"Clinical" pathology

[Enkidu]

If cellular therapy becomes a viable method to treat patients, do you guys think that pathology will be able to expand into clinical work? I'm thinking it would be something like radiation oncology, where cancer patients are just sent to transfusion to plan and provide cellular therapy and manage whatever complications arise. I'm guessing that it would be similar to how radiology managed to venture into more clinical work when it became "interventional".

Just a thought - cellular therapy has awesome potential, I wonder if it will remain a part of transfusion medicine or be taken over by something like heme/onc.

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[thebouque]

Chances are that heme/onc will be involved in cellular therapy.

 

[gbwillner]

If cellular therapy becomes a viable method to treat patients, do you guys think that pathology will be able to expand into clinical work? I'm thinking it would be something like radiation oncology, where cancer patients are just sent to transfusion to plan and provide cellular therapy and manage whatever complications arise. I'm guessing that it would be similar to how radiology managed to venture into more clinical work when it became "interventional".

Just a thought - cellular therapy has awesome potential, I wonder if it will remain a part of transfusion medicine or be taken over by something like heme/onc.

Depends on where. This is definitely a real possibility at academic centers with aggressive clinical pathology departments that have their own pheresis centers. At Penn CP does Rituximab infusions and has a large center with the capacity to do it. There is no reason to think they couldn't. Other places I've been to like WashU and MGH could also probably take this role. It would be dependent on the interdepartmental politics of the university to sort it out.

 

[2121115]

If cellular therapy becomes a viable method to treat patients, do you guys think that pathology will be able to expand into clinical work? I'm thinking it would be something like radiation oncology, where cancer patients are just sent to transfusion to plan and provide cellular therapy and manage whatever complications arise. I'm guessing that it would be similar to how radiology managed to venture into more clinical work when it became "interventional".

Just a thought - cellular therapy has awesome potential, I wonder if it will remain a part of transfusion medicine or be taken over by something like heme/onc.

The issue with pathologists doing anything along those lines is the lack of responsibility. What happens if the patient codes? Or something less serious but still needs immediate physician supervision? If you haven't even had an intern year what are you going to do? Pathologists cannot take ultimate responsibility for the patient. Personally, I would not want a pathologist laying a hand on me. Most pathologist aren't even BLS CPR certified, much less can they help you if it's just you and them and you have an acute issue.

 

[Enkidu]

The issue with pathologists doing anything along those lines is the lack of responsibility. What happens if the patient codes? Or something less serious but still needs immediate physician supervision? If you haven't even had an intern year what are you going to do? Pathologists cannot take ultimate responsibility for the patient. Personally, I would not want a pathologist laying a hand on me. Most pathologist aren't even BLS CPR certified, much less can they help you if it's just you and them and you have an acute issue.

Yeah- if the powers in pathology wanted to make this type of "transformation", they might do well to add an intern year. Radiology wouldn't have been able to develop interventionaly aspects without that level of clinical credibility.

 

[member0007]

Yeah- if the powers in pathology wanted to make this type of "transformation", they might do well to add an intern year. Radiology wouldn't have been able to develop interventionaly aspects without that level of clinical credibility.

You should spend your medical student time learning medicine like the rest of us already did before our residency in pathology. I do recommend an extra year of medical school for you.

 

[2121115]

Yeah- if the powers in pathology wanted to make this type of "transformation", they might do well to add an intern year. Radiology wouldn't have been able to develop interventionaly aspects without that level of clinical credibility.

I agree. If the CAP truly wants to "transform" the profession, they should start by pushing the ABP to require a true clinical year - not a BS fifth year of pathology but a true PGY-1 intern year in surgery, medicine, or a transitional year. Just like radiology and anesthesiology.

 

[Path or bust]

You should spend your medical student time learning medicine like the rest of us already did before our residency in pathology. I do recommend an extra year of medical school for you.

 

[KCShaw]

Depends on where. This is definitely a real possibility at academic centers with aggressive clinical pathology departments that have their own pheresis centers. At Penn CP does Rituximab infusions and has a large center with the capacity to do it. There is no reason to think they couldn't. Other places I've been to like WashU and MGH could also probably take this role. It would be dependent on the interdepartmental politics of the university to sort it out.

I think it would be a low percentage involvement when one looks across the country, but yeah. Some CP's already "treat" in some places. Some AP's stick needles in folks, too. Applying some basic critical care skills for the first 3 minutes of a major problem isn't as scary as it might sound to some people, particularly if you have half decent nurses who know the protocols better than most.

 

[Path_to_Endo]

Honestly think it would be a bad idea to 'treat'. Path is inherently a diagnostic specialty. If we wanted to be 'interventional pathologists' we would've become clinicians!