- Joined
- Apr 29, 2014
- Messages
- 82
- Reaction score
- 193
Your criteria for ranking programs...any regrets?
- Thread starter Patho_logical
- Start date
- Joined
- Jan 22, 2016
- Messages
- 11
- Reaction score
- 14
I think a bit part of this is the realization, after the recent major reimbursement cuts, that a lot of pathologists can simply do a lot more work than they had previously been accustomed to doing to maintain their same level of pay.
IE, the days of someone coming in, leisurely poring over 4-5 trays while slurping coffee, maybe doing a few frozens, then calling it a "day" are gone. A few years ago my group effectively absorbed the entire practice of a guy like that who retired. Yes, he was a dinosaur, but not only did we not add anyone, but with that work absorbed into a larger group of 6+ others, we barely even noticed it. So that was one "FTE" that effectively disappeared altogether!
If you look at the demographic info of currently practicing pathologists, about 15% of them are 60 years old or older. Although I think people have talked about a "retirement cliff", that's really not a huge cohort of imminent retirees. Although inevitably some these will be replaced by younger pathologists, with existing pathologists doing higher volumes, the replacement number may not be as high as the retirement number.
By far the BIGGEST cohort of pathologists in practice right now is the 50-55 year old crowd. In effect it means another 10-15 years before there is really going to be a large number of retirements. Also, I think this cohort is really more senior with more residual partnerships, power, and control than younger ones. As more and more specimens are controlled by large corporate groups, pathologists are just going to have less and less ability to control their own professional fates.
Offsetting this a *little* bit, global pathology specimen volumes are increasing and are expected to do so for some time. Extrapolate this out, and assuming no significant change to numbers of trainees, I think ten years from NOW, pathology may be in a place where increased volumes and significant decrease in practicing pathologists contributes to an actual shortage, but that doesn't help anyone now.
- Joined
- Aug 15, 2003
- Messages
- 28,059
- Reaction score
- 438
Retirements are happening and will continue to happen. This is combined with significant changes in how private groups operate and are organized. Academic groups are probably not showing similar changes unless their hospital system is buying other systems.
In some places this takes the fashion of the group losing business to reference labs. In others it's consolidation of multiple labs into a single administrative and practice unit. Small groups are definitely endangered. The question is how long will they continue to exist. Many will get absorbed into larger groups which in some cases will be a net benefit to the pathologists involved, and in other cases a net harm to the pathologists involved.
You will see all kinds of predictions. It is hard to know which are correct or legitimate. What is definitely true is that reimbursement is declining and so is autonomy. How much probably varies by location and practice pattern. This is true of almost all of medicine. Administration is increasing exponentially, but money pumped into healthcare is not. That money has to come from somewhere. Some of it is coming from patients, some of it is coming from consolidation, and some of it is coming from physician salaries.
Find a program that you like in an area you want to live. Although residency is a short time, it's a significant component of your life, often one in which major life events happen (marriage, kids, new friends, whatever). Find a place you want to live. And find a program where you will be happy attending. Programs can give you some prestige but this is worthless if you don't work at it. And the hardest working and smartest resident is likely to excel no matter where they are. And people will notice this.
In some places this takes the fashion of the group losing business to reference labs. In others it's consolidation of multiple labs into a single administrative and practice unit. Small groups are definitely endangered. The question is how long will they continue to exist. Many will get absorbed into larger groups which in some cases will be a net benefit to the pathologists involved, and in other cases a net harm to the pathologists involved.
You will see all kinds of predictions. It is hard to know which are correct or legitimate. What is definitely true is that reimbursement is declining and so is autonomy. How much probably varies by location and practice pattern. This is true of almost all of medicine. Administration is increasing exponentially, but money pumped into healthcare is not. That money has to come from somewhere. Some of it is coming from patients, some of it is coming from consolidation, and some of it is coming from physician salaries.
Find a program that you like in an area you want to live. Although residency is a short time, it's a significant component of your life, often one in which major life events happen (marriage, kids, new friends, whatever). Find a place you want to live. And find a program where you will be happy attending. Programs can give you some prestige but this is worthless if you don't work at it. And the hardest working and smartest resident is likely to excel no matter where they are. And people will notice this.
