It’s not just laboratorians, pathologist burnout has been taking its toll on labs throughout the country. Proscia’s Nathan Buchbinder offers some insights to the causes and cure to the pathologist shortage. 

By Chris Wolski

Summary: Pathologist burnout is a critical issue fueled by a shortage of professionals entering the field, increasing demand for diagnostic services, and the complexities of modern medicine, but innovations like digital pathology and AI offer promising solutions.

Takeaways:

  1. The pathologist shortage is driven by both fewer medical students choosing pathology and the increasing demand for diagnostic services, resulting in a significant gap between supply and demand.
  2. Burnout among pathologists stems from long hours, challenges in maintaining work-life balance, and the added complexities of precision medicine, but addressing these issues can positively impact retention.
  3. Laboratories can mitigate burnout by embracing transformative practices like digital pathology and AI, which enhance workflow efficiencies, improve job satisfaction, and ultimately contribute to better patient outcomes.

Burnout. It’s nothing new and it’s not unique to health care, but the consequences can be devastating and far reaching. While there is little debate about how the COVID pandemic affected laboratory staffing—that only accelerated an ongoing trend. And laboratorians aren’t the only ones experiencing burnout.

Pathologists are experiencing burnout in record numbers. Consider this: there are currently about 1,000 open pathologist positions with only about 600 residents and fellows entering the field each year, illustrating the extent of the pathologist shortage.[1]

Further Reading: The Causes and Potential Solutions for the Current Shortage of Clinical Laboratory Technologists

CLP recently spoke with Proscia Co-founder and Chief Strategy Officer Nathan Buchbinder about what’s fueling pathologist burnout and what we can do to extinguish it.

Buchbinder’s responses have been edited for length and clarity.

CLP: How big is the pathologist shortage, and what’s fueling it—is it just fewer medical students going into pathology or is it that testing demand is outstripping the rate at which pathologists are being trained?

Nathan Buchbinder: You’ve identified both of the key drivers. There are more pathologists leaving the practice, often due to retirement, than entering it at a time when demand for diagnostic services continues to grow. The number of first-year pathology residents and fellows remained almost unchanged between 2016 and 2021, increasing by only 0.7%.[2] Meanwhile, the pathologist population declined by 17.5% between 2007 and 2017.[3]

CLP: Burnout seems to be a recurring theme in today’s health care landscape. What are the factors leading to pathologist burnout? How is this affecting retention?

Buchbinder: As suggested above, pathology is plagued by a supply and demand challenge, and it’s taking a toll on pathologists’ work-life balance. It results in them working long hours to keep pace while maintaining their commitment to quality.

Advancements in precision medicine may also increasingly contribute to burnout. There’s no doubt in my mind that these developments should continue to be introduced into the clinic; we are already seeing their impact on patient care and in enabling pathologists to work at the top of their license. At the same time, they can add steps to the pathologist’s workflow, like running additional tests, so it’s important that we acknowledge the full picture.

Given the impact of burnout, it’s probably not surprising that pathologists will often look for a laboratory that is actively working to address the situation. This can impact retention—both positively and negatively.

CLP: What are some ways that laboratories can avoid burnout?


Buchbinder: I feel strongly that it’s time for laboratories to transform their pathology practices. Burnout is not a new phenomenon. If hiring a few more pathologists or making slight process changes were the answer, we would have almost certainly seen it start to ease by now.

On the other hand, innovations like digital pathology, which are modernizing operations, deliver many benefits that can combat burnout.

CLP: Where does automation or other workflow efficiencies come into play?

Buchbinder: Automation and other workflow efficiencies are among the benefits that I just hinted at. They enable pathologists to get through their caseload faster, hopefully helping to improve work-life balance. They also free pathologists from tedious tasks, which can improve job satisfaction.

Two examples will help to illustrate this. In shifting the standard from microscope to whole slide images, digital pathology enables pathologists to share images for consultation and collaboration with just a few clicks. This is a significant efficiency gain compared to the time spent shipping glass slides. Additionally, AI applications can be applied to images to automate routine tasks, like performing quality control and counting mitosis.

CLP: If you had to pick one factor that can make a big impact in lessening the pathologist shortage right now—what would it be?

Buchbinder: Considering the decline of the pathologist population, the most effective long-term solution for addressing the shortage is to inspire more students to enter the field. Innovations like digital pathology, AI, and companion diagnostics are redefining the role of the pathologist in a way that is incredibly exciting.

These technologies are giving pathologists access to more data than ever before. In turn, pathologists can serve as informaticists, synthesizing and interpreting data from various sources to make increasingly sophisticated decisions that can lead to more personalized treatment decisions and improved patient outcomes. At the same time, these innovations can help to drive efficiency gains, giving pathologists the time to step into this new role.

I believe that most people go into health care because they want to have a positive impact on patient care. The opportunity for pathologists to increasingly operate as informaticists can elevate the position that they play on the broader care team and is a very inspiring step forward for the field.

Chris Wolski is chief editor of CLP.

References

[1] Klipp, J. (2023). Pathologist Job Openings Remain Near Record High. Laboratory Economics, October 2023. 18(10) p. 10.

[2] https://www.aamc.org/data-reports/workforce/data/percentage-change-first-year-acgme-residents-fellows-specialty-2016-2021

[3] https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2734800