Partnership positions declining?

[KeratinPearls]

Is it true partnership track positions are on the decline?

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[Gene_]

I believe this to be true.

 

[DIce3]

free falling for over a decade

 

[pathstudent]

Is it true partnership track positions are on the decline?

Deninitely.

I interviewed at Oregon about ten years ago and the pd was en ex-private practice turned academic blood banker. He said his practice was sold to a corporation and the job became so miserable he took the academic job just to get out. He said there were no true private practice jobs in all of Portland. This was ten years ago. I can't imagine they have increased since then.

 

[Ruination]

He said there were no true private practice jobs in all of Portland. This was ten years ago.

I can't speak for whether they are decreasing or increasing, but I know first hand that there ARE real community practice jobs in Portland.

 

[pathstudent]

I can't speak for whether they are decreasing or increasing, but I know first hand that there ARE real community practice jobs in Portland.

Well maybe he was exaggerating at the time or my memory exaggerates or maybe he was talking about portland proper, but I know he said he got out of private practice because of his group being sold to a corporation.

Also it is worth stating the difference between being in private practice vs. community practice. Private practice implies the practice is owned by the pathologists with all profits divided between the partners. If you work for Ameripath and are at a community hospital you are in a community practice but not in private practice. THere are probably examples of private practice groups at larger seemingly academic type places, although I can't think of one off hand.

 

[coroner]

Well, I'll bite if this is gonna turn into one of those "the sky is falling" type threads that we like to make around here... I will say that I'm not sure of numbers either, but I've heard that as the impact of ACO's, Stark laws, and changes in reimbursement take effect, the trend will be for more groups to redistribute workload rather than hire another person on staff, until it starts affecting tee times and sippin' margaritas at their timeshare in Key Largo. That, plus the decline of satellite/reference labs is gonna put a lot of pathologists in the breadline who've been looking at prostates everyday for the last 7 years making those partnership positions even more so sought after. But, with the en masse retirement that everybody tweets about, no need to worry

 

[sirenomelia]

Several PP people have told me similar things that they sold out to ameripath, etc out of survival since the private offices were diverting specimens toward those entities anyway and that the security of living under their umbrella and knowing you have some dependable inflow of specimens/ work affords a great deal of security and the sacrifice of autonomy was worth it.

 

[WEBB PINKERTON]

Several PP people have told me similar things that they sold out to ameripath, etc out of survival since the private offices were diverting specimens toward those entities anyway and that the security of living under their umbrella and knowing you have some dependable inflow of specimens/ work affords a great deal of security and the sacrifice of autonomy was worth it.

There is NO SECURITY in pathology. Selling out sure doesnt guarantee it. Just kills off another competitor for these slide mills. They would not grow if not for acquistions. Very little organic growth with them. I've seen many lose business after getting bought out. Its not like Ameripath and others have a great reputation. An old group I worked for sold out to Labcorp and their volumes went in the crapper. After Labcorp bought another 2 labs in the area, they merged all those 2 with the other dying lab and showed quite a few people the door.

Specialty labs are the wave of the future. Seems like every day one crawls out from under a rock with some exclusive molecular test seducing physicians. Some new one in my area working the ENT circuit with some test for Thyroid aspirations.

 

[deleted314957]

that would be ameripath/quest. i have a copy of the hand-out literature.

 

[KeratinPearls]

There is NO SECURITY in pathology. Selling out sure doesnt guarantee it. Just kills off another competitor for these slide mills. They would not grow if not for acquistions. Very little organic growth with them. I've seen many lose business after getting bought out. Its not like Ameripath and others have a great reputation. An old group I worked for sold out to Labcorp and their volumes went in the crapper. After Labcorp bought another 2 labs in the area, they merged all those 2 with the other dying lab and showed quite a few people the door.

Specialty labs are the wave of the future. Seems like every day one crawls out from under a rock with some exclusive molecular test seducing physicians. Some new one in my area working the ENT circuit with some test for Thyroid aspirations.

What do you mean by specialty labs? Like dermpath diagnostics, Caris, Ameripath? What about in office labs? Seems like these in office labs are hurting their business.

 

[scienceguy19]

if only corporate labs would buy out our autopsy work... :/

 

[mlw03]

if only corporate labs would buy out our autopsy work... :/

If you're that averse, see if a resident in the local path residency (if one exists) wants to prosect and write the first draft of the report. It's amusing to me that one of the few areas of path that truly cannot be outsourced (autopsies) is so hated by those in the community. I get why and this isn't to resume that discourse. But my point is that if pathologists give up more and more of what we do, then when do we cease to be physicians considering an entire "case" and instead become techs, effectively doing pattern recognition only. I think this ties into the original question, because old school style private practice sounds a lot more like true medical practice, rather than the pod-lab style of practice of coming in and just looking at 80 prostate biopsies a day.

 

[WEBB PINKERTON]

What do you mean by specialty labs? Like dermpath diagnostics, Caris, Ameripath? What about in office labs? Seems like these in office labs are hurting their business.

Places like Thyroid Cytopathology partners. Once the bread and butter specimens go by the wasteside, these will be about all that exist.

http://www.thyroidcytopath.com/

Of course at some point they will scare labcorp, ameripath and others and sell out probably. Hard to say no when someone wants to overpay for you. My old lab couldnt say no.

 

[mlw03]

Places like Thyroid Cytopathology partners. Once the bread and butter specimens go by the wasteside, these will be about all that exist.

http://www.thyroidcytopath.com/

Of course at some point they will scare labcorp, ameripath and others and sell out probably. Hard to say no when someone wants to overpay for you. My old lab couldnt say no.

This is exactly what I was referring to. All thryoid cytopath, all day. How is that practicing medicine and not just pattern recognition? And if you're one of those pathologists and want to do something else in 5 years, are you going to be able to do so having only looked at thyroid slides since leaving fellowship?

 

[KeratinPearls]

Places like Thyroid Cytopathology partners. Once the bread and butter specimens go by the wasteside, these will be about all that exist.

http://www.thyroidcytopath.com/

Of course at some point they will scare labcorp, ameripath and others and sell out probably. Hard to say no when someone wants to overpay for you. My old lab couldnt say no.

Didnt know labs this specialized exist and how could reading thyroid cytopath be so profitable, that you can set up a business based on it? Anyone can read cytopath, so why would you send your cytos to these ppl (and be burdened with sending out the specimen) versus just having the local cytopath in your hospital read it (I guess that goes with any area of pathology)? Ive never heard of molecular cytopathology until I've read it on this forum. Is this a new field?

 

[Torsed]

Lots of fear in this blog. I made partner after 1 year. Do your homework before you sign on to a group, its that simple. If you limit yourself to working in Foggy Nutts, North Dakota can one really complain about grim aspects of not making partner. Some of our clinicians were I am send their material to LabCorp/other reference labs, but take assurance in the fact that those cases are only one lawsuit away from coming back, the business is pretty brisk so I am not to concerned and sometimes physicians change where they send material to like the wind shifting. I contend that even in my short attendingship time there has been major changes in the lab and it will continue to change. As far as the subspecialization of our field its not necessarily a bad thing, I am still the sentinel in what goes to the expert and what doesn't. I can't see a time when every special organ that comes out gets shipped to a different lab from every hospital in the country, its not feasible (but of course this IS American Healthcare....god knows what could happen).

 

[KCShaw]

Well, keep in mind that every specimen does not come from a hospital. Hospitals and other large'ish institutions are more likely to have 'one' lab they send pretty much everything to. But there's plenty of incentive for private offices and clinics (especially smaller ones or highly specialized ones) to do 'specialized' in-office/in-clinic biopsies or aspirations and send them to 'specialized' path labs for evaluation. We're not the only 'subspecializing' specialty. So while I wouldn't expect a thyroid path lab on every corner, I can see how a few might be in business.

 

[lipomas]

Private (partnership) jobs in every specialty are declining.

 

[Gene_]

Places like Thyroid Cytopathology partners. Once the bread and butter specimens go by the wasteside, these will be about all that exist.

http://www.thyroidcytopath.com/

Of course at some point they will scare labcorp, ameripath and others and sell out probably. Hard to say no when someone wants to overpay for you. My old lab couldnt say no.

Thyroid Cytopathology seems to be a branch of an already established private practice group called Brazos Valley Pathology and Trinity Pathology. From the little I have heard about the group, they seem to be very enterprising. They always seems to be hiring, which also raises a few red flags in my mind.

 

[schrute]

As accountable care organizations become the primer for 21st century medicine (Obamacare or no Obamacare), there is strength in numbers, and as group sizes increase, so does ability (or the need) to subspecialize.

The subspecialization trend has been a long time coming and affects most other fields as well. That has the unfortunate side affect--particularly in the current economy--of turning the jobs market into a battle of attrition, and whoever can survive the most fellowships [or at least the fellowship(s) most relevant to a particular job opening] often has a distinct advantage. ie. employers can be picky and one is more apt to be "competitive" having 1 or 2 fellowships. Whereas 25 yrs ago a 5 yr pathology residency would put one on roughly the same playing field as most of ones' colleagues (for non-academic jobs), that is not true today (though the same can be said for most non-primary care fields). That's the product of the free market and modern medicine (including training), but is nonetheless morally defeating and the source of much anxiety, frustration and apathy from the younger generation of physicians/trainees who have to jump through increasingly smaller and more numerous hoops to reach an goal that is less prestigious (monetarily & socially), and more laden with bureaucratic garbage.

We recently had a visit from the incoming CAP president who, aside from telling lots of warm fuzzy stories, did his best to convince our residents that pathology is in great shape, we should encourage med students to enter pathology, and our best bet in the gamble of nationalized care & ACOs is to make ourselves a more visible & impactful member of the hospital team. See patients...join committees...get involved...hold conferences...talk to more clinicians...make yourself visible. That's fine & dandy, but it does nothing to address the relative disparity of trainees-to-jobs, nor does it acknowledge the obvious reality that pay & volume are on diverging paths while complexity of diagnoses on an ever steeper and steeper slope. Time is finite variable whereas the number of trainess COULD be a finite variable were it not for our leadership feeling otherwise.

The despair is palpable and heartfelt pats on the back meaningless.

I remember being asked on a med school interview what I would do if tomorrow I won the lottery. Despite the obvious reality that most of us (save the masochistic few that are convinced they are more important than they are) wouldn't slave away our entire lives given the opportunity, I could at least muster up the fortitude for a half earnest answer which I half believed. Ask me that question today and you'll have to pardon me from laughing hysterically in your face.

 

[deleted314957]

As accountable care organizations become the primer for 21st century medicine (Obamacare or no Obamacare), there is strength in numbers, and as group sizes increase, so does ability (or the need) to subspecialize.

The subspecialization trend has been a long time coming and affects most other fields as well. That has the unfortunate side affect--particularly in the current economy--of turning the jobs market into a battle of attrition, and whoever can survive the most fellowships [or at least the fellowship(s) most relevant to a particular job opening] often has a distinct advantage. ie. employers can be picky and one is more apt to be "competitive" having 1 or 2 fellowships. Whereas 25 yrs ago a 5 yr pathology residency would put one on roughly the same playing field as most of ones' colleagues (for non-academic jobs), that is not true today (though the same can be said for most non-primary care fields). That's the product of the free market and modern medicine (including training), but is nonetheless morally defeating and the source of much anxiety, frustration and apathy from the younger generation of physicians/trainees who have to jump through increasingly smaller and more numerous hoops to reach an goal that is less prestigious (monetarily & socially), and more laden with bureaucratic garbage.

We recently had a visit from the incoming CAP president who, aside from telling lots of warm fuzzy stories, did his best to convince our residents that pathology is in great shape, we should encourage med students to enter pathology, and our best bet in the gamble of nationalized care & ACOs is to make ourselves a more visible & impactful member of the hospital team. See patients...join committees...get involved...hold conferences...talk to more clinicians...make yourself visible. That's fine & dandy, but it does nothing to address the relative disparity of trainees-to-jobs, nor does it acknowledge the obvious reality that pay & volume are on diverging paths while complexity of diagnoses on an ever steeper and steeper slope. Time is finite variable whereas the number of trainess COULD be a finite variable were it not for our leadership feeling otherwise.

The despair is palpable and heartfelt pats on the back meaningless.

I remember being asked on a med school interview what I would do if tomorrow I won the lottery. Despite the obvious reality that most of us (save the masochistic few that are convinced they are more important than they are) wouldn't slave away our entire lives given the opportunity, I could at least muster up the fortitude for a half earnest answer which I half believed. Ask me that question today and you'll have to pardon me from laughing hysterically in your face.

That's sad. I have more money than I will ever need and I work because it is my hobby and I enjoy it. I will never stop unless health issues force it.

 

[path or no path]

As accountable care organizations become the primer for 21st century medicine (Obamacare or no Obamacare), there is strength in numbers, and as group sizes increase, so does ability (or the need) to subspecialize.

The subspecialization trend has been a long time coming and affects most other fields as well. That has the unfortunate side affect--particularly in the current economy--of turning the jobs market into a battle of attrition, and whoever can survive the most fellowships [or at least the fellowship(s) most relevant to a particular job opening] often has a distinct advantage. ie. employers can be picky and one is more apt to be "competitive" having 1 or 2 fellowships. Whereas 25 yrs ago a 5 yr pathology residency would put one on roughly the same playing field as most of ones' colleagues (for non-academic jobs), that is not true today (though the same can be said for most non-primary care fields). That's the product of the free market and modern medicine (including training), but is nonetheless morally defeating and the source of much anxiety, frustration and apathy from the younger generation of physicians/trainees who have to jump through increasingly smaller and more numerous hoops to reach an goal that is less prestigious (monetarily & socially), and more laden with bureaucratic garbage.

We recently had a visit from the incoming CAP president who, aside from telling lots of warm fuzzy stories, did his best to convince our residents that pathology is in great shape, we should encourage med students to enter pathology, and our best bet in the gamble of nationalized care & ACOs is to make ourselves a more visible & impactful member of the hospital team. See patients...join committees...get involved...hold conferences...talk to more clinicians...make yourself visible. That's fine & dandy, but it does nothing to address the relative disparity of trainees-to-jobs, nor does it acknowledge the obvious reality that pay & volume are on diverging paths while complexity of diagnoses on an ever steeper and steeper slope. Time is finite variable whereas the number of trainess COULD be a finite variable were it not for our leadership feeling otherwise.

The despair is palpable and heartfelt pats on the back meaningless.

I remember being asked on a med school interview what I would do if tomorrow I won the lottery. Despite the obvious reality that most of us (save the masochistic few that are convinced they are more important than they are) wouldn't slave away our entire lives given the opportunity, I could at least muster up the fortitude for a half earnest answer which I half believed. Ask me that question today and you'll have to pardon me from laughing hysterically in your face.

wow! that's very depressing

 

[path24]

As accountable care organizations become the primer for 21st century medicine (Obamacare or no Obamacare), there is strength in numbers, and as group sizes increase, so does ability (or the need) to subspecialize.

The subspecialization trend has been a long time coming and affects most other fields as well. That has the unfortunate side affect--particularly in the current economy--of turning the jobs market into a battle of attrition, and whoever can survive the most fellowships [or at least the fellowship(s) most relevant to a particular job opening] often has a distinct advantage. ie. employers can be picky and one is more apt to be "competitive" having 1 or 2 fellowships. Whereas 25 yrs ago a 5 yr pathology residency would put one on roughly the same playing field as most of ones' colleagues (for non-academic jobs), that is not true today (though the same can be said for most non-primary care fields). That's the product of the free market and modern medicine (including training), but is nonetheless morally defeating and the source of much anxiety, frustration and apathy from the younger generation of physicians/trainees who have to jump through increasingly smaller and more numerous hoops to reach an goal that is less prestigious (monetarily & socially), and more laden with bureaucratic garbage.

We recently had a visit from the incoming CAP president who, aside from telling lots of warm fuzzy stories, did his best to convince our residents that pathology is in great shape, we should encourage med students to enter pathology, and our best bet in the gamble of nationalized care & ACOs is to make ourselves a more visible & impactful member of the hospital team. See patients...join committees...get involved...hold conferences...talk to more clinicians...make yourself visible. That's fine & dandy, but it does nothing to address the relative disparity of trainees-to-jobs, nor does it acknowledge the obvious reality that pay & volume are on diverging paths while complexity of diagnoses on an ever steeper and steeper slope. Time is finite variable whereas the number of trainess COULD be a finite variable were it not for our leadership feeling otherwise.

The despair is palpable and heartfelt pats on the back meaningless.

I remember being asked on a med school interview what I would do if tomorrow I won the lottery. Despite the obvious reality that most of us (save the masochistic few that are convinced they are more important than they are) wouldn't slave away our entire lives given the opportunity, I could at least muster up the fortitude for a half earnest answer which I half believed. Ask me that question today and you'll have to pardon me from laughing hysterically in your face.

So the current CAP President is a joke, just like past presidents. Hide from the obvious number one issue in pathology.

Shortage...never going to happen people. With this economy and the future of medicine....pathology should be your last choice. You need a job/future you can trust and that by no means is in pathology.

On topic....I do know a couple of pathology partnership tracts where they never conveniently make partner...hahaha...I am sorry but we are going to have to let you go.....thanks oversupply. They are good 2-3 year rotations.

 

[thebouque]

So the current CAP President is a joke, just like past presidents. Hide from the obvious number one issue in pathology.

Shortage...never going to happen people. With this economy and the future of medicine....pathology should be your last choice. You need a job/future you can trust and that by no means is in pathology.

On topic....I do know a couple of pathology partnership tracts where they never conveniently make partner...hahaha...I am sorry but we are going to have to let you go.....thanks oversupply. They are good 2-3 year rotations.

Sounds like dentistry in Canada. Fortunately the health of pathology in Canada is great in most provinces.

 

[mlw03]

Sounds like dentistry in Canada. Fortunately the health of pathology in Canada is great in most provinces.

Heck yeah it is - in Alberta, they start in the low 300s. Now that said, in the spirit of this thread I think all pathologists are government employees, so no partnership issues. Plus, Canadian pathologists are AP-only style I believe.

 

[thebouque]

Heck yeah it is - in Alberta, they start in the low 300s. Now that said, in the spirit of this thread I think all pathologists are government employees, so no partnership issues. Plus, Canadian pathologists are AP-only style I believe.

Indeed, as far as I know, there is not privatization of pathology in Canada. As you said, most pathologists are AP only (the residency is 5 years: 1 clinical year and 4 years of AP). However, some community pathologists are what we call 'general pathologists' (the equivalent of your AP+CP).

 

[veo1]

wow! that's very depressing

Its also very true

 

[Whiskeyjack]

That's sad. I have more money than I will ever need and I work because it is my hobby and I enjoy it. I will never stop unless health issues force it.

Interesting. So while others complain about a lack of jobs your keeping a spot that could otherwise go to another pathologist who NEEDS a job and the financial security it provides so you can indulge in your hobby.

Why not look at some unknowns or get the CTTR or some'n.

Wonder why pathology job market is in such bad shape.

 

[mlw03]

Interesting. So while others complain about a lack of jobs your keeping a spot that could otherwise go to another pathologist who NEEDS a job and the financial security it provides so you can indulge in your hobby.

Why not look at some unknowns or get the CTTR or some'n.

Wonder why pathology job market is in such bad shape.

Seriously? A job is not a right. If a group thinks this guy brings more to the table than a new trainee, why should this guy retire if he still contributes?

This is the type of entitled attitude that has given our generation a crappy reputation in the workforce.

 

[MirkoCrocop]

Interesting. So while others complain about a lack of jobs your keeping a spot that could otherwise go to another pathologist who NEEDS a job and the financial security it provides so you can indulge in your hobby.

Why not look at some unknowns or get the CTTR or some'n.

Wonder why pathology job market is in such bad shape.

lol@ implying he ought to quit to let us youngins have a piece of the pie. When I'm in my 50s, 60s or so and I still enjoy working and want to keep my job, I'll surely keep working, too.

 

[cjw0918]

Sorry, but I think it's selfish and crappy to hang on to a job to amuse yourself. Get a life, old men with more money than God who don't have jack s*** to do. THAT generation has done plenty to screw our generation in medicine. THEY did not have the hurdles that we do in practicing today. THEY enjoyed the "golden age" of medicine.

What ever happened to gracefully riding off into the sunset?? People hang on way past their prime and it's just ugly. Have some class and dignity, folks. It's just a job, not your whole freaking identity. Enjoy your spoils and let us young guys slog for a while. Geez. Get a puppy if you're that bored.

 

[2121115]

Sorry, but I think it's selfish and crappy to hang on to a job to amuse yourself. Get a life, old men with more money than God who don't have jack s*** to do. THAT generation has done plenty to screw our generation in medicine. THEY did not have the hurdles that we do in practicing today. THEY enjoyed the "golden age" of medicine.

What ever happened to gracefully riding off into the sunset?? People hang on way past their prime and it's just ugly. Have some class and dignity, folks. It's just a job, not your whole freaking identity. Enjoy your spoils and let us young guys slog for a while. Geez. Get a puppy if you're that bored.

Not sure if this post is serious.

 

[mlw03]

Oh, I think it is. And it's that kind of attitude that isn't helping our generation's cause. We're ENTITLED to jobs it would seem, and the older generation should ride off into the sunset, even if they're still competent at their jobs.

 

[deleted314957]

maybe he/she can come to my hospital and convince the medical staff that i have served for the past 22 years as medical director that he/she can do a better job and inspire more trust than i can.

 

[cjw0918]

Oh, I think it is. And it's that kind of attitude that isn't helping our generation's cause. We're ENTITLED to jobs it would seem, and the older generation should ride off into the sunset, even if they're still competent at their jobs.

Yes, we're entitled to jobs. Who in their right mind would NOT feel this way after all of the training including multiple fellowships, boards and subspecialty boards, skyrocketing cost of medical education, onerous burdens of MOC, the litigious modern medical climate, Wal-Mart style take over of private practice pathology, and excessive government regulations, ALL for less pay??

I'm supposed to be willing to put up with all this and smile while some old guy who didn't have to deal with all this clings to his cushy job because otherwise he'd be bored?? Don't think so.

I didn't say it was right, but this is definitely how I feel. This is not to say that I don't respect the hell out of the knowledge these guys have accumulated. I just think at some point, you should gracefully fold and get out of the way if you have any class at all. Life is not THAT long. Hell, I'll be amazed if I even live to 60.

 

[Substance]

The real solution is for pathology to cut its residency positions by 50%. They could start by stonewalling the FMGs/IMGs.

That way, every grad could find a place to use their skills for the betterment of patient health, the job market fears would subside, the income would increase due to a lower supply, and more enterprising intelligent medical students would go into pathology, blazing trails at breakneck speeds rather than doing pathetic immunostain studies ad nauseum.

Stop fighting amongst yourselves and start fighting your professional organization.

 

[2121115]

Yes, we're entitled to jobs. Who in their right mind would NOT feel this way after all of the training including multiple fellowships, boards and subspecialty boards, skyrocketing cost of medical education, onerous burdens of MOC, the litigious modern medical climate, Wal-Mart style take over of private practice pathology, and excessive government regulations, ALL for less pay??

I'm supposed to be willing to put up with all this and smile while some old guy who didn't have to deal with all this clings to his cushy job because otherwise he'd be bored?? Don't think so.

I didn't say it was right, but this is definitely how I feel. This is not to say that I don't respect the hell out of the knowledge these guys have accumulated. I just think at some point, you should gracefully fold and get out of the way if you have any class at all. Life is not THAT long. Hell, I'll be amazed if I even live to 60.

Umm... no.

And BTW, a pathologist with 25 years experience is way more valuable than a new graduate. Plain and simple.

 

[lipomas]

Yes, we're entitled to jobs. Who in their right mind would NOT feel this way after all of the training including multiple fellowships, boards and subspecialty boards, skyrocketing cost of medical education, onerous burdens of MOC, the litigious modern medical climate, Wal-Mart style take over of private practice pathology, and excessive government regulations, ALL for less pay??

I'm supposed to be willing to put up with all this and smile while some old guy who didn't have to deal with all this clings to his cushy job because otherwise he'd be bored?? Don't think so.

I didn't say it was right, but this is definitely how I feel. This is not to say that I don't respect the hell out of the knowledge these guys have accumulated. I just think at some point, you should gracefully fold and get out of the way if you have any class at all. Life is not THAT long. Hell, I'll be amazed if I even live to 60.

What the F is all this about? You guys bitch and moan about all of these excessive regulations, etc, and I suspect just hate Obamacare to death. But at the same time you talk out of the other side of your mouth and want MORE regulations to prevent anyone other than a pathologist from profiting or self referring, MORE regulations to prevent reduction in reimbursement, MORE regulations to prevent reference labs from stealing business, and now you're advocating that people who have succeeded "enough" (whatever that means) need to give it all up so someone else can share it? This is pathetic! If a real socialist/marxist was going to design policies they would do it this way.

Damn, it's like a microcosm of society on here. I WANT MY MEDICARE AND MY SOCIAL SECURITY AND MY TAX WRITEOFFS BUT YOU BETTER NOT RAISE MY TAXES!

Campaign slogan for the next election: Trying to have it both ways!

 

[rollwithit]

maybe he/she can come to my hospital and convince the medical staff that i have served for the past 22 years as medical director that he/she can do a better job and inspire more trust than i can.

Exactly. Why go with uncertainty when you can go with the old faithful. It's up to the incoming pathologist to show why they create more value than you do - it just shouldn't be presumed that newer is better.

 

[cjw0918]

Of course guys with 25 years experience are more valuable than a newbie. I should hope anyone in any field with that much experience is more competent and better at his/her job. He/ she should be.

What I'm saying is that the lack of opportunity we have today sucks. It's not the same as it was for those guys. Their success is and was not totally dependent on them as people. They came along at the right time to benefit from their circumstances. I don't know how many of these guys really understand that it's just not the same world for us. And why would they?? They are blissfully hoarding their nice PP jobs in the community.

And btw, I have a great job so it's not an issue that I personally couldn't find anything. But I resent the hell out of the old guys that are uncaring and/or unaware of our current situation. This seems to describe the majority that I have met over 60.

 

[mlw03]

I don't feel that way, but then again, I'm in a different job market than you are. Because you all hate autopsies so much, me and my kind have a strong job market for the foreseeable future. But your sentiments are just wrong - none of us are entitled to a job, and if you as an applicant can't bring more overall value to a job than the "old guys" then why should a group/hospital boot the older guy to make way for a weaker employee? You resent the old guy for continuing to do a job he's good at?! I agree with the sentiment that we need to reduce the number of residency spots. Pathology as a field is doing a poor job of matching supply and demand. Until that is rectified, this problem will continue.

Yes, we're entitled to jobs. Who in their right mind would NOT feel this way after all of the training including multiple fellowships, boards and subspecialty boards, skyrocketing cost of medical education, onerous burdens of MOC, the litigious modern medical climate, Wal-Mart style take over of private practice pathology, and excessive government regulations, ALL for less pay??

I'm supposed to be willing to put up with all this and smile while some old guy who didn't have to deal with all this clings to his cushy job because otherwise he'd be bored?? Don't think so.

I didn't say it was right, but this is definitely how I feel. This is not to say that I don't respect the hell out of the knowledge these guys have accumulated. I just think at some point, you should gracefully fold and get out of the way if you have any class at all. Life is not THAT long. Hell, I'll be amazed if I even live to 60.

 

[cjw0918]

I of course agree with limiting residency positions. But I just don't ever see this happening as long as residents are cheap labor for the gross room. And I don't think the old guys should be fired to make room for a newbie. No one should be fired who's doing a good job. I would like to see them voluntarily say sayonara in favor of doing something other than what they've done for 35 years. This however seems unlikely knowing a lot of these guys. We are better off hoping for cuts in residency positions, which are also unlikely to happen.

 

[mlw03]

I of course agree with limiting residency positions. But I just don't ever see this happening as long as residents are cheap labor for the gross room. And I don't think the old guys should be fired to make room for a newbie. No one should be fired who's doing a good job. I would like to see them voluntarily say sayonara in favor of doing something other than what they've done for 35 years. This however seems unlikely knowing a lot of these guys. We are better off hoping for cuts in residency positions, which are also unlikely to happen.

I hear you, but think of it from their side. They like what they do, they're good at it, they contribute to society, it's probably not too hard for them anymore. There's just no reason for them to give that up to go be a bump on a log waiting to die, to put it bluntly. I do think it might be nice to see more older pathologists transition into retirement by working less and less over time, allowing younger folks to learn from their experience, with respect to the practice as well as business of pathology. I'm a young guy now, but I like to think I'll do something like this when I get near 60.

 

[pathstudent]

While you might feel entitled to a job. You are not entitled to this guys job.

First a pathologist with 30 years experience is 20x more valuable and 50x less dangerous than one just out if training

Second when you are 65, making 400k a year doing a job you enjoy, have a wife kids and grandchildren that youd like to help out, you won't quit either.

Yes, we're entitled to jobs. Who in their right mind would NOT feel this way after all of the training including multiple fellowships, boards and subspecialty boards, skyrocketing cost of medical education, onerous burdens of MOC, the litigious modern medical climate, Wal-Mart style take over of private practice pathology, and excessive government regulations, ALL for less pay??

I'm supposed to be willing to put up with all this and smile while some old guy who didn't have to deal with all this clings to his cushy job because otherwise he'd be bored?? Don't think so.

I didn't say it was right, but this is definitely how I feel. This is not to say that I don't respect the hell out of the knowledge these guys have accumulated. I just think at some point, you should gracefully fold and get out of the way if you have any class at all. Life is not THAT long. Hell, I'll be amazed if I even live to 60.

 

[bosco77]

I think the point that they are trying to make is that the baby boomer generation, on account of sheer numbers, has the most power to distort policy in order to benefit themselves.
They ate the cake and now their "hobby" is licking the plate.
This is a general truism, not solely related to the pathology job market.
I come from a mediocre program so it may not hold true for better places, but half of these people need to retire. Somehow they accumulated the years but not the wisdom.

 

[cjw0918]

Thanks, bosco.

I think I just see things differently from some of you. You see the old guys behind the scope and think he has security, a job he enjoys, and a nice life. Good for him! I hope that's me someday.

I see them and think I hope that's NOT me when I'm that age. Please tell me there is more to life than pathology which can hold my interest. Why would anyone not want to travel, play golf, chase the grandkids, learn a new language, or take up sailing when you have the money, time, and health to do it?? Life is so short and there are so many things to do.

So I suppose some should guys work forever if that's what's meaningful to them. I'll never get it, and I'll continue to think they're boring, sad, and yes, a bit selfish. To me the people hanging on to these jobs are the entitled ones, since they believe they have the right to do this for such flimsy reasons as it is their "hobby."

But alas, it is perfectly within their right to keep working if they desire!! (I'm still an American here, despite what lipomas thinks.) By all means, pursue happiness and all that stuff. I just wish it didn't mean behind the scope for so many of them. As for me, I will always think these guys are on the uninteresting, one-dimensional, and self-involved side. God knows they will never notice or care.

 

[rollwithit]

"The old guy sticking around too long" issue can also be partially solved by a decrease in residency spots. Part of the reason they stick around so long is because they can take advantage of the oversupply of pathologists and not have to work high volume themselves. Decrease the supply in pathologists and these partners will have to compensate the younger pathologists more to the point it's not worth their energy working into their 70s. They simply will either have to work more or make less of a return. They stick around because they can make a great return cheaper labor while not being too terribly stressed. Tweaking the supply back into the favor of practicing pathologists should put enough pressure on the old farts to cash out and retire.

 

[deleted314957]

"The old guy sticking around too long" issue can also be partially solved by a decrease in residency spots. Part of the reason they stick around so long is because they can take advantage of the oversupply of pathologists and not have to work high volume themselves. Decrease the supply in pathologists and these partners will have to compensate the younger pathologists more to the point it's not worth their energy working into their 70s. They simply will either have to work more or make less of a return. They stick around because they can make a great return cheaper labor while not being too terribly stressed. Tweaking the supply back into the favor of practicing pathologists should put enough pressure on the old farts to cash out and retire.

i am curently singing out an annual average of about 11.000 surgical, cyto and marrow accessions ( not specimens ) per year (no paps)---general hospital stuff and heavy on GI. This is not to mention my functions as lab medical director and committee stuff. i think i'm earning my keep. a number of "younger " pathologists have TRIED to cover for me and they were incapable. they don't come to my hospital anymore.

 

[rollwithit]

You are an employee now, right? My theory was more directed towards the older pathologist partners since they can reap the benefits of employing cheap labor.

At any rate, I'm not suggesting the older folks aren't earning their keep. I'm just saying a change in the supply of total pathologists would give incentive for the older pathologists to leave the market. There are always hard ass outliers such as yourself. Of course, I'm operating under the assumption that most wouldn't want to remain highly active. Could be a bad assumption, but I doubt it.