Balancing Workload with Digital Pathology

It is hard for pathologists to get the right balance of work. On any given day, there is too much work, too little work, late arriving work, or unevenly distributed work. These issues in workload can be extremely frustrating and lead to long working hours and an imbalance in a pathologist’s professional and personal life. This can ultimately lead to burn out.

How do Radiologists handle workload balancing?

In radiology all images are digital and interpreted on monitors. Radiology has been completely digital for more than 10 years. Digital radiology allows radiology practices to distribute the work based on radiologist specialty and work units. For example, work is distributed by algorithm to musculoskeletal radiologists, neuroradiologists, abdominal radiologists and breast radiologists. The amount of work in a radiologists queue or worklist is determined by work units (internally derived RVUs) with a radiologist expected to perform 1.0 FTE’s worth of work. If a radiologist has a meeting or tumor board, work is reduced in the radiologist’s queue. Near the end of the day, the radiologists voluntarily take cases to interpret from a general unassigned pool of cases (usually chest exams), if they have completed their assigned work. A radiologist who is assigned to work at a low volume hospital can help the overall practice interpret cases because the digital work can be interpreted anywhere. An interventional radiologist who has a cancellation in the patient schedule can also pull cases from the unassigned pool and help the practice. The radiologists that I have interviewed are very satisfied with their workflow and workload balance. They think it is efficient and fair.

How can Pathologists be like Radiologists? Can digital pathology help in workload balancing?

Digital pathology with whole slide images can help to level the workload by allowing cases to be interpreted anywhere in a practice. If a pathologist is located at a low volume hospital, they can help the overall practice by receiving digital cases.  Like the radiologists, pathology cases can be assigned by algorithm to subspecialists and generalist and by an internally derived work unit.  (I will discuss how different pathology groups define work units in a future blog).  Like the radiologists, a pathology group could have an unassigned pool of generalist cases (for example gall bladders, appendices, etc) that pathologists can draw from when they have finished their assigned work.  If a pathologist has a meeting or tumor board, work can be removed and reassigned from their queue.  Most importantly, if a pathologist is located at some distance from the histology lab, they do not have to wait for a courier to bring their assigned work or additional immunohistochemistry.  Work is available as soon as the case is scanned.  Balance in workload can be achieve, and it can help prevent burnout. However, it will take courage to adopt and adapt to digital pathology.

Photo by Saffron Blaze – Own work, CC BY-SA 3.0,