Stanley J Robboy, Saurabh Gupta, James M Crawford, Michael B Cohen, Donald S Karcher, Debra G B Leonard, Barbarajean Magnani, David A Novis, Michael B Prystowsky, Suzanne Z Powell, David J Gross, W Stephen Black-Schaffer1. 1. From the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Robboy); The Smart Cube, Noida, India (Mr Gupta); the Department of Pathology and Laboratory Medicine, North Shore-Long Island Jewish Health System, Manhasset, New York (Dr Crawford); the Department of Pathology, Huntsman Cancer Hospital, University of Utah, Salt Lake City (Dr Cohen); the Department of Pathology, George Washington University, Washington, DC (Dr Karcher); the Department of Pathology, University of Vermont College of Medicine, Burlington (Dr Leonard); the Department of Pathology, Tufts University School of Medicine, Boston, Massachusetts (Dr Magnani); Novis Consulting, Lee, New Hampshire (Dr Novis); the Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York (Dr Prystowsky); the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas (Dr Powell); Policy Roundtable, College of American Pathologists, Washington, DC (Dr Gross); the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston (Dr Black-Schaffer).
Abstract
CONTEXT: Pathologists are physicians who make diagnoses based on interpretation of tissue and cellular specimens (surgical/cytopathology, molecular/genomic pathology, autopsy), provide medical leadership and consultation for laboratory medicine, and are integral members of their institutions' interdisciplinary patient care teams. OBJECTIVE: To develop a dynamic modeling tool to examine how individual factors and practice variables can forecast demand for pathologist services. DESIGN: Build and test a computer-based software model populated with data from surveys and best estimates about current and new pathologist efforts. RESULTS: Most pathologists' efforts focus on anatomic (52%), laboratory (14%), and other direct services (8%) for individual patients. Population-focused services (12%) (eg, laboratory medical direction) and other professional responsibilities (14%) (eg, teaching, research, and hospital committees) consume the rest of their time. Modeling scenarios were used to assess the need to increase or decrease efforts related globally to the Affordable Care Act, and specifically, to genomic medicine, laboratory consolidation, laboratory medical direction, and new areas where pathologists' expertise can add value. CONCLUSIONS: Our modeling tool allows pathologists, educators, and policy experts to assess how various factors may affect demand for pathologists' services. These factors include an aging population, advances in biomedical technology, and changing roles in capitated, value-based, and team-based medical care systems. In the future, pathologists will likely have to assume new roles, develop new expertise, and become more efficient in practicing medicine to accommodate new value-based delivery models.
CONTEXT: Pathologists are physicians who make diagnoses based on interpretation of tissue and cellular specimens (surgical/cytopathology, molecular/genomic pathology, autopsy), provide medical leadership and consultation for laboratory medicine, and are integral members of their institutions' interdisciplinary patient care teams. OBJECTIVE: To develop a dynamic modeling tool to examine how individual factors and practice variables can forecast demand for pathologist services. DESIGN: Build and test a computer-based software model populated with data from surveys and best estimates about current and new pathologist efforts. RESULTS: Most pathologists' efforts focus on anatomic (52%), laboratory (14%), and other direct services (8%) for individual patients. Population-focused services (12%) (eg, laboratory medical direction) and other professional responsibilities (14%) (eg, teaching, research, and hospital committees) consume the rest of their time. Modeling scenarios were used to assess the need to increase or decrease efforts related globally to the Affordable Care Act, and specifically, to genomic medicine, laboratory consolidation, laboratory medical direction, and new areas where pathologists' expertise can add value. CONCLUSIONS: Our modeling tool allows pathologists, educators, and policy experts to assess how various factors may affect demand for pathologists' services. These factors include an aging population, advances in biomedical technology, and changing roles in capitated, value-based, and team-based medical care systems. In the future, pathologists will likely have to assume new roles, develop new expertise, and become more efficient in practicing medicine to accommodate new value-based delivery models.
Authors: Tiffany Michele Hébert; Adam Cole; Nicole Panarelli; Shaomin Hu; Jack Jacob; Jeffrey Ahlstedt; Jacob J Steinberg; Michael B Prystowsky Journal: Acad Pathol Date: 2019-05-30
Authors: Stanley J Robboy; David Gross; Jason Y Park; Elizabeth Kittrie; James M Crawford; Rebecca L Johnson; Michael B Cohen; Donald S Karcher; Robert D Hoffman; Anthony T Smith; W Stephen Black-Schaffer Journal: JAMA Netw Open Date: 2020-07-01
Authors: Saurabh Gupta; W Stephen Black-Schaffer; James M Crawford; David Gross; Donald S Karcher; Jill Kaufman; Doug Knapman; Michael B Prystowsky; Thomas M Wheeler; Sarah Bean; Paramhans Kumar; Raghav Sharma; Vaibhav Chamoli; Vikrant Ghai; Vineet Gogia; Sally Weintraub; Michael B Cohen; Stanley J Robboy Journal: Acad Pathol Date: 2015-10-13