By Evan Falchuk

The first thing you see when you enter the Toronto General Hospital’s Pathology Department is a prominent sign bearing a quote from Sir William Osler.  “As is your pathology, so goes your clinical practice,” it says.  It’s the first clue that there is something special happening here.

Dr. Silvia Asa is the Chief of the department and has built a remarkable facility in downtown Toronto.  With a team of nearly 40 full-time pathologists in a multi-specialty setting, and dozens of residents and fellows, her department reviews thousands of samples a week.  Walking the halls where the doctors do their work, you might think you were in a law firm, except for the massive microscopes adorning each desk.  The technology and organization were just about the opposite of what I saw in Argentina.

But it wasn’t the technology that was most impressive.  It was the deep passion the doctors clearly feel about the art of pathology, and the prominence it must have in any realistic conversation about quality in health care.  “Pathology has always been in the basement,” Dr. Asa told me, and she means it more than just literally.  Most hospitals have their pathology departments in basements, where the space needed for big lab equipment is at less of a premium.  But it also reflects the importance some place on pathology, almost treating it as an afterthought.

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