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JAMA Network Open Jul 2020There is currently no national organization that publishes its data that serves as the authoritative source of the pathologist workforce in the US. Accurate physician...
IMPORTANCE
There is currently no national organization that publishes its data that serves as the authoritative source of the pathologist workforce in the US. Accurate physician numbers are needed to plan for future health care service requirements.
OBJECTIVE
To assess the accuracy of current pathologist workforce estimates in the US by examining why divergency appears in different published resources.
DESIGN, SETTING, AND PARTICIPANTS
This study examined the American Board of Pathology classification for pathologist primary specialty and subspecialties and analyzed previously published reports from the following data sources: the Association of American Medical Colleges (AAMC), the Accreditation Council for Graduate Medical Education (ACGME), a 2013 College of American Pathologists (CAP) report, a commercially available version of the American Medical Assoication (AMA) Physician Masterfile, and an unpublished data summary from June 10, 2019.
MAIN OUTCOMES AND MEASURES
Number of physicians classified as pathologists.
RESULTS
The most recent AAMC data from 2017 (published in 2018) reported 12 839 physicians practicing "anatomic/clinical pathology," which is a subset of the whole. In comparison, the current AMA Physician Masterfile, which is not available publicly, listed 21 292 active pathologists in June 2019. The AMA Physician Masterfile includes all pathologists in 15 subspecialized training areas as identified by the ACGME. By contrast, AAMC's data, which derive from the AMA Physician Masterfile data, only count physicians primarily associated with 3 general categories of pathologists and 1 subspecialty category (ie, chemical pathology). Thus, the AAMC pathology workforce estimate does not include those whose principal work is in 11 subspecialty areas, such as blood banking or transfusion medicine, cytopathology, hematopathology, or microbiology. An additional discrepancy relates to the ACGME residency (specialties) and fellowship (subspecialties) training programs in which pathologists with training in dermatopathology appear as dermatologists and pathologists with training in molecular genetic pathology appear as medical geneticists.
CONCLUSIONS AND RELEVANCE
This analysis found that most sources reported only select categories of the pathologist workforce rather than the complete workforce. The discordant nature of reporting may pertain to other medical specialties that have undergone increased subspecialization during the past 2 decades (eg, surgery and medicine). Reconsideration of the methods for determining the pathologist workforce and for all workforces in medicine appears to be needed.
Topics: Forensic Pathology; Health Workforce; Humans; Neuropathology; Pathologists; Pathology; Pathology, Clinical; United States; Workforce
PubMed: 32672830
DOI: 10.1001/jamanetworkopen.2020.10648 -
Gastrointestinal Endoscopy Aug 2020
Review
Topics: Biopsy, Needle; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Pancreas; Pancreatic Cyst; Pancreatic Neoplasms; Pathologists
PubMed: 32334016
DOI: 10.1016/j.gie.2020.04.040 -
Archives of Pathology & Laboratory... Jan 2023
Topics: Humans; Pathologists
PubMed: 36577091
DOI: 10.5858/arpa.2022-0226-ED -
Indian Journal of Dermatology,... 2018
Review
Topics: Dermatologists; Dermatology; Education, Medical; Humans; Internship and Residency; Pathologists; Pathology, Clinical; Skin Diseases
PubMed: 29770788
DOI: 10.4103/ijdvl.IJDVL_546_17 -
Nutrition in Clinical Practice :... Jun 2023It is well known in the medical and pediatric feeding community how parental stress affects outcomes of pediatric nutrition and feeding behaviors. There is growing... (Review)
Review
It is well known in the medical and pediatric feeding community how parental stress affects outcomes of pediatric nutrition and feeding behaviors. There is growing literature suggesting the impact of the COVID-19 pandemic in relation to caregiver and child stress. It could be suggested that this increase in stress contributed to or exacerbated pediatric feeding difficulties. In addition, the COVID-19 pandemic resulted in pediatric rehabilitation therapists quickly transitioning from in-person to virtual evaluation and treatment models. The purpose of this article is to review current literature regarding the definition and prevalence of pediatric feeding disorder, the impact of the COVID-19 pandemic on parent/child stress and relationships surrounding feeding, and this speech-language pathologist's perception of both the positive and negative aspects of providing ongoing outpatient feeding evaluations and treatments in the context of the COVID-19 pandemic, as well as clinical considerations for ongoing feeding therapy after the COVID-19 pandemic.
Topics: Child; Humans; COVID-19; Speech; Outpatients; Pandemics; Pathologists; Speech-Language Pathology
PubMed: 37057872
DOI: 10.1002/ncp.10999 -
Clinical Breast Cancer Jun 2016Molecular characterization of breast cancer is pivotal for identifying new molecular targets and determining the appropriate treatment choices. Advances in molecular... (Review)
Review
Molecular characterization of breast cancer is pivotal for identifying new molecular targets and determining the appropriate treatment choices. Advances in molecular profiling technology have given greater insight into this heterogeneous disease, over and above hormone receptor and human epidermal growth factor receptor 2 status. Agents targeting recently characterized molecular biomarkers are under clinical development; the success of these targeted agents is likely to depend on identifying the patient population most likely to benefit. Therefore, clinical trials of breast cancer often require prescreening for, or stratification by, relevant molecular markers or exploratory analyses of biomarkers that can predict or monitor the response to treatment. Consequently, the role of the pathologist has become increasingly important. The key considerations for pathologists include tissue availability, ownership of archival tissue, type of diagnostic/biomarker test required, method of sample processing, concordance between different tests and testing centers, and tumor heterogeneity. In the present review, we explore how pathology is used in current clinical trials of breast cancer and describe the various technologies available for molecular testing. Furthermore, the factors required for the successful application of pathology in clinical trials of breast cancer and the issues that can arise and how these can be circumvented are discussed.
Topics: Biomarkers, Tumor; Breast Neoplasms; Clinical Trials as Topic; Female; Humans; Pathologists; Pathology, Molecular
PubMed: 27103546
DOI: 10.1016/j.clbc.2016.02.016 -
PloS One 2022Assess the work environment of salaried pathologists via (1) the national workload system (L4E), (2) work distribution among/in three hospital groups, and (3) the...
OBJECTIVE
Assess the work environment of salaried pathologists via (1) the national workload system (L4E), (2) work distribution among/in three hospital groups, and (3) the frequency of significant absences or departures (SADs).
METHODS
Automated analysis of pathology reports from a regional laboratory (accessioned 2011-2019) using validated computer code.
RESULTS
The study set contained 574,099 pathology reports, reported by 63 pathologists. The average yearly L4E workload units/full-time equivalent for three hospital groups were 8,101.6, 6,906.5 and 4,215.8. The average Gini coefficient for full-time pathologists in the three hospital groups were respectively 0.05, 0.16 and 0.23. The average yearly SADs rates were respectively 13%, 16% and 9%. The group with the highest SADs rate had the intermediate Gini coefficient and intermediate workload.
CONCLUSIONS
High individual workload and work maldistribution appear to be associated with SADs. Individual workload maximums and greater transparency may be essential for limiting staff turnover, maintaining high morale, and efficient laboratory function with a high quality of care.
Topics: Humans; Laboratories, Hospital; Pathologists; Personnel Turnover; Workload
PubMed: 35333879
DOI: 10.1371/journal.pone.0265905 -
American Journal of Speech-language... Jul 2020Purpose Pediatric feeding disorders (PFDs) present as a complex clinical challenge because of the heterogeneous underlying etiologies and their impact on health, safety,... (Review)
Review
Purpose Pediatric feeding disorders (PFDs) present as a complex clinical challenge because of the heterogeneous underlying etiologies and their impact on health, safety, growth, and psychosocial development. A multidisciplinary team approach is essential for accurate diagnosis and prompt interventions to lessen the burdens associated with PFDs. The role of the speech-language pathologist (SLP) as a member of the multidisciplinary team will be highlighted. Method This clinical focus article reviews the definition of PFDs and pertinent literature on factors that contribute to the development of PFDs, the accurate diagnosis, and current interventions for infants and children. As part of the multidisciplinary team, the SLP has an integral role in determining whether a child cannot or will not eat and working with the team to identify and carryout appropriate interventions. Collaboration between SLPs and psychologists/behavioral specialists in conjunction with the parents/caregivers as part of the multidisciplinary team is essential to the advancement of therapeutic goals. Conclusions Due to their complex nature, the successful management of PFDs is only possible with the care and expertise of a multidisciplinary team, which includes parents/caregivers. SLPs are important members of these multidisciplinary teams and provide valuable input for the accurate identification and effective remediation of PFDs.
Topics: Child; Communication Disorders; Feeding and Eating Disorders; Humans; Infant; Pathologists; Speech; Speech-Language Pathology
PubMed: 32650658
DOI: 10.1044/2020_AJSLP-19-00069 -
Journal of Hepatology Jan 2019
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Pathologists; Prognosis; Tertiary Lymphoid Structures
PubMed: 30414735
DOI: 10.1016/j.jhep.2018.10.017 -
European Heart Journal Jun 2021
Topics: Allografts; Graft Rejection; Heart; Heart Transplantation; Humans; Pathologists
PubMed: 34000014
DOI: 10.1093/eurheartj/ehab226