Transcript

Aleks: [00:00:00] Digital pathology events are interdisciplinary event by definition because digital pathology is interdisciplinary. But until one of my podcast guests actually asked this question at the digital diagnostics summit, how many of you are pathologists? And very few people raised their hands. I didn’t know how low the attendance was.

Meet the Panelists

Aleks: So today, together with my guests, It’s Dr. Giovanni Lujan, a seasoned pathologist, myself, a mid-career pathologist, Dr. Alae Kawam, an early career pathologist, and Nick Best, an online publisher from Pathology News. We’re going to be discussing this topic.

Why Few Pathologists Attend Digital Pathology Conferences

Aleks: Why there are so few pathologists attending digital pathology conferences.

Be sure to stay till the end because Dr. Kawam is only joining us in the second half of the podcast. Let’s dive into it.

I have special guests here.

Giovanni: Hello,

Aleks: And I got Nick…

Nick: Hello,

Aleks: Nick say who you are and why [00:01:00] did you like this meeting?

Nick: So I’m Nick Best from Pathology News and I love this meeting because it is a new unique way to network with like minded people.

It’s not manufactured networking. It’s people who are trying to drive our industry forward coming together and discussing how to make it happen.

Aleks: Okay, same question to you Giovanni, who are you and why did you like this meeting?

Giovanni: I’m Giovanni Lujan, Director of Digital and Computational Pathology at The Ohio State University. It’s my first time here and definitely I echo what Nick just said.

I became an instant fan. I love it the way that everybody has the same goal. Everybody is approaching it from different angles and we learn from each other. It’s definitely a learning experience as well as a celebrating experience, so it’s great.

Discussion on Conference Attendance

Aleks: So yesterday we had a fireside chat with kind of prominent people in the digital pathology space [00:02:00]  and you asked a question that was kind of eye opening to me because you asked, how many pathologists in the room, are in the room?

Can you raise your hands? And I was shocked. How few hands were up. Can you comment on that and like your experience in other meetings that are supposed to be pathology meetings? I mean digital pathology is very multidisciplinary, so it’s not just for pathologists, but let’s talk about it.

Giovanni: Yeah, it’s something that I started noticing at the DPA, which is by by definition the Digital Pathology Association.

Obviously, you expect to be largely…largely attended by pathologist, whoever. That’s, that’s not the case. And pathologists are usually a minority. So it seems like the pathology.

Aleks: How many people raised their hands?

Giovanni: Yesterday, 10.

Aleks: 10. Oh my goodness. And we are like a [00:03:00] hundred. How many people did we have in the room?

Like…

Giovanni: I will say probably

Aleks: at least a hundred. Yeah,

Giovanni: Maybe a few. Over a hundred I would say. But yeah, it’s just, just 10 people, which. tells you 10 percent and I think that’s pretty much what we see in other big meetings that are supposed to be pathology driven.

Nick: Why do we see that? Is that the fault of the event or is it the pathologists not wanting to come?

Do they not have time? Do we need to make more one day events where they feel they can actually leave the lab for a day perhaps whereas two days, three days meetings. That’s that’s a long time to be away. You know, what can, what can these conferences do to attract more pathologists?

Giovanni: That was my point yesterday.

The point I was trying to make is that we are getting to in general to compliant about the fact that these meetings are like we were talking. This is a, we’re learning from each other. We’re [00:04:00] celebrating, but we are kind of preaching to the choir. Everybody here is already on board is already interested in the pathologist community.

Which is supposed to be driving this or be one of the main driving forces is kind of missing their own body, so to speak. So how do we bring them in? That’s the question. And what we should be doing is not just celebrating with the people who are here, but recognizing that pathologies are, to me, are the main factor that it is kind of precluding digital pathology to go to the next step.

Meaning. Adoption is not…

Aleks: We have to adjust a mic here. We have a special handle for the mic. Look here.

Giovanni: She’s so fancy. I always admire her all the [00:05:00] the her craftsmanship for this. So anyways, so this is something that we need to keep thinking about how to target the pathologists to get them to listen to experience.

In my experience as a pathologist, I believe that if pathologists try it, they will love it and they don’t go back. The problem is that they have set some boundaries that they don’t even want to go there. They don’t want to listen to it. So that’s one of the main.

Aleks: But where do you insert this? Like where do you insert it?

How? What’s your plan for making it mainstream in pathology among pathologists.

Engaging Young Pathologists

Aleks: And, um, let me just, um, tell the listeners, tell the digital pathology trailblazers about another comment that was, uh, interesting. That was from a young generation pathologist, born in 92. Uh, she had a different perspective of, first, wanting very much to, uh, work digitally.

And the second Sentiment was [00:06:00] but how can I make it happen if I’m just starting like there’s nobody in my organization It’s gonna hand me this digital pathology on my computer. How do I do it? Nick I see you…

Nick: Obviously coming from a non medical background I think about this maybe slightly differently and I wonder whether labs that have gone digital need to invite young pathologists in to trial.  Actually give something ago because even if they’re not at the same lab.  You know, like open days.

Labs should have open days and say to young pathologists, come in, “see exactly why we’re so passionate about this technology. See why we feel it’s our future.”  And then once they’ve tried it, like you say, they’re going to want to go out and, and actually it doesn’t necessarily have to be just young pathologists.

Bring in the skeptical. Bring in the old generation that are skeptical. Let them see what you see. And perhaps that might just change their minds.

Aleks: Giovanni, how would you do that? How, like, how will you make it happen in the pathology community?

Giovanni: What Nick just [00:07:00] said, targeting the scepticals and bringing them to the table and let them experience what digital pathology is about and how much benefits they can find into transitioning now.

The sooner the better, because as we were discussing yesterday too, the fact of becoming digital is not just switching a microscope for a scanner and now instead of looking under the microscope, looking at the screen. The main benefit is that now we transform those images into pixels and we can analyze it by all the AI tools available and the more we wait as pathologists to get into that realm, the more, uh, It is going to take for, for us to catch up.

So that sense of urgency, I think is not, it hasn’t been established very well that the general consensus is that, Oh no, you need to adopt it [00:08:00] because now you have a digital image. But I think the concept needs to be no, you need to adopt it because that’s going to be required for you to survive as pathologists in the future yet to survive in order to continue caring for your patients. Otherwise, pathologists who do this transition will definitely be the ones that are going to take over and replace those pathologists who are not up to date with the digital skills.

Mentorship and Adoption Strategies

Nick: I think what would be good is maybe if, I don’t know who it’s going to be, whether it’s CAP, whether it’s DPA, we could, we could introduce a mentorship program where not just the young generation, but those that are fully like yourself can say, yeah, I can take you through this.

I can show you what my digital workflow looks like because that’s another thing that we always get, we always hear. They think that buying a scanner is their digital, they’ve gone digital, and of course it’s not. [00:09:00] And I think AI has almost a little bit become that scanner of the, the, the late 2000s, where now everyone’s like, well, I’ve got a scanner, I’ve got AI, I’m digital.

And of course that’s not true. That’s not the case and I think they could do with that education from someone who’s been through it. They’ve been through the adjustment.  But of course that’s going to take time.  But whether someone like the DPA or CAP or you know USCAP or whatever it is could come in and create a sort of generalized mentorship program, but it’s but then it’s going to take you guys to be able to do it.

Giovanni: I have a question for for Nick.

Aleks: And then me like grabbing, taking over my podcast. I cannot ask a question, but that’s okay. These are great guests.

Global Perspectives on Digital Pathology

Giovanni: We believe here in the United States that we are behind, behind Europe and behind Asia and behind most industrialized nations in adoption. Uh, you, you spend a lot [00:10:00] of your time in the UK.

Tell me what difference do you see in how, what do we need to do to get to the level that you are there, if you believe that, that’s, that’s the truth, that Europe is ahead of us.

Nick: So I think it was explored in the fireside chat last night. I don’t, I don’t think it’s not miles ahead. You know, the UK isn’t miles ahead.

I think there is more of a desire for adoption. I don’t think there’s, I don’t think there’s a lot of pathologists that don’t want to adopt. Um, obviously the biggest thing as, and it’s been coming up in this meeting a lot is. It, it is how the reimbursement, that’s doesn’t, that’s completely different. And that’s not just digital, that’s all types of medicine, isn’t it?

You know, in terms of, we, we come from the NHS, National Health Service. We pay our taxes, that pays for it, but we, you know, we don’t have an insurance that then pays, you know, pays for our healthcare. And so actually it’s, it’s, it’s on the hospitals and it’s whether they find the business case to go digital, whereas here I think [00:11:00] that’s a bit more difficult to find that business case.

Aleks: You want to comment on that? Or do I have the allowance to speak? Thank you.

And that was a question as well from, uh, from this young pathologist yesterday. Like, how can we promote, how can we, like, make it happen even if we don’t have authority to do it. I very much believe in leadership through influence.

And that’s what I basically started doing online. And that’s what you guys at Pathology News are doing. And I think like everybody here, like you said, Giovanni, we are here. We are preaching to the choir in terms of adoption, but on the other hand, we’re also like troubleshooting stuff. But and everybody has like a different angle of implementation.

I had people in my panel yesterday, the lessons from the trail…

People are walking by and waving at us because we are having this impromptu [00:12:00] podcast.

But my adopters were like everybody had a different story and I believe that, and there was one lecture yesterday by Dr. Lydia Joseph where she was not really like a digital pathologist at her core, but started doing something very patient-centric, doing the patient clinics, explaining to patients their pathology reports, their pathology findings, and then she used digital pathology as a tool to leverage this.

So for me, like, whoever has a mission, whatever that’s going to be, like online influence, uh, education, leading an institution to go digital, like there is an angle for you to go beyond what you’re already doing to the outside. So like for example this mentorship the maybe open days or something like that. What I would do like as somebody interested in digital pathology if I had somebody who was on the fence, but not like categorically no [00:13:00] I would maybe try to take them to a conference with me and like walk them with me through the booths of my sponsors who are also like close collaborators right now.

I know exactly what they’re doing. I know how to explain it to people who don’t have the knowledge I have. So that’s kind of my angle, like very much, um, individual driven promotion of technology. What do you guys think? Nick, I’m going to start with you because you’re in a similar space as me.

Nick: Yeah, I feel, I feel exactly the same actually, and actually we’ve heard a lot of, you know, team, we’re a team, we’re a team in moving this forward.

Actually, I do think we are a team, of course, but we’re also a team of individuals that each need to make that step to make it, to help the adoption. Um, you know, at Pathology News, our kind of goal is to empower users to see exactly what’s going to be needed. You know, we want to educate them. Um, on on on a digital [00:14:00] workflow on, you know, the pitfalls.

So, you know, we have podcasts, webinars, these sorts of things to help people. But yeah, I think a mentorship program. But again, I can say, I think that’s gonna have to be individuals are gonna have to be have to buy in. We need to buy into the individuals to say, Yes, I’m happy to mentor someone or two, three students, whatever it might be.

Um, but yeah, I think individually, everyone’s got to sort of take their responsibility.

Aleks: Beyond your like multiple appearances on international stages and online presence. So you’re like kind of covering all grounds. Um, what are your thoughts on that?

Giovanni:  I think the fact what we heard yesterday for, from the, this, uh, young pathologist is new in practice. It was sort of new. Not eye opening, but just a confirmation.

Something that we’ve seen in our institutions. The new generations are completely, [00:15:00] uh, set on that they are going to be digital. And that they, that’s the future. And they are coming out and populating now the workforce. So I think if we kind of, cater to them and empower them to start being the driving force at their new, uh, workplaces.

That will be probably a big, big, uh, event or… or…

Future of Digital Pathology

Giovanni: That might might tilt the balance because now in order for this practice is to attract this new workforce, they definitely will have to be digital and to be offering this kind of Digital AI Future so I think that kind of we’ve been doing the opposite right trying to target…

Aleks: Convert the old guys who already love their microscopes.

Giovanni: We call ourselves seasoned pathologist.

Aleks: Sorry, I would [00:16:00] call myself maybe mid-career. Mid-career, seasoned, and new generation. These are our categories for today.

Giovanni: I’m just making fun.

Aleks: I’m making this up.

Giovanni: We, the old pathologists, need to understand that. The future belongs to the new generation, so we kind of have to prepare the road for them.

And we haven’t been doing a good job, right, as a specialty. So now they are coming into the workforce and they are creating those, uh, expectations or they are kind of awakening to the new generation. reality that their expectations are not fulfilled by the current workplaces. So I think that would be a good, good way to do it.

Like after I heard this pathologist. Yesterday I went and talked to her and I think what we came up with, you know, plans.

Aleks: Let’s talk about your plan for, uh, for [00:17:00] Path Visions. He just, can you reveal that? If not, that’s okay. We can just cut it.

Giovanni: No, I think, I think…

Aleks:  Because at Path Visions, every, all of us are going to be there.

Nick is going to be there, Giovanni and me, and we need to do something like a similar follow up on this one.

Giovanni: Absolutely.

Aleks: Yeah, what did you ask her to do?

Giovanni: We will be, uh, the, the host that the, the podcast that they usually host. It would be…

Aleks: Beyond the Scope by…

Giovannie: Beyond the Scope.

Aleks: DPA-Digital Pathology Association.

Giovanni: Exactly the, the Digital Pathology Association podcast. Beyond the scope, we will be there. Pathology visions, the DPA-sponsored meeting. So we’ll be there in a little bit, like a different format will be doing small on-the-spot interviews. We have our set with, uh, um,

Aleks: Let’s call her Dr. Kawam. Do you want to join us on our impromptu podcast?

Cause we’re talking [00:18:00] about you all the time. Probably your ears are burning.

Nick: Ill come out, bye!

Aleks: Nick, thank you so much for joining. We are having our new guests. So let’s start with the first question. Who are you and why do you like this meeting?

Alae: Uh, my name is Alae, and I like this meeting because it’s a very safe space to share how you feel about digital pathology.

Aleks: She was the pathologist who commented yesterday that new generation is different than their previous generations. And I think it’s, I think people who, let’s say, mid career and seasoned pathologists, often dismiss this as like, like, old pathologist. Um, I think like the feeling is there is a feeling of dismissal of this kind of, um, I don’t know, feelings, perception.

But this is the new reality. These are the people that are going to be the next. diagnosticians of the world. And after COVID, it’s different. So [00:19:00] Dr. Kawam, Alae, tell us, tell us like elaborate on your comment.

Alae: I think that came from a place of personal experience, but I tend to like reflect a lot. And one thing that I realized was like, we do have to work with leadership, right?

You can’t accomplish anything without leadership. And it is on us to say something, but what’s on them is to be receptive to the things that we have. And I won’t. You know, leadership and, you know, the generation that’s basically retiring right now to look at us as an investment. Like, we will basically take on whatever projects that they’re working on.

We are the future. We’re, you know, going to carry on their vision. Now, being clear about the vision, whatever, I mean, the new technology is emerging, right? We have to be the ones to be the segue into making things more efficient, making things more sustainable. Um, I’m a huge advocate for wellness, right? So digital pathology for me, like when I heard it, you know, first learned about digital pathology and remote sign out, oh wow, I can sign up from everywhere.

That’s the way it reverberated with me. Now that’s not necessarily the case. I had a mentor who was like, no, digital sign out for me [00:20:00] means I can send my cases out faster and get, you know, like shorter turnaround time. I was like, no, why would you do that? I mean, work-life balance is one aspect of it. And the reality is, you can’t, you dissociate, you know, the benefits of this technology just for you know, the patient, yes, patient care is paramount.

I am not denying that. That is extremely important. You know, when a patient gets out of the hospital faster, when they get an answer, that closure for the patient is extremely important. However, I will say there are other benefits. Um, when you do think of, like, a large company, um, retention has become an issue over time.

Um, partially because, you know, people are leaving, they’re not happy, whatever, and they want to talk about burnout. It’s a huge conversation. However, when you do introduce this technology and make it part of the standard of, um, The practice. I think I’ve mentioned before. It’s like it’s nice to see digital pathology evolving, but I want to make it the not gluten free option, like make it the standard, not the secondary option.

I think that’s the vision. I think that a lot of people who agree with that. It’s just that how do we get traction for it in [00:21:00] places that are less likely to accept this technology, whether it’s fear, whether it’s fear of wasting money. I mean, that’s a very major concern. Um, but I’m hopeful. Um, I do want to say out to leadership.

Listen to us. We are an investment where we want to learn. We want to work with you. Um, we do see the potential. Um, so yeah, work with us. And we’re here to, you know, we’re here to make the dreams come true.

Giovanni: This is she great. So this is she’s been…

Aleks: The new generation guys.

Giovanni: So I was, I was previously, before she just happened to walk by,

Aleks: I think we like manifested her presence into the show today.

Giovanni: She has graciously accepted to join the DPA podcast for our production and uh, at Pathology Visions. And yesterday I had an idea when, after she talked about that, that we probably would be good to have her co-host with me the interviews. [00:22:00] So when we. I was telling you it’s going to be a different format.

We’re going to, instead of doing long interviews, we’re going to be doing mini-interviews. Some will be pre-arranged with people, but mostly, I think we will just speak out from people walking by. We will be set on the Pathology Visions booth. And the idea now is that we will co-host. And so you will have questions from the new generation and from the old generation.

So we both will kind of interview or, or, or guest from two different angles. Is she that. How our views reflect on, on, on reality when we actually do those questions. I’m very excited about this at the DP at the DPA meeting pathology visions. This will be your host.

Alae: I’m actually super excited for it. I think when we were on the call [00:23:00] talking about it, I was just like, Oh my God, I’m so excited.

I had a moment. Um, but I will say. Don’t be afraid to share how you’re thinking, um, when you have an idea and you feel like, you know, you don’t know who’s listening. And sometimes the people who are in these spaces actually want to hear things. They actually want the feedback. And I’ll say like our generation, we’re very like fearful and anxiety-ridden.

I get that. Been there, done that. But get out of your head and don’t be afraid to share how you feel like that has to come from a confidence within yourself to say like, okay, like I actually believe in this. Um, I see a future in this. I’m going to say something. I am taking a risk, and I’m fully aware I’m taking a risk.

However, if it’s in the right place, they will be receptive to what you’re saying. And I think that, you know, people do want to hear support. You know, we’re supporting this movement. Um, you might not feel it locally where you work, but at the same time, you, you, you will get support in certain spaces, and I will say like, find those spaces where you find the support, make your, you know, connections, network with people, and, you [00:24:00] know, obviously friendship is something super important as well, um, the professional connections are another thing, but, It’s, it’s, it’s these places where you find support and that support can come in the form of ideas.

Hey, did you try this? Did you try getting involved? It’s actually like an unwritten, I don’t know how to explain it. Like there’s no formula. Everything in life, you know, we think that those are from, there’s no formula. You just kind of go with the flow and see how things come to you. And hopefully, um, you will, you know, achieve great, great things.

Aleks: I just want to give a context how this all happened. So yesterday I was a host of a panel and Alae asked a question like, “How do I do it when I don’t have authority to make it happen?” And my answer was like, talk about it, learn it. And the next thing that happened, she speaks up at the fire, uh, fireside chat.

And the next thing that happens is Giovanni asks her to be the co-host of the podcast at PathVision, the digital pathology conference, uh, for the Digital Pathology Association. So like you, [00:25:00] like did what you wanted to do within. Like two day span by just coming to this conference and, um, We already and you did it already ahead of time because we connected on LinkedIn We had the call and you were like I already knew you so when I when we met here We were like LinkedIn friends already

Giovanni: I think I if I was the owner or a pathologist principal in a group and I see her I will hire her right there on the spot, or at least make an offer and try to grab her from wherever she is, because this is what it will drive, and it will kind of, to me, what I think, is that it will bridge the gap between generations, having the new pathologists lead the way of what they want, so that the, all the generations, decision pathologists who are controlling the market right now understand that we need to create and pave the road for them to succeed and flourish, that it’s not only about us.[00:26:00]

That we shouldn’t just be thinking, oh, I’m going to retire in five years, ten years, so I don’t want to hit it. I think we need to be a little bit more responsible, that it’s not about us, it’s about the patients and how the new generations are going to cater to them. And so it was, it was really, it was, it was an eye opener for me.

Alae: I, you know, I want to comment, I want to comment on that and, and it’s, again, it goes back to what I was saying. It’s an investment. We are an investment. You know, these businesses need to keep rolling and you need to make sure that the next generation is prepared, at least with the tools. Um, one thing that I want to share with, I guess, people who are in, you know, a similar vote as me is know how to communicate things appropriately.

Work on your communication skills. Know the jargon, know the language. If you need to sit down on business-type things, just so you can get a sense of how people think, on the other side, the decision-makers, that’s an important skill to have. Um, you don’t need a higher degree for it, but educating yourself within [00:27:00] that space is a very powerful, powerful skill.

And just knowing how to communicate in general, knowing how to link with people, or don’t be afraid to reach out. That’s how, you know, I reached out, I linked in, and that’s how, that’s how we met. The World Wide Web, right? Don’t be afraid to use this web. Don’t be afraid to use resources that are around you.

We really have a lot of power that we just haven’t, um, been conscious of. Um, but we’re here, and we’re, you know, we’re making things happen, so. Awesome. Thank you so much. I appreciate it.

Conclusion and Next Steps

Aleks: Before we wrap up, I want to say this is all happening at the Digital Diagnostics Summit organized by Lumea who brought here, uh, the movers and shakers as the Lumea people say of the industry.

So we’re just like, it’s an impromptu podcast. It’s not going to be distributed live, but it is definitely very spontaneous without scripted questions. So. To wrap up, guys, what is going to be your next step to advance digital pathology after we go home? [00:28:00]

Giovanni: We’re going to do our next podcast at Pathology Issues with my, my co-host.

We’re going to work on that and we’re going to be going all for it and trying to bring this new, fresh approach. To our podcast, to the DPA, now with a voice from this new generation. So that’s what we’re going to do.

Aleks: Let me, let us talk offline how I can help maybe distribute this initiative. Um, how about you?

Other than the podcast, what’s your next thing that you’re going to do?

Alae: Um, I’m going to actually talk with my leadership and say, “Hey, I was at this conference and there was a lot of people talking and there’s some good stuff that was said. And obviously I’m going to make it a lot more formal and professional and be a little bit more strategic in what I say.”

But I do want them to know that we exist. And sometimes you don’t have to physically push for anything, but just getting slight [00:29:00] exposure, the idea in their head and just talking about it. I’m just talking about it, talking about it. Sometimes when you talk about things, people get sparked interest and they realize like, oh, wow.

Maybe this can solve one of my problems. Um, staffing issues is always an issue. For example, oh, we’re understaffed. Oh, maybe if we can do, offer, you know, a flexible option for some pathologist or whatever it is, that may be a solution. So, um, thinking in terms of solutions, not in terms of just problems, I think is super helpful.

And, you know, just to slowly bring things in, I think is what I’m going to do.

Aleks: That’s amazing. Thank you so much.

Giovanni: What are you going to do, Alex?

Aleks: I’m going to talk to you offline, how to, uh, create even more splash for the DPA podcast initiative. Uh, and I’m going to go and have this podcast edited so that you guys can share it with people.

And everybody who’s listening and, uh, who thinks digital pathology is a good thing, When it’s out, please share and send to those who are like, not totally against but who are on the fence so that they [00:30:00] can hear different perspectives.

Thank you so much guys for joining me.

Giovanni: Thank you for having us. This is great.

Alae: Thank you. Thank you so much.

Aleks: And I wish you a fantastic day and I talk to you in the next episode.

Thanks so much for joining and staying till the end. It means you are a true digital pathology trailblazer. Let me know why do you think so few pathologists are attending and what changes you need to happen in the pathology departments for digital pathology not to be optional, to be the mainstream, to be the main menu, something that everybody can benefit from. The doctors, the patients, the hospital administration, and basically the whole healthcare system. So drop the comment below and I talk to you in the next episode.