$100/hour as a Pathologist

[KeratinPearls]

Full Job Description​

We are looking for a full-time pathologist to run an AP lab for our GI business in Cumming, GA. This is a full-time position with flexible hours. Pathologist must be willing to do grossing of specimens as well as read slides.
1. Board-certified Pathologist (MD) who is licensed to practice in the state of Georgia;
2. Doctor of Medicine (MD), who is licensed to practice in the state of Georgia with at least one year of laboratory training during residency or at least two years of experience supervising high complexity testing; or,
3. Doctor of Medicine (MD) in chemical, physical, biological, or clinical laboratory science from an accredited institution and certification by a board approved by HHS.
4. Ability to do grossing of specimens as needed.
Job Type: Full-time
Pay: From $100.00 per hour
Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible schedule
• Health insurance
• Health savings account
• Professional development assistance

Schedule:

• 8 hour shift
• Monday to Friday

Supplemental pay types:

• Bonus pay

Education:

• Doctorate (Required)

License/Certification:

• Medical License (Required)

Work Location: One location

$100 per hour for grossing and reading of slides? LOL. Are we technicians now? That’s $200,000 a year with 2 weeks vacation! Is there word going around between gastroenterologists that they can low ball pathologists and get away with it?

If you look up the site if the job ad:
4150 Deputy Bill Cantrell Memorial Rd #290, Cumming, GA 30040

You get GI-North.

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This is not uncommon either. I’ve talked to pathologists who were offered low salaries (200,000) to sign out a lot of GI or just low salaries in general, from group private practice.

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[Med Director New England]

I was once (~ 5 yrs ago) offered 15.00 / US dollars per 88305 for outpatient GI work. As a side gig
Back then derm’s doing solo or side gigs were getting 25-35 per 88305.

Politely declined, but someone else did sign up.

 

[WEBB PINKERTON]

Pre-pandemic you would have found someone easily for that rate. Now I am not so sure. They could luck into a lone wolf who has burned a lot of bridges and is desperate.

Hell, traveling histotechs are getting nearly that much now.

Stay away from these in-office lab jobs. They are not stable with venture capital and hospitals on buying sprees. Once they swoop in, the lab will revert back to the broom closet it was before someone came up with the idea of having a lab.

 

[gbwillner]

Agree this is subpar but including benefits it's not that bad. Roughly 200K plus benefits plus bonus, so total comp could be like $250K or more and this is pretty much mean pay for our specialty. Or it was.

 

[Alteran]

Just taking a stab in the dark, but in any other scenario, this would be a ~$1 million account for a group to have - professional charges only. They're pocketing all the technical and keeping 80% of the professional. In a perfect world, that's $1.8 million gross (professional + tech) minus pathologist ($250,000), histotech ($80,000), and lab expenses ($350,000) for a net of about $1.1 million or $560K per GI doc for doing absolutely zippo.

At least that's what their less than stellar bean counters told them on the proforma. The funny thing is most, probably all, insurers treat these POD labs as commercial labs and hose them at about 40-60% of Medicare rates. The dirty secret is that most of the POD labs have uncollectable rates upwards of 30% and/or provide most of their services for more than what they're being paid by commercial insurers.

 

[coroner]

Pay: From $100.00 per hour

Supplemental pay types:

• Bonus pay

The kicker here is the bonus pay, and ideally it's a pretty hefty bonus. If it's production/RVU-based, it would have something along the lines of an extra couple of hundred grand a year for this to be worthwhile. $100/hr is crap. Think about it, that's only $800/day. Locums is now starting at $1200/day = $150/hr, and upwards. I just saw got an email the other day for a job paying $2K/day. Having said that, I'm sure someone out there will sign up.

I was once (~ 5 yrs ago) offered 15.00 / US dollars per 88305 for outpatient GI work. As a side gig...

Politely declined, but someone else did sign up.

Yup. That's about 40% of the PC, and pretty much all we can expect. Kudos to you for declining if it was because you refused to get low-balled. But, it's no surprise they found someone else to accept this.

 

[cmz]

So this group is comprised of two MDs and three FNPs? I also forgot to mention a "board certified" NP. Are NPs now able to do colonoscopies/EGDs? It's Georgia, so I want to say yes, they probably can scope real people.

I would definitely like to know what kind of volume this group is producing -- if all five of these providers can scope, maybe you're looking at somewhere in the neighborhood of 200-300 jars/day (and I am being conservative). Before anyone balks at that number, please understand that you have to float the salaries for a COO/Marketing Director and do not forget to include all of the division managers and office employees. I would also wager that they bill out anesthesia, too.

 

[gbwillner]

The kicker here is the bonus pay, and ideally it's a pretty hefty bonus. If it's production/RVU-based, it would have something along the lines of an extra couple of hundred grand a year for this to be worthwhile. $100/hr is crap. Think about it, that's only $800/day. Locums is now starting at $1200/day = $150/hr, and upwards. I just saw got an email the other day for a job paying $2K/day. Having said that, I'm sure someone out there will sign up.


Yup. That's about 40% of the PC, and pretty much all we can expect. Kudos to you for declining if it was because you refused to get low-balled. But, it's no surprise they found someone else to accept this.

I'm just going to say that locums work SHOULD pay more than a full-time job, otherwise no one would take it. Locums offers I've seen are now almost double what you post and it makes sense. Hourly pay should be more than you would get from full time employment. It's why you pay a plumber $150/hr + $300 just to show up. He sits on his ass the rest of the day.

 

[coroner]

Locums offers I've seen are now almost double what you post and it makes sense.

Double of what? I posted locums rates starting at $1200/d and upwards of $2K/d.
Double could be either $2400/d or $4K/d which is a significant difference. At $4K/d = $20K/wk = $920,000/yr, w/ 6wks of vacay.
This is orthopedic spinal surgeon territory Kindly send me that ad so I can quit my job...

 

[KeratinPearls]

Was told by another pathologist who who does locums that on average locums pay is $1500/day with as high as 2000-2200.

This guy also mentioned he was doing $700/day back when locums pay was turd crap. So locums pay is not always higher than a regular full time job.

 

[Pingu]

My last locum I paid 2200/day for a decent to high volume practice. And that was the only locums I could find availability with (semi-short notice) and had 3 agencies looking.

 

[caffeinegirl]

My last locum I paid 2200/day for a decent to high volume practice. And that was the only locums I could find availability with (semi-short notice) and had 3 agencies looking.

What was the payment to the locums pathologist?

 

[cmz]

What was the payment to the locums pathologist?

I do not think they would know unless the locums divulged that info. I would guess maybe they keep 60-70%? I think I might pull a Tom Dillon and start doing "fake business" with some of these companies to see what they actually let you keep.

From personal experience, I used to pay up to $1500/day for locums to handle high volume work. This was pre-covid. Our usual local rate was $800 but we covered med-mal. Our policy holder grants us 30 free days of locums coverage, but our regular hired muscle all had med-mal plans under our company umbrella. Unfortunately, the pathologists we relied on locally have since retired (COVID accelerated their retirement plans for sure) and now we strictly deal with the terms the locums companies provide. With that said, we haven't had luck finding locums or a locums company that can properly coordinate coverage. At this point, we are simply just absorbing the volume when pathologists need breaks.

 

[caffeinegirl]

I do not think they would know unless the locums divulged that info. I would guess maybe they keep 60-70%? I think I might pull a Tom Dillon and start doing "fake business" with some of these companies to see what they actually let you keep.

From personal experience, I used to pay up to $1500/day for locums to handle high volume work. This was pre-covid. Our usual local rate was $800 but we covered med-mal. Our policy holder grants us 30 free days of locums coverage, but our regular hired muscle all had med-mal plans under our company umbrella. Unfortunately, the pathologists we relied on locally have since retired (COVID accelerated their retirement plans for sure) and now we strictly deal with the terms the locums companies provide. With that said, we haven't had luck finding locums or a locums company that can properly coordinate coverage. At this point, we are simply just absorbing the volume when pathologists need breaks.

The only reason I ask, is that there is a big discrepancy between the numbers listed here - there is the payment to the locums company from the employer, and then the payout to the locums pathologist (which is what's left after the company gets their fee). I've seen ad listings for 900-1200 per day - that's different than what the employer pays the company doing the search. Just wanted a clarification. Thanks!

 

[Pathological_Liar]

I was once (~ 5 yrs ago) offered 15.00 / US dollars per 88305 for outpatient GI work. As a side gig
Back then derm’s doing solo or side gigs were getting 25-35 per 88305.

Politely declined, but someone else did sign up.

Separate issue, but this is what new private payer (Anthem, etc) contracts are offering path groups.
Staying out of network risks payers invoking surprise billing legislation, which reduces provider negotiation leverage.

I'm actually surprised this hasn't been discussed much here. It looks like we're headed toward a future where medicare offers the best reimbursement among major payers.

 

[cmz]

Separate issue, but this is what new private payer (Anthem, etc) contracts are offering path groups.
Staying out of network risks payers invoking surprise billing legislation, which reduces provider negotiation leverage.

I'm actually surprised this hasn't been discussed much here. It looks like we're headed toward a future where medicare offers the best reimbursement among major payers.

Now would be a good time for a pathologist that practices in California to comment on the surprise billing legislation. LaDoc? Elsewhere, we are taking -12% to the chin. I'm also not sure why this hasn't been discussed at length here, but I suspect that perhaps people are steering away from this topic due to lack of time because they are trying to recover that 12%. It's a wonderful time to be alive in today's market.

 

[WEBB PINKERTON]

Separate issue, but this is what new private payer (Anthem, etc) contracts are offering path groups.
Staying out of network risks payers invoking surprise billing legislation, which reduces provider negotiation leverage.

I'm actually surprised this hasn't been discussed much here. It looks like we're headed toward a future where medicare offers the best reimbursement among major payers.

Everything will be bundled at some point.

 

[gbwillner]

The only reason I ask, is that there is a big discrepancy between the numbers listed here - there is the payment to the locums company from the employer, and then the payout to the locums pathologist (which is what's left after the company gets their fee). I've seen ad listings for 900-1200 per day - that's different than what the employer pays the company doing the search. Just wanted a clarification. Thanks!

In my discussion with Locums groups in years' past, their markup is 30%. But that also includes whatever they need to pay to get the doc there... So if they need to pay for food and lodging for a path and flights for every weekend this comes out of their 30%.

 

[coroner]

A locums agent called me the other day. I knew it was an agency when I saw the caller ID; but, I took the call anyway just to inquire what are the latest going rates. She said for pathology, the range has been $1400/d at the lowest, and the highest was $2250/d, with the average being 2K.
And all these quoted rates go entirely to the pathologist.

As mentioned by other posters, locums rates for pathology have definitely gone up since the pandemic. Likewise, they have similarly gone up for other health care fields e.g. our hospital (like others) has had trouble staffing nurses, because many have been quitting their permanent jobs since travel nursing pays a lot better. Rates have gone up, which they almost have to given what inflation has been recently...📈

 

[path24]

How long till an uptick in residency spots? Academics/corporate labs aren't going to be happy with an "ok" job market. They will definitely bring back the huge oversupply/cheap labor.

 

[WEBB PINKERTON]

It's unsustainable. Health systems can't continue to pay traveling wages. Used a traveling histotech lately? 90 bucks an hour. Nurses are making a killing. I am seeing health systems so desperate to end the traveling, they are offering nurses huge retention bonuses to stay on a year or more. I hope this bizarre game of musical chairs stops soon. I've seen two hospitals nearby close in the last year.

 

[cmz]

It's unsustainable. Health systems can't continue to pay traveling wages. Used a traveling histotech lately? 90 bucks an hour. Nurses are making a killing. I am seeing health systems so desperate to end the traveling, they are offering nurses huge retention bonuses to stay on a year or more. I hope this bizarre game of musical chairs stops soon. I've seen two hospitals nearby close in the last year.

Pretty soon physicians will start walking to greener pastures. There aren't enough of us to go around (no matter the specialty). Period.

 

[mike-sheree]

Pretty soon physicians will start walking to greener pastures. There aren't enough of us to go around (no matter the specialty). Period.

I think there’s enough. Just the geographic distribution is toward urban areas. More folks need to do like Webb and get out of the cities. 40 acres, some water feature, hogs and your own outdoor (or indoor) range sounds like heaven.

 

[cmz]

I think there’s enough. Just the geographic distribution is toward urban areas. More folks need to do like Webb and get out of the cities. 40 acres, some water feature, hogs and your own outdoor (or indoor) range sounds like heaven.

There may be enough pathologists in the workforce, but the centralization of services is driving the trend of shunting labs/specimens out of the non-urban areas. LabCorp/Quest has 2 week TAT on simple biopsies in my area. Despite this, it's very hard to take back this volume and remain competitive. You're also dealing with a different generation of pathologists that are replacing all of the boomers, including yourself.

 

[Med Director New England]

There may be enough pathologists in the workforce, but the centralization of services is driving the trend of shunting labs/specimens out of the non-urban areas. LabCorp/Quest has 2 week TAT on simple biopsies in my area. Despite this, it's very hard to take back this volume and remain competitive. You're also dealing with a different generation of pathologists that are replacing all of the boomers, including yourself.

It's unsustainable. Health systems can't continue to pay traveling wages. Used a traveling histotech lately? 90 bucks an hour. Nurses are making a killing. I am seeing health systems so desperate to end the traveling, they are offering nurses huge retention bonuses to stay on a year or more. I hope this bizarre game of musical chairs stops soon. I've seen two hospitals nearby close in the last year.

MA considering legislation to cap traveling RN salary. It sounds illegal to me - pro RN groups will certainly challenge in court if it passes

These long TAT are b/c of shortage of tech staff (not just the big boys, most labs). A private lab near me is thousands of blocks behind b/c of HT shortage. Plenty of paths around to eat up the cases once on glass.

 

[WEBB PINKERTON]

MA considering legislation to cap traveling RN salary. It sounds illegal to me - pro RN groups will certainly challenge in court if it passes

These long TAT are b/c of shortage of tech staff (not just the big boys, most labs). A private lab near me is thousands of blocks behind b/c of HT shortage. Plenty of paths around to eat up the cases once on glass.

We have used a few traveling histotechs in the past year. They are doing quite well and plan on riding this all long as they can.

Seems silly for individual states to cap traveling nurse pay. They just won't come to your state if they can make more other places. They can come work at our health system and collect 50 grand just for staying a few years.

 

[cmz]

How efficient/lean can you get if you run a histo set up with Sakura's automated embedding system, microtomes, etc?

 

[KeratinPearls]

MA considering legislation to cap traveling RN salary. It sounds illegal to me - pro RN groups will certainly challenge in court if it passes

These long TAT are b/c of shortage of tech staff (not just the big boys, most labs). A private lab near me is thousands of blocks behind b/c of HT shortage. Plenty of paths around to eat up the cases once on glass.

Saw some guy post how much he makes as a traveling nurse on Instagram. $5,000-$9,000 a week!

 

[Mad Jack]

I was once (~ 5 yrs ago) offered 15.00 / US dollars per 88305 for outpatient GI work. As a side gig
Back then derm’s doing solo or side gigs were getting 25-35 per 88305.

Politely declined, but someone else did sign up.

 

[SunBakedTrash]

View attachment 364182

The pigeon is also the radiologist. I would much rather be replaced by this bird than by a nurse with a weekend education and an attitude problem.

 

[WEBB PINKERTON]

CMS now says pigeons have the equivalent of a biology degree and can do high complexity testing. Joke all you want to about them but they are coming for your job.

 

[TrojanRaggy]

CMS now says pigeons have the equivalent of a biology degree and can do high complexity testing. Joke all you want to about them but they are coming for your job.

They are coming for us because you chopped off all their trees

 

[WEBB PINKERTON]

If a group were to hire a pigeon that could screen slides, I guarantee you another path group will try to kidnap that thing like a truffle pig. You would have to have 24 hour surveillance.

I've never even seen a pigeon in the woods. City bird.

 

[SunBakedTrash]

I heard Boston pigeons are not as diagnostically good as Baltimore pigeons. Too much research and not enough time getting food pellets for identifying tumor samples.