Time to learn about fine needle aspiration and cytopathology with Dr Celina Nadelman. She has a private practice and that is a rate situation. Get inspired and enjoy her episode. Dr. Celine Nadelman, MD talks to Dr. Justin Trosclair, DC on A Doctor's Perspective Podcast How does one go from psychology (neuroscience), art and then switch it up and go into medicine? Dr. Nadelman even spent multiple years in Italy developing her artist vibes but ultimately the practice of medicine is an art as well as a science so the two melded nicely. Some people know they want to not only do medicine but which specialty from high school age, but she was a bit unsure and had to try out a few things to figure out that Fine Needle Aspiration (FNA) pathology was her best fit. When she was in the process of residency, the big push was primary care but through a series of events and personal contact she found that pathology was her path. She was also a talented surgeon but with her desire to have a family and balance family with the surgery responsibilities, Dr. Celina decided that wasn’t her path. Fine Needle Aspiration Biopsy Smallest needle possible, getting a smear of tissue, looking at in the microscope and determining what it is you have. It’s the smallest amount of tissue needed to make a diagnosis. Pathologist is the Doctor’s Doctor A lot of anatomical pathology is pattern recognition. You know what it is supposed to look like and in what location and then you start to recognize what’s wrong and what patterns wrong have. Her specialty is cytology aka thyroids and head and neck tumors. She has her own private clinic doing FNA biopsy but it’s a pretty rare thing and Dr. Nadelman is hoping a platform like A Doctor’s Perspective Podcast will help others to do the same thing. It is a little hard to be private because you compete against the hospital pathologists. A problem is that any MD can do a fine needle aspiration but many many times they don’t get enough readable material, or it’s full of blood (bad) and both make it difficult to make a correct and confident diagnosis. Having to get more than one biopsy is not a pleasant experience for the patient and in her private practice, she can get the sample, smear it on a slide immediately and put it in under the microscope she has in the room to make sure it’s readable. (Rapid On Site Evaluation). She gives a great story around minute 18 about a case that she did that required a second FNA because what she saq bedside would require extra tissue for further testing. This also saved the patient from having to come back to the office and from another pathologist reading it as, need more tissue for evaulation. Especially in this case it could have been a 1 year terminal diagnosis or not. Diagnosing normal and cancer is easy she says. The tough stuff are the tissues that are irregular and make you need to send out the sample to molecular specialist and beyond. Who is a good referral source for a private practice pathologist? Would it surprise you that she has to meet face to face with doctors, just like you do, so they refer to her instead of the hospital? Dr. Nadelman has been married for 24 years and this was during both of their professional school years and have 3 kids. Listen at the end for her marriage tips. A top tip is to not be in cruise control on your marriage. You have to engage each other in partnership. Also, don’t be afraid to go to a counselor. www.