Lab Medicine Rounds

In this episode of “Lab Medicine Rounds,” host Justin Kreuter, M.D., interviews Eric Hsi, M.D., chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic in Rochester, Minnesota, about the lab’s important role in healthcare.

Timestamps:
00:00 Intro
00:42 Importance of labs in current medical practice
02:41 Understanding & appreciating the role of lab medicine
05:30 Working as a team to affect patient care
08:14 What advice do you have for upcoming lab professionals to cultivate their leadership skills?
12:43 Where do you see the future of laboratory medicine?



What is Lab Medicine Rounds?

A Mayo Clinic podcast for laboratory professionals, physicians, and students, hosted by Justin Kreuter, M.D., assistant professor of laboratory medicine and pathology at Mayo Clinic, featuring educational topics and insightful takeaways to apply in your practice.

- This is Lab Medicine
Rounds, a curated podcast

for physicians, laboratory
professionals and students.

I'm your host, Justin Kreuter,

a transfusion medicine pathologist

and assistant professor
of Laboratory Medicine

and Pathology at Mayo Clinic.

Today we're rounding with Dr.

Eric His, chair of the Department
of Laboratory Medicine

and Pathology at Mayo Clinic
in Rochester, Minnesota.

Thanks for joining us today, Dr. Hsi.

- Dr. Kreuter thank you for inviting me.

This is gonna be a
interesting and fun event.

- Absolutely. So this
episode, we're really kind

of continuing this celebration

of celebrating the laboratory.

And so I wonder if we
could kind of get into this

by kicking off with, you
know, from your perspective,

why is it important to
highlight the presence

of the laboratory in
current medical practice?

- I mean, I think it's
always a good time to sort

of remind people that the
laboratory, you know, is, is there

to provide, you know,
services for our patients.

I think the number is bandied about that.

You know, 70% of all, you know,

medical information comes
from the laboratory.

And so, you know, we have a
major role in providing data,

actionable information to
our clinical colleagues

to make patient care
and treatment decisions.

And so with such an important
role, it doesn't help,

you know, hurt to get in front of people

and raise that awareness again that we,

we are a part of the care team.

- Right. I like how your answer
really highlights this is

by maybe playing this role
that it's kind, I mean,

when you say it's providing
70% of the information,

that's pretty substantial.

But then also to talk about,
it's a reminder, I guess it's,

it's easy to kind of be always counted on

to be providing these
results in a timely fashion.

- Oh, certainly. And I, I,
I think, you know, I, well,

COVID PR was a huge example of
getting lab front and center,

and it certainly raised awareness.

And at other institutions I've
been, you know, the awareness

that, you know,

at some point in time the
laboratory touches pretty much

every single patient in their journey.

And there's not a lot of
specialties that can say that.

Right. So one of my colleagues
here says, you know, we,

we are involved in healthcare
from cradle to grave in

that actually is to some degree true.

- Yeah. So, so that makes me
wonder, you know, I'm, I kind

of, everybody I think really
enjoys hearing stories.

And I'm curious about your
story of how you first kind

of came to understand

and appreciate this extensive role that,

that the laboratory plays
in medical practice.

- That's a great question.

You know, I was, I think there's,

people come at it from different,
you know, vantage points

and I, I was not one
of those persons that,

you know, grew up and said, oh,
I, I, you know, I understand

what the laboratory does in a hospital

and I, you know, that wants be me

or my, you know, my, my
parents were not pathologists.

'cause we run into those, you know, those,

those types of people too.

And I, I came out of more out of a

interest in the science background.

My dad was a chemist and,

and I, you know, was a chemistry major

and I sort of gravitated
towards laboratory science,

but didn't really understand until

really in medical school that

the laboratory played an
important, you know, role

in, in medicine.

And it,

and it truly wasn't until I had

taken a year off from medical school

and did, you know, basic science
research and then came back

and already then realized
like, I really like laboratory

and I knew there was
a laboratory component

in, in hospitals.

And so then I decided to do
a pathology rotation. Right.

And, and because of the
research I was doing

and I was on, in, in on like
part of what they rotated you

through was heme hematopathology.

And, you know, that first
day I basically knew, oh,

that this is what I, I wanna do

because my research was in
immunology and lymphoid biology

and, you know, I was sitting
there with a lymphoma expert

and I'm like, wow, this
is really cool enough.

It looks like the light bulb went off.

And I then I knew that,
you know, pathology,

lab medicine was gonna be the way I went.

- Wow.
- That's a story.

- I think that's a, a
nice, nice kind of point

to highlight then for our
students that are listening about,

you know, certainly there are
rotations you do in different

places, but understand that, you know, Dr.

Hsi really kind of came to
it from the research angle,

I think really helped kind of magnify

and put things in focus.

And so it kind of,

I guess I guess the takeaway
from there is to always be open

to opportunities and
look to connect the dots.

- Yeah. I I think, you
know, having an open mind,

being curious always will, will help you

in, in that regard.

- So, you know, now in
your role as as chair

of the Department of Laboratory Medicine

and pathology, you know, you're,
you're kind of really in a,

a key leadership role

and you know, that's an area that maybe

for other physicians, some
of our physician listeners

or laboratory professionals, that's a role

that many aren't used to thinking about.

So I'm kind of curious
about how, how do you

and your team work together to,

to really affect patient care?

- Yeah, that's a great question.

I mean, you pathology, you know,

you learn to be a leader

because you have to lead
within the laboratory, right?

And you, you have to start,
you know, organizing people to

around common goals within
the lab to, you know,

raise the quality, develop the new,

as you through career in
pathology in medicine,

you understand that there's
roles in that medical leadership

of the clinical laboratory.

It gets to the exact question you want.

You, you, you raise is,
you know, how do you work

with the team then to
further the, the impact

of laboratory practice
into the clinical practice

and how do you, you know, stay abreast

and work with people that stay abreast

of the most recent developments?

I am, you know, very brand
new to Mayo Clinic of,

obviously I'm new of Mayo
Clinic for my entire career,

but I, I am new here figuring
out the, you know, how

to operate in this environment.

But, you know, one thing
that's is immediate clear is

that there are, you know,

leaders in the field in pretty
much every specialty in lab

medicine and pathology.

And, you know, these are the
places where you can have

a large impact by pushing the boundaries,

doing innovative tests, working

with a very sophisticated
medical practice.

And it's that kind of
marriage of, you know,

being on the cutting edge of technology,

AI automation

to really improve patient care.

And that's, you know,
what the, the focus of,

of a place like Mayo really
sort of lends itself to

that singular mission.

And it's been nothing but a
pleasure to be here so far.

- You know, if I can put a
couple of things together,

I think, you know, in the
earlier answer you were talking

about the important role of, of curiosity

and always remaining curious.

And then now in this answer
on how you're working

to affect patient care, you're
talking about, you know,

leadership building bridges,
pushing the boundaries,

advancing innovative practice.

I'm kind of curious for, you know,

what are your thoughts about,

for our maybe student listeners

or kind of young faculty
that are curious and,

and want to cultivate those
skills of, of leadership

and working in this direction,

what advice do you have for them?

- Wow, that's a great question.

I, I would think, as you
say, you know, be curious,

having an open mind,
understand, especially nowadays

that you can't do everything yourself.

Working in teams becomes very fulfilling.

You can always do more in
a, in with, with a team

around you than, than than by yourself.

And that, you know,

particularly those interested in pathology

and lab medicine as a career
is that it's so diverse.

I mean, pathology and lab medicine is all

of medicine, right?

We the consultants to other physicians

and, you know,

you can do almost anything
in laboratory medicine for,

in pathology from, you know,
being a forensic pathologist to

doing HLA testing to hematopathology, to,

you know, focusing on GI pathology
to clinical microbiology.

I mean, it is all of that.

And you can find a niche for yourself

and develop that, that interest.

So, you know, going into pathology

and lab, making that
decision seems like, oh,

I've decided my specialty,

but still the entire world

of medicine in a way is still open to you.

And you have to, you know,
decide if I'm gonna specialize

and what that's gonna be,
what what do I like to do?

And so it's a really,
it's a really nice place

to be when you, you understand that,

you know, possibilities
remain open to you no matter

where you go in your career.

I mean leadership lab, you know,

and that, that kind of role is also open

to you. So yeah,

- Maybe, and also, I wonder
if I can flip it around

to the other side and think
about advice for our clinicians

that are listening to this podcast.

And maybe there are clinicians,
hopefully if they're listen

to this podcast that they are aware of,

of the role in thinking about the role of,

of laboratory medicine,

but they might share it
with their colleagues.

And so for, for the listener

who maybe hasn't thought about the role

of the laboratory in their practice,

what would be your advice
for how to kind of approach

building that bridge maybe more

explicitly in their practice?

I think maybe some
clinician listeners may not

understand where to start.

- Yeah. I would say, you know,
please reach out, contact us.

We, we don't bite.

We, we love, in fact,
part of our, you know,

pathologists oftentimes are introverted

and, you know, we need to be brought up,

but we are always happy to, to consult

and, you know, lend our expertise.

You know, we become part
integral parts of the care team.

I think that's one area
that we, as a field,

our next big push is

to become a little more
integrated in front

and center in in the care team.

And, you know, I, one of the, my hobbies

and you know, is sort of, you
know, in lymphoma pathology

and, you know, I got involved
in some clinical, you know,

research groups and research
foundations that, you know,

deal with certain kinds of lymphoma.

It's a patient advocacy,

get to patients is another avenue

that is really satisfying

because patients are also
curious about laboratory testing

and their particular results.

And so that's another, you know, way

that pathologists may not
have not traditionally been

involved in part of the care team.

But that's certainly was a very fulfilling

exercise for me.

Other pathologists actually
are involved with that.

Transfusion medicine
people deal with, you know,

more directly with patients
and things like that.

So I think, you know, as,
as, as we as a field develop,

you know, our next frontier is really

to get a little more front
and center in the care teams.

- Wow. So that really leads
into my final question.

I was wondering if we could
kind of close out, you know,

you're, you're obviously in a
very key leadership position

and you've already kind of
tipped your hand a little bit for

where do you see the
future of the laboratory?

Where's, where's the laboratory headed?

If you could elaborate
a little bit for us?

- Yeah, that's a a great question. Yeah.

I, I maybe alluded to a little bit

that was a good segue, I guess.

But I think there's other as,

as we move forward in information.

'cause I think at the end of the day, yes,

we're doing all these
testing, our laboratories are

generating, like we said,
you know, a large chunk

of the information being
used to treat patients.

But at the end of the day,
it's information, right?

And so how do we leverage
that information in new ways

to add to, you know, the,
the diagnostic decisions

we're even talking, you know,
as, as you may know, you know,

Mayo Clinic has been digitizing
its entire glass archive

for over, you know, millions
of slides, which is great.

But at the end of the day,
okay, so now we've just

put the information there.

Now what we need to do is
figure out, you know, how

to unlock that information

and get new data from the archival,

you know, image data that we, we have.

And that's, that's certainly
one of the new frontiers,

you know, leveraging, you
know, ai, machine learning,

digital pathology on one side
helping to automate things.

And then on the other side
is just as I just mentioned,

you know, getting the people

and the, the lab professionals, you know,

more front and center
in the care teams with

that new information that we bring. Right.

- Right. And I almost as I hear you listen

to your answer there,
it makes me think about

meaning making is kind of
the, the phrase that kind

of pops up in my mind of, you know,

we have this information,
but what does this mean?

And I think, you know, I I really, that

that mission you're talking
about getting the pathologist

more integrated with the care
team really resonates with me.

What do you think is, might
be our biggest challenge

with that step forward into more of those

that clinic domain?

- Yeah. Well I think it's,
you know, part of it is,

you know, workforce

and kind of like keeping
people interested in

going into the field.

Yeah. Is you and I both
know, it's getting harder

and harder to find people
that get into the field

because, you know, there's so
many things people been doing

and how do we make sure

that people understand
there's this super interesting

career path that is contributing to health

of the population and,

and you know, how do we keep
those people interested?

And then how do we continue
to develop the skillsets

that we need in terms of, you know,

information management

and computational pathology, which is kind

of the new buzzword, right?

And, and build those skill sets
into the training program so

that we can continue
to grow as a specialty.

I think those are things
that we will be trying

to figure out over the next
coming, you know, decade.

- Wow. That's a great way to close out

that makes my medical educator
heart go pitter-patter

to hear you bring in the close of

where is the laboratory going
to, talking about the people

in our community of practice and,

and how we're training 'em.

Thanks so much for joining us, Dr. Hsi.

- Oh, thank you.

It's been a pleasure. Happy Lab week

- And thank you to the
audience for joining us.

We invite you to share your thoughts

and suggestions by email.

Please direct any suggestions

to MCL education at mayo edu
in reference this podcast.

If you've enjoyed Lab Medicine
Rounds, please subscribe.

And until our next rounds
together, we encourage you

to continue to connect lab medicine

and the clinical practice
through insightful conversations.