Dr. Davis, who is a forensic pathologist at the University of Kentucky College of Medicine, has comented "The autopsy has long been and remains the gold standard for confirming or ruling out diagnoses and plays an integral role in promoting the public health." However, data show the rate of autopsies performed in the U.S. has fallen. According to the most recent data from the Centers for Disease Control and Prevention in 2007 nine percent of all deaths were autopsied, compared with 19% in 1972. Of even more concern has been that for deaths due to diseases such as cancer and cardiovascular disease the autopsy rate was 4%, compared with 17% in 1972.
Elizabeth C. Burton, MD, pathologist and deputy director of the autopsy service at Johns Hopkins University School of Medicine in Baltimore, has said among the consequences of the declining autopsy rate is inaccurate mortality statistics, which are used to determine the incidence and prevalence of particular diseases. And pathologist Jennifer Baccon, MD, PhD from Hersey, Pennsylvania has said the reduction in autopsies also means physicians are missing opportunities to improve care for patients. Dr. Baccon, assistant professor of pathology and neurosurgery at Penn State Milton S. Hershey Medical Center, has said "We do our absolute best to treat everybody to the highest quality of care, but if we do not learn from our experiences, I think we lose something valuable."
Improved imaging that some physicians mistakenly think eliminates the need for an autopsy has been part of the reason for the decline in autopsies. Also, a lack of payment for the procedure by health insurers and Medicaid has been a problem. Furthermore, in 1971 there was a decision by the Joint Commission to drop its requirement that hospitals have an autopsy rate of 20% to 25% for deaths that occur there. Dr Davis has said doing an autopsy "is a duty we owe our patients. You don't abandon patients simply because they die. You still have to do the best job you can in certifying their cause of death for the benefit of the family and the greater community." These considerations about the importance of autopsies are certainly worth emphasizing.
