Title: Examining the Details: The Pathologist’s Influence on Promoting Health Equity
In the meticulous and systematic realm under the microscope, every slide narrates a narrative. A fragment of tissue, a drop of blood—each sample represents an individual, a family, a life affected. For those practicing pathology, these slides are not mere scientific specimens but crucial components of a patient’s experience. Whether that experience is just commencing, navigating through ambiguity, or approaching its conclusion, pathologists frequently are the first to uncover its trajectory.
As volatile social and political issues overwhelm the news, the laboratory stays an impartial arena. Here, cells articulate in hues and structures, free from stereotypes and prejudices. This is where impartiality intersects with compassion. Nevertheless, the role of a pathologist extends well beyond recognizing disease under magnification—it is a vital aspect of fostering diversity, equity, and inclusion in healthcare.
The Pathologist’s Unseen Impact
Often invisible to patients, pathologists serve as the essential foundation of medical decision-making. It is estimated that up to 70 percent of clinical choices are influenced by lab results. Every diagnosis, every treatment plan, and every prognosis typically initiates in the lab. Within this environment, the pathologist scrutinizes everything from biopsies and blood specimens to genetic tests and microbial cultures.
However, pathology transcends mere science—it’s a manifestation of a transforming medical philosophy committed to equity. Each lab result represents a possible crossroads for justice or inequality. This has led the field of pathology to not only identify disease but also to diagnose and rectify inequity.
From Biased Standards to Fair Practice
Traditionally, some laboratory methods unintentionally ingrained racial or gender biases. For instance, the estimated glomerular filtration rate (eGFR)—a key kidney function assessment—previously included race-based adjustments that frequently deferred diagnoses and treatment for Black patients. Likewise, sex-based reporting of ferritin levels—an indicator of iron levels—was grounded in assumptions rather than equitable scientific principles.
Pathologists, in collaboration with professional organizations and health system leaders, have been instrumental in addressing and amending these biases. The ongoing endeavor to eliminate outdated, discriminatory benchmarks from standard lab reporting reflects these efforts. These alterations guarantee that test results provide equitable insights and timely care for all, independent of race or gender.
Initiatives like these stand as a testament to pathology’s determination: science must equitably serve every patient.
Health Equity as a Holistic Commitment
The commitment to cultivate equity extends beyond the laboratory. Motivated by initiatives such as United Against Racism and For Every Patient, health systems are striving for structural transformation. One innovative health system is actively preparing for the Joint Commission’s Health Equity Certification—a distinguished recognition of comprehensive, system-wide equity practices.
This certification entails a thorough review, assessing each department’s role in providing fair, inclusive care. For clinical laboratories, this means guaranteeing that protocols do not inadvertently perpetuate health disparities. Additionally, it involves educating laboratory personnel about these matters, enhancing awareness of the human context tied to every sample.
Pathologists are partnering with leadership to ensure these topics remain visible and pertinent. Whether through educational materials or modifications to clinical practice, their aim is to make certain that no patient is overlooked due to a lack of comprehension or fairness within the system.
Honoring the Individual Behind Every Specimen
If you were to inquire about what inspires a pathologist’s work, it’s not solely the science. It’s the realization that every test is connected to someone—a parent, a sibling, a child. Amid the tranquil routine of examining slides, a deep sense of empathy and responsibility propels the specialty onwards.
Pathologists endeavor to guarantee that beyond clinical precision, their work contributes to a healthcare system that is fair, inclusive, and rooted in universal respect. This encompasses acknowledging the significance of health literacy in equity. When patients grasp their lab results and their implications, they are better equipped to manage their care. Hence, providing accessible, comprehensible reference materials for both staff and patients is becoming an increasing priority.
Looking Ahead
In today’s environment, where divisions frequently overshadow our collective humanity, pathology serves as a reminder of our unified biology—and our shared future. Under the microscope, we are all comprised of the same elements. No one’s cells reveal their race, gender identity, insurance status, or social background. Thus, every patient merits the same level of care and dignity.
The pathologist’s perspective offers clarity, not only in diagnosing disease but also in shedding light on inequality and paving the path for transformation. From the removal of race-based adjustments in reporting to advocating for inclusive policies and education, pathology is at the forefront of medical equity.
We may appear different when entering a hospital, but under the microscope, we all shine the same. That is a truth deserving of amplification.
Author: Dr. Michael Misialek, MD
Pathologist, Advocate for Health Equity
View his profile on LinkedIn: Michael Misialek, MD.