T-Shaped Pathologists
My long commute to work these days offers a lot of protected time to listen to various medical and non-medical podcasts. For some time, my favorite non-medical series has been the Stanford University Entrepreneurial Thought Leaders – full of lessons applicable to any business or profession. I listened to one last week that discussed how great management teams are formed and discussed the strategy of hiring “T-shaped people”. This is a visual metaphor created by Bill Moggridge of IDEO Design. Like any great design the idea is simple, easily grasped, and yet layered with implications. Tim Brown also of IDEO summarized the idea of hiring T-shaped people in a great article in Fast Company.
“We look for people who are so inquisitive about the world that they’re willing to try to do what you do. We call them “T-shaped people.” They have a principal skill that describes the vertical leg of the T — they’re mechanical engineers or industrial designers. But they are so empathetic that they can branch out into other skills, such as anthropology, and do them as well. They are able to explore insights from many different perspectives and recognize patterns of behavior that point to a universal human need.”
Sound familiar? It should. All last week I was ruminating about how Primary Care Pathologists are T-shaped pathologists. The overwhelming majority of us have some deep expertise in at least one area of anatomic or clinical pathology – our vertical leg – which is capped by our horizontal knowledge of general pathology. Let’s face it – in the community practice setting that most of us find ourself in – the value to your group, to your clinicians, and to your patients is that you are not only the resident expert in “skin, GI, breast, fill in the blank”, but you can also handle a 2AM transfusion crisis or brain tumor frozen.
But as I sat down to explore this concept further in a blog post, I realized that the “T-shape” metaphor may be just a bit too simple to apply to a Primary Care Pathologist. In reality, our horizontal abilities aren’t horizontal at all. They ramify way beyond expertise in our own specialties, interdigitating and interfacing with all other medical specialties, with patients, and with hospital administration – actively empathetic with all. And then as I thought about the vertical leg – I realized that a linear straight line down doesn’t do that justice either. I have had the good fortune to work around some of the finest primary care pathologists who have an uncanny depth of knowledge in their specialty area focus. And this is not just an ability to identify to recognize fascinomas – it is more the depth of knowledge about the implications of their diagnoses. They understand all aspects of the treatment challenges inherent in the diagnoses they make, whether it is the efficacy or side effects of drugs, the necessities for surveillance, or the cosmetic outcomes of the procedures that will result. In short their knowlege ramifies and empathizes even within their “narrow” area of expertise.
So as I sat in Pegasus Coffee House on Sunday morning trying to make sense of this by sketching it all out on a napkin – the diagram I came up with looked less like a T – and more like a Tree. In effect, the horizontal and vertical directions of our practice not being linear, but extending in all necessary and available directions like branches and roots. So the punch-line thought for this week is that Primary Care Pathologist are in reality “Tree-Shaped Pathologists”. As all of you continue to arborize this week, any thoughts on this visual metaphor are, as always, welcome – and again thanks for all your feedback e-mail or otherwise so far.
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