Arch Pathol Lab Med. 2018 Nov 6. doi: 10.5858/arpa.2018-0379-OA. [Epub ahead of print]

"Please Help Me See the Dragon I Am Slaying": Implementation of a Novel Patient-Pathologist Consultation Program and Survey of Patient Experience.

Booth AL1, Katz MS1, Misialek MJ1, Allen TC1, Joseph L1.

Author information

1

From the Department of Pathology, University of Texas Medical Branch, Galveston (Dr Booth); the Departments of Pathology and Laboratory Medicine (Dr Joseph) and Radiation Medicine (Dr Katz), Lowell General Hospital, Lowell, Massachusetts; the Department of Pathology, Newton-Wellesley Hospital, Newton, Massachusetts (Dr Misialek); and the Department of Pathology, University of Mississippi Medical School, University of Mississippi Medical Center, Jackson (Dr Allen).

Abstract

CONTEXT.—:

Pathologists evaluate human disease and teach medical students, residents, and clinicians. Historically recognized as the "doctor's doctor," pathologists are well suited to be a direct patient resource of individualized, accurate information.

OBJECTIVE.—:

To develop and implement a pathology consultation service whereby patients review their tissue slides directly with the pathologists.

DESIGN.—:

A pathologist conducted patient consultations, reviewing biopsy or surgery findings on a multiheaded microscope or computer screen. The pathologist evaluated patients' understanding of their disease and invited patients to ask specific questions. We recorded patient demographic data and assessed utilization with a short patient satisfaction survey using 6 questions with a 5-point Likert scale and 2 questions for open response.

RESULTS.—:

A total of 31 patients came for consultation; 39% (12 of 31) were accompanied by a friend or family member. Patients' median age was 59 years, with a strong female predominance (90%; 28 of 31). The majority of patients had breast cancer (58%; 18 of 31) or hematologic malignancy (19%; 6 of 31). Of the 31 patients, the survey response rate was 58% (18 of 31). Top-box scoring demonstrated program support, with 89% (16 of 18) of respondents strongly recommending the experience to another patient. Additionally, 78% (14 of 18) strongly agreed that they felt more empowered after seeing their disease. Mean scores for Likert-based questions all were higher than 4.0.

CONCLUSIONS.—:

To our knowledge, this study is the first report of direct patient-pathologist consultation. Early data suggest that the program may provide effective patient-specific education. The high response rate and favorable assessment of the program suggest that it may be a valuable resource for some patients.