Pathology News would like to pay tribute to one of the founders of our profession, Ronald S Weinstein who sadly passed away on December 3^rd last year at the age of 83. Weinstein was known by some as the “father of telepathology,” and his medical career spanned nearly six decades.

Weinstein was born in Schenectady, New York on November 20, 1938 and graduated from Union College in Schenectady. After a brief period spent as a congressional intern in Washington and three summers working as a chemist at Woods Hole Marine Biological Laboratory, he entered Tufts Medical School in Boston, where he obtained his M.D. degree in 1965 before moving on to a to residency at Massachusetts General Hospital (MGH).

It whilst at MGH that Weinstein had his first taste of telemedicine. The hospital was at that time experimenting with an early program to create a link by television camera to a clinic at Logan Airport. Weinstein was asked to look at a few cases and was to say later that this stuck in his mind.

Moving back to Tufts as Associate Professor of Pathology in 1972. Weinstein also became Director of Electron Microscopy in the Mixter Laboratory for Electron Microscopy and published papers on freeze-fracture electron microscopy and urinary bladder cancer.

In 1975, at age 36, he became the pathology department chair at Rush-Presbyterian-St. Luke’s Medical Center in Chicago, and it was here, in 1986 that Weinstein first showed the potential of remote diagnostics through telemedicine as part of a demonstration by his company Corabi Telemetrics (one of several companies that he founded at that time). From Washington D.C. Weinstein was able to examine a tissue sample from a breast-cancer patient in El Paso and correctly diagnose that her tumor had spread.

Later Weinstein would go on to patent and commercialize robotic telepathology but it was at this moment that the word “telepathology,” coined by Weinstein himself, was introduced to the English language.

This was the early days of the internet and a breakthrough moment for the those of us involved in the techniques of modern ‘digital pathology’. Today we have access to sophisticated scanning platforms, high resolution displays and rapid fibre optic connections, and we can only begin to imagine the magnitude of this achievement back in 1986.

It was clear that Weinstein was well aware of the significance and the potential of his work. a few months before his ground-breaking demonstration, in May 1986, he wrote in the journal of Human Pathology “The limited availability of pathologists in some rural locations and areas serviced by federal medical centers is a bottleneck in the United States health care delivery system,” And in a speech around the same time Weinstein noted “Somewhere along the line, engineers figured out how to put satellites in space and revolutionized the financial industry. What I’m going to talk about today is how the very same changes are going to revolutionize the way that we practice medicine.”

In 1993, Weinstein patented telepathology systems and telepathology diagnostic networks and established an international telepathology service network linking the United States, Mexico and China. In 1996, he became Founding Director of the Arizona Telemedicine Program (ATP), which he co-founded with Arizona State Representative Robert Burns and which he remained involved with for the rest of his life. The ATP now links 160 sites in 70 communities by broadband telecommunications and has provided telemedicine services for 1.4 million cases in 61 subspecialties of medicine. He also became executive director of the Institute for Advanced Telemedicine and Telehealth (T-Health Institute), a Phoenix division of the ATP, in 2004.

It was in a 2011 journal article written by a student and a faculty member from an Indian medical school that Weinstein was referred to as the “father of telepathology”. An epithet which has been readily accepted amongst his peers.

Weinstein lived long enough to see his innovations become mainstream and to be proved of monumental importance for health care when the country went on lockdown during the pandemic in March 2020

“He was always ahead of his time, connecting rural and frontier communities with up-to-date health information, technical assistance and consulting through distance learning, webinars, workshops and instruction,” said Dr. Daniel Derksen, director of the University of Arizona Center for Rural Health.

“Telemedicine wasn’t well known before the pandemic, but without it, many people who were reluctant to receive in-person treatment or attend primary care visits during lockdown and even now, would not have received any care once the pandemic set in.”

Weinstein’s work was recognized in May 2021 when a new Arizona law was signed by Gov. Doug Ducey, making permanent the telehealth flexibility that had been permitted under executive orders Ducey had issued during Arizona’s COVID-19 public health emergency.

Weinstein’s career long drive for extending the impact of telepathology included not only broadening the reach of his technology, but also bringing greater humanity to medicine through its application. In a project at the Tucson Breast Center, he helped to eliminate what could be a long and stressful wait by enabling women to have a breast biopsy, get the results and then consult with a specialist, all on the same day.

“The majority of phone calls I get are from women who want to know where their breast biopsy report is,” he told the journal Health Executive in 2007. “The terror in their voice is really moving.”

In fact Weinstein’s contributions to telemedicine went well beyond even the technological and clinical perspectives. He continually worked to improve public policy and to incorporate his telemedicine approach into routine public health care.

As a result, Medicaid in Arizona started paying for telemedicine services and the federal government soon followed suit with Medicare beginning to pay for telemedicine and telehealth appointments for all Medicaid.

Will Humble, executive director for the Arizona Public Health Association noted “Dr. Weinstein was so effective for so many different reasons. One of those reasons was his ability to comprehend public policy and actively work to change health care policies in the state,”

Beyond his contributions to the medical field and the field of telemedicine, colleagues described Weinstein as energetic and upbeat.

Daniel Derksen noted that, “Dr. Weinstein was an inventive, creative innovator – creating a vision of enhancing health care delivery and making it more accessible via implementation of an ‘information superhighway.'”

“Ron was just a very energetic, positive person. He was inspiring. He was welcoming and collaborative — always willing to lend a helping hand. He was a terrific person and all of us who worked closely with Ron are going to miss him deeply. Hopefully, we can honor him by continuing to expand and improve the programs that he was so foundational in getting started.”

Will Humble added, “Dr. Weinstein really struck me as someone who was just so interested in so many things. He accomplished more than most people ever will. He had an interesting life personally and professionally and did so many interesting things. I will miss him a lot, but I see his life as one that was well-lived. He truly loved his work, and not everyone can say that.”

Ronald S Weinstein is survived by his wife, a daughter, Katherine Weinstein Miller; a son, John; and two grandchildren.