3 Questions with Lija Joseph, MD

When Lija Joseph, MD, completed her medical training in India, she took an exam, as all graduates did, that matched her into a specialty. For Dr. Joseph, she didn’t know much about what pathology involved when she matched into it, but once she started her training, fell deeply in love with the specialty, appreciating its attention to detail, and solving mysteries to help patients. She sees every slide as both a challenge and an opportunity, and attributes her understanding of possibilities and limitations to the opportunity she had to see how pathology is practiced in resource limited settings, such as during her training in India, and seeing the plethora of options available for the pathologists who practice in the United States. 

Here, Dr. Joseph, medical director in the Department of Pathology and Laboratory Medicine at Lowell General Hospital in Lowell, MA, shares what fulfills her about pathology, her responsibility to patients, and more.  

What aspects of pathology do you find most intriguing and fulfilling, and how do they align with your personal and professional interests?  

The mystery of a patient’s diagnosis which clinches on a pathologist, and the depth of diagnostic prowess that we can provide in helping the team offer the best treatment options for every patient is exciting for me. Working with a group of colleagues who share the same passion allows me to be part of a community that supports each other and elevates mutual passion for the field is professionally fulfilling. There are many times that we are reading up on each other’s cases to come up with a diagnosis. We are acutely aware that there is a patient that is waiting to know what is going on and our role in solving that mystery and allaying their anxiety is rewarding. 

It was distressing to me once when a pediatrician stated to me, “You are not a real doctor, you don’t see patients.” This was hurtful but made me determined to find a way to share with colleagues in the medical field understand what we do. The concept of the pathology clinic, which is supported by ASCP, is a great way to showcase what we do to the patients and to other colleagues. 

As a pathologist, you have a unique perspective on disease diagnosis and patient care. How do you approach the responsibility of delivering accurate and timely diagnoses, knowing they have a significant impact on patient outcomes?  

In October 2016, I read a story about Linnea, a patient who travelled 25 miles to see what lung cancer looked like. It was a turning point in my career. It inspired me to start the weekly Pathology Clinic at Lowell General Hospital. Since then, we have met with more than 250 patients, and all of our pathologists meet with patients or speak with them on the phone if they have questions. It has not been easy to launch a program like this. However, when the Cures Act 2021 went into effect, our hospital was poised to engage with the patients and enhance their care experience, due to this and other programs that we implemented here. I appreciate our administrative and clinical leadership trusting us with the vision that we had and for supporting us unconditionally in launching this program. These encounters are reimbursed by most insurance carriers. It is also something pathology residency program directors should consider in attracting more medical students into the field, who may be hesitant assuming that our specialty ‘does not see patients.”  

What do you hope to leave as your legacy in the laboratory?  

I hope that every member of the lab finds the joy of their purpose in the lab. As the lab generates over 70 percent of objective data about a patient, the possibilities are limitless. Always keep the patient as the center of our mission. Anytime we struggle with a dilemma in the lab, ethical, clinical, or personal, if we can ask ourselves “what is best for the patient?” the answer usually emerges. Sometimes, it might be that “I am too tired, I might make a mistake, I should wait till tomorrow to resolve this,” or “I need help, I should ask a colleague,” might be what is best for the patient. Above all, I wish that everyone has an opportunity to work with a group of colleagues who support you, to be your best self. I have been fortunate to find that and that is my sincere wish for all of you as well.