3 Questions with Deepti Reddi, MD, FASCP

One night, at 10:45 p.m., Deepti Reddi, MD, FASCP, a pathologist in the Division of Anatomic Pathology, Gastrointestinal, Hepatic, and Pancreatic Pathology at the University of Washington, received an intraoperative consultation request from the liver transplant surgeon. A young patient with a history of cirrhosis and primary sclerosing cholangitis that was complicated by cholangiocarcinoma was awaiting a liver transplant, and the team needed to assess lymph node status—if cancer was present, the transplant would be canceled.

While Dr. Reddi hoped not to find malignancy, she identified two foci of adenocarcinoma in the lymph node, and as a result, the patient did not receive a liver transplant and passed away two days later. This experience, and others like it, have underscored for Dr. Reddi the gravity and responsibility of her role as a pathologist, particularly during pivotal moments in a patient’s care journey.

Here, Dr. Reddi shares her insight on the fulfillment she finds in pathology, and more.

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

As a pathologist, giving a diagnosis places me at the forefront of clinical decision-making in patient care, which is one of the most fulfilling aspects of being a physician. I am committed to ensuring that each patient receives an accurate diagnosis and appropriate care, which is why I am actively involved in patient quality assurance committees and national organizations (i.e., NCCN) that shape cancer care guidelines.

My role is to promptly provide patient diagnoses in both clinical and intraoperative settings, ensuring that patients receive appropriate care from my clinical colleagues. As pathologists, we are fully committed to diagnostic accuracy and precision. Our goal is to support personalized and precision medicine by integrating histology, serology, molecular testing, cytogenetics, clinical data, and radiologic findings.

Pathologists often collaborate with other healthcare professionals to provide comprehensive care. Can you describe a situation where you effectively collaborated with colleagues from different disciplines to optimize patient management?

As a pathologist specializing in cancer, I rely heavily on collaboration with surgeons and oncologists. In one case, I received an ovary resection specimen that grossly appeared to be a fibroma. In the EMR, there was no clinical suspicion for carcinoma, and tumor markers were low by serology. However, the surgeon noted suspicious intraoperative findings, so we performed a frozen section. Under the microscope, I identified Signet Ring Cell Carcinoma within the fibrous ovary. This finding allowed the surgeon to appropriately stage the patient, who then received timely postoperative care from the oncologist.

What are some of the biggest challenges you face in your field, particularly when it comes to supporting patient care?

One of the biggest challenges in medicine today is the continued cuts in reimbursement and possibly Medicaid. Since the COVID-19 pandemic, nearly every level of healthcare has faced significant staffing shortages. With increasing workloads and limited incentives, the field is becoming less attractive to current and future healthcare professionals.