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August 2007
Of the job and extraordinary volunteers

Thomas M. Sodeman, MD

As my friend Paul Bachner likes to say, the College invariably survives its presidents. Dr. Bachner held this office between 1999 and 2001, so he ought to know. And he’s right, of course. The College grows in different ways under each president, but overall, we know where we’re going and make steady progress to get there regardless of who’s signing this column.

So I don’t want to do one of those final columns that says, “Look at what I did while I was here.” The notion of an instant look-back puts me in mind of what Chinese premier Zhou Enlai said when Henry Kissinger asked what he thought about the French Revolution. It’s too soon to tell.

Still, the final column is as good a time as any to talk about what the presidency is and what the president does. It is also a good place to talk about opportunities that my estimable successor, Jared Schwartz, will inherit next month.

The president keeps a hand on the tiller to make sure we remain faithful to our mission. The bottom-line responsibility is to ensure that we are true to who we are, to the goals we’ve set for ourselves, and to the task of creating the best possible future for our patients and for our specialty.

As president, there are many miles to travel and much to be learned, but the members and staff do most of the work. The president communicates and coordinates and mostly tries to stay out of the way of 3,500 extraordinary member volunteers. There is a great deal going on all the time, and somebody has to be thinking about how well our decisions and initiatives match up with our shared vision and the long-term strategies we’ve agreed to employ. That’s really the job.

The CAP is a successful organization by any definition, and as such we have a responsibility to the profession to lead, to provide tools and resources, and to make sure that pathologists are able to continue to practice with excellence. We recognize that the specialty is in constant evolution and that the rate of change has accelerated. We also realize that external agents of change now influence the nature of the challenges we encounter and the pace with which we encounter them.

As specialists with a strong science background, pathologists have always been able to adapt quickly to changes in medicine. Still, rapid evolution creates a need for education. The College has a responsibility to those who structure training programs and work with our residents, and an equally important role in continuing education for practicing pathologists.

Wonderful new tools in such disciplines as proteomics and genetics challenge pathologists to integrate emerging knowledge and to do so quickly. New cancer therapies that require close monitoring for safety and efficacy give the pathologist a much more prominent role in day-to-day patient care decisionmaking. And increased investment in our industry, coming as it does from new types of investors, is further evidence that the pathologist is becoming an increasingly prominent member of the patient care team.

The College seeks to ensure that pathologists are front and center, prepared to use new tools created through stepped-up investment and interest in diagnostic and therapeutic innovations. As these new tools become more available, pathologists will participate in more patient care decisions that call for an ability to integrate diagnostic findings and prognostic indicators. We will be increasingly expected to provide informed advice about treatment alternatives and next steps. Excellence in pathology will be less about collecting information and more about sharing knowledge. The effective pathologist will be more visible, more accessible, and more actively involved in patient care planning—less a technician and more a physician.

Recognizing that it is in some ways easier to expand upon the content of a laboratory report than to become a more visible member of the patient care team, the College has launched a campaign to raise the profile of pathology and perhaps the expectations of our patients. Those who fly American Airlines to attend CAP ’07 will have an early opportunity to see two-page advertisements in the September and October editions of American Way in-flight magazine. The advertisements feature patients (a woman with cervical cancer in September and a man with colon cancer in October) who attribute their survival to their pathologists’ accurate and quick diagnoses. Two CAP public education programs, MyHealthTestReminder.org and MyBiopsy.org, are described and promoted as well. The advertisements will be available online for pathologists to download and customize for use in marketing their practices, and poster versions will be available at CAP ’07.

I was a resident in pathology in 1969 when “Butch Cassidy and the Sundance Kid” was released in theaters and the catch phrase “Who are those guys?” became a part of the cultural lexicon. In an unforgettable sequence, a “super posse” tracks the two charismatic outlaws through water and over rock. Time and again, Butch and Sundance evade them only to find that the detectives have reappeared on the horizon. Time and again, one turns to the other and mutters, “Who are those guys?”

For a long time, pathologists were “those guys.” Tissues and samples were sent “to the lab” and diagnoses were returned. We were medicine’s detectives, experts whose work was widely respected but little understood.

Our emerging role as a more visible member of the patient care team is a healthy change, all to the good. It has been a wonderful experience to be a part of this chapter and to see so much evidence of a bright future for pathology.

I know who “those guys” (and those gals) are: You’re the best. Thank you so much for the opportunity to serve.


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