Have you ever felt like no one knows exactly what you do for a job; friends, family, even your colleagues? As a clinical pathologist, if you are ever asked what your job entails, it might take you a full 10 minutes to just explain the surface of it and by that time your audiences’ s eyes have glazed over and they are wondering when their next coffee break is. It can get pretty lonely when very few people understand your daily life of work.
I currently hold a general clinical pathology position and oversee the microbiology, chemistry, and immunology sections of a community hospital laboratory that services two hospitals totaling a little over 500 beds. I also get consulted on point of care testing and consult at two critical access hospitals that have a general AP/CP pathologist directing their lab.
As a new clinical pathologist, I was asked to blog about my experiences during the first year of working in the real world. I thought it would be a great venue to talk about how I have combatted the “loneliness” I face when I feel like no one knows what I do. Over the next couple of months I will highlight some of the tasks I have undertaken in my current position and I’d also love to hear what other clinical pathologist’s careers look like and/or how they have evolved over the years.
The beauty of a career in clinical pathology was explained to me by an attending during my residency training –you make of it what you want to. He also told me to not venture into the lab because they will ask you to do things, and since I am not very good at following advice, that is exactly the first topic I would like to explore: getting into the lab on a daily basis.
When I was in training, one of the best ideas I took away for my job was microbiology rounds. The first attending I observed holding these was a medical microbiologist that would round through the micro lab every day asking the techs if they had any odd cultures, questions that needed to be answered or anything that required follow up. When I took this job, I knew I wanted to incorporate this type of rounding as part of my work. My office is conveniently located at the back of the microbiology laboratory, so as I walk through the lab, I make it a point to say hi and ask the technologists if they have any issues, or any interesting cultures. It is not a formal rounding, but issues come out of these interactions and give me items to follow up with on a daily basis. Having my office located in the lab also allows the techs to come to me throughout the day with any questions they may have and has established a great rapport between us.
I also round through the chemistry and immunology section of the lab, specifically hitting second shift, as they lack a lot of interaction with clinicians. This has been a harder task for me because my subspecialty training was microbiology. I feel comfortable interacting with the technologists and lab staff, but when I first started I had the fear that I would not know the answer to a question I might be asked. Lucky for me, there are not as many questions that come out of these rounds. But of the questions I have gotten and I did not know the answer, it has never been a problem by me saying “I don’t know off the top of my head, but let me get back to you”. It also helps that I drop off candy in the break room while they wait on me – it is truly amazing how chocolate helps you make friends (thanks for the tip, Mindy Kaling). In addition to troubleshooting, rounding through the lab has given me the opportunity to interact with other people who have a passion for laboratory medicine. The techs will get just as excited about an interesting organism that was isolated or a new instrument we might bring in, and it is great to be able to share that passion you feel for your job with others.
Next month I will discuss a little more about the “formal” interactions I have set in the lab, but for now, let’s hear from you: how do you get involved in the lab and the technologists you work with?
-Lori Racsa, DO, is the director of microbiology, immunology, and chemistry at Unity Point Health Methodist, and a Clinical Assistant Professor at the University Of Illinois College Of Medicine at Peoria. While microbiology is her passion, has a keen interest in getting the laboratory involved as a key component of an interdisciplinary patient care team.
Lablogatory 
Thanks for your post. As a retired clinical chemist with some 37 yrs in the lab, I identify with your indecision on being questioned by non-lab folks as to “what do you do in the lab?” Historically, I’ve usually mumbled something about cholesterols and quality control and writing procedures.
Additionally I strongly endorse your action of making rounds. This follows an old management maxim known as “managing by wondering around”. It is important that bench techs feel part of a team and have a opportunity to discuss and sometimes vent over problematic instruments and procedures and are made to feel valued for their efforts. I have too often seen colleagues who isolate themselves in their office on academic pursuits and other peripheral activities and are largely clueless as to what’s happening in their own lab. Having an office close to the lab (even when it’s sometimes windowless) is also a plus as it gives techs easy access to discuss problems and provide input.
Keep up the good work.
Hi Ron – Thank you for your comments!
Bravo!
Excellent summation
I look forward to your next installment
Please contact me so that we can continue the conversation
daltermd@hotmail.com
David Alter MD DABCC
100% Clinical Pathology
I am a Clinical Microbiologist and I enjoy the interaction of our docs who do rounds. I’m sure it takes some extra schooling to become a Clinical Pathologist but the work seems like it would be interesting. Thanks for the blog post, very good read. I have a Bachelor of Science in Microbiology so I’m currently working on getting my clinical certification.
First of all I want to thank you a lot for this blog. It would be really helpful for us.
2nd I am a clinical pathology resident in Egypt and suffering from a lot of issues in my work like you said the most important is the relation with my colleagues from technicians and chemist because there are no job description at all.
Hang in there Rania – I think training was one of the toughest parts about clinical pathology because you are so busy trying to learn the technical aspects of the lab and disease processes or doing research that you can miss the forest for the trees. I recommend hanging on to your clinical pathology faculty and just follow them around all day to see what they do and how they interact with technologists and other clinical faculty – I wish I had done more of that than reading when I was in training.
Hi there!… I though I was the only one that feels that way. Clinicians always tell me: “oh clinical pathologist, it’s hard to deal with the biopsies in the OR right?”… and I spend like 10 minutes explainig what do we do for living in the lab… or in the blood bank. It’s kind of frustrating sometimes.
I’ll follow your posts.
Thanks for sharing!
Haha – yes! I still remember a physician I met when first I started my job called me two days later wanting to discuss the results of a biopsy he had performed; I had to let him down gently saying that what was not the kind of pathology I practice but told him to call me if he ever had any issues or questions about his patient’s laboratory results.
I was a MT(ASCP)BS and worked in a hospital lab for 43 years. Had the same Pathologist for most of those years. He made rounds to each lab section daily and knew all of the techs by name. He always shared unusual surgical specimens in relation to our work. That made us feel special. We all rotated weekends and he always had doughnuts for the Saturday crew in the break room. Sounds to me like you are starting off on thr right foot. Keep up the good work. It means a lot to your staff (or Staph, lol).
Haha – thanks for the pun and thank you for the encouragement!
Excellent blog. I work in a suburban teaching hospital histology section and all our attending pathologists (AP & CP) have a similar style of rounding and being approachable with questions. They tend to favor their sub specialty and interests but are always willing to listen and research with me. It helps us feel connected and appreciated. Our cytology section had to relocate to a more remote area and their feeling of isolation is palpable. Bravo for making the effort to interact with the lab techs and keep 2nd shift involved. I can assure you it is much appreciated!
I trained AP/CP but after two years went CP only and after a clinical chemistry fellowship and a transfusion medicine fellowship I had no desire to sit the AP boards. CP is a great (misunderstood) area of medicine – and seems to be attracting more DOs these days! Keep up the blog – everybody will benefit!