Madam, - Recent discussions about delayed or incorrect diagnoses have highlighted the importance of pathology in the management of patients with cancer. No longer is it acceptable that a cancer diagnosis be made without access to clinical and radiological information.
Where possible, surgeons, pathologists and radiologists meet to pool information on each patient in order to arrive at the most secure diagnosis for every patient. Such multi-disciplinary meetings have added enormously to the safety and accuracy of pathology diagnoses and have helped to reduce, but not yet eliminate, error by pathologists, radiologists and surgeons.
Unfortunately, it is impossible to exclude error from every aspect of life. Pathologists are also human. However, when individual test results or the subsequent clinical course diverge from the expected, immediate steps are taken to investigate the inconsistency and alter treatment and management accordingly. This combined care approach extends beyond formal, organised multi-disciplinary team meetings and regularly includes informal discussions between pathologists and clinicians in radiology departments, operating rooms and hospital restaurants.
Every pathologist is aware of the critical importance of convergence in diagnosis. Imagine then, a pathologist sitting in an industrial warehouse on the M50 wrestling with the subtle pathologic nuances of a breast biopsy without free and easy access to the radiologists and surgeons involved in the patient's care - they can't be called colleagues, as the pathologist no longer works in the hospital. Such, is the likely future scenario for pathologists in Ireland, soon to be set out by the HSE in its forthcoming review of pathology services.
Of course, the HSE will argue that with modern communications technology allows pathologists to have immediate access to clinicians, radiologists and other investigations.
In a state where a national electronic patient record is but a pipedream and where interns spend countless wasted hours searching for lost X-rays, such arguments don't carry much weight. But then, do arguments matter when the discussions throughout this HSE-initiated review of pathology services were minimalist at best? - Yours, etc,
Dr MICHAEL A. FARRELL, Terenure, Dublin 6W.