present it to the tumor board, where a team of physicians discuss the case, and work directly with the treating physician. If the patient was diagnosed at another hospital and comes here, they usually bring their slides with them and then look at those to render our diagnosis. 

Pathologists become involved in a patient's care
Pathologists become involved in a patient’s care

The other area where pathologists intersect with patient care is if they need a fine-needle aspiration, where they use a needle to take a small sample of cells. The surgeon or the treating physician will call a pathologist to do that. Also, when surgeons remove tumors or tissue in the operating room, a lot of times they need to know if they got all of it, or they need to confirm what they removed. So, in that case, they do what is called frozen sections, which are rapid diagnoses while they’re waiting in the operating room.