It was a constant struggle. Upper management demanded a 10% increase in productivity each year. I fought it saying that case reports are piece work. Then I rejoiced when a pathologist finally made it into upper management thinking that they would value and represent the professional staff. I was totally wrong. Pathologist are trained to be conformists and have no management experience.
Did you ever wonder how a pathologist could be right all of the time? Less than 1 error per year? It is because of no quality assurance. The only feedback occurs when a client complains and a client has a vested interest in not complaining in front of his own client/pet owner. Even if a case goes for review the reviewer bends over backwards to shield their associate from draconian management. Looking at VLA cytology reports there was only about 80-90% agreement between pathologists. Saying that pathologists are diagnostic demigods is marketing.
Your comments are spot on, experienced the same exact things. Especially accurate about the lack of QA being the only reason they can promise such an unrealistic accuracy score. Even the best pathologists in the world would be >1%, that's just how medicine works.
Hopeful those dynamics change in the future, but to have any chance we would need real competition in the diagnostic space, not just an oligopoly of 2-3 companies dominating the labor pool and clients locked into 5-7 year contracts.
This reads like classic ops math. Inputs unbounded, outputs tightly measured. That gap doesn’t get solved by “work faster,” it gets solved by constraints, triage and quality thresholds. If you don’t define the max, the system will always punish the human
I know, right??? I have to say the worst I heard was a vet pathologist on LinkedIn who commented their record was *SIXTY* slides on a liver mass!!! 😱🤦🏻♂️
I understand not wanting to miss a lesion on something that was hard to sample, but there really is a diminishing returns effect with more slides, and at a certain point it probably *decreases* sensitivity because the pathologist gets tired and starts cursory skimming. IMO the maximum # of slides you would ever need to send in for most lesions is 4-6
It was a constant struggle. Upper management demanded a 10% increase in productivity each year. I fought it saying that case reports are piece work. Then I rejoiced when a pathologist finally made it into upper management thinking that they would value and represent the professional staff. I was totally wrong. Pathologist are trained to be conformists and have no management experience.
Did you ever wonder how a pathologist could be right all of the time? Less than 1 error per year? It is because of no quality assurance. The only feedback occurs when a client complains and a client has a vested interest in not complaining in front of his own client/pet owner. Even if a case goes for review the reviewer bends over backwards to shield their associate from draconian management. Looking at VLA cytology reports there was only about 80-90% agreement between pathologists. Saying that pathologists are diagnostic demigods is marketing.
Your comments are spot on, experienced the same exact things. Especially accurate about the lack of QA being the only reason they can promise such an unrealistic accuracy score. Even the best pathologists in the world would be >1%, that's just how medicine works.
Hopeful those dynamics change in the future, but to have any chance we would need real competition in the diagnostic space, not just an oligopoly of 2-3 companies dominating the labor pool and clients locked into 5-7 year contracts.
This reads like classic ops math. Inputs unbounded, outputs tightly measured. That gap doesn’t get solved by “work faster,” it gets solved by constraints, triage and quality thresholds. If you don’t define the max, the system will always punish the human
Who has time to MAKE 32 slides?! If feel awful if I send in 3.
That is an AWFUL system for you guys. I had no idea
I know, right??? I have to say the worst I heard was a vet pathologist on LinkedIn who commented their record was *SIXTY* slides on a liver mass!!! 😱🤦🏻♂️
I understand not wanting to miss a lesion on something that was hard to sample, but there really is a diminishing returns effect with more slides, and at a certain point it probably *decreases* sensitivity because the pathologist gets tired and starts cursory skimming. IMO the maximum # of slides you would ever need to send in for most lesions is 4-6
At sixty slides just take the fucking mass...
Amen!!! 🙌
Nice work Eric...the struggle is real.