Bootstrapping the Integration of Pathology and Radiology

A recent article in the New York Times (see: A Threat So Big, Academics Try Collaboration) discusses the increasing popularity of multidisciplinary centers in universities that are devoted to complex problems such as environmental sustainability. These centers draw faculty and student talent from diverse academic disciplines that normally do not collaborate but each of which bring unique problem-solving skills to the table. Below is an excerpt from the article (boldface emphasis mine):

The political landscape of academia, combined with the fight for grant money, has always fostered competition far more than collaboration. But the threat of global warming may just change all that.....So more universities are setting up stand-alone centers that offer neutral ground on which engineering students can work on [sustainability problems such as] alternative fuels while business students calculate the economics of those fuels and political science majors figure how to make the fuels palatable to governments in both developing nations and America’s states.

I have a special interest in the merger of pathology, lab medicine, and radiology into a new medical specialty of diagnostic medicine. The chance of such a change happening spontaneously is probably low because the professionals working in these disciplines are relatively content with the status quo and may have difficulty envisioning a new medical specialty. A necessary element for such a merger to proceed, therefore, is a less risky environment in which various facets of this type of clinical collaboration can be tested. In short, I think that it would be a good idea for large academic and research hospitals to establish "centers" to test the practicality of an integrated department of diagnostic medicine.

For me, the most successful current examples of such "centers" where heterogeneous groups of medical specialists collaborate are cancer hospitals. The unifying factor for such centers is that all of the various physicians working in them can focus on patients with a specific type of disease -- cancer. In a diagnostic center, all of the various specialists will collaborate on a set of processes in the healthcare delivery continuum: the diagnosis of disease, the assessment of disease prognosis based on the diagnosis, and the choice of therapy based on the nature of the diseased tissue or neoplasm.

Comments

[The PACS Designer]

Another discipline where integration of medical specialties would be of benefit to practitioners and patients is cardiology. With the large volume of parameters in cancer and cardiology it makes sense for practitioners to form teams to provide the best of care for their patients through the elimination of duplicate lab tests, imaging procedures, and other treatment specialties. Cardiology is seeing CT scanners deployed which can give imaging information that will avoid the need for invasive cardiology procedures. Cancer researchers can collaborate more effectively when they have the complete history of treatments their patients have received from multiple disciplines.

[bev M.D.]

Dr. Friedman;

That is an excellent idea. I have read your many posts on this concept and have been thinking to myself, it'll be a cold day in Hades when that happens in the private arena, from where I retired. But what better place to test it than in a cancer hospital, where it is already occurring on an informal basis? Give your next conference speech on that topic; maybe it'll get some traction.