The incoming CAP president chairs a committee that
maps out strategies to achieve the College's goals. The Board of Governors
asked our strategic planning committee to take on an added challenge:
We were charged with devising a new vision for the College.
It's a challenging endeavor, putting poles to that
tent. Structuring a vision involves balancing needs and commitments, identifying
priorities, and working through a strategy. To cobble it all together,
we talked to colleagues in medicine and to people from industry and other
professions. We listened closely, and we read a lot before we started
writing. We edited a lot, too.
This column is about the transformative power of vision,
but vision is a soft concept, which makes it a tough sell. So the strategic
planning committee put a lot of effort into spelling it out.
People who talk about vision often mention "thinking
outside the box," which is another good idea that means different things
to different people. We wanted to spell that out, too.
Our collective vision must anticipate and account for
fundamental shifts now occurring in health care philosophy and medical
research, shifts that will affect treatment and early disease detection.
Emerging technologies and enhanced clinical focus will enable us to assume
a central role on the treatment team and create a promising future for
There's a lot of volatility, but certain premises apply.
The environment of medicine is highly competitive. New technologies with
promising clinical applications are emerging at an amazing rate. While
we are the specialty best prepared to work with these new tools, we are
physicians, not technicians. None of us went to medical school so that
we could provide test results. We specialized in pathology because we
wanted to work with the whole patient rather than focus on one disease
or organ system. It is our grasp of the big picture that positions us
as the specialists who should determine how these new technologies will
best be applied to critical questions around diagnosis, prognosis, and
If the 15,000 members of the College were cross-country
runners, the CAP would be our coach. The racecourse would be the distance
to be covered between the here-and-now and our collective vision for pathology.
The coaching strategy would be structured to grow a competitive team by
building skills, creating resilience, and fostering community.
A cross-country race can cover wooded, muddy, or dusty
terrain; the courses vary greatly, which means surprises for newcomers
and a home-field advantage. Each team is assigned a starting position,
called "the box." Mostly, it's a mind game; they like to say that the
race is won or lost before the starting gun goes off. Running partners
execute nuanced maneuvers to establish dominance; subtle intimidation
is allowed, but it's a civilized sport.
Though microchips in runners' shoes are increasingly
employed to nail down exact race times, many courses still feature the
"chute," a funnel that forces runners to cross the finish line one at
a time. Officials with clipboards and stopwatches stand at the entrance
to the chute; standings are recorded by hand. The seconds tick down on
a digital clock at the finish line as the runners sprint through that
Pathology is engaged in a civilized competition. It's
a mind game, which plays to our strengths, but every one of us should
be watching the clock. We are the elite athletes in medicine's race to
the future because we have the broadest grasp of the fundamental nature
of disease. Asserting ownership of new technologies is a key element,
but our vision is not about the tools. It's about the pathologist as a
superspecialist trained to understand the fundamental nature of all disease
and to work with physicians in all disciplines. Our patients may see many
specialists for different reasons over time, but they will always need
The College is a transforming agent. Through the College,
we can leverage our resources to drive a transformed role for the pathologist,
still the master diagnostician but now also the physician who applies
emerging technologies and integrates data. In this vision, the pathologist
becomes the chief knowledge officer on the treatment team.
When people share a goal, when they think like a team
and focus as individuals, momentum takes over. This competition is ours
to embrace, along with wonderful technologies that will speed our pursuit,
enable us to work more efficiently, and significantly expand the scope
of practice for our specialty. The College and its members have been training
for this race—developing standards and performance measures, providing
information and education, advocating for quality—for a long time.
What does it mean to enable a vision? It means to protect
it with ferocity, to fuel it with commitment, to share it with fervor,
and above all to believe in it. This is our arena and we have the home-field
advantage. The College will hold our vision aloft as we launch out of
the box and head for the chute.
Dr. Schwartz welcomes communication from CAP
members. Send your letters to him at email@example.com.