Shortage of Pathologists?

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You mean for going into pod labs, ****** of the clinicians. Makes me low.

No, I meant going into private practice (or academics too). Of the GI fellows I met in residency, all went into either private community practice or academia. No pod labs. Small n obviously, but that's what I saw and was commenting on.

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I understand those involved with sending the letter to the Congressional Council may be hesitating to post here. However, further discussing this may help alleviate some conspiracy theories. Please let us know what the pathologist retirement age number was for calculating the projected shortage- was it 65?
 
I'm sorry all but I just can't let this go. Really, I'm just trying to understand how this projected shortage conclusion was reached mathematically. I thought knowing some of the data points would help and the retirement age number is a good place to start. Since no one who actually sent the letter will respond, will some of the residents who know those on the executive resident committee of the CAP and/or ASCP please ask those "in the know" how this conclusion was reached mathematically?
 
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I'm sorry all but I just can't let this go. Really, I'm just trying to understand how this projected shortage conclusion was reached mathematically. I thought knowing some of the data points would help and the retirement age number is a good place to start. Since no one who actually sent the letter will respond, will some of the residents who know those on the executive resident committee of the CAP and/or ASCP please ask those "in the know" how this conclusion was reached mathematically?

That is a good point. Whose to say there will be a shortage? And even if there was maybe it would be better if pathologists just had to work harder to get the job done. We are not salaried state employees with two 15 minute breaks and a 30 minute lunch. If we work more we make more. It could be a good deal. I am pro shortage.

If you have two kids and bump it up to 3 or 4, you can't say there aren't enough parents to get the work done and claim a shortage of parents. You just got to work harder. That's the model we should pursue.

"a shortage of pathologists" give me break, scare tactics. And so what if there is. The work that needs to get done will eventually get done.
 
I'm sorry all but I just can't let this go. Really, I'm just trying to understand how this projected shortage conclusion was reached mathematically. I thought knowing some of the data points would help and the retirement age number is a good place to start. Since no one who actually sent the letter will respond, will some of the residents who know those on the executive resident committee of the CAP and/or ASCP please ask those "in the know" how this conclusion was reached mathematically?

The AAMC does workforce surveys on a periodic basis. In year 2006, about 50% of working pathologists were over age 55. As a discipline we are #3 in terms of the percentage of working physicians over age 55. The exact data are found in figure 6.

Daniel Remick, M.D.
Chair and Professor of Pathology and Laboratory Medicine
Boston University School of Medicine, Boston Medical Center
 

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The AAMC does workforce surveys on a periodic basis. In year 2006, about 50% of working pathologists were over age 55. As a discipline we are #3 in terms of the percentage of working physicians over age 55. The exact data are found in figure 6.

Daniel Remick, M.D.
Chair and Professor of Pathology and Laboratory Medicine
Boston University School of Medicine, Boston Medical Center

In the year 2016, 50% of the pathologists will be over 56.
In the year 2026, 50% of the pathologists will be over 57.
etc. etc.

This data is interpreted to me that there is little reason to retire when you are a partner pathologist and you can employ some schmuck to sign out many cases at a fraction of the cost while you sit back and stay "unretired". Churn em and burn em!
 
In the year 2016, 50% of the pathologists will be over 56.
In the year 2026, 50% of the pathologists will be over 57.
etc. etc.

This data is interpreted to me that there is little reason to retire when you are a partner pathologist and you can employ some schmuck to sign out many cases at a fraction of the cost while you sit back and stay "unretired". Churn em and burn em!

I don't know, that data is fairly compelling. The 50% of working pathologists that are over 55 can't survive purely by exploiting the bottom 50%... the pyramid has to be a little broader than that.
 
I don't know, that data is fairly compelling. The 50% of working pathologists that are over 55 can't survive purely by exploiting the bottom 50%... the pyramid has to be a little broader than that.


That "data" has been there for 20 years and can be interpreted as broadly as you want, meaning essentially nothing -- even if you believe it to be true.

If you are not familiar with the job market, then you should not assume much other than you are not in a good position to be defining the terms of your practice, as nearly every other branch of medicine does. Few pathologists retire at age 65 when the job becomes as enjoyable as any other hobby if you are at the top. Good luck getting there, however.
 
I don't know, that data is fairly compelling. The 50% of working pathologists that are over 55 can't survive purely by exploiting the bottom 50%... the pyramid has to be a little broader than that.



It just reflects that pathology is conducive to having a longer career than other specialties; in no way does it portend a shortage. Surely residency spots haven't dramatically decreased over the last 30 years. It is not like there are fewer young pathologists now than there were 30 years ago.
 
The AAMC does workforce surveys on a periodic basis. In year 2006, about 50% of working pathologists were over age 55. As a discipline we are #3 in terms of the percentage of working physicians over age 55. The exact data are found in figure 6.

Daniel Remick, M.D.
Chair and Professor of Pathology and Laboratory Medicine
Boston University School of Medicine, Boston Medical Center

BU Pathology- I see your data point. Do you agree that other data points also need to be considered, such as the 600 or so new pathology residents every year (Figure 13) and the median retirement age for pathologists which may be increasing due to the sagging economy and increased longevity? Not to mention the fact that many of your pathologist colleagues feel there is an oversupply now that needs correcting.
Please be aware that many of us are concerned about the supply/demand situation not primarily because of money but primarily because of practice environment and patient care. It is much harder to stand your ground on patient care issues (proper lab staffing and training, adequate time and resources to work up cases, etc.) when those in charge know one hundred CV's will instantly materialize if they want to replace you. These things are really occurring, and many of us are really worried.
 
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That is absurd reasoning that just because the median age of a pathologist is greater than other docs means their is a looming shortage. Take professional athletes. The median age of a pro golfer is greater than that of a pro tennis player. Would you conclude that there is a looming shortage of pro folders. No you would realize that golf is conducive to a longer career.

The median age of pathologists is greater than er docs, transplant surgeons, obs,and trauma surgeons because the nature of the work and physical demands.
 
BU Pathology- I see your data point. Do you agree that other data points also need to be considered, such as the 600 or so new pathology residents every year (Figure 13) and the median retirement age for pathologists which may be increasing due to the sagging economy and increased longevity? Not to mention the fact that many of your pathologist colleagues feel there is an oversupply now that needs correcting.
Please be aware that many of us are concerned about the supply/demand situation not primarily because of money but primarily because of practice environment and patient care. It is much harder to stand your ground on patient care issues (proper lab staffing and training, adequate time and resources to work up cases, etc.) when those in charge know one hundred CV's will instantly materialize if they want to replace you. These things are really occurring, and many of us are really worried.

Let's be sure we are talking facts and not internet rumors. The only places that mention pathology oversupply is this forum, and one year during a CAP residents forum. I do not know of any pathologist looking for a job who is unemployed. When I go to the national meetings and ask program directors, fellowship directors and chairs if any of their trainees cannot find a job, the answer has always been no. Most pathologists in leadership positions are concerned that we will not be training sufficient pathologist. I respectfully disagree with the statement that many believe there is an oversupply and would need to see evidence that many of my colleagues feel there is an oversupply.

Next, for the statement that 100 CVs will arrive for every job opening. That has not been my experience. We currently have a position posted and recieved 37 applications. This is about the number of applications that we receive whenever we post a job. This is a large number, but most of these applicants are applying widely. One of the applicants could not come to interview for several weeks, because she/he had so many other interviews scheduled. Another accepted a position between the time the CV was submitted and we began calling the references (which was less than 3 weeks).

The issue of appropriate professional staffing is important, and it is necessary to provide optimal patient care. There needs to be a good working relationship with the hospital administration, so that they are convinced of the value added by the pathologist. A few weeks ago I was at a health management seminar for anesthesiologists, radiologists, emergency room physicians, and pathologists. The speakers emphasized how the world has changed. Physician groups can no longer expect that they will maintain an exclusive contract with a hospital for their career just by being good. Regardless of discipline, you need to prove your value to the hospital an a periodic basis, and not just when contract renewal comes up. As accountable care organizations form and we move away from a fee for service (which I believe will happen) there will be increased expectations that you demonstrate how your group contributes.

Finally, to answer the bigger question, will there be a job in the future for pathology graduates? My agenda in posting on this forum is to ensure that all bright medical students consider a career in pathology, just to be clear. The latest survey showed that 100% of graduating trainees got a job, and 95% were satisified to very satisfied with the position (see previous posts on this issue). The data indicates that currently pathology trainees get good jobs. The data also indicate many pathologists are approaching retirement age.

Daniel Remick, M.D.
Chair and Professor of Pathology and Laboratory Medicine
Boston University School of Medicine, Boston Medical Center
 
I've seen many pathologists working well in to their 80s. Age has no relevance.

Plenty of us do know unemployed/underemployed pathologists. That is total BS to imply that this forum is the only place that talks about a pathologist surplus. Maybe in Mass with RomneyCare there isnt a surplus but that sure isnt the case in my area. The corporate labs have pretty much bought everything and are much more productive.

Bright medical students will not find pathology rewarding as it is practiced right now. Wanna work in a slide mill pumping out tons of cases with falling profit margins, go into pathology. Plus its hell on your body to sit chained to a scope all day. Bright students would be better off leaving pathology to introverts who dont mind being crapped on.
 
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37 applicants for one job (pathoutlines has the quotes for more CVs for one job).....so is a shortage meaning only 15 applicants for one job.

If it wasn't a BU academic position and just a general position, you probable would have seen 50+ CVs and 100 wouldn't surprise me.

Pathologists are a dime a dozen...patients wait for appts...specimens don't (and they never will).

Taking funds to produce doctors that aren't needed, while there are actual shortages in other specialities....pathetic. Never let a crisis go to waste! (Even if it isn't a pathology crisis)
 
Student Doctors- Well, you've seen this discussion evolve. My advice to you is talk to current pathology residents and fellows. Seek opinions as to the current practice environment not only from program directors and chairpersons but also from community pathologists and junior academic staff. These endeavors are well worth your time. If you decide that pathology is for you, then welcome.
 
I'm sorry all but I just can't let this go. Really, I'm just trying to understand how this projected shortage conclusion was reached mathematically. I thought knowing some of the data points would help and the retirement age number is a good place to start. Since no one who actually sent the letter will respond, will some of the residents who know those on the executive resident committee of the CAP and/or ASCP please ask those "in the know" how this conclusion was reached mathematically?

It makes sense if you think about it. Don't know the specific numbers, but if there are X pathologists, handling Y specimens, it stands to reason that if there is specimen growth and aging pathologists, more pathologists would be needed. Most projections showed a continual growth in specimen # with minimal growth in the actual # of practicing pathologists. And since the average age was increasing, ergo there would be a need for more pathologists. As I have said before, I think a lot of the "pathologist need" stuff that came out was operating under assumptions that turned out to be incomplete. It didn't account for increasing efficiency and specialization among pathologists as well as technology.

A lot of people who apply for jobs are not unemployed. Many are looking for something better, whatever that means for them (sometimes location, sometimes salary, sometimes work environment, sometimes practice duties).

I tend to agree that there is far more discussion on these forums about the poor job market than there is in real practice. As I have said, the most common response I hear when I ask people about the job market (and I have asked a lot in the past) is "well I have heard the job market is bad but my situation turned out well." Take that for what it is worth.
 
Bright medical students will not find pathology rewarding as it is practiced right now. Wanna work in a slide mill pumping out tons of cases with falling profit margins, go into pathology. Plus its hell on your body to sit chained to a scope all day. Bright students would be better off leaving pathology to introverts who dont mind being crapped on.

That is totally false. Pathology needs more bright medical students. I find my job very rewarding in many ways.

I am not sure what people expect - you go to med school and expect someone to just jump up and hand you your dream job? No, you might have to work at it and look around. Again, this is not limited to pathology AT ALL. Do you guys ever talk to people in other specialties? They change jobs all the time. They complain about working conditions, salary, job availability, long hours, etc. The specific complaints change from specialty to specialty but they never go away. And people in other (non-medical) jobs complain even more.

We have a lot of "the grass is always greener on the other side" types of people on these forums, but unfortunately most of them only think the grass is green and they haven't actually seen it.
 
I can share my personal experience and anyone can infer whatever they want.

I am a current dermpath fellow at a name brand top tier program, residency training at a very well known prorgam too. Board certified with excellent references and with a wide network of friends, colleagues, seniors and faculty. I have been looking for jobs even before the start of fellowship i.e > 8 months now. I have applied to posted positions, cold called, randomly emailed CVs, networked at the meetings and anything else you name. If i give an estimate, I have probably contacted around 200-225 places so far (academic, private groups, corporate labs). Right now, I have only 2 interviews lined up and I am not sure whether I will get an offer or not. Everyone I talked to that includes current dermpath fellows, faculty and employers say that the market is horrible right now, people are afraid to hire and willing to work extra hours as no one can predict with surety how the future will be 2 years from now.

@ BU Pathology: I respectfully disagree with you. Right now there is an oversupply of pathologists and the bad job market is due to that. It is a bitter fact whether we accept it or not.

I meet dermatology residents everyday, every single 3rd year derm resident is getting bombarded with job offers (emails, phone call from recruiters, you name it !!!) and they don't believe when I tell them I am applying for jobs and putting that much effort.

And BTW, I am not the only one. I know atleast 5 other current dermpath fellows who are in similar situation like me. And yes, I am willing to do general surg path and take CP call AND I am not geographically restricted AND I do NOT need a visa.
 
wow. You contacted over 200 places and only received 2 interviews?
I thought dermpath was considered to have one of the better job markets in pathology. Well if this is true, I can imagine it must be worse for the non-dermpath people. Are you already board certified in AP/CP?

I can share my personal experience and anyone can infer whatever they want.

I am a current dermpath fellow at a name brand top tier program, residency training at a very well known prorgam too. Board certified with excellent references and with a wide network of friends, colleagues, seniors and faculty. I have been looking for jobs even before the start of fellowship i.e > 8 months now. I have applied to posted positions, cold called, randomly emailed CVs, networked at the meetings and anything else you name. If i give an estimate, I have probably contacted around 200-225 places so far (academic, private groups, corporate labs). Right now, I have only 2 interviews lined up and I am not sure whether I will get an offer or not. Everyone I talked to that includes current dermpath fellows, faculty and employers say that the market is horrible right now, people are afraid to hire and willing to work extra hours as no one can predict with surety how the future will be 2 years from now.

@ BU Pathology: I respectfully disagree with you. Right now there is an oversupply of pathologists and the bad job market is due to that. It is a bitter fact whether we accept it or not.

I meet dermatology residents everyday, every single 3rd year derm resident is getting bombarded with job offers (emails, phone call from recruiters, you name it !!!) and they don't believe when I tell them I am applying for jobs and putting that much effort.

And BTW, I am not the only one. I know atleast 5 other current dermpath fellows who are in similar situation like me. And yes, I am willing to do general surg path and take CP call AND I am not geographically restricted AND I do NOT need a visa.
 
It makes sense if you think about it. Don't know the specific numbers, but if there are X pathologists, handling Y specimens, it stands to reason that if there is specimen growth and aging pathologists, more pathologists would be needed. .


There is a possible major flaw in your reasoning. Is the average age of pathologists getting longer because they are not training enough young ones or are older pathologists working longer? You need to know that before you can reach your conclusion. And do we really know that the average age is increasing significantly. What was the average age of a pathologist in 2000?

There are about 600 pathologists entering the workforce every year. How many entered the workforce in the 70s? If it was 1000 back then, then yes I would agree there will be fewer patholoigists in the coming years.

Also do more specimens necessarily mean more hours of work. Big surgery specimens have been decreasing over the years. If it is an increase in ratio of small:big specimens, maybe we could use even less pathologists because increasing efficiency allows a pathologist to sign out even more cases per day. I was told that the few dermatopathologists at UCSF work like animals and sign out 50,000 cases a year.

And it is so myopic to only think about our field.
We need more primary care docs to increase health and wellness and improve the quality of life in the US.
 
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wow. You contacted over 200 places and only received 2 interviews?
I thought dermpath was considered to have one of the better job markets in pathology. Well if this is true, I can imagine it must be worse for the non-dermpath people. Are you already board certified in AP/CP?

Thank you for your story mario. This is a grim reality people. The market is GOD AWFUL. I'm speaking from the trenches. Brace yourself......
 
I've seen many pathologists working well in to their 80s. Age has no relevance.

Plenty of us do know unemployed/underemployed pathologists. That is total BS to imply that this forum is the only place that talks about a pathologist surplus. Maybe in Mass with RomneyCare there isnt a surplus but that sure isnt the case in my area. The corporate labs have pretty much bought everything and are much more productive.

Bright medical students will not find pathology rewarding as it is practiced right now. Wanna work in a slide mill pumping out tons of cases with falling profit margins, go into pathology. Plus its hell on your body to sit chained to a scope all day. Bright students would be better off leaving pathology to introverts who dont mind being crapped on.

Romneycare has nothing to do with massachusetts pathology staffing. Any problems in pathology in massachusetts are likely related to health care monopolies (the MGH system and/or private labs buying practices).

That is a piece of crap statement, by the way, about how bright students will not find pathology rewarding and shouldn't go into it. Bright students should go into whatever they are best at, because they will most likely succeed. I could look at any career excepting that of professional athlete or K street lobbyist and tell you reasons why bright students should avoid it.
 
Ok, I'll bite, I'll share my experience, YMMV, yada yada yada.

I did ap/cp residency in a top-to-just-below-top tier institution followed by a surg-path fellowship in a just-below-top-to-mid tier institution. I presented a couple of posters and had no publications while in residency (did have a couple of papers cooking, though, not exactly great CV padding). I started looking for a position around sept of my fellowship year (2010-2011), intensified my search by Nov/Dec. I had 2 interview offers by mid-Jan, and by the time I had my 2nd interview, I had an offer from the 1st place I interviewed at, which was pretty much my 1st choice. Took the offer. Have been 110% satisfied since. In the weeks that followed I had 2 additional interview invites, a couple of additional requests to have my references contacted prior to setting up potential interviews, and a few e-mails over the subsequent months asking if I were still looking for a position, all of which I had obviously declined.

Caveats:
I had my AP/CP boards.
I got **** done in residency and in fellowship. I can't say that my knowledge was spectacular compared to my peers, but I knew enough to know what I needed to ask for help with, or to look up, or to just say "I don't know". I was't a whiner. I wasn't a b*tch/do*che.
I had great references that were very supportive of me (one even with what some of you might refer to as "brand-name recognition").
I was not restricted geographically (but somewhat selective, see below), althoug my spouse did have some demands.
I did apply broadly, but not all that broadly. Basically I applied to a number of job ads posted on pathologyoutlines, ascp, healthcareers, allhealthjobs, va.gov, etc. that sounded good and where in a somewhat desirable location. I also cold-called (well, cold e-mailed) a number of academic depts to inquire about any positions they may have, or have heard of, and to keep me in mind, yada yada yada. I wasn't going to waste my time applying to a place I knew I wasn't going to be happy at.
I'm pretty normal, i.e. I don't come off as an a-hole, an introvert, a show-off, a know-it-all, etc. (at least not on a first date). I don't bs. I tell it like it is, yes, even at an interview.

I guess I don't know what the "true" job-market is out there. I found a job I love. All the other fellows, including subspecialty fellows, I graduated with got exactly the jobs they wanted and most were quite restricted geographically in a rather "tight" market.

I don't know what advice to give folks like mario. I don't know him/her from Adam. However, over my few brief years in pathology, I have seen many residents/fellows/staff come and go, and there are certain individuals that either
1. overestiamte their abilities, which others can spot right away
2. underestimate their abilities, are withdraw, too shy, to quiet, etc. that others would not feel comfortable working with
3. are do*chebags/b*tches, that no-one wants to work with
4. just want to put in their 9-5
5. have burned a few too many bridges (pathology is a small world, trust me)
6. have no clue what they want, other that a couche job, with great perks, and lots of $$$, a company car also helps (truest me, there are folks like that)

All you other newly minted, gainfully employed pathologists, please feel free to chime in...
 
There is a possible major flaw in your reasoning. Is the average age of pathologists getting longer because they are not training enough young ones or are older pathologists working longer? You need to know that before you can reach your conclusion. And do we really know that the average age is increasing significantly. What was the average age of a pathologist in 2000?

There are about 600 pathologists entering the workforce every year. How many entered the workforce in the 70s? If it was 1000 back then, then yes I would agree there will be fewer patholoigists in the coming years.

Also do more specimens necessarily mean more hours of work. Big surgery specimens have been decreasing over the years. If it is an increase in ratio of small:big specimens, maybe we could use even less pathologists because increasing efficiency allows a pathologist to sign out even more cases per day. I was told that the few dermatopathologists at UCSF work like animals and sign out 50,000 cases a year.

And it is so myopic to only think about our field.
We need more primary care docs to increase health and wellness and improve the quality of life in the US.

It's not my reasoning. I am saying that projections were made many years ago that turned out to be misleading for many reasons. Many of them the reasons you mentioned.
 
Some corrections, I went back and had a look at my sent box to see exactly how many applications I have emailed and it seems around 140 to 145, definitely not 200 plus. My apologies for an in-correct number.

@Kluverb- I am happy for you and may be next year I will be saying the same things but right now things do not look as easy as you mentioned, may be last year was better in terms of market situation..

I want to mention few points though. Atleast 7-8 groups I interacted with and currently in touch said that they currently have a need for additional pathologist/ dermpath and would be interested in having me as associate but they are reluctant to hire as there is so much uncertainty right now in terms of looming cuts in reimbursements especially 88305 (dermpath workhorse). Almost all of them said they will decide in January about bringing a new associate and if that the case they will invite me for the interview ( I already had phone interviews with 2 of them).

And today I received the third official interview invite and kind of an unofficial invitation to stay as junior faculty at my current institution if I decide. So it raises the count to total 4 . I am pretty confident now that I will have a job in few months.

But it's not easy and I would still say that there is an oversupply right now. There is still a good chance that a newly trained fellow may go unemployed, specially if geographically restricted to one area/ city which is not the case in any other specialty with the exception of nuclear medicine.
 
Just pulled this one from pathoutlines:

'Seeking an experienced fellowship-trained genitourinary pathologist, board certified in cytopathology, for a unique opportunity with a rapidly growing private regional pathology laboratory. The qualified candidate will possess 3-5 years experience in AP general and GU pathology with board certification in cytopathology and completed GU fellowship'


I mean really. How many cyopath boarded, GU fellowship trained pathologists with 3-5 years of experience are there? I would imagine most pathologists with this background already have decent gigs. Is this what pathology residency has come to...I mean this degree of subspecialization?
 
Just pulled this one from pathoutlines:

'Seeking an experienced fellowship-trained genitourinary pathologist, board certified in cytopathology, for a unique opportunity with a rapidly growing private regional pathology laboratory. The qualified candidate will possess 3-5 years experience in AP general and GU pathology with board certification in cytopathology and completed GU fellowship'


I mean really. How many cyopath boarded, GU fellowship trained pathologists with 3-5 years of experience are there? I would imagine most pathologists with this background already have decent gigs. Is this what pathology residency has come to...I mean this degree of subspecialization?

LOL ludicrous
 
Looks like employers are getting pickier. Next thing you know, job postings will be asking for a triple board certified pathologist with 10 years experience.

Just pulled this one from pathoutlines:

'Seeking an experienced fellowship-trained genitourinary pathologist, board certified in cytopathology, for a unique opportunity with a rapidly growing private regional pathology laboratory. The qualified candidate will possess 3-5 years experience in AP general and GU pathology with board certification in cytopathology and completed GU fellowship'


I mean really. How many cyopath boarded, GU fellowship trained pathologists with 3-5 years of experience are there? I would imagine most pathologists with this background already have decent gigs. Is this what pathology residency has come to...I mean this degree of subspecialization?
 
Just pulled this one from pathoutlines:

'Seeking an experienced fellowship-trained genitourinary pathologist, board certified in cytopathology, for a unique opportunity with a rapidly growing private regional pathology laboratory. The qualified candidate will possess 3-5 years experience in AP general and GU pathology with board certification in cytopathology and completed GU fellowship'


I mean really. How many cyopath boarded, GU fellowship trained pathologists with 3-5 years of experience are there? I would imagine most pathologists with this background already have decent gigs. Is this what pathology residency has come to...I mean this degree of subspecialization?
Sounds like it could be a lab run by urologists.
 
Just pulled this one from pathoutlines:

'Seeking an experienced fellowship-trained genitourinary pathologist, board certified in cytopathology, for a unique opportunity with a rapidly growing private regional pathology laboratory. The qualified candidate will possess 3-5 years experience in AP general and GU pathology with board certification in cytopathology and completed GU fellowship'


I mean really. How many cyopath boarded, GU fellowship trained pathologists with 3-5 years of experience are there? I would imagine most pathologists with this background already have decent gigs. Is this what pathology residency has come to...I mean this degree of subspecialization?

And are they really even needed? I mean, come on, any experienced, solid general surgical pathologist can do just fine with 98% + of the world of GU biopsies and cyto. That is what we do for God's sake.
 
That'd have been my guess. Sign out urines, prostate and bladder biopsies all day long. Generate massive amount of revenue, of which the pathologist would likely be given a paltry percentage.

Not necessarily. There are actually a lot of fairly ethical (from the physician relation standpoint, anyway) large practice groups which either employ pathologists and pay them the full technical fee + more for running the lab, or actually have them as partners. It's probably more likely in a larger group where the pathologist would be full time. An established, "expert" GU pathologist can be quite an asset for marketing purposes.

I have no idea how common it would be however, probably not that common.
 
Not necessarily. There are actually a lot of fairly ethical (from the physician relation standpoint, anyway) large practice groups which either employ pathologists and pay them the full technical fee + more for running the lab, or actually have them as partners. It's probably more likely in a larger group where the pathologist would be full time. An established, "expert" GU pathologist can be quite an asset for marketing purposes.

I have no idea how common it would be however, probably not that common.

That'd be great if there were more situations like that, rather than the pod lab type situation. This isn't my area, so I suppose I spoke out of turn before. But a true partnership type of practice would be fair and beneficial for all I would think.
 
No. Being a full-time pathologist treated as an "equal" in a big private urology or GI group is very bad. A while ago, the 2 big private GI groups in my city asked me to run a big combined AP in-office anatomic path laboratory for them. They raised parternship as an incentive and offered to pay generously. I told them to go f*** themselves. They got someone else to do it quite easily. Obviously, there is no shortage of pathologists. It's not about the money. There is no job security working at an in-office anatomic pathology laboratory. If the federal government ever closes the IOAS exception in the Stark law (as they should) then you are immediately out of a job. If you need to re-certify in anatomic pathology with a time-limited certificate, good luck passing the re-certification exam if all you do all day is sign out endo biopsies or prostate core needle biopsies. Finally, AP is indeed a commodity and it can be outsourced immediately and at any time. All in-office AP arrangements suck hairy bean bag for the pathologist. I'll leave those jobs to the beggars chasing for pennies. I'd sooner work at a university or apply to a family practice residency than facilitate these abusive in-office labs.
 
There is no job security working at an in-office anatomic pathology laboratory. If the federal government ever closes the IOAS exception in the Stark law (as they should) then you are immediately out of a job.

Ok, but the flipside is this would benefit the non-pod lab pathologists as contracts would get diverted back to multi-disciplinary private practice groups, community hospital-based pathologists, universities/academics, etc.

If you need to re-certify in anatomic pathology with a time-limited certificate, good luck passing the re-certification exam if all you do all day is sign out endo biopsies or prostate core needle biopsies.

Isn't the recertification exam supposed to be take-home? That would be ridiculous to go back to Tampa every ten years from your thirties until sixties or seventies to take a written exam. Meaning, if it's take home, the pass rate should be very high. Also, my understanding is the material is also not going to be at the level of difficulty as the original certification boards taken after residency which again would make the pass rate extremely high.
 
Isn't the recertification exam supposed to be take-home? That would be ridiculous to go back to Tampa every ten years from your thirties until sixties or seventies to take a written exam. Meaning, if it's take home, the pass rate should be very high.


No, it will likely be a situation just like the first time. Not easier. The pass rate for AP/CP is already high. And yes, the ABP would have no problem making you come back to Tampa into your 60's.
 
No, it will likely be a situation just like the first time. Not easier. The pass rate for AP/CP is already high. And yes, the ABP would have no problem making you come back to Tampa into your 60's.

Totally agree with this. I have no reason to believe that they won't have us flying down to Tampa every 10 yrs. When I talk to people in other specialties they can't believe that our board exam is only offered in one city.

On a more positive note at least the abp website has been updated and only looks about 10 years behind the times now.

For dessert, another job listing:

'Candidates must be eligible for or hold a valid Tennessee medical license and be board certified in Anatomic and Clinical Pathology with added qualification in subspecialty of GI pathology. Two or more years experience in diagnostic general pathology is preferred. Those who have spent two years or more in a single specialty practice are discouraged. Salary is commensurate with training and experience, and benefits package is competitive.

Pathgroup is a large multispecialty regional pathology company with a core laboratory practice in Nashville, TN. GI accessions require attention of fellowship trained GI pathologists.

Duties will be divided with other skilled GI pathologists. Other duties include management of hospital surgical and clinical pathology as well as Non GYN cytology specimens. Specialist consultants are available in the group.'

Anyone else see the dichotomy here? Groups like these promote subspecialization. In turn trainees seek out GI/GU/dermpath fellowships only to be offered positions in these GI/GU/dermpath only labs that are so prevalent these days. Subsequently when its convenient for them they don't want applicants that have spent time in single specialty practices!! Unbelievable!! I like the line 'GI accessions require attention of fellowship trained GI pathologists'. Really?! Why do we even do residency then??
 
Is this not the model we're seeing now in private practice? Forming a mini-academic type setting, where you have your GI person, GU person, cyto person, etc? This would allow the group to promote themselves to hospitals and clinicians as having that type of subspecialty expertise "to provide for your patients."
 
In the year 2016, 50% of the pathologists will be over 56.
In the year 2026, 50% of the pathologists will be over 57.
etc. etc.

This data is interpreted to me that there is little reason to retire when you are a partner pathologist and you can employ some schmuck to sign out many cases at a fraction of the cost while you sit back and stay "unretired". Churn em and burn em!

This is exactly the truth. From my recent interviewing, most all private practices had an owner/ partner(s) who expected to come in at 11 with a newspaper under their arm poke their head around, play with themselves at their desk for a while, and then leave early while taking 10-12 weeks off a year and bringing their pictures of their trips to Katmandu and Bora Bora to decorate their desks. The actual workers/ pathologists were salaried and were busting their hump and were politely indignant that these people hung around and didnt sell/ turn over the practice that they knew was making money hand over foot on their backs. Its this baby boomer generation of self-entitled, lazy ********* that sees no problem with milking the lifeblood of the next generation for everything they can get.
 
This is exactly the truth. From my recent interviewing, most all private practices had an owner/ partner(s) who expected to come in at 11 with a newspaper under their arm poke their head around, play with themselves at their desk for a while, and then leave early while taking 10-12 weeks off a year and bringing their pictures of their trips to Katmandu and Bora Bora to decorate their desks. The actual workers/ pathologists were salaried and were busting their hump and were politely indignant that these people hung around and didnt sell/ turn over the practice that they knew was making money hand over foot on their backs. Its this baby boomer generation of self-entitled, lazy ********* that sees no problem with milking the lifeblood of the next generation for everything they can get.

Look at it from their perspective. Why on earth would they retire from such a situation? Sounds pretty cush, no?
 
Its this baby boomer generation of self-entitled, lazy ********* that sees no problem with milking the lifeblood of the next generation for everything they can get.

If you also include bankers in that " ********* " category, you've captured the American condition in a single sentence.
 
Look at it from their perspective. Why on earth would they retire from such a situation? Sounds pretty cush, no?

For real. I'd do the same thing. If you really want to stop them from doing that, then form your own group and undercut their contract with the hospital. That will get their attention.
 
For real. I'd do the same thing. If you really want to stop them from doing that, then form your own group and undercut their contract with the hospital. That will get their attention.

This sounds like a real solution, offer a lower price with better service. Where is raider with his alpha mentality to lead?
 
Isn't that kinda also what people are complaining about? Other companies/groups/whatever zooming in and undercutting everyone and turning the profession into a bunch of overworked underpaid folks at slide mills?
 
Just pulled this one from pathoutlines:

'Seeking an experienced fellowship-trained genitourinary pathologist, board certified in cytopathology, for a unique opportunity with a rapidly growing private regional pathology laboratory. The qualified candidate will possess 3-5 years experience in AP general and GU pathology with board certification in cytopathology and completed GU fellowship'


I mean really. How many cyopath boarded, GU fellowship trained pathologists with 3-5 years of experience are there? I would imagine most pathologists with this background already have decent gigs. Is this what pathology residency has come to...I mean this degree of subspecialization?

This sounds like a fake job posting for someone who the group already wants to hire or for someone who is trying to alter their visa status.
 
This is exactly the truth. From my recent interviewing, most all private practices had an owner/ partner(s) who expected to come in at 11 with a newspaper under their arm poke their head around, play with themselves at their desk for a while, and then leave early while taking 10-12 weeks off a year and bringing their pictures of their trips to Katmandu and Bora Bora to decorate their desks. The actual workers/ pathologists were salaried and were busting their hump and were politely indignant that these people hung around and didnt sell/ turn over the practice that they knew was making money hand over foot on their backs. Its this baby boomer generation of self-entitled, lazy ********* that sees no problem with milking the lifeblood of the next generation for everything they can get.

Yeah, these practices suck. In my view they are almost worse than the clinician owned labs, because they should know better.

I mean, money is important, ok? But researchers have done thousands of studies which show that more money does not mean more happiness, unless you are comparing poverty to lower middle class. But what does everyone always want? Money. And what people most definitely do NOT want is to make LESS money. Physicians rode the gravy train in the 80s and early 90s and since then they have been doing various things to maintain income. Working harder, doing more procedures, manipulating the billing systems. You exhaust one option you go to another. The logical next step is to employ other physicians and profit from their labor. although this has been happening for eons in academics as well as in other ways.

I get really pissed off with some clinicians who employ pathologists because all they talk about is quality, fellowship training, etc, but they really only care about money. They make the money work, then they backtrack and turn it into quality. Quality is secondary, although it can be made to seem primary.

So yes, you have the baby boomer generation raised on growth and profits the primacy of wealth. And their kids are now finishing med school and they think they "deserve" everything that anyone else has, just because they exist. So it isn't really going to get any better. In fact, the problem is is that the newer generation is becoming easier to exploit because there are so many true believers out there who don't want the high salary or profit sharing. And there are more foreign graduates who are willing to do almost anything to establish themselves, and know that if they keep working harder than everyone else they might be the one exploiting others some day. So it's tough. But this is true in every profession. Even the day care industry is becoming cutthroat. As bad as you folks want to say some pathologists have it, give me a struggling pathologist's options any day over a struggling law school grad or struggling MBA grad. Yikes. These people could conceivably kill someone to get ahead.

My group is ethical. Physicians we work with are largely ethical. I would like to think this is not unusual. I don't think it is as uncommon as people on these forums say.
 
Look at it from their perspective. Why on earth would they retire from such a situation? Sounds pretty cush, no?

The thing is, it often doesn't matter if they retire. They still "own" the group and if they don't make younger people partners then they keep a controlling interest even after they retire. Or they "advise" the group. And they draw a salary or profit sharing or whatever. It's like teachers' unions. No matter how much active teachers are willing to give and negotiate, the retirees still vote and have the numbers, and control everything.
 
Just another example... I am currently a fellow who is seeking a job for July 2012. I personally started early in my search for a job over a year ago. Because of my wife's practice, I am locked into a very specific geographic area where the market is considered very tight. I initially sent out about 15 CV's to different groups in my area. I followed this up with a phone call to each practices and have talked to people to try and work any connection possible. The availability of jobs would have been described as "bleak" about three months ago if you would have asked me then. More recently things have started to pick up. I have had 4 interviews in the past two months with two second round interviews during that time. Most of the other groups who are not hiring have at least had open communication and said to keep in touch. There are no official job offers yet but things seem to be moving towards that with at least one group. I also know lots of people who have finished fellowship training in recent years who ALL (with few exceptions) have found jobs. Sure they may not be their dream job in the location they wanted, but they were finding positions. And most of them were receiving pretty decent starting offers, not the $120-140k that I have seen quoted on here. Don't get me wrong, I am NOT saying the market for Pathology is great or will improve drastically in the next few year, because I don't think that. I have actually been very involved in the CAP in the past and understand why they are predicting a future shortage. I also know there are significant flaws in the numbers and sampled population that are polled for some of these surveys. But with that said, I also don't think the market is as impossible as everyone makes it out to be. Maybe one or two steps away from impossible :) In the past 3 years practically everyone I know found job somewhere. This is just my 2 cents on the whole situation. I will update the thread when and if things change.

KSQ
 
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Just another example... I am currently a fellow who is seeking a job for July 2012. I personally started early in my search for a job over a year ago. Because of my wife's practice, I am locked into a very specific geographic area where the market is considered very tight. I initially sent out about 15 CV's to different groups in my area. I followed this up with a phone call to each practices and have talked to people to try and work any connection possible. The availability of jobs would have been described as "bleak" about three months ago if you would have asked me then. More recently things have started to pick up. I have had 4 interviews in the past two months with two second round interviews during that time. Most of the other groups who are not hiring have at least had open communication and said to keep in touch. There are no official job offers yet but things seem to be moving towards that with at least one group. I also know lots of people who have finished fellowship training in recent years who ALL (with few exceptions) have found jobs. Sure they may not be their dream job in the location they wanted, but they were finding positions. And most of them were receiving pretty decent starting offers, not the $120-140k that I have seen quoted on here. Don't get me wrong, I am NOT saying the market for Pathology is great or will improve drastically in the next few year, because I don't think that. I have actually been very involved in the CAP in the past and understand why they are predicting a future shortage. I also know there are significant flaws in the numbers and sampled population that are polled for some of these surveys. But with that said, I also don't think the market is as impossible as everyone makes it out to be. Maybe one or two steps away from impossible :) In the past 3 years practically everyone I know found job somewhere. This is just my 2 cents on the whole situation. I will update the thread when and if things change.

KSQ

Good luck on landing an offer. Do you mind letting everyone know what kind of program you're in (top ten, top 1/3, middle 1/3, bottom 1/3) and whether your fellowship is one of the supposedly more sought after ones (derm, GI, heme, etc). I have seen with my own eyes a vast difference between the haves and have nots in training programs and the opportunities available to graduates. Also, if you're not uncomfortable sharing, what general geographic area are you in?
 
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