Behind the Slides: How Pathology Clinics Are Shaping the Future of Patient Care

When patients are diagnosed with a disease or illness, they are understandably driven to know as much as possible about their diagnosis, treatment, and myriad other information. One way to support this is through pathology clinics—whether virtual or physical—which can fill communication gaps, drive more accurate diagnoses, support personalized treatment plans, and improve patient outcomes. 

With advancements in technology, increased collaboration with clinicians, and a greater emphasis on early detection, pathology clinics can also reorient pathologists from behind the scenes to the center of patient care. 

What are pathology clinics?  

A pathology clinic is an opportunity for patients to directly connect with a pathologist to understand their disease and get more nuanced answers to their questions, according to Dr. Lija Joseph, MD, Medical Director in the Department of Pathology and Laboratory Medicine at Lowell General Hospital, Massachusetts. 

Patients come to pathology clinics for a variety of reasons, from wanting to look at their slides, to understanding treatment plans, or even bringing family members to ascertain genetic risks. 

“The ultimate goal is that the patient has access to the person who made that life-altering diagnosis,” Dr. Joseph explains. She finds this especially important in an era of artificial intelligence (AI), where “the human connection and an empathetic listener and educator is lost.” 

Additionally, with patients having access to their own medical charts through the CURES Act, there could be a greater need for pathologists to explain information, she suspects. 

These clinics don’t have to take up tremendous resources or square footage either, she points out. Pathologists can be available by phone, telehealth, or in-office. 

Bridging the gaps in patient care 

The ideal goal is to make pathology clinics a routine part of practice, especially for oncology patients, says Dr. David Li, a hematopathologist and consultant at Mayo Clinic’s Department of Laboratory Medicine and Pathology in Florida. 

They can bridge gaps between provider-patient communication, he says. He shared a recent case where he observed a distressed email exchange within EPIC between a patient and their providers post-biopsy. 

“Unfortunately, the primary providers don't always have a lot of time to address these questions from patients. These messages can sit for multiple days. This is where a pathologist [in a pathology clinic] can come in and really help patients understand their results,” Dr. Li says. 

Even patients with medical knowledge can benefit from a pathology clinic. Dr. Joseph recounted the story of a 71-year-old nurse with breast cancer who came in to weigh her treatment options, which hinged on whether her biopsy margins were positive or negative. Thanks to a clear and more informed explanation, she fully understood why her doctor recommended a mastectomy. 

Deepening patient understanding 

Another perk of pathology clinics, according to anatomic and molecular pathologist, Joseph Maleszewski, MD, is that they can take medical explanations out of the realm of the “abstract and theoretical” and drive home important points about treatment and medication regimes, soothing internet-search driven anxieties. 

As Professor of Pathology and Medicine, Section Head of Cardiovascular Pathology and Senior Associate Dean for Academic Affairs at the Mayo Clinic Alix School of Medicine, Dr. Maleszewski sees these clinics as an opportunity to build on the idea that “knowledge is power.” He and his colleagues in Rochester, Minnesota took this idea even further, starting a clinic they call On My Path, for patients who undergo heart or lung transplantation. Not only do patients get one-to-one sessions with a pathologist in a comfortable setting, but they also get to see their own explanted organ. They are also given a 3D printed “copy” of that organ to take with them and teach others. 

“They’re able to see it and touch it, ask questions about it, take photos of themselves with it,” Dr. Maleszewski says. 

For the more than 350 patients who have come through their clinic over the last seven years, “This has been just an absolutely phenomenal experience,” he says. 

Unexpected positive consequences 

Pathology clinic sessions not only allow patients to learn about their own disease but often have “unexpected consequences for their continued care,” Dr. Malezewski says. 

For instance, sometimes they see cases of diseases that are genetic or heritable in nature. “One time I was looking at a case of something called hypertrophic cardiomyopathy with a family. And at the end, the woman who was in her thirties who was accompanied by three of her daughters, said to me, ‘You mean to tell me my daughters are at risk for this disease?’” 

As a result, the woman’s daughters were tested and found that one of them also had the condition. 

The role of technology in pathology clinics 

Pathology clinics are also easier to run thanks to digital pathology, Dr. Li says, making it so that patients don’t all have to travel to take advantage of the sessions. “With digital pathology and Zoom and Microsoft Teams, I can pull up images, scan images of their slides, or I can share their pathology directly from my microscope.” 

Additionally, digital pathology has made sharing information across the country easier, enabling a pathologist in California to get an instantaneous consultation from someone at Johns Hopkins or Mayo Clinic, for example. 

AI will undoubtedly make some of these processes even more efficient in the future. 

Making pathology visible 

Pathology clinics can have a powerful impact on the field of pathology by drawing back “the curtain” behind which the specialty can seem to feel stuck, Dr. Maleszewski says. 

“We can say to patients, ‘We've long played a role in your care, and now you get to sit down and pick our brains.’ Almost all of them immediately light up and they're very curious, and they want to know more,” he explains. 

This is not only good for patient care, but it also makes sure that pathology stays front and center in patients’ minds, Dr. Maleszewski says. 

The future of pathology clinics in reshaping healthcare delivery 

Dr. Joseph feels visibility is equally important “to our own colleagues; there are enough other subspecialty doctors who don't directly interact with us and don’t even fully understand what pathologists do.” 

This could potentially help with recruitment to the field, which is difficult to advertise to medical students. 

Even more exciting, Dr. Joseph feels that pathologists are moving to the forefront of personalized treatment plans and “precision medicine.” She envisions a future where pathologists could be more intricately involved in research teams at pharmaceutical companies as primary investigators of clinical trials. 

“I foresee a future of patho-oncology, or precision pathology, which does not exist today, where you provide personalized care for a cancer diagnosis,” she says. 

Funding pathology clinics 

For pathologists concerned about making the case for a pathology clinic to their C-Suite, Dr. Maleszewski has “zero doubt based on the more than 350 encounters that we've had here at Mayo that this is doing right by our patients.” 

“They leave each of these experiences better, more empowered, more prepared, happier than they came into those experiences. And that is a win for everyone,” he says. 

Dr. Li points out that most clinics form in “grassroots ways” and don’t need to be complicated. 

For those who need to make more of a financial case, Dr. Joseph points out “pathology clinics, if done correctly, are billable, reimbursable, and bring visibility.” 

Ultimately, Dr. Maleszewski believes that “anytime you impart knowledge to the patient, the patient becomes an integral partner in their own journey of wellness, making them more compliant and fully engaged.”