By Juliet Farmer
Diana Marie Padgett, MD, an anatomic and clinical pathologist, is president and treasurer at Pathology Associates of Harrisonburg (Virginia), as well as medical advisor to Blood Bank and Point of Care Testing. She received her bachelor’s degree in biology with a minor in biochemistry from University of Tennessee, Knoxville, where she graduated summa cum laude (1998). She received her MD from University of Tennessee Health Sciences Center in Memphis, where she graduated summa cum laude (2003). She also has a one-year degree in Dutch studies from Leiden University (1997), and has successfully completed USMLE Step 1 (2001), Step 2 (2003) and Step 3 (2005). Dr. Padgett completed a residency in combined anatomic and clinical pathology at University of Virginia Health System in Charlottesville (2003-2007), and a fellowship in pediatric and development pathology at University of Tennessee Health Science Center/St. Jude Children’s Research Hospital/LeBonheur Children’s Medical Center in Memphis (2007-2008).
Dr. Padgett is board certified in combined anatomic and clinical pathology and pediatric pathology. She previously worked at St. Jude’s Research Hospital Department of Structural Biology in the Professional Oncology Education Program (1999), as well as University of Tennessee, Memphis, Department of Ophthalmology as a senior research assistant (1998-1999). Dr. Padgett has been published in the American Journal of Surgical Pathology, Infection and Immunity, Surgical Neurology, Archives of Pathology & Laboratory Medicine, American Journal of Neuroradiology, and Ophthalmic Research.
When did you first decide to become a physician? Why?
When I graduated from college in Knoxville, my intention was to stay there and enter veterinary medicine and work in research. However, my fiancé got an engineering job in Memphis, so I went with him and worked for a year in the Department of Ophthalmology. During that time, I had a chance to do a lot of shadowing at the medical school and decided to apply for that instead.
How/why did you choose the medical school you attended?
Two reasons: it was my in-state school, and my husband was working in the same city.
What surprised you the most about your medical studies?
The large amount of behavioral counseling involved. The medicine itself interested me, but in many specialties, more time was spent in negotiation than treatment. With common but serious medical problems such as hypertension and type 2 diabetes, medication can help to manage the problem, but dietary and lifestyle changes are necessary for truly effective treatment (really they are more important). This is a great opportunity to work with patients, but it is about counseling and negotiation, rather than physiology. Some doctors love this part of the job and are very good at it. However, it was not the part of medicine that appealed to me.
Why did you decide to specialize in your field?
Pathology is heavily tilted toward the scientific/medical side. I still spend most of my time working with people (80 laboratory employees, other physicians and hospital administration), but I enjoy those interactions more. Also, I see cases from so many different patients that I see something rare and interesting every day.
If you had it to do all over again, would you still specialize? (Why or why not? What would you have done instead?)
Yes. I would do pathology again. My second choice would be radiology.
Has being a pathologist met your expectations? Why?
Yes, I love doing the pathology part. Lab administration is less interesting, and becoming more important as reimbursement sharply declines.
What do you like most about being a pathologist? Explain.
You have a major impact on the care of hundreds of patients, and see interesting things every day. Also, I have strong relationships with physicians in many fields, which helps to keep my up-to-date and on my toes.
What do you like least about being a pathologist? Explain.
Managing laboratory resources, including personnel, in the face of the major payment cuts in the last two years.
What was it like finding a job in your field–what were your options and why did you decide what you did?
There were several jobs available at the time I was looking. I ultimately had the choice of two different types of jobs–academic pediatric pathology and private practice general pathology with laboratory medicine. For reasons of both schedule and broadness of scope, I chose the private practice job.
Describe a typical day at work–walk me through a day in your shoes.
There are several different types of tasks I do (we rotate through three different days): sign-out of cases at the microscope, perform fine needle aspiration biopsies, frozen sections, laboratory administration with meetings, and general fielding of questions about anything laboratory. We occasionally also perform autopsies. We are busy, but there is plenty of time for coffee, lunch, etc.
On average: How many hours a week do you work? How many hours do you sleep per night? How many weeks of vacation do you take?
I work about 50 to 60 hours per week, plus about six hours every fourth weekend. We take overnight call every fourth night, but rarely have to come to the hospital, as most questions can be addressed over the phone. I sleep as much as I want at night and take 12 weeks of vacation per year.
Do you feel that you are adequately compensated? Why or why not?
Yes, but pay is declining along with reimbursement.
If you took out educational loans, is/was paying them back a financial strain? Please explain.
I did not take out loans.
In your position now, knowing what you do – what would you say to yourself when you were beginning your medical career?
Be aware of the cost in terms of both time and finances. You will likely always be able to find work, but the pay is going down and the type of work is different from what it used to be. Make sure you are doing what you love.
What information/advice do you wish you had known when you were beginning your medical studies?
Try multiple specialties as early as possible to be certain you are choosing the right path.
From your perspective, what is the biggest problem in health care today?
The administrative (non-medical) part is becoming larger, particularly now when things are rapidly changing. Physicians are targeted now for cuts to save costs, and I think it will take a while for that pressure to ease.
Where do you see your specialty in five to 10 years?
Fewer pathologists with more rigid but also more advanced testing protocols. Also, a lot more “employed” rather than independent physicians.
What types of outreach/volunteer work do you do, if any?
Our group provides free pathology services to the Harrisonburg Free Clinic, as well as patients seen elsewhere who qualify for free clinic services. We also host and teach a lot of students in various allied health professions.
Do you have family? Do you have enough time to spend with them? How do you balance work and life outside of work?
I am married and have two young daughters. My husband works part time, which helps with sick kid days, etc. I spend plenty of time with my family, but definitely lean on friends and family for unexpected issues.
What is your final piece of advice for students interested in pursuing a career in your speciality?
Pathology is very different from most other medical specialties, so make sure you give it a try. You may love it like I do.