Originally posted by DireWolf
I was simply inquiring if the issue of being the final authorithy on diagnosis was considered a positive or negative for those considering pathology - or if it's even an issue at all. Almost every area of medicine carries a huge responsibility where patients' lives are at stake every day. I am not asking for input on what area of medicine I should/could pursue. I am confident that I can handle that responsibility. This post was not meant to express a lack of confidence in myself when dealing with pressure situations- rather to start a discussion of how this particular aspect of pathology is viewed by those interested in the field. The only pathologist I've spoken to at length mentioned he considered teaching rather than private practice because of a few missed diagnoses he made even with the consultation of his colleagues.
the pathologist you probably talked to (if it's who i think it is) isn't a very good example of a modern pathologist, IMO. don't judge the field by what he says-- he's a great teacher, but he hasn't been "out in the field" so to speak in quite awhile.
i enjoyed path-- in fact i was down to it and peds for residency. what it finally boiled down to was that I just wasn't ready to give up my stethoscope. i didn't go into medicine to look at slides, flow cytometries, run a lab, or do autopsies-- though i find each one of these things enjoyable, in the end it wasn't what i could see myself doing as a career. not to mention i found myself getting a little stir-crazy while at the scopes signing out (the path equivalent of rounds, lol). path has a lot of upside-- no gomers, good hours, good pay-- and while the sterotypical "pathologist" is still out there, for the most part my experiences with pathologists and residents has been they're pretty much like everyone else.
to address your original question-- while you are the "definitive" answer for diagnoses, you will always have colleagues to bounce things off of. in fact, anything not textbook will usually get passed around at least 2 or 3 times (it's as simple as taking the slide to Dr. XXX and saying, "hey, can you look at this?"). normally there isn't a time crunch (unless you're doind frozen sections) so you have time to look things up as well. anything really really strange you'll send off. so yes, you are it, but nothing is completely on you unless you choose it to be.
another thing that i liked about path is that unlike the medical weatherman, the radiologist, most pathologists will give you an answer instead of a possibility
anyway, that's just my take.