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As the Joe W. and Evelyn M. Grisham Distinguished Professor and Chair of the Department of Pathology & Laboratory Medicine at the University of North Carolina School of Medicine, Russell Broaddus, MD, PhD, is inspiring the next generation of residents to view pathology as a “front and center” driver of patient diagnosis and treatment.

Dr. Broaddus first got involved with ASCP via Dr. Ali Brown, CEO of ASCP. They first met when she was a surgical pathology fellow and he was a faculty member at The University of Texas MD Anderson Cancer Center. Dr. Broaddus states, ”Even early in her training, we could tell that Dr. Brown was a dynamic leader. Being incredibly smart and hard-working like she is certainly helps.”

Here, Dr. Broaddus talks with Critical Values, sharing his perspectives on patient care, first-person experiences with advancements in pathology and laboratory medicine since the 1990s, and lessons learned when you break out of your comfort zone.

Knowing that your results influence a patient’s diagnosis and treatment, can you share a moment when you felt especially connected to patient care?

Every year, I teach our new residents that pathology is a primary driver of patient therapeutics, especially for cancer. In my view, we are certainly not “behind the scenes” as many characterize pathology. We are front and center! When you think of our role in this way, it is especially inspiring.  

I have had numerous patients cold-call me and ask for explanations for their pathology reports. I remember one patient declaring, “Wow, that is a much better explanation than the one my oncologist gave me!”

How do advancements in pathology and laboratory medicine inspire you in terms of improving patient care?

Advancements in pathology help us provide better care for patients. I am disappointed that too often these are viewed as ‘disruptors’ or ‘threats’ to pathologists.  

When I was starting pathology residency in the early 1990s, immunohistochemistry (IHC) was just getting started. It was not yet widely available in many clinical labs. We routinely placed small chunks of a suspected tumor in flow cytometry medium or glutaraldehyde fixative for electron microscopy block-and-hold ‘just in case.’ We performed flow cytometry on nearly everything. Many felt that flow would replace much of what pathologists did at the time.

As IHC evolved and became more widely available, many were worried that IHC would replace hematoxylin and eosin (H&E) staining for a primary diagnosis. As molecular diagnostics became more relevant in cancer patient care, many in pathology were worried that molecular would replace diagnostic pathology. There are now technologies that can reliably measure gene expression in formalin-fixed paraffin-embedded (FFPE) tissues. I expect that these platforms will be invaluable to pathologists in the molecular work-up of cancer patients.

Similarly, many are worried now that AI will replace pathologists. In the past, all of these earlier technological advances since the 1990s have helped to make pathology even more important to patient care. These technological advances haven’t replaced any pathologists.

I believe AI will be an exciting advance and help us provide even more clinically relevant information for our patients. Simple AI that may recognize metastatic cancer in a lymph node is not that exciting to me. Rather, I am looking forward to seeing how image analysis of routine H&E-stained slides can unlock important diagnostic and prognostic information that the human eye cannot see during the usual light microscopic examination of patient slides. I believe that will be the next frontier.

What are some of the lessons you've learned through the different leadership and volunteer roles?

Opportunities are rarely, if ever, presented to you as opportunities. Rather, they are more often presented as problems to be solved. While it may take a lot of work to solve that problem, and it may involve stepping outside your comfort zone, the act of working to solve an important problem can lead to important personal growth. By the way, I believe “comfort zone” is an overrated concept. Staying in your comfort zone means you are not growing.