Much like whole slides themselves, blogs I am finding have some of the same characteristics for different reasons – they are persistent, consistent and efficient. One can choose to get daily feeds or follow on a reader seamlessly. Each blog and blogger has his or her own style that covers what is important to them whether they be personal, technical or cover particular topics or fields of interest to them.
One of the deliverables of the blog I find most interesting is receiving comments to past posts with new ideas or questions long after I have thought of them or posted on the subject that allows me to re-visit these topics.
Recently I received a comment to a posting from June of last year on the issue of outsourcing of digital slides and the implications of such based on a paper written by the president of ASCP. The original post touches on my thoughts on this issue which I think presents opportunities rather than threats to pathology.
The comment submitted reads "I’m a big fan of outsourcing medical readings of digital slides and imaging to India. Once you have a resource in India that is proven to be respected and trustworthy it makes sense to outsource, especially at night. I think it would be amazing if doctors allowed patients to request readings from a 3rd party if they so chose (discounted option). Sort of like hotels offering basic rooms vs Penthouses in terms of service. What do you think?"
No doubt that second and third consultations are commonly sought by patients and their families seeking additional opinions to help them decide the best course of action that suits them. Clinicians, pathologists and patients alike continually seek help from one another for appropriate answers and solutions to help guide diagnosis, therapy and follow-up for their patients or themselves. It is one advantage we all have, providers and patients alike to not only "real" in-person consultation, referrals – whether they be slides mailed or patients referred to other clinicians for their opinion but also "virtual" or "electronic" consultations for patient care or radiology/pathology interpretations.
As I posted initially, workflow and demands in pathology do not necessitate the middle of the night coverage demanded in radiology. Furthermore, if you look at these kinds of practices in radiology, often times they are US trained radiologists providing coverage for an institution where they have practiced or are credentialed to practice in performing the same work they would do on-site but negating the need for on-call radiologists.
I think the idea that slides, once put into a format that can be transferred more readily in a digital form compared to a physical form, will be read by someone arguably at the same quality but discounted price is not a business model that threatens pathology. I have suggested work be in-sourced from those who need help given the expertise and still relatively low cost in this country.
This presents an opportunity using technology to leverage the expertise and need that benefits all involved rather than commoditizing anatomic pathology services.