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WA lawmakers address critical shortage of forensic pathologists

Dr. Nicole Yarid, an associate medical examiner for King County, walks into the autopsy room dedicated to examining people who died from COVID-related complications. Yarid told KNKX that the pandemic response has detracted from other priorities.
Ted S. Warren
/
The Associated Press
Dr. Nicole Yarid, an associate medical examiner for King County, walks into the autopsy room dedicated to examining people who died from COVID-related complications. Yarid told KNKX that the pandemic response has detracted from other priorities.

State lawmakers are addressing the critical shortage of doctors who are trained to perform autopsies in Washington state.

When someone dies unexpectedly, autopsies are an important part of figuring out what happened. Forensic pathologists are the only ones who can perform an autopsy, a key step in determining the cause and manner of death. The work they do can inform public health statistics and even dictate life insurance payouts.

The Washington State Senate unanimously passed a bill this week that would create a loan repayment program for certified forensic pathologists.

The reimbursements would be offered to board-certified pathologists who work in high-need areas of Washington for four years. They would be eligible for up to $25,000 for each of those four years.

The bill would also expand training opportunities, by tasking the Washington Association of Coroners and Medical Examiners (WACME) with growing the medical residency program and establishing two new fellowships on each side of the state.

And it would greenlight a study that would help identify other ways to grow the pool of trained professionals, who are essential to a functioning system of death investigation. WACME’s recommendations for further addressing the shortage would be due to the legislature by Oct. 1, 2024.

In 2020,KNKX Public Radio brought you a three-part series on the challenges facing Washington’s patchwork death investigation system, among them the shortage of board-certified pathologists.

Only a handful of counties statewide have appointed medical examiners — forensic pathologists who perform autopsies but also serve as administrators leading their offices. Most counties have elected coroners who rely on a pool of traveling forensic pathologists to perform their autopsies.

That pool of travelers is rapidly shrinking and it’s hard to recruit to replace them, in part because it’s difficult work for less money than they can make in other medical fields.

Timothy Grisham is deputy director of the Washington Association of County Officials who has worked on this and other legislation related to improving death investigations in Washington.

Grisham said the latest bill, Senate Bill 5523, is a sort of “triage” approach to the shortage: offering a short-term financial solution that has proven effective in other states while other longer-term solutions are studied.

“There’s pretty much no one in the state that would not be affected by this. Everyone dies. Everyone’s parents die,” Grisham said of the proposed law. “It's really a holistic look at how do we help fix a problem right now and then how do we go forward and create a system that's more tenable.”

The shortage of people certified to perform autopsies is not just a Washington problem. There are only about 500 forensic pathologists nationwide, and recruitment is stagnant.

“In 2018, where you saw a 17% increase and people coming out of medical school for general practitioners, you saw a 17% decrease in forensic pathologists,” Grisham said.

Senate Democrats said in a news release this week that Washington needs 25 accredited pathologists, but there are only 18 statewide. Grisham’s association has warned lawmakers that the state is in danger of losing national accreditation.

The bill now moves to the House for consideration.

Updated: May 3, 2023 at 2:54 PM PDT
Substitute Senate Bill 5523 passedin the 2023 legislative session.
Kari Plog is a former KNKX reporter who covered the people and systems in Pierce, Thurston and Kitsap counties, with an emphasis on police accountability.