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The lab behind the lens: Equity begins with diagnosis

Michael Misialek, MD
Policy
May 14, 2025
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Another day, more slides pass under my lens. Each represents a patient, a family, friends, uncertainty—maybe the beginning of a journey they are soon to realize, maybe it is the end of a journey. Each is unique.

These are turbulent times we live in. Deep divides separate our country. However, under the microscope there are no politics, no labels or preconceptions. The rainbow of colors the cells illuminate shines bright for every patient.

The pathologist, an often-overlooked specialist, is an important member of the care team. All treatment begins with our diagnosis.

Pathology takes diversity, equity, and inclusion seriously. We treat all patients. Our workforce is diverse. Recent changes we have implemented include eliminating race- and gender-based lab resulting for certain tests, ending decades-old discriminatory practices. For instance, pathologists were crucial in advocating for removing race corrections from EGFR reporting. Additionally, we were at the table when deciding on ending sex-based reporting for ferritin. Tests are always under scrutiny to ensure equal care for all.

My health system is committed to achieving health equity for our patients through the United Against Racism and For Every Patient campaigns. To recognize these efforts, the system has requested the Joint Commission’s Health Equity Certification. This means a team of Joint Commission surveyors will be performing a one-day onsite comprehensive review of our approach to improving health equity. Every department of the hospital plays a part, including pathology and the laboratory.

As we prepare for the Joint Commission survey for the Health Equity Certification, I and other lab leaders are working on ways to educate the staff about these important topics. We recognize that health literacy remains a challenge across hospitals within our system and nationwide. To help bridge this gap, we are making reference materials easily available for staff.

It is often stated that 70 percent of medical decisions are based on lab results. Pathologists recognize the importance of the lab in health care. The lab touches all patients, either figuratively with the phlebotomist’s draw, the results from blood samples generated by the lab, or the slide passing under the pathologist’s microscope. There is a patient and family behind every one of these specimens. We want to make sure care is equitable and understandable.

Pathologists are devoted to diversity, equity, and inclusion. Health equity is imperative for our patients. We all look the same under the microscope. Remembering this will go a long way in today’s world.

Michael Misialek is a pathologist.

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