Transforming care: Direct pathologist-patient interactions.

Abstract

e13564 Background: Since 2021, the 21 st Century Cures Act has required near-immediate release of test results to patient portals, ushering in a new norm for patients’ access to their laboratory data and pathology reports. Diagnostic reports are often laden with complex medical terms, which can exacerbate patient anxiety and confusion. Several institutions have sought to relieve this patient anxiety by establishing direct patient-pathologist consultations, also known as pathology clinics. Pathology clinics can improve the experiences of cancer patients, pathologists, oncologists, and other care providers. This study aimed to better understand current pathologist awareness, interest, and implementation of pathology clinics. Methods: To examine understanding of the role of pathology clinics in improving patient care, explore variations in how clinics were implemented, and examine related educational needs, a cross-sectional survey was deployed to a nationwide sample of 27,368 pathologists, pathology trainees, and laboratory directors/administrators. The survey asked whether the respondents had a pathology clinic at their institution and how the clinics operated (e.g., what the objectives were, what types of patient consultations, how patient visits were recorded, etc.). It also asked about challenges respondents who either had an operational pathology clinic or were in the process of implementing one had encountered. Results: There were 276 respondents to the survey, more than half of whom (n = 159, 58%) were from hospitals of varying sizes (e.g., fewer than 100 beds to more than 500). The majority of the respondents (n = 142, 51%) indicated that they had not heard of pathology clinics prior to the survey, and only 15 respondents (12%) reported that their institution either already had a clinic or were in the process of establishing one. For most of these respondents, the primary aims of their clinic were to explain the results of tissue biopsies to patients (n = 12, 80%) and answer their specific questions (n = 11, 73%). While the number of respondents with pathology clinics was low, more than half of the respondents (n = 8, 53%) reported encountering challenges in the process of establishing a clinic. The top challenges were concerns about scope of practice (e.g., the clinical and legal boundaries of patient engagement), logistical issues (e.g., lack of physical space), and issues with reimbursement (e.g., billing). A few respondents also expressed concerns related to institutional buy-in from clinicians or hospital administration. Conclusions: While literature has shown various benefits from institutions implementing pathology clinics, there are many considerations and challenges to address, including how to engage oncology partners. There are opportunities to increase awareness of pathology clinics and provide resources to pathologists, care partners, and institutions to support the development of pathology clinics.