Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
JCO Oncol Pract. 2021 Oct;17(10):e1559-e1566. doi: 10.1200/OP.20.00948. Epub 2021 Apr 2.
Traditionally, pathologists have been branded the doctor's doctor, with a position behind the microscope and limited interaction among patients, despite their rich understanding of disease development and ability to navigate personalized medicine in an era of dynamic molecular testing.
We piloted a unique patient-pathology consultation service, whereby pathologists review tissue specimens with oncology patients, facilitating a platform for heightening patient understanding of their disease and guiding additional genetic and molecular evaluation. We conducted a retrospective survey assessing patient experience.
Fifty-nine patients participated in the patient-pathology clinic consultation, with a median age of 64 years and a female predominance (33, 55.9%). The majority of patients were treated for sarcomas (11, 18.6%), breast cancer (10, 17%), and GI tumors (10, 17%). Half of the participants consulted regarding a metastatic disease (28, 47.5%). Thirty patients (50.8%) were referred to additional workup, 11 patients (18.6%) to a second opinion, and 25 participants (42.4%) were counseled to complete genetic sequencing or additional molecular profiles on their pathologic samples. Twelve patients (20.3%) were referred for pathology revision within our institution. Three patients (5.1%) had a change in treatment plan resulting from the clinic visit. The majority (90%) would recommend the patient-pathology clinic to other oncology patients.
To our knowledge, this is the largest study of patient-pathologist consultation services implemented at a single institution. Our work suggests that the program may provide effective patient understanding and reinforce the role of the pathologist as the patient's doctor. This work surfaced the concerns of patients, regarding their pathology reports, and demonstrated that the patient-pathology clinics are a valuable platform to address patients' distress regarding uncertainty of their diagnosis and an integral resource engaging directly with patients, driving additional evaluation and patient-targeted treatment.
传统上，病理学家被誉为医生的医生，他们的工作位置在显微镜后面，与患者之间的互动有限，尽管他们对疾病发展有深入的了解，并且能够在动态分子检测时代驾驭个性化医学。
我们试点了一种独特的医患病理咨询服务，让病理学家与肿瘤患者一起检查组织标本，为提高患者对自身疾病的理解水平并指导进一步的遗传和分子评估搭建平台。我们进行了一项回顾性调查，评估患者的体验。
共有 59 名患者参加了医患病理诊所咨询，中位年龄为 64 岁，女性居多（33 例，55.9%）。大多数患者接受肉瘤（11 例，18.6%）、乳腺癌（10 例，17%）和胃肠道肿瘤（10 例，17%）治疗。半数参与者咨询的是转移性疾病（28 例，47.5%）。30 名患者（50.8%）被转至进一步检查，11 名患者（18.6%）转至第二意见，25 名参与者（42.4%）接受了关于在病理样本上进行基因测序或额外分子谱分析的咨询。12 名患者（20.3%）在本院接受病理复查。3 名患者（5.1%）因就诊而改变了治疗计划。大多数患者（90%）会向其他肿瘤患者推荐医患病理诊所。
据我们所知，这是在单一机构实施的最大规模的医患病理咨询服务研究。我们的工作表明，该项目可能为患者提供有效的理解，并加强病理学家作为患者医生的角色。该工作揭示了患者对其病理报告的担忧，并表明医患病理诊所是一个有价值的平台，可以解决患者对诊断不确定性的困扰，也是直接与患者互动的重要资源，推动了进一步的评估和以患者为中心的治疗。
