National Forensic Pathologist Shortage Slows Autopsies in Washington


When a human torso washed ashore on Dungeness Spit on the northern edge of the Olympic Peninsula in September, authorities immediately wondered whether it might be the remains of one of the victims of the floatplane that crashed off of Whidbey Island during Labor Day weekend.

But without a dedicated forensic pathologist in rural Clallam County, the remains were transferred to Thurston County, said Nathan Millett, Clallam County deputy coroner. Ultimately, it took three weeks for officials to formally determine the remains were those of 66-year-old Patricia Hicks, a retired school teacher who was among the 10 people aboard the plane that plunged into Mutiny Bay on Sept. 4.

One reason for the delay, according to Millett, was a national and statewide shortage of forensic pathologists, medically trained doctors who perform autopsies.

"There aren't enough doctors to do the autopsies in the country right now and with drugs and violence skyrocketing in the last couple of years, it's getting to be a real critical work-shortage problem," he said.

According to Hayley Thompson, Skagit County coroner and president of the Washington Association of Coroners and Medical Examiners, there are about 500 forensic pathologists in the United States. Washington has 18, three of whom work in the eastern region, and 11 of whom work through King, Pierce and Snohomish counties.

While the recommended caseload for a forensic pathologist is 250 to 325 cases a year, in the past five years more doctors have been forced to perform more autopsies annually, Thompson said. In King County, that figure is closer to 400.

In the absence of available doctors to perform autopsies, coroners are having to use more creative ways to investigate deaths such as using X-rays and medical records, Thompson said.

For cases such as homicides, which require autopsies, the shortage can mean deaths take longer to investigate, making it impossible to meet the state's 90-day deadline to close cases.

"I don't like to have to tell families it can be five to seven months before I give them an answer. That sounds like years to them," Thompson said.

Part of the delay is also exacerbated by backed-up toxicology labs, she said, adding that a toxicology report can take 60 to 90 days.

The issue has been raised by the National Association of Medical Examiners for nearly two decades, Thompson said. In Washington, Thompson has been trying to spread awareness and formally study why the shortage exists.

Nationally, the forensic pathology field is neither well-advertised nor well-paid. About 20 graduates a year finish a fellowship that prepares them to be a board-certified forensic pathologist, Thompson said.

Although Millett is not a forensic pathologist, he has assisted doctors in thousands of autopsies and fell in "love" with the field after working in the Boston medical examiner's office.

Coroners and medical examiners regularly see evidence of some of the most "horrific things that can happen to a person," he said.

"Just being able to provide answers and, at least in a small way, help people going through some of the most unimaginable things is actually incredibly rewarding," he said.