1. TRANSFORMING PATHOLOGY: The Ingredients for Change A Chef’s Husband’s View Jared N. Schwartz, MD, PhD President, College of American Pathologists

2. Transforming Pathology: The Ingredients for Change A Chef’s Husband’s View Jared N. Schwartz, MD, PhD President, College of American Pathologists Jared N. Schwartz, MD, PhD President, College of American Pathologists

3. A Chef’s Husbands View

4. What’s changing that will require pathologists to transform? Patients Primary Care Physicians How Care is Delivered & By Whom Technology

5. What does the consumer want? High quality Convenience Fast & accurate information Trust & confidence

6. Help! Fast and accurate results Understandable and useful information Direction on therapy What does the patient’s treating physician want?

7. …and sometimes that primary care provider isn’t a physician “Nurse practitioners with master’s degrees are already filling the primary care shortages and providing quality, cost-effective care, many times in places that physicians are unwilling to practice.” Wendy Vogel Nurse Practitioner, Oncology Blue Ridge Medical Specialists, TN WSJ, April 2, 2008

8. Patients & physicians want a full course meal, not just the appetizer Am I at risk of developing cancer? Is there a chance I have cancer today? Do I have cancer today and what type is it? Has my cancer spread and how aggressive is it? What are the most effective & safe therapies for me? Is my therapy working with acceptable toxicity? Has my cancer come back? Risk Assessment Screening Differential Diagnosis Treatment Selection Treatment Monitoring Surveillance Prognosis & Staging

9. Are we defining our contribution to patient care too narrowly? “…but all I know how to do are liver biopsies!” Are we defining our contribution to patient care too narrowly? “…but all I know how to do are liver biopsies!”

10. What barriers exist? Payment Information Technology (e.g., gene patents) Lack of agreement on integrating role Education Lack of interoperability; software issues, security issues Mindsets

11. Are we responsible for the appetizer or the whole enchilada?

12. Pathologists have the opportunity to fulfill many roles Innovator Test Provider Interpreter Data Integrator Clinical Consultant

13. Pathologists have the necessary ingredients to provide answers, but…

14. … it’s not about the tools

16. The Perfect Dish requires the right mindset Have an open mind to new ideas, technologies, and ways of practice Acknowledge market forces driving changes in your practice Engage the change Be life long learners Develop new skills and leverage core knowledge

17. Interact with patients and other clinicians Broaden your sphere of influence Expand beyond the tissue on the slide—all diagnostic tools are available to you Market your services for consults Expand value by influencing prognosis and treatment …be a part of the treatment team

18. “Students need to learn how to think critically, how to argue opposing ideas. It is important for them to learn how to think. You can always cook.” ~ Charlie Trotter

19. Futurescape 2008 offers ingredients to spice up your practice with new ideas and opportunities

20. Futurescape is providing you a taste of the future… Jose Costa, MD Mara Aspinall Jennifer Hunt, MD, MEd James Versalovic, MD, PhD John Tomaszewski, MD … from pathology’s ‘Top Chefs’

21. New technology and applications expand the opportunity menu Michael W. Vannier, MD Carl Jaffe, MD Bruce Friedman, MD Robert Brown, MD Ron Weinstein, MD King Li, MD

22. … and how some are making the recipes work in their practice Ronnie Garner, MD Liron Pantanowitz, MD Richard Friedberg, MD, PhD Erin Grimm, MD Rodney Schmidt, MD Eric Walk, MD

23. “I keep coming back to the question: When is food good? And the answer always begins with proud cooks. People who take pride in performing what really amounts to alchemy.” ~ Anthony Bourdain

24. “I was 32 when I started cooking; up until then, I just ate.” ~ Julia Child

26. TRANSFORMING PATHOLOGY: Emerging technology driving practice innovation