Potential Competition with RADs

[Molly Maquire]

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HI,

I have been reading about some of advances in radiology, namely PET scanning and MR Spectroscopy, that can be used to diagnose cancer or determine surface markings on cells.

Does anyone think that this will undercut the traditional role of the Pathologist? Any opinions on whether this would reduce the profession's status as makers of the "definitive" diagnosis?

Thanks.

 

[rirriri]

I have heard/read a little bit about this new technology, but I can't say i'm too knowledgable about it.

What I do know though is that this technology is VERY expensive to use and is years away from being implemented into a hospital setting.

Medicine is not like engineering or business where the price of things fall drastically as time progresses. Old technology like CT scans and MRIs are still very expensive and I believe that new technology available to test for cancers will stay expensive for years to come and only a few hospitals will reallly have access to such technology.

Another thing to consider is that even IF this technology became mainstream, there STILL needs to be an expert when it comes time to actually discuss the cancer/disease involved in the case. A pathologist will more than likely still be involved with these cases and will probably be required for an opinion.

I don't worry about technology and its negative impact on fields, because all fields of medicine evolve WITH technology rather than against technology. Some people say that the future of Radiologists are even at risk due to complex computer programs which could replace their work.....I don't buy into that either.

cheers!!

 

[oldandtired]

Dont worry. There will always be a need for pathologists in our lifetime.

Even with all the fancy technology in radiology, it still always comes down to tissue for a diagnosis.

 

[Sertraline]

I think potential threats(for loss of income/niche) exist for everyone in the field of medicine, not just for pathologists.

Radiologists are worried that cardiologists are taking over cardiac MRI and that clinicians are now starting to read their own radiological studies and (try to) bill for it. They also have to worry about the threat of teleradiology(although this may be the case for path as well) with cheaper labors abroad.

Anestheologists are well aware that nurse anethesits are potential threat to their job market. Things are good now but who knows what's gonna happen in 10 or 20 years.

Clinicians in general are constantly fighting HMOs and Medicaid for better reimbursements, and ever rising malpractice insurance premiums.

Botton line is that none of us can't get away from these issues.
Can't predict things. There are too many variables.

I am gonna do what I think I like given my circumstances....

I apologize for boring the heck out of everyone. Just had to get it off my chest.

Peace.

 

[oldandtired]

I agree with above poster. Every field has competition and a somewhat uncertain future. The only contant is that you will probably be practicing your chosen field for 20-40 years. Remember that not one field has gone extinct in medicine. Doctors still make MUCH more than the average and always will.

 

[pathstudent]

what about the specialists in syphilis from the early 20th century?

extinct, baby!

 

[GreatPumpkin]

I am sure they just switched to tuberculosis. hehe

 

[Doctor B.]

Then to the HIV.

 

[Whisker Barrel Cortex]

I wouldn't worry too much about these imaging techniques cutting into pathology. They are actually used a great deal already (we use PET routinely and MRI spect for brain tumors semi-regularly) and will probably advance quickly, the tissue diagnosis is the final diagnosis and clinicians will not start therapy in almost all cases until a pathologic sample has been obtained. I don't think any imaging study will be able to replace that. Even if some of the initial identification of tumors is by imaging only, when it is removed, pathology will be needed.

 

[pathcrusader]

I think pathologists will collaborate with radiologists with increasing frequency, but the fields will never make one or the other obsolete. I know never is a strong word. But as pathologists, what we will make our livelihoods on and at the same time help people will be not only by identifying and characterizing disease processes, but also by learning how they occur from the organismal level to the cellular to the atomic probably. In addition to identifying the location of a disease, our specialty gives us the leverage and the backing to investigate how a disease occurs and how it exercises its effects on a person. Some say that the difference between pathology and radiology are black and white. I think that view is pretty hackneyed and inaccurate. I think the radiologist and the pathologist together create an amazing environment for advancing medicine. I think it can become a wonderful partnership. I personally look forward to working with radiologists in the future.
Whereas pathology has it's feet embedded in pathogenesis and diagnosis. Radiology has positioned itself into the diagnostic and treatment arenas. So, yes, there is overlap and the two combined make for a powerful diganostic result with and without tissue. these are just my humble thoughts.

 

[Mindy]

Boy did I think about this a lot before applying (ask GP!)

Anyway, I think the future of pathology may reside in the nuclear material---ya know that genetics thing. I think that tissue and proper identification will be needed for targeted molecular therapy.

But for now, as radiology keeps finding smaller and smaller ditzels, we should keep getting more and more (albeit often smaller) specimens.

Mindy

 

[ckent]

Originally posted by Mindy
Boy did I think about this a lot before applying (ask GP!)

Anyway, I think the future of pathology may reside in the nuclear material---ya know that genetics thing. I think that tissue and proper identification will be needed for targeted molecular therapy.

But for now, as radiology keeps finding smaller and smaller ditzels, we should keep getting more and more (albeit often smaller) specimens.

Mindy

I wholeheartedly agree with that sentiment. These days, with so many more scans/lab tests/fluid being tapped and everyone afraid of being sued for not working something up appropriately, the amount of work for pathologists and the number of "normal" samples they are asked to analyze keeps going up. Biopsy and tissue diagnosis will always remain the gold standard of diagnosing just about every disease.