Pathologist practicing as a GP?

[HRantz]

I know that pathologists can write prescriptions, as long as they have a medical license. They can also supervise pathologist assistants (obviously). My question: can they supervise a PA in a general medical practice? For example, a medical clinic where a PA has been practicing fairly independently and just needs a physician to oversee him or her (due to retirement or move of the previous physician).

Understandably, malpractice insurance would need to cover practice outside of pathology. But what other limitations are there? I imagine it varies depending on the state, but to what degree of practice does a basic medical license typically cover?

Our clinical colleagues have managed to encroach upon pathology. To what degree can we encroach upon them?

---

Members don't see this ad.

 

[jp123ok]

Having a medical license allows you to practice medicine and surgery. There is nothing stopping you from seeing patients or supervising PAs. An internet search will reveal examples of Board Certified Pathologists practicing in various areas of clinical medicine. I think the key issue is medicolegal risk. Given that pathologists in the US do not even do an intern year, how will you convince a jury that you were competent to practice clinical medicine if you screw up and get sued?

 

[coroner]

As mentioned above, a medical license means you can practice any kind of medicine or surgery as granted by the laws of that state. The limitations are: 1. What are you confident and proficient in that does not put the patient at harm 2. What privileges you will be granted in a medical facility/setting if you are working under their roof 3. What are you covered for by your malpractice carrier 4. Who will give you or your practice business/volume based on your qualifications/credentials.

The bigger question is why would you even want to? Clinical medicine??? C’mon that’s why a lot of us went into Pathology: because we didn’t want to see patients. Look, I know the job market isn’t booming, but there’s no way one should have to entertain the thought of clinical medicine as a backup plan. Plus, the opportunity cost would outweigh most if not all other means of medical practice you are probably competent and qualified for. Unless you’re knocking down intravitreal Lucentis injections and organ transplants like it’s nobody’s business. Maybe consider botox parties/clinics as an extra revenue stream, tops…

Our clinical colleagues have managed to encroach upon pathology.

Explain. Nobody else is pushing glass, which is our bread & butter. Or for that matter doing IHC, flow, FISH, autopsies, overtaking medical directorships, etc. The only other thing might be some molecular testing which is still up in the air.


Btw, HRantz, no posts in over 4 years since you got your first job and now you’re asking if you can supervise PA’s….

 

[HRantz]

The comment above is a problem I am seeing in pathology: that patients are something to shy away from and avoid. Living and working in a small town has shown me that those patients are my co-workers, neighbors, and friends. I care about them and don't want to be isolated from them. The few opportunities I've had to interact directly with patients have been some of my most meaningful experiences. Working with patients is not a "back-up" plan, something to consider if there are no pathology jobs to be found; for some of us we may come to find it desirable after working alone in an office. I am looking for something more meaningful. Whether it involves direct patient care or not, I'm not sure, but I know that I want to be looking at ALL my options, not just those considered traditional pathology practice.

As for clinical colleagues encroaching upon pathology, I was thinking about performance of FNAs and bone marrows (which I understand that other fields may have done in the past but should be rightly ours because we are more likely to understand the importance of a good sample), clinical groups having in-house labs, or even "owning" their own pathologist. (I don't mean to go off-topic with this line of conversation; it wasn't the purpose of my original post, and I just wanted to answer your question.)

 

[coroner]

I’m assuming you mean the pathologist’s lack of enthusiasm to see patients as the “problem” you’re seeing, which I disagree. Many of us did not want to ever have to deal with another rectal exam, kids with runny noses, prolonged labor and deliveries of pregnant moms with mood swings, the list goes on. How is that a problem? Maybe for you, but not the majority of pathologists who do not pine to have these experiences again. This is what makes our field unique and is a positive in my opinion, not a problem.

...those patients are my co-workers, neighbors, and friends. I care about them and don't want to be isolated from them. The few opportunities I've had to interact directly with patients have been some of my most meaningful experiences.

You shoulda figured this out in medical school before going into Pathology.

But, it sounds like you’re having regrets now; hence, why you’re inquiring about other options. I’ll leave you with a quote from yaah

If you don't like it, you need to get out. Don't torture yourself, you have to do something you love as a career. If it involves realizing you made a mistake and having to sort of start over, then so be it. Better to make the change than to stick with it out of spite or a sense of obligation. You don't want to make your life a "what if" situation.

 

[WEBB PINKERTON]

Dr Wheeler posted a nice commentary about the Transformation of Pathology

http://blogs.medscape.com/thomaswheeler

The field better take a lesson from radiology and do more interventional. There are niches that could be filled.

Otherwise I guess you do tattoo removal for extra cash...Or open an anti-aging clinic.

 

[Over9000]

In-vivo microscopic diagnosis is RIFE for the taking by pathologists.

The ABP and training programs appear more concerned about preserving autopsy than taking advantage of this new modality that will revolutionize diagnosis as much as MR and CT have before it. The first step in taking advantage of this technology is to re-instate a clinical internship. Pathologists need to be able to manage patients if they're going to stick probes in them.

If we don't take ownership of this, I can tell you the derms, cards and GIs will (almost like they've taken ownership of...us! We just never learn.)