The pathos of pathology and a possible cure: H.P. Smith Memorial Lecture

This H.P. Smith Memorial Lecture attempts to define and prescribe treatments for a malady afflicting clinical pathology today--its difficulty in communicating the vital role of the pathologist in patient care to the public, politicians--and, in many instances, our own colleagues in other medical specialties. In paying tribute to a pioneering clinical pathologist, Dr. H. P. Smith, attention is drawn to his diagnosis of these problems--a diagnosis he perceived decades ago. The ancient meaning of pathos, the Greek stem for which the word pathology comes, is used to pinpoint the problems that have led to clinical pathology's own pathos--the lack of recognition afforded those physicians who practice it. A review of the conditions that led to this state is presented, and these conditions are compared with others present in our specialty, e.g., the "behind the scenes" situation of surgical pathology and the decline of the utilization of the autopsy. Factors that tend to frustrate the normal relationship between the clinical pathologist and the patient, as well as his or her role as a consultant to the attending physicians, are summarized. Suggestions are put forward for changing the image of the clinical pathologist from one of near invisibility to one of dynamic interaction with patients and with other physicians of the medical care group, for the good of all concerned.