You Might Be A Primary Care Pathologist

    My maiden blog post seems to have some resonance.  I can't say my inbox is overflowing, but I have gotten my share of e-mails this week from pathologists all over the country and, yes, the world, most of which explore the thematic thought of “I think I am a primary care pathologist too”.  And I had a lot of “this is so cool” moments reading them this week.  Maybe I am reaching the frontier of my vocabulary, or I am just worn out from a particularly eventful call week, but I am having a tough time finding the words to describe the tone of all of the notes from my brothers and sisters in spirit.   It is sort of a hybrid epiphany of self-awareness and deep connection - a synchronous “yea, that’s who I am” and “wow, there are others out there who are just like me” feeling.  It made me think that it was time now, early in the life of this blog, to define just who is a “primary care pathologist” - just close the door to my office, stay up all night with black coffee and write the manifesto.  It’s proved to be one more entry on infinite list of things that are much easier to think than to do.  

    In the old days the label put on us (by whom I never figured out) was the “doctor’s doctor”.  I never fully understood or cared for this moniker - too much of a reek of pomposity and hubris for me.  It is an attempt to capture the scope of our profession, the idea that critical diagnostic information that we provide pervades and impacts all other specialties of medicine.  But, in reality, it presents us as meta-physicians, and my take away message/opinion that I want to shout from today’s blog soap box is -  “Meta” is not what we are, nor what we want to be.  And those of you who proudly wear the mantle of primary care pathologist know very well that you are not meta-physicians.  We know that the truth of the matter is that - yes indeed, the diagnoses we provide, the procedures we perform, the education we provide to physicians does permeate all medical specialties AND healthcare systems and is one of the critical ingredients that cements the care of patients.  But we do this by being physicians first in our vision, our attitude, our associations, our talk, and our walk.  We primary care pathologists have never seen ourselves as the Jedi-doctors on some sort of elevated plane.  We are physicians and pathologists - very, very imminent to the care of patients, never transcendent. 

    That’s about as far as I got on the whole manifesto effort - I hope it speaks to some of you.  But if it doesn’t I found myself on another thought tack these week which might also serve to help define us.  In this exercise,  we turn to the rigorous philosophical method of the sage Jeff Foxworthy.  So, with all apologies for what will be a lack of Mr. Foxworthy’s humor,  here’s my list for this week - all of which are real examples of actions by other primary care pathologists that I know.  And of course I ask all of you to add to this list - it is, after all, part of the power of blogging.

If you have ever taken phone calls from patients to help explain their diagnosis, you might be a primary care pathologist.

If you have ever scrubbed into a surgical procedure to help the surgeon identify key areas to sample for frozen section, you might be a primary care pathologist.

If you have ever manned a booth at a community health fair that educates women about Pap and HPV testing, you might be a primary care pathologist.

If you have spent an enormous time over the past 3 months helping your hospital prepare for the impending H1N1 epidemic, you might be a primary care pathologist.

If you look around your lunch table most days and see physicians of other specialties and no other pathologists, you might be a primary care pathologist.

If your pattern of practice looks anything like any of the pathologists on this CAP website, you might be a primary care pathologist.

And finally, if you have ever gotten a card like I got this week from the parents of a stillborn 10 week fetus that said: “Dear Dr. Henderson, thank you for doing all the testing on our son and finding out his gender for us - your help was greatly appreciated” - you might indeed be a primary care pathologist.  

And indeed you might get a little choked up and be damned proud that you are.

Comments

[Dr. Derek Ellingson, DO, PGY-3]

Sometimes it takes a second voice for the first to be heard. Let me know if I can be helpful. I'm with you all the way.

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Greg,
You may become the Thomas Paine of pathologists. I might even reference your blogs in hospital contract negotiations.

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