New Low for Comp Health

[LADoc00]

Comp Health recruitment has called me now 3 times for the same absolutely craptastic offer:

They are looking for someone to sign out 125x88305s of skin per day for $1,000/day.

This is in Northern California in literally one of the highest cost of living areas in the world, Silicon Valley for an obviously idiotic group of greedy dermatologists.

Let's reflect on this math. Per the 2015 CMS fee schedule and mind you Derm groups are often at 150%+ of medicare rates because they dont see as much medicare as other specialties, that would be $90.64 global per case or a revenue for the Dermies of $11,330 PER DAY. They want to pay you $1,000.

Now the -26 pro fee calculation would be $45.22 per 88305 for a total of $5,652 PER DAY just for the read. But they really want to pay you $1,000.

Then consider their "real collections" closer to 150% local CMS rates....a whopping $16,995 gross revenue per day. But they want to pay you $1,000 or roughly 5.8% of the gross.....

UNREAL.

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[AZpath]

Pathologists are dime a dozen. Locums= desperate pathologist.

 

[Over9000]

Clearly some schmuck with a decade-old Yemenese medical degree who completed PA-training..er....residency at Albany and fellowships in "surg path" and autopsy will gladly lick the boots of those dermatologists.

They post that offer because they know they can get some idiot to take it.

That's less than 10 bucks a case.

Anyone who accepts that offer is a *****. If I were hiring and a CV came across my desk with THAT job in the employment history, I'd call the idiot, give them a good wall-to-wall discussion and then blacklist the SOB.

 

[doctalaughs]

Out of curiosity is 125 dermpath cases a day a reasonable caseload or is that high? What is typical lab / processing overhead as a percentage? Woudn't $1000 a day be 20k a month or 240k a year? Not amazing but seems not so low (i am just curious, our group sends all specimens to the local university and do not employ a pathologist or have a lab). On the other hand I know a lot of dermatologists who read all the easy stuff (bcc/scc/cysts) and send the excisions and high risk, high time stuff out, which seems worse than the above situation.

 

[pathstudent]

Yes 240k seems low when you are generating 1 million a year for the dermatologists off your professional work alone.

 

[doctalaughs]

Yes 240k seems low when you are generating 1 million a year for the dermatologists off your professional work alone.

Understood, but the 1 million is not profit and there is overhead. I bill well over 1 million a year and don't take home anything close to that. But i understand there is admin/clinic/billing/collections overhead. In addition I also understand I would not be able to easily get that many patients if I hung my own shingle (and for a pathologist its even harder).

It does sound like the above situation is exploitation but where is the cutoff? If they paid 300k a year instead of 240 would it be fair? 400? 500? Again, i dont care because we dont employ any pathologists.

 

[pathstudent]

What would be fair is if I got to keep 100% of my professional component.

Should you have to pay 80% of your professional reimbursement to the family practice docs that refer to you?

I have no problem if Uris, derms or gastros want to try to make money off making slides but I find it disgusting when they make money by splitting fees.

 

[doctalaughs]

Fair enough although only about 25 percent of derm practice is referral based (the other 75 is word of mouth marketing and return visits)

By the way if you know of a family practice group that is willing to hire me, funnel all the referrals and pay a million a year let me know!

 

[yaah]

It is unreal but what if this isn't a fulltime job for some people? 125 cases probably wouldn't take 9 hours every day. I don't do derm but common cases you could probably knock that out in a few hours.

This is, of course, putting aside the blatant and obvious ethical breach of billing the full rate for someone else's work and paying them a margin of it.

But yes, this is good evidence of the massive increase in efficiency of pathologists over the last couple of decades. 20 years ago 125 cases was probably 3-4 people. Now it's a 0.4 FTE or something. This is one of the main things that advocates for increasing residency positions don't seem to understand or account for.

 

[mario2010]

That's too low, bordering illegal. They can get into issues with CMS. Anything less than 70--75% medicare is a red flag and can spell trouble for both the physician group and pathologist. Usual going rate hovers around $25 per derm specimen (after 2012 medicare cuts). I get calls every now and then to read in-house and offers vary b/w $20-$28 bucks per specimen. Even Labcorp is paying their contract pathologists around $20 per specimen for part time work.

 

[icpshootyz]

It is unreal but what if this isn't a fulltime job for some people? 125 cases probably wouldn't take 9 hours every day. I don't do derm but common cases you could probably knock that out in a few hours.

This is, of course, putting aside the blatant and obvious ethical breach of billing the full rate for someone else's work and paying them a margin of it.

But yes, this is good evidence of the massive increase in efficiency of pathologists over the last couple of decades. 20 years ago 125 cases was probably 3-4 people. Now it's a 0.4 FTE or something. This is one of the main things that advocates for increasing residency positions don't seem to understand or account for.

125 cases is is pretty high. When you factor in how many cases require levels, stains, etc that should be a full day's work. Not too many dermpaths are seeing that much more than that.

 

[dr.weiner]

That's essentially what corporate dpath labs are paying for entry level gigs. Sign out 125-150 cases per day, 275-300K a year, when you are probably billing 10x that.

 

[path24]

Another great pathology moment!! This proud moment has been proved by program directors, cap, ascp, uscap, academics....and the massive over training.

Send them the shortage article, that will show/scare them! haha.

So pathetic, so sad. We get what we deserve.