The Causes and Consequences of Pathologist Burnout

A while back we shed light on a growing negative trend in the clinical laboratory space with help from Dr. James Crawford. In the article, shared here and published in Clinical Lab Products magazine, Crawford spoke in great detail about a shortage of qualified medical lab technologists. He noted that the crisis comes after years of growing concern and offered steps all clinical labs can take to help manage the problem.

Today, we focus on a separate but related issue, the stress and burnout of being a pathologist and running an independent pathology practice during turbulent times.

Learn More: Process Improvement and Advanced Technology to Help Relieve Laboratory Staffing Burden

Troubling Numbers from a Recent Poll  

If you’re a pathologist, it’s a good bet you’ve felt burnout during your career and there’s a good chance that you’re affected by burnout today. That’s according to a 2020 poll conducted by the American Society of Clinical Pathology (ASCP) and published by the American Journal of Clinical Pathology.

The poll showed that 71.4 percent of practicing pathologists reported burnout symptoms at some time, and 32.9 percent reported it as a current issue. The poll also identified six contributing causes for workplace burnout:

• Lack of autonomy
• Bureaucracy (including both regulatory and compliance issues)
• Challenges of a LIS system/EHR
• Mergers and acquisitions
• Workload
• Isolation

Other unique contributors to burnout included depersonalization due to a lack of direct patient contact and the perception that their efforts usually went unrecognized. 

Consequences of burnout included inattentiveness, irritability, and “tiredness” resulting in job transitions, increased medical errors, and consequent malpractice claims.

The Role of the Pandemic and Rising Labor Costs 

While researching for this blog post, we enlisted the help of a former practicing pathologist with an excellent information technology and laboratory information system (LIS software) background.

Our pathologist understands how LIS systems bring intrinsic value to modern laboratory operations. He’s a well-respected voice within the industry who agreed to share his insight as part of a background interview, and for that, we’re grateful. 

What we learned during the interview was not surprising. Anxiety and stress among pathologists are on the rise as they collectively deal with rising cases and a lack of qualified personnel to share the workload. 

Some of this can be attributed to COVID, with patients now coming in for operations and biopsies that they put off during the pandemic. Another contributing factor is the red ink that hospitals and health systems continue to deal with, forcing cutbacks on staffing across the board to make the finances work. 

One unexpected byproduct of the current state of affairs also came out during the interview, and that’s the fact that participation by pathologists and informaticians in volunteer groups like the Association of Pathology Informatics is also noticeably down. This is because they simply don’t have the time to commit to volunteering as committee chairs and project participants. 

Adding Automation to Laboratory Workflow Management and LIS System Processes 

A contemporary pathologist typically signs out 40-to-50 cases during 10-to-12-hour days. Many also work nights and weekends because surgical specimens routinely come in on Fridays and are processed overnight.

In terms of hours worked, in the past, it was generally accepted that a pathologist would work fewer hours than clinicians, but that concept is changing as pathology departments start to get shortchanged in terms of FTEs.

For many, the solution starts with laboratory software systems that support automation. For example, clinical pathology is a prime example of what can be accomplished with automated clinical lab workflow.

A chemistry or hematology lab requires only a few people to support the automation as specimens are clinically processed via belts and analyzers and only touched once or twice from entering the lab until they leave and are put into storage. 

The current state of surgical pathology has much less automation, but it’s moving in the right direction thanks to advances in technology that are present in advanced lab information systems. 

Learn More: The Power of Integration: Unleashing the Potential of LigoLab's LIS System & Lab RCM Platform

It used to be difficult to automate precise elements of surgical pathology. For instance, creating thin sections was an acquired skill. But that’s now changing with automated cutting devices, automated stainers, and advancements in digital pathology. 

Just as important has been the evolution of modern pathology lab software in the form of LIS systems that now serve as the central hub for all laboratory data. 

These new modern LIS lab solutions feature interface engines that maximize connectivity with all laboratory analyzers and devices. They are also rule-based, enabling lab directors and managers to build simple to complex rules and actions that replace inefficient and mistake-prone human intervention with automation. 

Learn More: How do I Know if My Laboratory has Outgrown its LIS System?

Lastly, the best LIS lab solutions are now also designed with just-in-time functionality, allowing users to track the specimen at every stage while erasing the chance for lost or mislabeled specimens. 

The fundamental question in the face of overwork and personnel shortages is at what point of frustration does the pathology practice abandon the old way of doing things and invest in technology and automation that a modern lab information system can readily provide to ensure a successful surgical practice? 

Artificial Intelligence, Digital Pathology, and Modern Lab Information Systems

Many believe pathology informatics is about to explode and the future is more automation and technological advancements. 

Because of this, modern LIS systems like the LigoLab Informatics Platform are well positioned for what’s likely to be a pathology revolution in the next 5-to-7 years. 

Industry experts believe that support for artificial intelligence (AI) and digital pathology will be required to manage caseloads. They think we will soon see one pathologist routinely being as productive as two pathologists are at present.

This belief is also backed by a recent report released by Signify Research that suggested the global market demand for digital pathology was likely to double by 2025. 

With the adoption of this new technology, we may soon see a digital pathology workflow where a single pathologist will scan and release 60-to-70 percent of his or her cases based solely on the results of digital images scanned by image analysis software. 

Another 20-to-30 percent of the cases will be more challenging with the software providing a diagnosis that the doctor may or may not agree with. 

Lastly, 5 percent of the cases will be so challenging that the software will need the human help of a pathologist for the proper diagnosis. 

In closing, one can easily argue that an investment in the future of pathology is warranted because it continues to be the greatest bargain in healthcare. 

Anatomic and clinical pathology labs only take a small part of a typical health system’s budget (roughly 5 percent in most cases). Despite this small slice of the pie, laboratory test results lead to 70-to-80 percent of all medical decisions. Clinical labs contribute mightily to the care of patients and, in relative terms, are inexpensive.

Is Your LIS Laboratory Information System Ready for What’s Coming Next? 

If surgical pathology practices are to overcome the current issues covered here, a modern rule-based LIS laboratory information system that supports automation and maximized connectivity is a must-have. 

It’s clear that rigid and legacy LIS systems are going the way of the dinosaur and are being phased out by unified LIS software solutions that are both comprehensive (full of features with new enhancements developed daily) and flexible (include thousands of configurable entities that give clinical labs and pathology groups the ability to quickly introduce new tests, results, reports, and new fields). 

The best LIS systems also operate without multiple data silos between modules and departments and include pathology lab management solutions for laboratory billing (lab revenue cycle management, lab RCM), too. 

Not all LIS systems are created equally, so choose wisely. Ask about the LIS system provided and the LIS software vendor’s approach to support and upgrades. 

You’ll find the best LIS for your lab will be backed by a LIS company interested in your lab’s long-term success, one with low upfront costs and aligned pricing, no hidden fees, and one that is motivated to work with you and your team to make your lab super-efficient and productive. 

Learn More: LigoLab Informatics Platform: Uniquely Designed to Deliver Maximum Value