As veteran readers of Lab Soft News may know, I have developed a special interest in the conversion or merger of pathology, lab medicine, and radiology with the eventual [potential] outcome of a "Department of Diagnostic Medicine." I have been struggling in my various notes to come up with a good name for this concept and have finally settled on in-vivo/in-vitro diagnostics which I will refer to here using the acronym IV2DM.
The July issue of CAP Today discussed this idea in its cover story. You can link to the story as a PDF file (see: In diagnoses, a tale of two specialties) or in text format at the CAP Today web site. For me, the significance of this article is twofold. First of all, it's important that one of the CAP most respected publications is giving such prominence to this idea. The second important point that is emphasized in the article is that the Methodist Hospital in Houston is exploring this idea in depth through its research arm, The Methodist Hospital Research Institute (TMHRI).
One of the most intriguing aspects of IV2D for me is the means by which it will evolve in the two specialties and the workplace. In other words, how and where will the idea take root and flourish? The money quote from the CAP Today article was the following (boldface emphasis mine):
“I think what’s going to happen is that two or more smart people with a particular interest around a specific topic are going to talk,” says Dr. [James] Musser, associate chair, Department of Pathology, The Methodist Hospital, and executive vice president of the Research Institute. “They’re going to start formulating specific ideas. It could be, for example, liver pathology or infectious disease. I don’t think we know where the solutions are going to come from. I think much of this is going to be driven very much at the grass-roots level, in my opinion, by two or more individuals who have a shared passion over some medical problem or biomedical problem. And that’s how this synthesis of fields is going to move forward.” On a practice level, Dr. Musser foresees “a hybrid field filled with hybrid individuals,” much like what has happened in molecular pathology. “Now we have training programs in molecular and so forth, and a society and journals, and it’s a viable academic enterprise. Hybrid vigor is crucial to the ongoing success of any discipline,” he adds, including medicine.“If fields don’t mutate they die.”
I believe that Dr. Musser is right on target here on a couple of counts. IV2D will surely evolve from the bottom up rather than emerge fully formed in some healthcare setting. This evolutionary process will be driven by local partnerships to demonstrate the power of combining in-vivo and in-vitro diagnosis. I am also struck by the aptness of his reference to "hybrid vigor." Perhaps the label of diagnostic hybridist will find favor among the practitioners of this new specialty, much like the intensivist, hospitalist, surgicalist, and proceduralist.
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