CEO SUMMARY: Pathology is about to undergo a market transformation similar to radiology. As clinicians insist on more precise diagnostic and prognostic information about their patients, pathologists will have a perfect opportunity to reposition themselves as essential partners with the referring physician. IMPATH points the way, but there is room for many other pathologists to follow.
ONE BRIGHT SPOT IN THE PROFESSION of pathology is IMPATH Inc. At a time when most pathology practices are under financial siege, this company is posting record increases in both cases and revenues.
In one sense, studying IMPATH’s business strategies and market successes is like looking into the future through a crystal ball. Pathologists can get a peek at the way anatomic pathology services will evolve to serve the needs of tomorrow’s integrated clinical environment.
The profession of pathology is about to embark on a golden age. The transformation of anatomic pathology can be compared to that of radiology. With the arrival of MRIs, CATs, PETs, and related alphabet soup technologies, clinicians increased their reliance on radiologists to aid in each step of a patient’s disease: diagnosis, prognosis, therapy, and treatment follow-up.
IMPATH is an early pioneer at integrating the various clinical advances in cancer detection, and making them available to community hospital-based pathologists as a “one-stop” shop. In this regard, its business strategy is a winner, because it is positioned to be an ally of a local pathology practice, not a competitor for specimens.
But there is a more subtle business strategy at work, which pathologists should better appreciate. As new clinical discoveries unlock the secrets of different types of cancer, several consequences result which benefit pathologists. IMPATH is anticipating these discoveries and establishing a clinical organization which can recognize them and bring them to market as early as possible.
Proven Business Formula
Most laboratorians know this proven business formula. In the 1970s and 1980s, Albert Nichols, M.D. positioned Nichols Institute as the market channel which took newly-discovered assays from the research laboratory and became the first to introduce them into clinical usage. IMPATH is similarly positioning itself to be a market channel between research laboratories and clinicians.
Several trends make this feasible. First, detection of the cancer can occur earlier and earlier in the disease cycle. This opens up new opportunities for successful intervention.
Second, as different forms of a cancer are identified and better understood, it becomes important that pathologists and clinicians incorporate this knowledge into their diagnoses.
IMPATH’s President, Anu Saad, Ph.D., talks about the impact of this clinical trend. “Take lung cancer, for exam- ple. Right now, early diagnosis of lung cancer is more difficult to accomplish than for breast cancer. As early diagnostic tests for lung cancer are developed, the opportunity for the pathologist to add value increases proportionately.”
“What pathologists have done for hundreds of years is look in a microscope and do pattern recognition. Soon objective technologies and an algorithmic process will supplant reliance on the microscope.”
Anu Saad, PH.D.
President, IMPATH Inc.
Three, advances in the understanding of breast cancer and prostate cancer demonstrate that:
1) technology which permits early detection increases the volume of specimens referred to pathologists;
2) technology which allows the pathologist to differentiate the disease means that clinicians can tailor treatment of the patient in the most appropriate ways; and
3) it becomes vital for the pathologist to then be involved in diagnosis, prognosis, and follow-up as part of the clinician’s team.
From THE DARK REPORT’S perspective, these are established dynamics in the clinical marketplace. Match these clinical dynamics with demographic trends of an aging population and an increase in the prevalence of cancer, and
it becomes reasonable to conclude that pathology is about to enter its golden age.
As these events unfold and anatomic pathologists find themselves more intensely involved with clinicians than before, another benefit will accrue. Pathologists will find reimbursement for these emerging services to be generous.
Early Detection of Cancer
The reason is simple. Early detection of a cancer, combined with a speedy and accurate determination of its specific type, will save thousands of dollars in misapplied treatment, not to mention improving the patient’s personal comfort during the course of the disease. Informed consumers will insist that their health plans (and their employers) pay pathologists for these value-added services.
In making these predictions, THE DARK REPORT notes that market parallels exist in other segments of health- care. Radiology has already been mentioned. Minimally-invasive surgical methods, based upon lapriscopes and similar instruments, have created new clinical opportunities for surgeons.
Anatomic pathology will undergo its own transformation, using new technology. IMPATH demonstrates how new technology is increasing the demand for non-traditional anatomic pathology services. Automated cytology companies are making similar demonstrations.
In contrast to the doom and gloom about declining reimbursement, anticipating these technology and market developments make it clear that a golden age for anatomic pathology is soon to appear.