Askew Pathology Consultation
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After almost 40 years of private practice in hospital based pathology, the time has arrived in May 2017, to change chairs so to speak and take on different responsibilities. As my partners and I discussed 8 months prior, it was becoming time as I turned 75 the next May, to quit roping and branding, but if they wanted, I would continue “riding the fence line” in the future. During the months leading up to May 2017, I conceived ASKEW PATHOLOGY CONSULTATION as a method to continue doing some of the professional practices that I had come to really enjoy, namely promoting the pathology group I help found in 1981, as well as promote some digital pathology devices that I believe will change the way pathologists practice in the future.

Two other important aspects of my time in the saddle includes comprehensive breast centers and related education in breast pathology. In 1995 I learned about such comprehensive centers while attending a Laszlo Tabar three-day conference showcasing the importance of the comprehensive approach. Part of the pathologist participation was learning digital pathology. At first this meant learning how to prepare for the weekly prospective conference and incorporate digital images of the gross specimen, sub-gross and microscopic aspects of a given case and put all of these images into a PowerPoint presentation. This exercise became a labor of love, always trying to improve the presentation to be informative and educational at the same time.

Later in my professional life, I began experimenting with video productions of digital pathology devices, explaining how each device enhanced one’s professional activities. This lead to the creation of educational videos for patients and mammo-techs.

Two of my favorite businesses are interlinked in a visual sense, one leading into the other. Many years ago during residency training, as I practiced to recognize disease, I also knew I was seeing things under the microscope that most people cannot even imagine. That was the early visual recognition that pathology and the visualization of disease was a special calling that I would relish/enjoy for a lifetime. These visual sights are what lead to a deepening of interest in digital imaging and digital pathology as that technology became available over the past twenty years.

Comprehensive

In 1995 two colleagues challenged me to attend a Laszlo Tabar conference on Comprehensive Breast Centers. In a lot of ways, this conference and the many that followed, changed my professional life in a very good way. What Dr. Tabar professed was for physicians to work closely together and meet once a week in a prospective meeting to present each patient for as long as it took, to collectively look at the history, the mammorgraphic images and pathology images and diagnosis. By working together, everyone learned more about the patient they would ultimately treat and at the same time, gain a better understanding of what went into the mammographic workup as well as how pathologists contributed to the diagnostic process. This close working relationship has continued in our initial team over the past twenty plus years. We believe it has definitely brought better patient care because of our collaborative participation in the weekly conferences.

Education

The idea for an educational segment came about one year ago when I heard a mammo-tech say to me “what is mucinous carcinoma of the breast?” My immediate thought is that she is asking me to show her the pathology side of what she is imaging every day. Of course she isn’t finding that special kind of breast cancer every day, but wouldn’t it be education for her to see the pathology side of what she saw on mammographic imaging. So that was the start. In this section there will be topics of interest to both the mammo-tech as well as some patients. Not all patients, understandably, want to see pathology.