In this episode of The Pathology Report, host Dr Ian Gassiep is joined by Prof Caitlin Keighley, a microbiologist and infectious diseases physician at Southern IML Pathology in Wollongong, to discuss the vital yet often misunderstood role of pathology stewardship in healthcare. They explore what stewardship looks like in real-world practice and how it shapes patient care. Prof Keighley defines pathology stewardship as “doing the right test for the right patient at the right time,” emphasising that the ultimate goal is better outcomes, not just cost savings. Together, Prof Keighley and Dr Gassiep debate this tension between cost and clinical value, the role of electronic decision support systems in test ordering and the challenges of balancing efficiency with issues such as alert fatigue and workflow disruption, particularly for junior doctors and GPs. Prof Keighley examines the issue of selective reporting in microbiology, where limiting the antibiotics displayed on lab reports can help reduce resistance, citing some Australian examples that are showing its real-world impact. The podcast highlights the practical realities of stewardship, from clashes between test rejection rules and rural healthcare needs to the question of whether technology simplifies decision-making or complicates it. It concludes with reflections on Australia’s strong governance and regulatory frameworks, and how the country consistently delivers high-quality health outcomes at a relatively low per-capita spend on pathology and medicines. RCPA MembersThis podcast is an RCPA-endorsed CPD activity. Each episode gives you an opportunity to gain CPD hours in three easy steps:Step 1. Listen or watch the podcast here, on your favourite podcast channel or on YouTubeStep 2. To claim your CPD hours, please complete and pass this short online quizStep 3. Sit back and let us load your CPD hours into your CPD profile for youThe Pathology Report is produced by the Royal College of Pathologists of Australasia and is part of the Talking HealthTech Podcast Network.Learn more about the RCPA at rcpa.edu.au and discover other shows in the network at talkinghealthtech.com/podcast/network.

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