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What is a Pathologist?

pathology, Cedars-Sinai, Laboratory tests, Clinical Microbiology

In nearly every hospital, there's a special laboratory that patients and visitors will never see. But what goes on in this laboratory is vital to the care and treatment each patient receives.

"We are lost behind the doors of the laboratory and no one really knows what we do," says Margie Morgan, medical director of Clinical Microbiology in the Department of Pathology and Laboratory Medicine at Cedars-Sinai.


"Laboratory tests guide more than 70% of medical decisions for patient care. We play a huge role in the diagnosis of disease."


What is pathology?

Pathology is a wide-ranging field of medicine that studies many different types of diseases. It's the bridge between science and medicine. Lab workers perform diagnostic testing to guide physicians in the proper way to treat diseases.

How does Morgan respond when people ask what she does for a living?

"You know when you have a sore throat or a urinary tract infection and you go to the doctor to get a test? My laboratory will take the throat or urine specimen and perform tests that identify the pathogen that is causing the infection. We can identify the bacteria, the fungus, the virus, etc."

Morgan says people often think that all diagnostic and laboratory tests are done solely by machine. However, there's a team of highly trained pathologists and clinical laboratory scientists working to ensure the accuracy, efficiency and proper protocol for each and every test.

"Laboratory tests guide more than 70% of medical decisions for patient care," Morgan says. "We play a huge role in the diagnosis of disease."



Pathology and cancer diagnosis and treatment

Anatomic pathologists play an important part in cancer diagnosis and guiding the course of treatment for each patient.

"Any time a surgeon or endoscopist takes tissue from a patient, it's our job to tell the clinicians what's in the tissue so that they can make informed treatment decisions," says Dr. Kevin Waters, associate director of the Anatomic and Clinical Pathology Residency Program at Cedars-Sinai.

Dr. Waters helps identify what stage of cancer a patient has, which can be a tough process, he says.

"We put our heart and soul into trying to hit the right threshold for all our diagnoses," he says.



Detectives 'on the hunt' for a diagnosis

"Being a pathologist can often feel like you're a detective on the hunt for a diagnosis," says Dr. Bonnie Balzer, vice chair of Anatomic Pathology at Cedars-Sinai.

Dr. Balzer's specialty also involves cancer diagnosis, identifying the stage of the cancer, tumor size and depth of the invasion.

This is where the detective work comes into play.

"The rarity of the diagnosis and the more exotic the disorder, the more difficult the diagnosis is to make," Dr. Balzer says.

"The mass you get from a biopsy may not be the primary site," Dr. Balzer says. "This is when you're left hunting—not only for the diagnosis, but also where the tumor originated from and what its molecular characteristics are."

Teaming up to deliver fast results

In the face of the COVID-19 pandemic, the valuable work of the laboratory has moved to the forefront. At Cedars-Sinai, the Department of Pathology and Laboratory Medicine is in charge of COVID-19 testing. 

Morgan says it's taken an incredible team effort from staff in the microbiology and molecular pathology laboratories to ensure the success of COVID-19 testing.

"In the lab, you need to be clever," Morgan says. "You need to think ahead, and you can't let this get the best of you. You have to keep moving forward."

A medical profession for the truly passionate

Few will get a peek behind the scenes of the pathology lab, but know that those working round-the-clock to deliver test results are very passionate about what they do.

"We put all our effort into each case," Dr. Waters says. "It's hard to put into words how much we care about each case we have because we know how important it is for the patient."