The forensic pathology industry is facing a workforce shortage. These are the men and women who determine how and why a death happens. They are being overwhelmed, and the pandemic has only made things worse.
“What you’re seeing now is part of our autopsy examination room,” said Francisco Diaz as he walked around the Office of the Chief Medical Examiner in Washington D.C.
He is the deputy chief medical examiner.
“The purpose of the medical examiner is to do two things, to determine why people die and to classify the manner of death,” he said.
Diaz and his team have their hands full. Here, bodies are brought in, x-rayed, and analyzed every day. Most of them are bodies of those who have died of unnatural causes, like homicide, suicide, and certain accidents.
They’re brought here, where seven forensic pathologists work.
“As medical examiners and forensic pathologists you are dealing with death and tragedy every single day,” he said.
This year the volume has been higher than usual, in large part because of the COVID-19 outbreak.
“The peak of our pandemic was April, May. At that time we had that emergency morgue off campus,” Diaz explained. “We handled approximately 400 decedents or dead bodies.”
The increase in autopsies needed is not only due to COVID-19 directly, but other ripple effects.
“What I see as a consequence of the pandemic is a lot of people are dying at home because they choose not to seek medical attention because they may have concerns that they may get contaminated at hospitals,” Diaz said.
If they die at home, they’re sent straight to D.C.’s Medical Examiner’s Office. Most people who die in a hospital are handled by the hospital, except for in certain jurisdictions like D.C. where they will help out with the hospital's cases as well.
Regardless of where the cases are coming from, jurisdictions are strapped for resources. It’s a problem across the industry right now -- one that’s been facing a workforce shortage for years.
“A lot of the policy makers think that it's a waste of money. You're just spending money on the dead, but everything we do is for the living,” said Victor Weedn, Forensic Science Professor at George Washington University.
He’s an expert in the forensic pathology industry.
“We are terribly undermanned, under served these days. It is thought we have 500 to 600 board certified forensic pathologists working in the field across the United States and that's simply not enough. It’s estimated we really ought to have 1,200 to 1,500 forensic pathologists.”
The lack of workers has become more evident due to the pandemic, and also a growing epidemic.
“And then the opioid crisis hit. That immediately caused 10% to 30% more cases because of all the overdose deaths,” Weedn said. “On top of that you have the COVID pandemic. The overdose cases have not declined, in fact they've continued to increase. And now we’re seeing a wave of homicides increasing our caseload still further. We are facing a true workforce shortage.”
Weedn also talked about how some of their investigations on COVID-19 patients who passed helped answer some questions we had early on in the pandemic.
Increasing a workers caseload is not a great option, according to Weedn. The National Association of Medical Examiners has accreditation standards.
“A forensic pathologist really isn't supposed to do more than 250 autopsies a year. If you have more than that it’s considered an infraction of the standard,” he said. “When you start doing more than that, things get lost. Details get lost.”
This puts many offices in a bind.
“In the face of such a severe workforce shortage you find that people have changed the criteria for what deaths they will investigate and that means there are certain deaths that will go uninvestigated. A murderer could get away with murder. That’s certainly a possibility,” Weedn explained.
As the workload remains heavy for many jurisdictions, Diaz said education and exposure for the industry might be their best bet in getting more interest.
“I think every crisis brings an opportunity. And I think this is an opportunity for forensic pathology to be on the forefront and let the public at large know what we do, how we do it, and to encourage young people to pursue a career in forensic pathology,” Diaz said.