Shortage of Pathologists a Factor in Adoption of Digital Pathology

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WITHIN THE UNITED STATES, it is now recognized that the demand for surgical pathologists exceeds the available supply. There are more vacant positions than qualified applicants to fill them. 

The question yet to be answered is when this shortage of pathologists will have a negative impact on the pathology profession’s ability to return accurate, timely results to referring physicians. To date, for example, there are no public news stories about cancer patients in this country waiting weeks or months for the results of their biopsies. 

That is not the case in the United Kingdom, however. As early as 2017, the severe shortage of histopathologists in that country’s National Health System (NHS) was triggering news stories about large numbers of cancer patients waiting as much as six months to learn the results of their biopsies. 

The shortage of histopathologists in the United Kingdom was a major reason why, in 2020, the NHS announced a £50 million (US$59 million) initiative to develop a national digital pathology network. It is establishing several pathology centers of excellence across the country. 

U.K.’s Pathologist Shortage

The goal is to shorten average turnaround time for pathology cases so that cancer patients are not waiting months for the diagnosis that is needed to start their treatments. One way that digital pathology can enable this is by making it fast and easy for pathologists in any region to be assigned cases, do the analysis, and report the results. 

Here in the United States, it was primarily pathologists in academic centers that were the first to adopt and use digital pathology. This started in the mid-2000s. Digital pathology systems enabled academic pathology groups to contract with pharmaceutical companies and drug developers to read digital images in support of drug research and clinical trials. 

Academic center adoption of digital pathology also had another consequence. For the past 15 years, nearly all pathology residents and fellows were trained almost exclusively with digital images. This means that a large number of pathologists practicing today were trained with digital pathology tools. 

Factors Favoring Digital Path

Thus, what may be about to occur in the pathology profession is a “perfect storm” where the inadequate supply of pathologists versus the growing demand favorably changes the economics of digital pathology. 

This will happen as digital pathology vendors demonstrate how their digital pathology systems increase the productivity of individual pathologists, allowing them to sign out more cases without compromising quality and accuracy. 

As this happens, it will illustrate the economic principle that increased demand encourages an increase in supply. In this case however, it won’t be a big increase in the supply of pathologists in the U.S. Rather, it will be the substitution of digital pathology as the tool that increases the productivity of individual pathologists, allowing them to close the supply-demand gap. 

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