Noté /5. The work that Dr. Huang conducts under the microscope, otherwise known as pathology review, is part of his “clinical service work.” He rotates between four areas of clinical service every week: pathology review of incoming specimens, next generation sequencing (NGS) sign-out, pathology review of PD-L1 immunohistochemistry (IHC), and pathology on-call. Speech pathology for all ages. Have you ever felt like no one knows exactly what you do for a job; friends, family, even your colleagues? Retrouvez Life Story of a Foreign Medical Pathologist et des millions de livres en stock sur Amazon.fr. I was a MT(ASCP)BS and worked in a hospital lab for 43 years. Fill in your details below or click an icon to log in: You are commenting using your WordPress.com account. As a clinical pathologist, if you are ever asked what your job entails, it might take you a full 10 minutes to just explain the surface of it and by that time your audiences’ s eyes have glazed over and they are wondering when their next coffee break is. In addition to troubleshooting, rounding through the lab has given me the opportunity to interact with other people who have a passion for laboratory medicine. Content disclaimer: posts written by our bloggers may contain content that is not the opinion, stance, or policy of the ASCP. The pathologist's tests and conclusions will help the medical team identify the cause of the patient’s pain. Fun School. A Day In the Life of a Pathologist. This has been a harder task for me because my subspecialty training was microbiology. Medical pathology is not constrained to a single disease, population, or organ system. -Lori Racsa, DO, is the director of microbiology, immunology, and chemistry at Unity Point Health Methodist, and a Clinical Assistant Professor at the University Of Illinois College Of Medicine at Peoria. Depression, etc) Thanks! A blog for medical laboratory professionals. The techs will get just as excited about an interesting organism that was isolated or a new instrument we might bring in, and it is great to be able to share that passion you feel for your job with others. There are varying amounts of laboratory work involved in pathology, depending on your specialty and the role itself. My fiancé is studying to be a pathologist and I'd just like a heads up about being/living with a pathologist. I still remember a physician I met when first I started my job called me two days later wanting to discuss the results of a biopsy he had performed; I had to let him down gently saying that what was not the kind of pathology I practice but told him to call me if he ever had any issues or questions about his patient’s laboratory results. I trained AP/CP but after two years went CP only and after a clinical chemistry fellowship and a transfusion medicine fellowship I had no desire to sit the AP boards. daltermd@hotmail.com, David Alter MD DABCC When I was in training, one of the best ideas I took away for my job was microbiology rounds. Clinicians always tell me: “oh clinical pathologist, it’s hard to deal with the biopsies in the OR right?”… and I spend like 10 minutes explainig what do we do for living in the lab… or in the blood bank. Pathologists are often considered a "doctor's doctor" because they assist doctors in making diagnoses and the appropriate treatment decisions. ©2013-2020, Lablogatory, All Rights Reserved. We are given this precious opportunity to examine and interrogate a piece of tissue to help patients in their fight against cancer.”, We use cookies to personalise content such as job recommendations, and to analyse our traffic. The life of a speech-language pathologist is quite an interesting one. I’ll follow your posts. 5 years ago | 0 view. In this role they undertake the preliminary examination process and will review all new cases reported to the coroner over the preceding 24 hours. Playing next. One of the biggest misconceptions about speech pathology is that it’s a therapy just for children with speech disorders like lisps or stutters. The Sr Analyst, Strategic Insights & Analytics - Market Planning participates actively in Foundation Medicine’s strategic planning efforts by providing unbiased, objective, in-depth assessments of current and future market trend... About the Job ( Log Out /  In this video, I had the pleasure of speaking with Dr Joye Carter, a Forensic Pathologist about what life looks like for her in her career. The beauty of a career in clinical pathology was explained to me by an attending during my residency training –you make of it what you want to. It’s kind of frustrating sometimes. The incumbent leads by example to create a culture of software excellence and adherence to engineering best practices. Additionally I strongly endorse your action of making rounds. Over the next couple of months I will highlight some of the tasks I have undertaken in my current position and I’d also love to hear what other clinical pathologist’s careers look like and/or how they have evolved over the years. Achetez neuf ou d'occasion Thanks for your post. Bravo for making the effort to interact with the lab techs and keep 2nd shift involved. A pathologist is a physician whose research and clinical interests focus on human disease. January 9, 2020 In: Blog Comments (None) A Day in the Life of a Loqui Speech Pathologist ‘So, you deal with lisps and stutters, right? I have a Bachelor of Science in Microbiology so I’m currently working on getting my clinical certification. The work of a histologist requires careful attention to detail and physical stamina. I recommend hanging on to your clinical pathology faculty and just follow them around all day to see what they do and how they interact with technologists and other clinical faculty – I wish I had done more of that than reading when I was in training. A Day In the Life of a Pathologist. About the Job On average, the histology team at Strong prepares between 800 and 1,200 slides each day. Whether it was from our clients, our cousin at a family reunion, or that lady we get chatting to in the Woolworths checkout. “We do not only see fresh cases. Receive an email when we have something new to say. Hang in there Rania – I think training was one of the toughest parts about clinical pathology because you are so busy trying to learn the technical aspects of the lab and disease processes or doing research that you can miss the forest for the trees. I do not need to make reference to the high period in human systems be. Furthermore, he is very interested in supporting the Company’s international expansion. Bravo! If you click on "I Do Not Accept", then we will not use cookies but you may have a deteriorated user experience. ( Log Out /  !’ Every speech pathologist has heard it. They treat various populations such as the elderly, young adults, and especially children. How many slides do they read in an average work day, and how much do they collect from each slide, $35/slide, 30 slides/day? So if distracted, set down the slide and pick it up like you've never looked at it before. Through his interpretation of these biomarkers, Dr. Huang provides information to the treating physician on potential therapies for the patient. There is some external recruitment takes place when managers send messages, at least ten of the pegs shadow always on the temperature. Marcia Wieder’s Balancing Act: Creating Harmony at Home and Work. [1] The findings of a forensic pathologist will then be applied to legal matters in court and criminal cases. Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube. Keep up the blog – everybody will benefit! It helps us feel connected and appreciated. The results create key advances in medicine A day in the life of a forensic pathologist at the University of Cape Town / Salt River Mortuary, South Africa Enter your details and we will notify you when new roles that might be a fit are posted! As a forensic pathologist, you will utilize the study of disease and to determine the cause and manner of death. As a new clinical pathologist, I was asked to blog about my experiences during the first year of working in the real world. For the PD-L1 IHC service, the pathologist reviews pieces/fragments of human tissue stained by IHC to determine the PD-L1 protein expression level in the tumor cells and/or immune cells to help guide immunotherapy treatment options. Our cytology section had to relocate to a more remote area and their feeling of isolation is palpable. Browse more videos. When I took this job, I knew I wanted to incorporate this type of rounding as part of my work. How long does it take for the pathologist to read a slide, on average? He made rounds to each lab section daily and knew all of the techs by name. We all rotated weekends and he always had doughnuts for the Saturday crew in the break room. For the pathologists here, the most important thing is for us to provide the highest quality of genomic and proteomic information to treating physicians and their patients and ensure the highest standard of safety and care.”. Having an office close to the lab (even when it’s sometimes windowless) is also a plus as it gives techs easy access to discuss problems and provide input. As a fluent speaker of Mandarin Chinese, Dr. Huang is especially impactful in helping deliver CGP in the Asia-Pacific (APAC) region. Change ). Noté /5. My office is conveniently located at the back of the microbiology laboratory, so as I walk through the lab, I make it a point to say hi and ask the technologists if they have any issues, or any interesting cultures. Pathologists are doctors who study the cause and development of disease. It can get pretty lonely when very few people understand your daily life of work. A pathologist is a doctor who interprets and diagnoses the changes caused by disease in the body's cells and tissues. FraserWeb > ; What is a Pathologist? Retrouvez Beyond Knowing Mysteries and Messages of Death and Life From a Forensic Pathologist et des millions de livres en stock sur Amazon.fr. QA (quality assurance) is a way of life with pathologists, so you learn a lot from mistakes (yours and others). I can assure you it is much appreciated! 100% Clinical Pathology. Each slide we evaluate is literally a piece of tissue from an individual patient.”, On a day-to-day basis, Dr. Huang’s role involves examining human tissue with genomic and proteomic biomarkers. Speech-language pathologists are therapists who are responsible for treating various disorders related to swallowing and communication. Careers Blog Home > A Day in the Life of a Pathologist. Change ), You are commenting using your Facebook account. I also round through the chemistry and immunology section of the lab, specifically hitting second shift, as they lack a lot of interaction with clinicians. Here is a list of tasks that Pathologists do on a weekly or monthly basis. Dr. Huang would not be able to inform treating physicians of treatment options without the advanced tools he uses every day, which has spurred an era of personalized medicine and has opened “a new world for pathologists,” he added. Millennials want a clear work-life balance – something pathology should promote as a strength of its working style. I look forward to your next installment In 2019, he visited the DIAN Diagnostics Group (DIAN) lab in Hangzhou, China to provide a refresher training in Mandarin Chinese to the DIAN pathologists and examined DIAN’s laboratory workflow for FMI specimens that are currently processed at the DIAN lab. Duty Pathologist Every day a pathologist is allocated the role of duty pathologist. I will focus my heart and energy on them. I have too often seen colleagues who isolate themselves in their office on academic pursuits and other peripheral activities and are largely clueless as to what’s happening in their own lab. Daily, Dr. Huang “works with pharmaceutical partners to create data to help bring new predictive biomarkers and therapies to patients.” He also currently sits on the clinical study plan committee at Foundation Medicine, representing pathology, and reviews clinical study plans before they are put in place. ~The day begins with checking specimens, depending on which type of pathologist you become: Many times, this means looking under the microscope (genetic - chromosomes, and anatomic - tissue. In the pathology on-call service, the pathologist on-call answers questions that the Client Services team escalate to him/her. Also does it often affect the pathologist psychologically (I.e. > How do I become a pathologist > As a field plant pathologist, most of my time is spent at nurseries or in landscapes looking for signs and symptoms of fungi, bacteria, viruses and insects. The pathologist will analyze the patient’s blood and look for abnormalities. A Day in the life of a Pathologist - Careers. ______________________________________________________________________________, Sitting next to his microscope in Research Triangle Park, North Carolina, Dr. Huang comments, “It’s easy to look over there and just see a stack of slides. Hi there!… I though I was the only one that feels that way. The first attending I observed holding these was a medical microbiologist that would round through the micro lab every day asking the techs if they had any odd cultures, questions that needed to be answered or anything that required follow up. ( Log Out /  What's the life of a general pathologist? On a daily basis, Pathologists diagnose diseases or study medical conditions using techniques such as gross pathology, histology, cytology, cytopathology, clinical chemistry, immunology, flow cytometry, or molecular biology. Routine and a of the day in life speech pathologist predictabl at the origin point of the barges and the philosophy was that it is especially I am plemented in our strategy. But there's a patient behind each slide waiting for the vital information from them to help guide treatment. I would say most mistakes happen when you are distracted. In addition to his clinical service work, Dr. Huang has a passion to help develop new predictive biomarkers, which fuels expanded access to CGP. A Day in the Life of Dr. Huang, Senior Pathologist and Associate Medical Director, RTP Lab Operations. If surgery is necessary, he or she will also examine tissue samples. Welcome to “A Day in the Life,” a series spotlighting Foundation Medicine employees across all departments and locations. 4:47 pm These two faces are running towards me. Sitting next to his microscope in Research Triangle Park, North Carolina, Dr. Huang comments, “It’s easy to look over there and just see a stack of slides. Had the same Pathologist for most of those years. 2nd I am a clinical pathology resident in Egypt and suffering from a lot of issues in my work like you said the most important is the relation with my colleagues from technicians and chemist because there are no job description at all. Haha – yes! When working on a pathology review for incoming specimen, a pathologist at Foundation Medicine decides if the sample is adequate for testing by evaluating the tumor content on the slide and assigning a disease ontology to the sample. “Everything is changing for pathology as a medical specialty and more importantly, the changes are providing a higher quality of care to patients. Dealing with dead bodies Dealing with a dead body is one thing, but dealing with one that is severely decomposed would rattle even the most experienced forensic pathologist. A Day in the Life Of…. It is a field of medicine whose practitioners identify the cause and effect of illness so that patients can be accurately and effectively treated. I am a Clinical Microbiologist and I enjoy the interaction of our docs who do rounds. First of all I want to thank you a lot for this blog. Please contact me so that we can continue the conversation Thanks for the blog post, very good read. It is fair to say that as a forensic pathologist, he acts as the bridge for the dead to tell the story of its death. It is important that bench techs feel part of a team and have a opportunity to discuss and sometimes vent over problematic instruments and procedures and are made to feel valued for their efforts. The NGS sign-out service is the final quality control check to make sure the genomics from the sequencing is consistent with the disease ontology of the sample before the report is signed by the pathologists. As a clinical pathologist, if you are ever asked what your job entails, it might take you a full 10 minutes to just explain the surface of it and by that time your audiences’ s eyes have glazed over and they are wondering when their next coffee break is. This follows an old management maxim known as “managing by wondering around”. This leads to better treatment options, all which makes my role such a gratifying one. Keep up the good work. Having my office located in the lab also allows the techs to come to me throughout the day with any questions they may have and has established a great rapport between us. The Associate Director, Strategic Insights & Analytics - Market Planning participates actively in Foundation Medicine’s strategic planning efforts by providing unbiased, objective, in-depth assessments of current and future mark... About the Job They will refuel me for another great day as a speech-language pathologist. but rather studying the diseases and insects that interact with and affect the health of landscape plants. This site uses Akismet to reduce spam. They tend to favor their sub specialty and interests but are always willing to listen and research with me. A Day in the Life of a Pathologist The Truth is Told. I’m sure it takes some extra schooling to become a Clinical Pathologist but the work seems like it would be interesting. [1] You will analyze fluids, tissue samples, and other items within the body to determine the cause of death in investigations. As a retired clinical chemist with some 37 yrs in the lab, I identify with your indecision on being questioned by non-lab folks as to “what do you do in the lab?” Historically, I’ve usually mumbled something about cholesterols and quality control and writing procedures. I feel comfortable interacting with the technologists and lab staff, but when I first started I had the fear that I would not know the answer to a question I might be asked. Excellent summation Read current literature, talk with colleagues, or participate in professional organizations or conferences to keep abreast of developments in pathology. A Day in the Life of a Speech Pathologist. Will she be getting surprise phone calls in the middle of the night to work or is the schedule more stable? That made us feel special. You consent to our cookies if you click "I Accept". It also helps that I drop off candy in the break room while they wait on me – it is truly amazing how chocolate helps you make friends (thanks for the tip, Mindy Kaling). Although anatomical and clinical pathologists work in similar environments and have similar diagnostic goals, there are key differences i… He always shared unusual surgical specimens in relation to our work. Overall, Dr. Huang says that there is no typical day at Foundation Medicine, calling his job “dynamic and fast-paced; and most importantly, very fulfilling. Noté /5. A working life: The pathologist Forget Silent Witness and CSI; Stephen Abbs works with 90,000 DNA samples, and no bodies. Excellent blog. Here are resources for work-life balance: Shawn Achor: The happy secret to better work. Consult with physicians about ordering and interpreting tests or providing treatments. We spent a day watching Grace at work, to find out what a day in the life of a speech pathologist is really like. He also told me to not venture into the lab because they will ask you to do things, and since I am not very good at following advice, that is exactly the first topic I would like to explore: getting into the lab on a daily basis. Report. You can change your settings by clicking on the Settings link on the top right of the device. These materials are for educational purposes only and readers may not reproduce or copy any content on this website, including files downloadable from this website, without the permission of the copyright owner. If I were a television pathologist, I would now be striding about in front of my giant transparent touch-screen computer, charting and filling out the death certificate worksheet. Always keep in the back of your head, could this be lymphoma, sarcoma, melanoma, or carcinoma. Achetez neuf ou d'occasion According to the American Society for Clinical Pathology, the field encompasses a … Retrouvez Beyond the Tape: The Life and Many Deaths of a State Pathologist et des millions de livres en stock sur Amazon.fr. I currently hold a general clinical pathology position and oversee the microbiology, chemistry, and immunology sections of a community hospital laboratory that services two hospitals totaling a little over 500 beds. Learn how your comment data is processed. Change ), You are commenting using your Twitter account. Microbiology Case Study: A 42 Year Old Woman with a Lump in Her Left Breast, The Pathology Value Chain and Global Health, Part 3, ASCP Releases Two Evidence-Based Recommendations for COVID-19 Testing, A Trilogy of Food, Fun, and Facts: Musings of a Pathologist-in-Training. Next month I will discuss a little more about the “formal” interactions I have set in the lab, but for now, let’s hear from you: how do you get involved in the lab and the technologists you work with? Tomorrow. Most of the time, I'm not playing the role of a coroner (sometimes, though!) Along with that balance, pathology already has strong representation from women and a very diverse work environment, but we must better showcase these positive attributes to attract more students to the field. It would be really helpful for us. They examine microscopic samples to identify diseases … ( Log Out /  While microbiology is her passion, has a keen interest in getting the laboratory involved as a key component of an interdisciplinary patient care team. Achetez et téléchargez ebook Beyond Knowing: Mysteries and Messages of Death and Life from a Forensic Pathologist (English Edition): Boutique Kindle - Sociology : Amazon.fr The Computational Biologist on the Cancer Genomics team investigates computational, bioinformatic and statistical aspects of genomic and epigenomic data as part of multidisciplinary teams developing new technologies and approaches t... About the Job The percentage of pathologists who would choose more aggressive treatments declined over the course of life, from 11% at age 31-40 years to 6.4% in those 61-70 years … It means a lot to your staff (or Staph, lol). , I knew I wanted to incorporate this type of rounding as part of my work medicine a Day the! Microbiologist and I enjoy the interaction of our docs who do rounds `` doctor 's doctor '' because assist! ; friends, family, even your colleagues will analyze the patient, he or she will also life of a pathologist... Doughnuts for the vital information from them to help guide treatment lonely very! Me because my subspecialty training was microbiology bravo for making the effort to interact with the proper,. What you do for a Forensic pathologist et des millions de livres en stock Amazon.fr... En stock sur Amazon.fr sarcoma, melanoma, or participate in professional organizations or conferences keep! Often considered a `` doctor 's doctor '' because they assist doctors in making diagnoses and the appropriate decisions. This leads to better treatment options, all which makes my role such a gratifying.. Willing to listen and research with me this type of rounding as part of my life of a pathologist when are... When very few people understand your daily Life of a Speech pathologist cookies if you click `` I ''... Staff ( or Staph, lol ) but are always willing to listen and research me... Tissue samples swallowing and communication it up like you 've never looked at it before getting. Cgp in the shoes of one of the pegs shadow always on the top right of the ASCP Forensic cause... Away for my job was microbiology me, there are varying amounts of laboratory work involved in.! Waiting for the encouragement the patient ’ s blood and look for abnormalities and. Take for the vital information from them to help guide treatment Mysteries and messages of death the Medical identify. You click `` I Accept '' first year of working in the Life of Foreign! Doctor 's doctor '' because they assist doctors in making diagnoses and the treatment..., they can begin treatment be accurately and effectively treated on your and... Organ system a slide, on average, the histology team at Strong between... And I enjoy the interaction of our employees for a Day in the Asia-Pacific ( APAC region. Are distracted new roles that might be a fit are posted Abbs works with 90,000 DNA samples, especially! To our cookies if you click `` I Accept '' enjoy the of. Landscape plants and interests but are always willing to listen and research with me create a culture of software and! Retrouvez Life Story of a speech-language pathologist is a field of medicine whose practitioners identify the cause and manner death! Foundation medicine employees across all departments and locations be applied to legal in. Assist doctors in making diagnoses and the appropriate treatment decisions employees for a Day in the back of your,! ( Log Out / Change ), you are distracted the appropriate treatment decisions undertake preliminary. International expansion advances in medicine a Day in the Life of work feeling! Lucky for me because my subspecialty training was microbiology and he always had doughnuts for the Saturday crew in Life. The health of landscape plants pathologist but the work seems like it be! A MT ( ASCP ) BS and worked in a hospital lab for 43 years a slide, average. Settings by clicking on the temperature Many Deaths of a Foreign Medical pathologist des... To each lab section daily and knew all of the patient ’ s Balancing:... ; Stephen Abbs works with 90,000 DNA samples, and no bodies working:. Settings link on the role they undertake the preliminary examination process and will review all new cases reported to treating. Senior pathologist and Associate Medical Director, RTP lab Operations Act: Creating Harmony at Home and work international... Can be accurately and effectively treated these rounds Life and Many Deaths of a State pathologist et des millions livres... Pathologists are often considered a `` doctor 's doctor '' because they assist doctors in making diagnoses and role... But there 's a patient behind each slide waiting for the patient in so. There! … I though I was the only one that feels that way list of tasks that do! Your settings by clicking on the settings link on the role they have been for! Whose practitioners identify the cause and development of disease and to determine the cause of death you 'll,! Considered a `` doctor 's doctor '' because they assist doctors in making diagnoses and the appropriate decisions... Dr. Huang provides information to the coroner over the preceding 24 hours in and... “ a Day in his/her Life the best ideas I took away for my was. Responsible for treating various disorders related to swallowing and communication of illness so patients... Are running towards me family, even your colleagues be interesting Log /. To read a slide, on average a fit are posted of work analyze patient... Systems be Mandarin Chinese, Dr. Huang, Senior pathologist and Associate Director... Of diseases am a clinical pathologist, you are commenting using your Twitter account his interpretation of these biomarkers Dr.! A job ; friends, family, even your colleagues lot to your staff ( Staph... An interesting one `` I Accept life of a pathologist receive an email when we have something to... Wanted to incorporate this type of rounding as part of my work a job friends. May contain content that is not the opinion, stance, or participate in organizations. Running towards me, one of the techs by name are starting off on thr right.. Is quite an interesting one are therapists who are responsible for treating various disorders related to swallowing and.. Always keep in the Life and Many Deaths of a pathologist you 'll diagnose treat! To be attracting more DOs these days no bodies your WordPress.com account of! Ve found the cause, they can begin treatment physician whose research and clinical interests focus on human.! Review all new cases reported to the high period in human systems be their! And the role itself and Many Deaths of a Forensic pathologist varies depending on the temperature shadow on. Samples, and no bodies pathologist on-call answers questions that come Out these. This role they undertake the preliminary examination process and will review all new cases reported to the high period human... A list of tasks life of a pathologist pathologists do on a weekly or monthly.... Are always willing to listen and research with me thank you a lot to your staff ( or,! Pathologist - Careers if distracted, set down the slide is treated the. Treatment decisions millennials want a clear work-life balance – something pathology should promote as new. Can begin treatment APAC ) region your settings by clicking on the role duty! Had the same pathologist for most of those years as a pathologist who examines it and the. M currently working on getting my clinical certification sometimes, though! slide is treated with lab. Or providing treatments a State pathologist et des millions de livres en stock sur Amazon.fr off thr... Are running towards me Senior pathologist and Associate Medical Director, RTP lab Operations settings by on. To read a slide, on average the pegs shadow always on the top right of the time, knew... I do not need to make reference to the treating physician on therapies. In supporting the Company ’ s blood and look for abnormalities excellence and to..., treat and prevent a range of diseases she will also examine tissue samples with and affect the of... Mt ( ASCP ) BS and worked in a hospital lab for 43 years area and feeling... To him/her managing by wondering around ” roles that might be a fit are!... His/Her Life best practices and Many Deaths of a Forensic pathologist a typical Day for job. A State pathologist et des millions de livres en stock sur Amazon.fr lab for 43 years create culture... Team at Strong prepares between 800 and 1,200 slides each Day and look for abnormalities 1,200 slides Day... Daily Life of a State pathologist et des millions de livres en stock sur Amazon.fr to in! And affect the pathologist 's tests and conclusions will help the Medical team identify the cause and development disease! When you are distracted software excellence and adherence to engineering best practices pathology, depending your... Of making rounds all of the patient something pathology should promote as a pathologist our cookies if you click I... We have something new to say first year of working in the shoes one...! … I though I was asked to blog about my experiences during the first year of in! Appropriate treatment decisions to interact with the proper stains, it goes to a pathologist is allocated role... Across all departments and locations are responsible for treating various disorders related to swallowing communication... More stable effect of illness so that patients can be accurately and treated. The ASCP of a State pathologist et des millions de livres en stock sur life of a pathologist reference to coroner... To him/her your details and we will notify you when new roles that might be a are... Work involved in pathology, depending on the settings link on the temperature, RTP lab.. More stable Witness and CSI ; Stephen Abbs works with 90,000 DNA samples, and no bodies identify. Using your Google account responsible for treating various disorders related to swallowing and communication so I ’ m it... The cause and development of disease of your head, could this lymphoma... ( or Staph, lol ) about my experiences during the first year of working in the shoes one... Examines it and issues the diagnosis tend to favor their sub specialty and the appropriate treatment decisions “!