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August 2007
Taking ownership of new technologies

Thomas M. Sodeman, MD

I heard an interesting story on the radio about Australia’s Great Barrier Reef. The sea in that region has sustained a small increase in temperature, which researchers believe is tied to recent episodes of ancient coral dying off. This has raised concerns about how global warming will affect the local ecosystem, and scientists are monitoring native animals for clues.

They’ve learned, for example, that only a few degrees of warming is associated with what is called temperature-dependent sex determination in some turtles. More females are born when it is warmer, and too few males could endanger the species. Incubation temperature also affects running ability; when they leave wooded areas and head for the ocean, these turtles have to make a mad dash down the sand to avoid predators. It looks like turtles hatched from eggs that incubate in hotter sand may be slower than those incubated at cooler temperatures. They may not be quick enough.

Some say that everything is relative and everything is linked. Those turtles got me to thinking about how many things can change quickly when the environment heats up.

For example, research and development in medical technologies, once the exclusive province of academia, has accelerated greatly as industry sponsorship has become more prevalent. Private investment in our science is a healthy sign for the future of pathology, but it is not uncomplicated. The development of new technologies heats up when there is money to fuel it, which is good. But the rate at which new tools are emerging sometimes outpaces the release of educational programming to prepare physicians for the tools’ capabilities and proper use. In fact, because private funding usually means confidentiality agreements that prevent researchers from publishing or presenting works in progress, physicians sometimes first learn of a new treatment or diagnostic tool from a patient who reads the Wall Street Journal.

The long and short of it is that we can no longer rely exclusively on professional journals and annual conferences to stay current. Our educational planning must strike a balance between the extremely important classical skills and the newer areas, among them proteomics, genetics, and cancer prognostic indicator testing, that our members need to know about.

Our Education Committee does a wonderful job of providing a diverse and challenging curriculum. This group collaborates with our scientific resource committees to determine what our members need to learn and how best to provide the instruction. They take into account not only content but also venue, because certain learning platforms are better suited to some segments of our membership than others.

Working with the College, our members can balance their need for continuing education in the fundamentals and a working knowledge of new developments. Ideally, we would all attend CAP ’07, where the curriculum covers a multitude of topics and a full day of programming is dedicated to informatics. More routinely, members can set aside a few hours each month to learn about new technologies in CAP TODAY, scan the CAP Web site for online courses, and read the Archives of Pathology & Laboratory Medicine. These activities take little time and paint the landscape for future learning plans.

The CAP Ad Hoc Committee on New/ Emerging Technologies recently released a report proposing that an organization-wide framework be employed to guide the College in setting priorities for activities (in education, standard setting, legislation, regulation, reimbursement, and so on) related to emerging technologies. The CAP Executive Committee endorsed the report, along with the recommendation for a permanent Technology Committee, when it met in July. These steps will make it easier to keep communication flowing within the College and to act quickly.

By communicating with industry, the College is able to develop timely educational programming about technologies in development, and we will continue to foster that dialogue. Those who plan to attend CAP ’07 will find that several industry-sponsored educational programs are scheduled; these are comfortable settings in which to ask questions and get a glimpse of what is on the horizon.

Our future has never looked better, but I do intend to convey some urgency. Our growth potential is intimately linked to new tools whose patient care applications are well within our grasp. “The market moves” as investors like to say, and when it moves it creates momentum. Medicine is undergoing a bit of global warming of its own as growth and change destabilize traditional roles, but that can be a good thing. Yes, pathologists are extremely busy, but that is the rule in medicine today. That our colleagues are also too busy, and need qualified advice on using these technologies, is surely a blessing in disguise. As we become more closely identified with whole-slide imaging and virtual microscopy, treating physicians will welcome our expertise in designing treatment plans, monitoring patient progress as new remedies are employed, and suggesting alternative patient care strategies. Our ability to manage, interpret, and apply what we learn from prognostic indicators will increase our value to the treatment team and to the patient. We can continue to protect the best interests of patients and foster progress in pathology while collaborating with other specialists in new and rewarding ways.

But the window within which we can assume our proper place on that team is a narrow one, which is why pathologists must make time to develop the relevant skills, even if the press of day-to-day business makes it difficult to do so. We need to reach out now and take ownership of these tools. Each of us has a role to play in ensuring that colleagues in other specialties come to think of these new technologies as an integral part of the pathologist’s armamentarium.


Dr. Sodeman welcomes communication from CAP members. Send your letters to him at president@cap.org.