From Pixels to Precision 005: The Role of Digital Pathology in Addressing Pathology Workforce Challenges

Despite the growing number of physicians across specialties including urology, internal medicine, and dermatology, pathology is one of only four specialties experiencing negative growth rates. Data from the Association of American Medical Colleges demonstrates a persistent decrease in active pathologists since 2015¹.



In parallel, pathology workloads continue to grow, particularly in the oncology space, driven by the 2% annual growth rate of cancer incidence in the United States and the corresponding 2-6% annual growth rate in cancer biopsy procedure volumes².

The declining supply of pathologists, coupled with the growing demand for their services, has led to significant workforce shortages. In this post of “From Pixels to Precision”, we discuss the role of digital pathology in overcoming pathologist workforce shortages by empowering institutions with differentiating strategies to both attract and retain pathologists within their organizations.

The Role of Digital Pathology in Attracting Pathologists:

Between 2015 and 2021, the percentage of post-graduate year-one pathology positions filled by graduates of U.S. allopathic medical schools fell from 46.6% to 32.4%^3,4. This downward trend is often attributed to medical students’ reduced exposure to pathology as a result of curriculum changes that have led to the elimination of free-standing pathology courses for many students^5,6. Additional factors contributing to this downward trend include minimal patient contact, negative perception of the specialty, and overall job market concerns have also been noted as contributory factors to this downward trend6.

In the face of this shrinking talent pool, health systems’ and laboratories’ ability to attract pathologists has become increasingly critical to ensuring timely and accurate patient diagnoses. Digital pathology presents opportunities to address these challenges by allowing institutions to (i) expand their hiring pools, (ii) inspire prospective talent, and (iii) onboard new hires efficiently.

• Expand the Hiring Pool Geographically: By enabling remote case sign out, virtual collaboration, and remote consultations, digital pathology opens up a global pool of expertise that otherwise would have been inaccessible if pathologists were required to sign out cases physically within the lab. With the recent enforcement discretion extension by CMS⁷, pathologists can now contribute their skills from home or other locations, shattering the constraints that have traditionally hindered hiring processes. Institutions that adopt digital pathology workflows can tap into a vastly broader talent pool, making the recruitment of qualified pathologists more accessible and efficient.
• Inspire Prospective Talent: Digital pathology presents a compelling value proposition for institutions seeking to attract talent, particularly younger pathologists drawn to the specialty by the growing relevance of advanced technology. Digital pathology empowers pathologists with artificial intelligence and machine learning tools that optimize historically manual workflows and enhance patient care through faster diagnoses and more informed treatment decisions. The prospect of entering a field and a workplace that is on the cutting edge of diagnostics and precision medicine can serve as a strong motivator for new and prospective pathologists driven by a desire to make an impact.
• Onboard Efficiently: Digital pathology not only enables larger hiring pools but also streamlines onboarding of new hires by reducing the time and resources required for training. Through digital archives, newly hired pathologists can access a vast on-demand repository of historical cases with ease. This efficiency is a crucial factor in addressing the time-sensitive nature of healthcare, allowing institutions to onboard new hires rapidly and integrate them seamlessly into the workforce to more readily serve patients.

The Role of Digital Pathology in Pathologist Retention:

Retaining pathologists is a multifaceted challenge, often tied to issues of work-life balance, job satisfaction, and professional impact. A 2023 Medspace report found that nearly 1 in 3 pathologists is experiencing burnout, with 58% of pathologists attributing their burnout to too many hours at work, 47% attributing it to lack of control/ autonomy, and 39% attributing it to too many bureaucratic tasks⁸. Digital pathology presents opportunities to address pathologist burnout to improve retention by allowing institutions to (i) enable pathologists to focus on the complex tasks they have been trained for and spend less time on easily automated task, (ii) adopt flexible pathology working models, and (iii) more effectively drive pathologist impact & professional development.

• Improve Workflows through Digital and AI: Traditional pathology workflows are bogged down by time-consuming and redundant administrative tasks, often leaving pathologists with little time to focus on patient care and diagnosis. A recent PathAI study suggests that for a lab processing about 100,000 cases annually, digital pathology alone can lead to time savings equivalent to 15-30% gains in efficiency. Digital workflows additionally allow labs to adopt AI algorithms that automate analysis of routine tasks such as quality control, tumor detection, and count-based biomarker quantification. For example, PathAI recently demonstrated a 25% reduction in average pathologist time spent per case with AI vs. without AI when quantifying PD-L1 expression in NSCLC. Such efficiencies allow pathologists to focus their time on complex cases and treatment-informing decision-making, while reducing their workloads and increasing overall job satisfaction in ways that are only possible through a digital workflow.
• Adopt Flexible Workflows: Digital pathology introduces transformative flexibility into a workforce traditionally tied to a physical microscope. Shawn Kinsey, Gastroenterology Pathologist and Medical Director at PathAI Diagnostics explains, “Digital pathology uniquely allows our pathologists to review cases and provide consultations remotely, aligning with the evolving expectations of the global workforce. This flexibility has been a powerful tool in enhancing pathologist job satisfaction, promoting a healthier work-life balance, and ultimately retaining skilled professionals within our lab.”
• Drive Pathologist Impact: Digital pathology dramatically expands the ways in which pathology can inform research and drug development by providing pathologists with the ability to access and interrogate rich repositories of digital slides and associated clinical data. Digital pathology-enabled AI allows pathologists to interrogate human tissue with unparalleled granularity and precision, which can be leveraged to inform optimal treatment options for patients. This suite of tools empowers pathologists to play an increasingly impactful role in both clinical care and research innovation, leading to increased professional fulfillment, job satisfaction, and retention of these skilled professionals.

Digital pathology has emerged as a game-changer in the realm of pathology, not only in revolutionizing diagnostic capabilities but also in addressing the challenges of pathologist hiring and retention. In embracing digital pathology along with the artificial intelligence that it enables, healthcare institutions can build a more engaged, fulfilled, and efficient pathology workforce.

 

 

⁽¹⁾Association of American Medical Colleges, Physician Specialty Data Reports (2015-2023)
⁽²⁾ Laboratory Economics "The U.S. Anatomic Pathology Market Forecast & Trends 2019-2021“
⁽³⁾ National Resident Matching Program . April 2019. Results and Data 2019 Main Residency Match. https://www.nrmp.org/wp-content/uploads/2021/07/NRMP-Results-and-Data-2019_04112019_final.pdf Published. [Google Scholar]
⁽⁴⁾ National Resident Matching Program . May 2021. Results and Data 2021 Main Residency Match. https://www.nrmp.org/wp-content/uploads/2021/08/MRM-Results_and-Data_2021.pdf Published. [Google Scholar]
⁽⁵⁾ McCloskey C.B., Brissette M., Childs J.M., et al. How influential are medical school curriculum and other medical school characteristics in students' selecting pathology as a specialty? Acad Pathol. 2023;10(2):100073. doi: 10.1016/j.acpath.2023.100073.
⁽⁶⁾ Tannenbaum, A. P., & Lilley, C. M. (2023, October 4). Perspectives from two recent medical school graduates on exposure to pathology during undergraduate medical education: A narrative inquiry. Academic pathology.
⁽⁷⁾ Department of Health & Human Services, Centers for Medicare & Medicaid Services. Clinical Laboratory Improvement Amendments of 1988 (CLIA) Post-Public Health Emergency (PHE) Guidance. Ref: QSO-23-15-CLIA. May 11, 2023.
⁽⁸⁾ Koval , M. L.. Medscape Pathologist Burnout & Depression Report. Medscape. https://www.medscape.com/slideshow/2023-lifestyle-pathologist-6016088#6