Patient contact in path.

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GreatPumpkin

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I was recently asked about patient contact in path in a message and I thought I would post my answer here as well. So if anyone is lurking that may be interested.

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Different subspecialties of path have variable degrees of patient contact. The subspecialties withe the most contact would be Transfusion Medicine and Cytopathology.

In large medical centers the transfusion medicine service normally runs an apheresis unit which deals with many patients everyday. Many you see over and over again for years. Some only once. Patients with sickle cell, host-vs-graft disease, stem cell harvest, Idiopathic Thrombocytopenia Purpura and others are seen routinely.

Cytopathology sees patients everyday as well, perform fine needle aspirates on inpatients, in clinics and in some places patients come directly to the pathology office.

The role for the path doc in all of our patient contact is almost always in the consultant role. We don't act as primary care givers. If that is the patient interaction you are looking for path is not for you.

That said path docs do not generally sit and thier office with out "people" contact. Pathologist are always conversing with other doctors and involved in individual cases all day long. Not to mention they normally have many employees and other collegues around.

Not being the primary care giver for patients has advantages. Such as not being called in the middle of the night for prescription refills, sniffles etc..etc.. Not being sued nearly as much. Getting paid better than most primary care givers. Being able to sit in my comfortable chair, listening to some nice toons and doing my work at 9am verses rounding at 6 or 7am. Going home at 5pm. Not working most all weekends. Taking call from home about one week out of six to eight weeks and generally only answering questions over the phone once or twice that week.

But, I am sure the folks that really want primary patient care can give you a list of reasons why as well. It really just depends on the individual.

Good luck. I highly recommend doing some path rotations to really see what it is like.

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It is always good to have it straight from the source instead hearsay.
Thanks!:)
 
hey gp,
i've heard from some of the others but i was wondering when you decided that path was for you. before med school? after an unexpected 3rd year rotation? just curious.
 
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I have the same type of question as augmel....that is, do most/all people that go into pathology have experience in lab work, research, etc...? I have zero experience in the lab and zero experience in research, but I find myself interested in the type of work that pathologists do...(i.e. consulting, detective type work). I haven't had my second year pathology course, so I imagine that I will wait and see if I like that, or is that not a good way to do it?
 
THANKS GP.... YOU ROCK!

Mindy
 
Thanks Mindy.

I always thought I wanted to do path. Like I mentioned in another post a TV show (Quincy) when I was a kid actually got me interested in path. I shadowed a path doc in private practice a few days prior to med school as well to find out if it was as cool as I thought it would be. During 2nd year histo I actually considered not going into path, I didn't enjoy histo much. The microscopes made me motion sick and it just seemed boring. Lucky for me I did a path rotation my first month of 4th year and got to really see what the job was like. And, I got to use some scopes that were not 40+ years old, hehe. No more motion sickness.

It seems like most people who go into path have a feeling they would like it, they do a rotation and bam they can't believe they even considered anything else. Lucky for all of us path is not a required rotation, it is like a great secret, if everyone knew I might have had trouble getting a good residency.
 
GreatPumpkin


Hello. I'll be an MS-I this coming fall, 2003. I am a Histo Tech right now and I have A LOT of interaction with the staff pathologists at my hospital. I really didn't know much about path before I began to work as a histo tech, and since working with them I am really interested (but my future is an open book right now). Do you do bone marrows where you are?
I think that there is so much to pathology that people are not aware of. The pathologists that I work with have a good deal a pt interaction, and a lot of interaction with docs who seek their advice, etc.
I think that that is a real selling point for me, the constant "super involved" conversations with physicians...when they're not angry:D Pathology is such an intellectual field, you just have to know soo much and constantly keep at the forefront of diagnostic research.
Could you elaborate on the role of the path in transfusion med, as I haven't seen that where I am?
Right on pathologists
 
I haven't done an elective in path yet so forgive me if this question seems to simple but how much microscope work is involved in pathology. My eyes are basically shot and I know that ne micropscope work will not be a good thing. Also, I get bad neck spasms huddled over the microscope. Are there aspects of path that don't involved microscopy?
 
Transfusion Medicine:
Jobs the pathologist does normally.

The overall supervisor of the blood bank and collections.
Involved with difficult antibody workups and transfusion reactions.
Answer questions about blood products clinicians have.
Triage blood products in times of shortage (occurs very frequently)

Is hospital has an apheresis unit:
Meet patients, discuss proceedures, obtain consent and write orders and medications needed. Proceedures include plasma pheresis, red cell exchange, leukopheresis, stem cell harvest and photopheresis. There to help out in any emergency situations with these patients, they can be very sick.

Al,
There is quite a bit of microscope work in the surg path, cytopath and heme path rotations. Much less or none on the other services. Transfusion medicine other clinical path rotations don't require much at all. There is also not a ton of microscope work in Autopsy and Forensics. Most of that involves more of a "gross" evaluation.
 
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