Flee Pathology Now!!!

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TMZ2007 said:
Just about everything else...
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Well, I think autopsy is safe as well.

Although - what is the salary for pathologists at these mega labs? Is it terrible?
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KeratinPearls said:
Agree 100% with this. Path unfortunately has not been viewed as a popular field by many AMGs. Thus, most spots are open for FMGs.
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I've been lurking the forum for a while and have noticed that this is one of the most discouraging forums in the residency section. Even though I'm very interested in pathology, it's hard to view pathology as a popular field when such a bleak view of one's own specialty is expressed by those who practice it. What would a realistic solution be? Limit the spots available and raise the bar so only AMGs can get into residencies? What about those PhD's that can apparently do the pathologist's job for "half the pay"?

In short, I think what I'm really asking is "What up with that?!". I would really like to know, 'cause from what I've seen pathology is pretty awesome and I still hope to apply next year.
 
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This thread is like so many others.. starting with a Denethor like "FLEEEEEEE FLEEE FOR YOUR LIVES!!!!!!!" complete with virtual spittle running down lips and wild eyed disconnect from anything approaching reality. I usually come back every couple months to see what's going on too and honestly this board is like reading Mayan apocalypse prophecies. Again, yes there are challenges.. there are challenges to being an educated professional .. some of you act like it's the first time in recorded human history that being an educated professional came with significant challenges. Get your thumbs out of your mouths, put away your blankies and stop scaring good students and residents away from a great specialty. (not because they all share the paranoia that is rampant here - but because they fear they may someday have to work with one of you, can't blame them for that at all)

And don't forget the requisite I'm stupid/naïve/wearing rose colored glasses/whatever just because I - like everyone else in pathology I've ever met in person or trained with - have a good job that I love coming in for every morning. <O:p></O:p>
 
First of all, I would just like to say that threads like this are seriously depressing. What ever happened to positive thinking and taking initiative?

Secondly, I wish that everyone would stop complaining online/dwelling on the negatives and instead, go out and DO SOMETHING about it. Get on the horn to our advocates. Let them know how you feel. CAP, ASCP, Representatives, Senators...any (or all) and let them know what is happening. Construct the thoughts that you are expressing on this forum into a coherent argument and explain the crisis to our advocates. Take charge to make change for the better.

When stuff gets hard, you should just flee? I don't think so. Together we can make a difference. I love pathology too much to just "flee" when things get tough.

Anything in life worth having doesn't come easy folks. It is time to take a stand, not run away.
 
We need to change the title of this thread to Free Pathology Now!! Since our work has been devalued so drastically.

Speaking of negativity. I dont think I have ever seen so many upset/depressed physicians at I have today at work. Nearly everyone is mad about Obama winning, no matter what specialty you are.
 
sham wow said:
I wish that everyone would stop complaining online/dwelling on the negatives and instead, go out and DO SOMETHING about it. Get on the horn to our advocates. Let them know how you feel. CAP, ASCP, Representatives, Senators...any (or all) and let them know what is happening. Construct the thoughts that you are expressing on this forum into a coherent argument and explain the crisis to our advocates. Take charge to make change for the better.
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Of course we have. Those who would propose to be our advocates are well aware of our issues, but usually just shrug their shoulders as if to say "yeah, life sucks doesn't it".

I've written letters to my congressmen, the CAP and ASCP. I've spoken with leadership of the CAP and ASCP at national conferences, and been witness to their double-talk answers when answering questions in public forums. I have zero faith that any of them can do anything for us.

Radiologists actually have clinic at my hospital. They sit with patients, go over their imaging and what it might represent and what types of treatment options are usually done in each case, then set the patient up a meeting with an oncologist/surgeon. The radiologists bill for this.

I seriously doubt any pathologist could pull something similar off. We have zero support, and have no one who will give us their ear because they have no true incentive for not pissing us off.

It's nice you still have your optimism and like to take things into your own hands, but I suspect that even you will reach a limit of how long you're willing to bang your head into a wall. We'll see what song you're singing once you're looking around and applying to jobs.

I suspect our only real chance for change is to revolt; strike. Unfortunately path is such a small field to begin with, and a large percentage of us are...non-confrontational. It would be a near miracle to get enough pull going.
 
sham wow said:
First of all, I would just like to say that threads like this are seriously depressing. What ever happened to positive thinking and taking initiative?

Secondly, I wish that everyone would stop complaining online/dwelling on the negatives and instead, go out and DO SOMETHING about it. Get on the horn to our advocates. Let them know how you feel. CAP, ASCP, Representatives, Senators...any (or all) and let them know what is happening. Construct the thoughts that you are expressing on this forum into a coherent argument and explain the crisis to our advocates. Take charge to make change for the better.

When stuff gets hard, you should just flee? I don't think so. Together we can make a difference. I love pathology too much to just "flee" when things get tough.

Anything in life worth having doesn't come easy folks. It is time to take a stand, not run away.
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Correct me if I am wrong, but from my limited exposure to the field I think pathology tends to attract more socially awkward, introverted individuals with poor political skills and zero desire to be politically active. This, coupled with lots of FMGs among faculty and residents with poor English skills and poor understanding of the political system in medicine, I am not surprised government, insurance, hospital admins roll over pathologists. I feel for the field. I think the field is great, but I am not hugely optimistic about its future
 
path or no path said:
Correct me if I am wrong, but from my limited exposure to the field I think pathology tends to attract more socially awkward, introverted individuals with poor political skills and zero desire to be politically active. This, coupled with lots of FMGs among faculty and residents with poor English skills and poor understanding of the political system in medicine, I am not surprised government, insurance, hospital admins roll over pathologists. I feel for the field. I think the field is great, but I am not hugely optimistic about its future
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Agreed. I know at first blush the concept of a strike seems childish, unrealistic, and/or somehow and admission of giving up, but at this point I see no realistic alternative.

Of course, by "strike" I do not necessarily mean an organized, full-fledged pan-country walk out (although I'm not ruling it out). But rather, pathologists need to take that same sort of firm, self-appreciative mindset when dealing with administrators, politicians, insurance and the like if we want to get anywhere.
 
Let me add there is NO area of medicine in US history that has been worse served by its leadership than Pathology. Beginning in early 1980s leading up to CLIA, the fat and bloated Pathology leadership was only concerned with saving their own hides and enriching themselves in the sell out boom that began in 1988.

CAP and ABP and the such have sold out the entire profession dating back to Virchow.

There is no area in the upper echelons of Pathology that have been left untainted by this rot:
1.) Academics have maintained the massive overtraining in Pathology to fatten their bottom lines and rely less on the Pathology Assts. who in some cases are making much more than actual Pathologists! (I have documented examples of hospital employed PAs making 110K/year while Pathologists are hired at 95K).

2.) The bloated robber barons who sold out to Quest/Ameripath have continued to pillage the marketplace when their own massive fortunes took hit first in the stock downturn in 2000-2001 and then with the RE crash in 2007.

3.) The appointed leadership at CAP have focused more on appeasing elected politicians in Washington with ridiculous QC requirements and absurd reporting formats rather than addressing the fact their members are literally on fire.

I cant even name 1 major force in Healthcare at the moment that is actually on our side.

This is literally a modern Masada. And like Masada, there may be none of us left to tell the tale.
 
LADoc00 said:
Let me add there is NO area of medicine in US history that has been worse served by its leadership than Pathology. Beginning in early 1980s leading up to CLIA, the fat and bloated Pathology leadership was only concerned with saving their own hides and enriching themselves in the sell out boom that began in 1988.

CAP and ABP and the such have sold out the entire profession dating back to Virchow.

There is no area in the upper echelons of Pathology that have been left untainted by this rot:
1.) Academics have maintained the massive overtraining in Pathology to fatten their bottom lines and rely less on the Pathology Assts. who in some cases are making much more than actual Pathologists! (I have documented examples of hospital employed PAs making 110K/year while Pathologists are hired at 95K).

2.) The bloated robber barons who sold out to Quest/Ameripath have continued to pillage the marketplace when their own massive fortunes took hit first in the stock downturn in 2000-2001 and then with the RE crash in 2007.

3.) The appointed leadership at CAP have focused more on appeasing elected politicians in Washington with ridiculous QC requirements and absurd reporting formats rather than addressing the fact their members are literally on fire.

I cant even name 1 major force in Healthcare at the moment that is actually on our side.

This is literally a modern Masada. And like Masada, there may be none of us left to tell the tale.
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the bloated robber barons you refer to saw that the light at the end of the tunnel was a train; at least I/my group did and knew it was time to exit while the getting was good. anyone who saw what i did and did not do the same if presented with the opportunity regrets it. i know several in that circumstance and they now make 1/2 or less than they did and they will get little or nothing from their practice equity when they retire
 
Im not playerhating Mike! If you see your house on fire, you leave. If you can leave carrying a large pot of gold, more power to you. Im glad you got out!

But the house is on fire and there is a ton of children still inside.

just saying.
 
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LADoc00 said:
Let me add there is NO area of medicine in US history that has been worse served by its leadership than Pathology. Beginning in early 1980s leading up to CLIA, the fat and bloated Pathology leadership was only concerned with saving their own hides and enriching themselves in the sell out boom that began in 1988.


Academics have maintained the massive overtraining in Pathology to fatten their bottom lines and rely less on the Pathology Assts. who in some cases are making much more than actual Pathologists! (I have documented examples of hospital employed PAs making 110K/year while Pathologists are hired at 95K).
.
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With that kind of chaff income, it would be better to retrain in internal medicine, surgery, etc. than to continue in pathology.

Your field is entirely disrespected and undervalued relative to the worth of your work. You're not professionals, you're commodities; necessary, important, but not rare enough to command any value. Interchangeable parts. Widgets.

It seems no medical students should ever entertain pathology as a career choice.

I think your field is soon dead. The slack will be picked up by PhDs, radiologists and other physicians.
 
Substance said:
With that kind of chaff income, it would be better to retrain in internal medicine, surgery, etc. than to continue in pathology.

Your field is entirely disrespected and undervalued relative to the worth of your work. You're not professionals, you're commodities; necessary, important, but not rare enough to command any value. Interchangeable parts. Widgets.

It seems no medical students should ever entertain pathology as a career choice.

I think your field is soon dead. The slack will be picked up by PhDs, radiologists and other physicians.
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By soon, I hope you don't mean within the next 40 years. I plan on having to work until I am 75.
 
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Substance said:
Nah bro. Ten years tops.
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Pathology has some life left in it, ten years may be overly pessimistic. But 30 years out, yeah there is a serious "Gates of Tartarus" situation out on the horizon.
 
sham wow said:
First of all, I would just like to say that threads like this are seriously depressing. What ever happened to positive thinking and taking initiative?

Secondly, I wish that everyone would stop complaining online/dwelling on the negatives and instead, go out and DO SOMETHING about it. Get on the horn to our advocates. Let them know how you feel. CAP, ASCP, Representatives, Senators...any (or all) and let them know what is happening. Construct the thoughts that you are expressing on this forum into a coherent argument and explain the crisis to our advocates. Take charge to make change for the better.

When stuff gets hard, you should just flee? I don't think so. Together we can make a difference. I love pathology too much to just "flee" when things get tough.

Anything in life worth having doesn't come easy folks. It is time to take a stand, not run away.
Click to expand...

http://www.youtube.com/watch?v=ep-xgd_eETE
 
Enkidu said:
Well, I think autopsy is safe as well.

Although - what is the salary for pathologists at these mega labs? Is it terrible?
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at my retirement i make/made $400k with bonus potential and a $15000 retirement match into qual and deferal retirement accounts.
 
mikesheree said:
at my retirement i make/made $400k with bonus potential and a $15000 retirement match into qual and deferal retirement accounts.
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I wouldn't call your situation a "mega lab" though.
 
Since this forum is anonymous, I would challenge all the 'Doom and Gloom' pathology attendings (Thrombus, LADoc et al) to provide some information about themselves. Specifically, what are you guys actually earning and how much has your salary decreased over time. I'm guessing that there isn't a single attending in private practice on this forum earning less than $200k and probably most are earning considerably more. Therefore, when you guys tell us that the 'sky is falling' people have to understand the context. DaSein77 had it right, pathology still offers the chance at a very comfortable living and for people who get into top residency/fellowship programs and network it still offers the chance of a very lucrative living ($500k/yr salary).
 
LADoc00 said:
Pathology has some life left in it, ten years may be overly pessimistic. But 30 years out, yeah there is a serious "Gates of Tartarus" situation out on the horizon.
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It was more like 13 months.
 
jp123ok said:
Since this forum is anonymous, I would challenge all the 'Doom and Gloom' pathology attendings (Thrombus, LADoc et al) to provide some information about themselves. Specifically, what are you guys actually earning and how much has your salary decreased over time. I'm guessing that there isn't a single attending in private practice on this forum earning less than $200k and probably most are earning considerably more. Therefore, when you guys tell us that the 'sky is falling' people have to understand the context. DaSein77 had it right, pathology still offers the chance at a very comfortable living and for people who get into top residency/fellowship programs and network it still offers the chance of a very lucrative living ($500k/yr salary).
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Im guessing they make at least 300K a year, most likely more.
 
For the benefit of junior people who must read these boards with terror and depression in their hearts, here are my two cents. These comments are not aimed at anyone in particular, by the way.

As with all things on the internet, one must consider the source and take everything with a grain (or handful) of salt. Many of the posters on this forum seem very knowledgeable and offer good insight into both the scientific and business sides of pathology. Yet there is also an ENORMOUS amount of negativity here, and some of it may be overblown. Don't get me wrong: much of this negativity is likely related to problematic issues that are truly happening out there in the real world and that are directly impacting the lives of these negative posters in a serious way. That doesn't mean, though, that an individual person's situation (or contentment and happiness with their situation) can be generalized to all members of our entire specialty. It also doesn't mean that every comment or anecdote on this forum is necessarily 1) completely true, 2) without exaggeration, or 3) without bias. I know when I am upset or frustrated I have a tendency to put a negative spin on things, and I wonder if that might possibly happen on this forum occasionally.

Certainly pathology faces some very difficult problems in the coming years, many of which I personally have little exposure to due to my position as a junior academic pathologist (since I post under my real name, anyone can verify where I work and can make judgements about my probable level of expertise or lack thereof on any of these topics). Admittedly, I am an optimist, I have no real personal experience with the challenges of private practice, and I am currently happily employed. So keep in mind that my comments come with that bias attached. But I am happy I chose pathology, happy with my current job, happy with my salary, and happy with my future prospects in our field. Maybe I have it all wrong and will be weeping in a few years. But I'm not weeping today.
 
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Looking at the 2013 ASCP job market study. A ton of fellows didn't find jobs. With the upcoming flow and ish tc cuts that hemepath fellowship is not going to do anything for you. Can't find a job after residency or fellowship....stay away from pathology.

Where is the shortage? Where???? We are training doctors that can't find work!!

Flee Pathology...you are going to have to when you can't find work.
 
Yah the bottom seems to have fallen out of Hemepath in such dramatic fashion that if I had seen the future some 13-14 years ago pre-Flow professional component reduction and now this, I would have taken that job for 175K with Bain out in NYC and rolled the bones in finance.

The thing that scares me is what the hell will happen with Hemepath? What if TC providers wake up and realize they are losing money on all this and just fold?

Who the hell will provide these services??
 
LADoc00 said:
Yah the bottom seems to have fallen out of Hemepath in such dramatic fashion that if I had seen the future some 13-14 years ago pre-Flow professional component reduction and now this, I would have taken that job for 175K with Bain out in NYC and rolled the bones in finance.

The thing that scares me is what the hell will happen with Hemepath? What if TC providers wake up and realize they are losing money on all this and just fold?

Who the hell will provide these services??
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The business will come back to hospital based pathologist groups. Doing heme only is a pipe dream these days, outside of academics. Too bad for the new grads I'll be competing for those same jobs with several years experience.
 
One other thing to notice in the report, nearly 40% of path residents have NO student loans. At least the low-level-pay academic jobs will have a steady stream of debt-free FMGs to keep the wheels turning.
 
Glass Pusher said:
One other thing to notice in the report, nearly 40% of path residents have NO student loans. At least the low-level-pay academic jobs will have a steady stream of debt-free FMGs to keep the wheels turning.
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That is due to the high number of MD/PhD's in pathology - no medical school debt for them.
 
zao275 said:
For the benefit of junior people who must read these boards with terror and depression in their hearts, here are my two cents. These comments are not aimed at anyone in particular, by the way.

As with all things on the internet, one must consider the source and take everything with a grain (or handful) of salt. Many of the posters on this forum seem very knowledgeable and offer good insight into both the scientific and business sides of pathology. Yet there is also an ENORMOUS amount of negativity here, and some of it may be overblown. Don't get me wrong: much of this negativity is likely related to problematic issues that are truly happening out there in the real world and that are directly impacting the lives of these negative posters in a serious way. That doesn't mean, though, that an individual person's situation (or contentment and happiness with their situation) can be generalized to all members of our entire specialty. It also doesn't mean that every comment or anecdote on this forum is necessarily 1) completely true, 2) without exaggeration, or 3) without bias. I know when I am upset or frustrated I have a tendency to put a negative spin on things, and I wonder if that might possibly happen on this forum occasionally.

Certainly pathology faces some very difficult problems in the coming years, many of which I personally have little exposure to due to my position as a junior academic pathologist (since I post under my real name, anyone can verify where I work and can make judgements about my probable level of expertise or lack thereof on any of these topics). Admittedly, I am an optimist, I have no real personal experience with the challenges of private practice, and I am currently happily employed. So keep in mind that my comments come with that bias attached. But I am happy I chose pathology, happy with my current job, happy with my salary, and happy with my future prospects in our field. Maybe I have it all wrong and will be weeping in a few years. But I'm not weeping today.
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Well stated, Dr. Gardner.
 
mlw03 said:
If things are so bad in the diagnostic path world, why aren't there more people training and working in the few areas in path that are non-competitive and with decent job markets? Forensic and blood banking come to mind, but there's probably a few others.
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Not to be mean, but how many pathologists who really love pathology went into it because of blood banking or forensics? I would say 80-90% of path residents never want to see another autopsy outside of residency and you forget to mention that blood banking fellowships are open to everybody . . . IM and others. Most people get into pathology b/c they like surg path or a subspecialty of it. Most do not go into it b/c they like chemistry or microbiology . . ..
 
I dunno.. When I was interviewing for residency, every interview day it seemed like there was at least one other person interviewing who voiced interest in forensics. That changes for a lot of those people -during- residency, in no small part because most attendings are bitter and not all that knowledgeable about doing them, and tend to have little or no financial motivation for doing them (it may actually cost them), so the cycle continues. It may even mean a few of those folks got put on the "eh" list in part because they were "too" interested in just forensics -- I can't say that doesn't happen. I don't know what the numbers are for applicants and what got them started, though that would be interesting to see. But I suspect the problem of medical schools failing to provide any instruction or exposure to real-world pathology means at least a few folks start looking at it because of the focus on forensics in popular media.
 
KCShaw said:
I dunno.. When I was interviewing for residency, every interview day it seemed like there was at least one other person interviewing who voiced interest in forensics. That changes for a lot of those people -during- residency, in no small part because most attendings are bitter and not all that knowledgeable about doing them, and tend to have little or no financial motivation for doing them (it may actually cost them), so the cycle continues. It may even mean a few of those folks got put on the "eh" list in part because they were "too" interested in just forensics -- I can't say that doesn't happen. I don't know what the numbers are for applicants and what got them started, though that would be interesting to see. But I suspect the problem of medical schools failing to provide any instruction or exposure to real-world pathology means at least a few folks start looking at it because of the focus on forensics in popular media.
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Forensics has to have the worst risk vs. reward equation of anything in all of medicine. The lifestyle is horrible. The pay is among the worst, often lower than the high school grad deputies that surround you and often boss you around like you are poodle on a short leash.

Its horrendous. Constantine's version of hell has nothing on the life of an actual forensic pathologist in modern America. Almost every forensics section is filled with IMGs and if its not IMGs, they have a "consultant" FP who spends little to zero time actually in the department so he/she can remain sane.

I would rather be a grunt in the Army tbh. If people are picking actual careers on the media's fantastical vision of something they are in for one hell of a sad reality down the road.

As I have said before: FORENSICS HAS NO BUSINESS BEING PART OF PATHOLOGY. make it a 2-year masters degree. make it a trade school thing. Get it the hell out of Pathology. There is no connection between Anatomic Pathology, Lab Medicine and actual day to day Forensics. Get it out and get it out now.
As a community college degree or a masters of science or something, the pay these sad folks get will actually start to make sense.
 
Bump. Tomorrow is 11/27/13. I am sure many will be wanting to flee pathology after new fee schedule.
 
LADoc00 said:
Forensics has to have the worst risk vs. reward equation of anything in all of medicine. The lifestyle is horrible. The pay is among the worst, often lower than the high school grad deputies that surround you and often boss you around like you are poodle on a short leash.

Its horrendous. Constantine's version of hell has nothing on the life of an actual forensic pathologist in modern America. Almost every forensics section is filled with IMGs and if its not IMGs, they have a "consultant" FP who spends little to zero time actually in the department so he/she can remain sane.

I would rather be a grunt in the Army tbh. If people are picking actual careers on the media's fantastical vision of something they are in for one hell of a sad reality down the road.

As I have said before: FORENSICS HAS NO BUSINESS BEING PART OF PATHOLOGY. make it a 2-year masters degree. make it a trade school thing. Get it the hell out of Pathology. There is no connection between Anatomic Pathology, Lab Medicine and actual day to day Forensics. Get it out and get it out now.
As a community college degree or a masters of science or something, the pay these sad folks get will actually start to make sense.
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I do 50 forensic cases a year, make 150K, and spend most of my day planning lunch. Don't waste too much time feeling sorry for us.
 
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Reading this thread really scared me as I was thinking about a pathology residency and then doing a medical microbiology fellowship....

If you are willing and committed to work in 'academia' or for a governmental agency (such as the CDC) will it still be that hard to get a job?
 
GtownCobra said:
I do 50 forensic cases a year, make 150K, and spend most of my day planning lunch. Don't waste too much time feeling sorry for us.
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What the heck are you eating that it takes you most of the day to plan it? You know there's porn out there to be watched, right?
 
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karish7 said:
Reading this thread really scared me as I was thinking about a pathology residency and then doing a medical microbiology fellowship....

If you are willing and committed to work in 'academia' or for a governmental agency (such as the CDC) will it still be that hard to get a job?
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Son (or daughter), a "medical microbiologist" is a 19-20th century profession. Today people who work in this field need 7th grade skills (typing on a keyboard, pushing start buttons and on switches). You have chosen a great example to illuminate just how out of touch the ABP is in sponsoring such a career path for a resident trained physician. I encourage you to find work in an unsaturated, 21st century relevant profession and pursue those goals. Pathology is oversaturated and we do not need any more "help".


Sincerely, (dad and mom)
 
Wow that is an uninformed post. While I would agree that there are other (and perhaps better depending on the individual) routes to working for the CDC and medical microbiology than a pathology residency, the premise of your post is otherwise quite objectionable and blatantly false.
 
I don't know anyone "fleeing" pathology. Our lab has, however, seen quite a remarkable uptick in physician retirements and office closures for private practice internists, family practitioners, and surgeons. Not entirely sure what the specific reasons are for each, no doubt some were ready to retire anyway, some are worried about reimbursement and new administrative requirements. But I think this month I have seen more emails from our client reps about "so and so is closing their office etc" than I have in the past 2 years combined.

What I would say is that people are not "fleeing" the practice of medicine in any field. But many do seem to be "fleeing" the pure private practitioner (particularly solo practitioner) environment. Docs are merging with larger physician groups or hospitals. The trend is perhaps even more pronounced in other fields than pathology.
 
yaah said:
I don't know anyone "fleeing" pathology. Our lab has, however, seen quite a remarkable uptick in physician retirements and office closures for private practice internists, family practitioners, and surgeons. Not entirely sure what the specific reasons are for each, no doubt some were ready to retire anyway, some are worried about reimbursement and new administrative requirements. But I think this month I have seen more emails from our client reps about "so and so is closing their office etc" than I have in the past 2 years combined.

What I would say is that people are not "fleeing" the practice of medicine in any field. But many do seem to be "fleeing" the pure private practitioner (particularly solo practitioner) environment. Docs are merging with larger physician groups or hospitals. The trend is perhaps even more pronounced in other fields than pathology.
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This is all part of the war on the entrepreneur and the individual. There is only so much cronyism and heavy handed regulation a business can take. sad day in America. The incentive to achieve and stand on ones own feet is being destroyed by those with a lust for power.
 
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bump. its that time of year to bring back this thread with the great title!
 
This thread was started two years ago. I would give anything to go back to the golden years of 2012
 
Ah...2012....What a time....Carly Rae Jepsen was playing on the radio and some of us were making a killing off the TC. Those were great times, unless you were Thrombus.

But here's my number
So call me, maybe.......
 
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