# Question Physician's Diagnosis Versus Pathologist's **URL:** \ **Category:** Factual Questions\ **Created:** [February 6, 2012, 12:25am UTC](https://boards.straightdope.com/t/question-physicians-diagnosis-versus-pathologists/611912 "2012-02-06T00:25:24Z")\ **Posts on this page:** 7\ **Page:** 2
**Author:** ![VOW](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/vow/32/3043_2.png) [@VOW](https://boards.straightdope.com/u/VOW)\ **Post date:** [February 8, 2012, 11:25pm UTC](https://boards.straightdope.com/t/question-physicians-diagnosis-versus-pathologists/611912/21 "2012-02-08T23:25:44Z")
I liked the post upthread where the person mentioned it’s the MANAGEMENT of chronic disease that really shows up at the postmortem. If the family doctor could indeed crack open a patient’s chest, pull out the heart, and stick it under the patient’s nose, there probably would be a MUCH greater compliance by the patients in taking medication, eating correctly, and getting exercise. For the most part, people with high blood pressure don’t “feel” the need to take all those stinkin’ pills, so they sit in a drawer someplace. When Grandma finally drops dead at the Thanksgiving dinner table, it’s the pathologist who pulls out the scarred, enlarged heart and said, “This lady missed out on watching her grandkids grow up because she didn’t take her medicine.” Oftentimes, the correct information is THERE. It’s what people DO with the information that makes all the difference. ~VOW ---
**Author:** ![KarlGrenze](https://avatars.discourse-cdn.com/v4/letter/k/dbc845/32.png) [@KarlGrenze](https://boards.straightdope.com/u/KarlGrenze)\ **Post date:** [February 9, 2012, 2:58am UTC](https://boards.straightdope.com/t/question-physicians-diagnosis-versus-pathologists/611912/22 "2012-02-09T02:58:38Z")
> [@AndyLee](#): > > Pathologists lose very little if they’re wrong. But you can find lots of examples of autoposies that are simply wrong. Poisons go undetected, that should’ve been, and wounds that are attributed to one thing, get the real diagnosis much later. Granted, that does happen, but I second what **Jackmanii** said, even if I work in a related field (animal vs human medicine). And again, it is important to different the subset of pathologists that specialize in forensics with the majority that reads biopsies. Even I as a veterinary pathologist read a fair amount of biopsies. Those are important in diagnosing tumors. It is with what they say that other physicians look at the info and start treatment. If that pathologist is wrong, a whole unnecessary treatment is started, which benefits no one. ---
**Author:** ![MsRobyn](https://avatars.discourse-cdn.com/v4/letter/m/90ced4/32.png) [@MsRobyn](https://boards.straightdope.com/u/MsRobyn)\ **Post date:** [February 9, 2012, 4:29am UTC](https://boards.straightdope.com/t/question-physicians-diagnosis-versus-pathologists/611912/23 "2012-02-09T04:29:51Z")
> [@DSeid](#): > > Old joke: > > What is the difference between an internist, a surgeon and a pathologist? An internist knows everything, but does nothing; a surgeon knows nothing, but does everything; a pathologist knows everything and does everything, but by then it’s too late. > > Back to the game. A radiologist I used to work for added his own specialty thusly: “A radiologist knows everything but will commit to nothing.” ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [February 9, 2012, 12:41pm UTC](https://boards.straightdope.com/t/question-physicians-diagnosis-versus-pathologists/611912/24 "2012-02-09T12:41:04Z")
> [@Jackmannii](#): > > Because we are veritable gods. 🆒 … One thing I will add is that pathology did seem to attract the most of the smartest (in the doing well in the classes smart kind of way) of the medical students in our class. Not sure if that would have translated to being good clinical diagnosticians or an ability to manage cases well, but still, a pretty impressive group. > [@MsRobyn](#): > > A radiologist I used to work for added his own specialty thusly: “A radiologist knows everything but will commit to nothing.” Is he sure about that? Maybe some clinical correlation is required. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [February 9, 2012, 1:27pm UTC](https://boards.straightdope.com/t/question-physicians-diagnosis-versus-pathologists/611912/25 "2012-02-09T13:27:03Z")
> [@MsRobyn](#): > > A radiologist I used to work for added his own specialty thusly: “A radiologist knows everything but will commit to nothing.” That’s why the official shrubbery of the Radiology Association is the Hedge. 😃 ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [February 9, 2012, 2:48pm UTC](https://boards.straightdope.com/t/question-physicians-diagnosis-versus-pathologists/611912/26 "2012-02-09T14:48:22Z")
> [@KarlGauss](#): > > In my practice, admittedly skewed to what is tantamount to a practice in ‘palliative geriatrics’, i.e. teaching hospital general internal medicine, the diagnoses are staring you in the face - diabetes, CHF, COPD, etc. Whether the last insult is a missed infection or infarction is seldom relevant. One of the common scenarios for a hospital autopsy is the chronically ill patient with what are euphemistically known as “multiple co-morbidities”. We get a request to do a post on a 78-year-old man with a 60-pack-year smoking history, type II diabetes, hypertension, emphysema, coronary artery disease, peripheral vascular disease, chronic renal failure, on a list of meds as long as your arm, who codes during his sixth hospital admission in the past year, and the family wants to know why Dad died “unexpectedly”. There are so many possibilities for what killed him, it gets difficult to pick the right one. ---
**Author:** ![MsRobyn](https://avatars.discourse-cdn.com/v4/letter/m/90ced4/32.png) [@MsRobyn](https://boards.straightdope.com/u/MsRobyn)\ **Post date:** [February 9, 2012, 9:45pm UTC](https://boards.straightdope.com/t/question-physicians-diagnosis-versus-pathologists/611912/27 "2012-02-09T21:45:16Z")
I’ve never worked in pathology, but I’ve worked with others who did. One day, we were in the break room eating lunch and swapping war stories. One of my co-workers told us that her old employer did a lot of autopsies requested by families looking for evidence to support wrongful death claims against former employers. Those paid the bills, but trying to figure out what to code and how to code it was a nightmare for her, so she left pathology to work in the glamorous field of oncology. And then there was the decedent I encountered at the VA. Seems his family was under the impression that Dad had had some device implanted in his arm during his service in Korea, and the family wanted to know what the device was, what it was for, and could they have it? The x-rays showed nothing except normal anatomy, and the radiologist noted there wasn’t even a scar on the skin. The pathologist talked to one of the patient’s children, who confirmed that Dad had been joking. (He’d been in my unit when he died, and I got to read some of this when I put his chart together for final disposition. You could hear the doctors’ eye-rolls on paper.) [Previous page](https://boards.straightdope.com/t/question-physicians-diagnosis-versus-pathologists/611912.md?page=1)