Many laboratories face growing caseloads and increasingly complex cases with too few pathologists to share the work. This article is for lab directors, department heads and hospital administrators looking at how better tools can ease the pathologist shortage, and where tools alone will not.
The shape of the pathologist shortage
Workforce concerns in pathology have been raised by professional bodies in many countries. The pressures are familiar: an aging workforce, long training pathways, rising cancer incidence as populations age, and reports that have become more detailed with each new classification, biomarker and staging system.
The shortage is also uneven. Pathologists tend to be concentrated in large urban centers and teaching hospitals, while smaller and rural hospitals struggle to recruit and retain them. Subspecialty expertise is even more unevenly distributed.
No software trains a new pathologist. What tools can do is return time to the pathologists you have, spread work more evenly, and extend expertise to places that lack it.
Where pathologists' time actually goes
Before buying anything, find out where the time goes. In many departments, a large part of the pathologist's day is spent on tasks that do not require a pathologist:
- Searching for slides, requisitions or previous reports.
- Chasing missing clinical information.
- Typing or correcting reports.
- Answering status inquiries from clinicians.
- Reconciling paperwork with what actually arrived.
- Waiting for slides that are not yet ready.
A short time study, or simply asking pathologists to log interruptions for a week, can reveal the biggest opportunities. The aim is to protect time at the microscope and for interpretation.
Include support staff in the exercise. Histotechnologists, secretaries and assistants often know exactly which steps generate rework, and their view of the workflow is frequently more accurate than any process diagram.
Tools that return time to pathologists
Complete case information at sign-out
When the case opens with the requisition, clinical history, gross description, previous pathology and pending studies in one view, the pathologist stops hunting. This sounds simple, but fragmented systems make it surprisingly rare.
Reporting efficiency
Well-designed templates, full-text search of prior reports, and voice dictation and AI scribes can reduce the time spent producing reports. AI-assisted drafting and consistency checks, such as flagging a size mismatch between the gross and microscopic sections, can catch errors earlier. The pathologist still reviews and signs every report.
Tracking that answers status questions
If clinicians can see that a case is in histology or awaiting immunohistochemistry, they call less. If lab staff can see the same, they answer faster when they do.
Prioritization
Flags for urgent and critical cases help ensure the most time-sensitive work is seen first, rather than in order of arrival.
Spreading work across people and places
Workload balancing
In a group practice, uneven distribution means some pathologists are overloaded while others have capacity. Visibility of each pathologist's queue, and agreed rules for assignment, help. Weighting cases by complexity rather than simply counting them avoids unfair comparisons. See balancing pathologist workload across a team for practical approaches.
Digital pathology and remote sign-out
Whole slide imaging allows cases to move to pathologists rather than the other way around. A hospital without a resident pathologist can scan slides for review elsewhere, and subspecialists can support colleagues across a network. Doing this safely requires validation, secure systems and clear governance, which are covered in telepathology and remote sign-out.
Task shifting
In some settings, appropriately trained staff take on defined tasks, such as grossing selected specimen types, under pathologist supervision and within local regulations. This should be governed by clear protocols, training records and quality monitoring.
Where AI fits, realistically
AI tools for pathology can assist with specific tasks: highlighting regions of interest, counting, quantifying biomarkers, screening for certain features or checking slide quality. Used well, they can let pathologists spend attention where it matters most.
They do not remove the pathologist from the loop, and they bring their own work: validation, monitoring, and understanding when the tool is likely to fail. A sensible approach is to target specific, high-volume, well-defined tasks and to measure whether the tool actually saves time in your workflow, not in a vendor demonstration.
Be wary of tools that add review steps without removing others. If every AI output must be checked, and the check takes as long as doing the task unaided, the net gain is zero, however impressive the algorithm.
Putting it into practice
A practical plan
- Measure current workload, turnaround time and the main time sinks.
- Fix information flow so cases arrive complete.
- Improve reporting efficiency with templates, dictation and search.
- Introduce tracking and prioritization.
- Consider digital pathology to share work across sites.
- Add targeted AI where a specific task justifies it.
- Review results and adjust.
Common mistakes when investing in tools
- Buying technology before mapping the workflow. A tool that speeds up a step that was not the bottleneck changes little.
- Adding systems without integrating them. Every extra login and duplicate entry erodes the time saved.
- Ignoring support staff. Many gains come from histotechnologists, administrators and assistants having better tools, not only pathologists.
- Underestimating change management. Pathologists need time to learn and adjust; plan training and expect a temporary dip.
- Measuring nothing. Without a baseline, you cannot show whether a tool helped.
Retention matters as much as recruitment. Pathologists who spend their days fighting systems and chasing paperwork are more likely to burn out or leave. Tools that remove daily friction are, in that sense, a workforce strategy as well as an efficiency one.
Key takeaways
- Tools cannot create pathologists, but they can return time and spread work more evenly.
- Start by measuring where pathologists' time goes, especially non-diagnostic tasks.
- Integrated case information, efficient reporting and good tracking deliver gains before AI.
- Digital pathology and remote sign-out extend scarce expertise when properly governed.
- AI assists with defined tasks under pathologist responsibility; measure its real effect.
Easing the pathologist shortage starts with removing the friction around each case. PATHOLOGY+ brings registration, tracking, reporting, dictation and slide viewing together in one cloud platform; see plans to find a fit for your team.