A toast...

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musom

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Dear self,

Today you are to be applauded.

You have been patient for years with the local ball bustin' group of -26 stealing, Bostwick sending Urologists. You have bit your tongue with their unjustified personal attacks that your lab is inadequate to take care of the needs of their patients, as their strategically placed complaints to hospital administration gave unneeded emotional permission to the group to continue to send all of the 12 part prostate biopsies performed on every man, woman and child that walked into their clinic to corporate America for 80% of the unjustified and certainly undeserved -26 (and even most TC). But you were patient. You were patient even upon the tongue-in-cheek reapproach when asking for the Medicare scraps from their practice. But you were understanding of the extreme difficulty of their administrative staff to conceptualize that Medicare would come this way and all the good payers would go that way. You have been patient. Your patience has now paid off, as the group of has been financially swallowed by the hospital corporation and boy does it taste good. The practice is now owned and operated by the hospital and the financially gluttonous Urologists are now hospital employees, just as you are. That -26 sharing is only a distant memory. Eat up kid, it's been a long time coming.

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I'll be curious to see how drastically the biopsy counts fall. Be sure to get back to us on that!
 
I am a radiation oncologist who treats prostate cancer quite frequently but I honestly don't know what happens between the time the urologist obtains a prostate biopsy sample and a report from a pathologist is written out (I honestly never thought it was something I needed to be concerned about).

I have a sense of what you are describing but can you describe in terms I would understand (what does "-26" or "TC" mean) and especially how this might affect the accuracy or quality of the pathology report and/or in general affect my decision making and ultimately patient care?

Thanks.
 
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Well sticky,

They are still on an RVU-based compensation model. Therefore, I don't expect the number of biopsies to fall dramatically. The incentive is still there, but not even of percentage of the strength it used to be. I will keep you updated as it progresses.
 
I am a radiation oncologist who treats prostate cancer quite frequently but I honestly don't know what happens between the time the urologist obtains a prostate biopsy sample and a report from a pathologist is written out (I honestly never thought it was something I needed to be concerned about).

I have a sense of what you are describing but can you describe in terms I would understand (what does "-26" or "TC" mean) and especially how this might affect the accuracy or quality of the pathology report and/or in general affect my decision making and ultimately patient care?

Thanks.

-26 means the professional component and -TC means technical component. In some cases, non-pathologists are able to client bill for pathology services rendered. Overall, the quality and accuracy of the pathology report should remain the same, if performed by a competent pathologist. I guess the question is if ALL biopsies performed were medically necessary. I would assume you would have to provide justification for that when sending out the bill.

Regarding the OP's letter to himself... you're in a bit of a bind when fighting against a urology group. I don't want to say that you're easier to replace (depends on how many other pathology groups are around you), but I can see administration siding with urology a lot easier than with pathology. The hospital would rather pocket the procedural fees than worry about the anatomic -TC charges they would be losing. If it were me, I wouldn't have remained silent...
 
-26 means the professional component and -TC means technical component. In some cases, non-pathologists are able to client bill for pathology services rendered. Overall, the quality and accuracy of the pathology report should remain the same, if performed by a competent pathologist. I guess the question is if ALL biopsies performed were medically necessary. I would assume you would have to provide justification for that when sending out the bill.

Regarding the OP's letter to himself... you're in a bit of a bind when fighting against a urology group. I don't want to say that you're easier to replace (depends on how many other pathology groups are around you), but I can see administration siding with urology a lot easier than with pathology. The hospital would rather pocket the procedural fees than worry about the anatomic -TC charges they would be losing. If it were me, I wouldn't have remained silent...


Indeed I was completely silent about the Urology group for years. It is coincidence that the hospital and the group mutually agreed to allow the urologists employeed positions. They were previously supportive of the institution, but financially separate. The coincidence of employment should hopefully work out to my favor.
 
Indeed I was completely silent about the Urology group for years. It is coincidence that the hospital and the group mutually agreed to allow the urologists employeed positions. They were previously supportive of the institution, but financially separate. The coincidence of employment should hopefully work out to my favor.
In that now since the bxs will be done in the hospital you'll get to bill PC?
 
In that now since the bxs will be done in the hospital you'll get to bill PC?
Does it matter if you're also an employed pathologist now? Has your pathology group been employed by the hospital this entire time as well? If not, how has the change from a private pathology group to being employed changed affected your group?
 
Does it matter if you're also an employed pathologist now? Has your pathology group been employed by the hospital this entire time as well? If not, how has the change from a private pathology group to being employed changed affected your group?

I've been employed since inception. However, this specific practice has historically been a private practice. I just took over after the retirement of the private practice guy.

The retiring pathologist kept his financials very private. I know he was paying out a pile for malpractice, 10% for billing, and he had a lot of recent attorney fees as well. Something tells me that I'm financially better off now as an employed physician that he was as a private practice physician. But I may never know for sure.
 
This has been happening for years. Good job on getting the biz though.

PS- Everyone should open a Kraken or Coinbase account, its getting hot in here. Cryptocurrency= the future
 
They have put options on bitcoin. Looks it is due for a crash.
 
Yes, give all your money to Coinbase. There's a lot of Chinese speculators looking to offload their coins to the greater fool...
 
I checked. Put options on bit coin have 200% implied volatility ( IV) .
Too bad it is just another way to lose big $. High IV means you can lose a ton even if it moves in the right direction
 
What's the IV of attempting to do a Path residency nowadays? Like 500%?
 
I am a big believer in cryptocurrency. I would not be upset if BTC crashes $11,000 or $15,000 tomorrow. My initial investment was on the very low end, so no harm no foul. I do believe that crypto has it's place in society and things will just explode even more in the next 10 years. BTC may not be top dog (though, I still think it will) but there will certainly be something to replace it. There's over 1100+ crytocurrencies out there right now. I've personally set aside a portion of my investment portfolio in cryptos (full disclaimer as I own ETH, LTC and XRP) but it's an amount that I am willing to part ways with if things sink. I don't know about you but I am loving 135,000% ROI.

Which is the bigger bubble -- cryptocurrency or the stock market bundled with student loans, home mortgages, etc aka the US dollar. There's a finite number of BTC but not a finite number of green as we seem to keep pilling on a lot of debt to keep printing presses busy. I personally think that anyone who denies the utility of cryptocurrency will be in for a rude awakening. The surface has barely been scratched. When this becomes (and it will) mainstream, you're going to look at BTC and say, "Wow, I wish I got in when it was ONLY $17,000 per coin." Then again, I could be full of **** :)
 
There is no bubble in cryptocurrency, what there is a bubble in is the current world order and power structure that involves a corrupt union of politicians and banking. Im buying bitcoin not because of its use as a financial instrument but because I believe in the coming Revolution.

BTC will absolutely be hitting over 30K per by the summer. Mark my words now.
 
For god's sake, stay away from these stupid investments like bitcoin and buy rental property/farm land. None of my relatives who lived through the great depression even know there was a depression since they had food and the necessities.
 
There is no bubble in cryptocurrency, what there is a bubble in is the current world order and power structure that involves a corrupt union of politicians and banking. Im buying bitcoin not because of its use as a financial instrument but because I believe in the coming Revolution.

BTC will absolutely be hitting over 30K per by the summer. Mark my words now.

Totally agree with this... except aim a little higher for BTC. It isn't impossible, but I think owning 1.0 BTC now will be the equivalent of owning $500,000 USD in 2 years. That or John McAfee said this:
 
For god's sake, stay away from these stupid investments like bitcoin and buy rental property/farm land. None of my relatives who lived through the great depression even know there was a depression since they had food and the necessities.

Webb read Tapscott's Blockchain Revolution or other literature on what and how blockchain will be used. THIS is the Black Swan event in human history Nassim Taleb said would be unpredictable and totally unexpected that will go onto to shape human civilization going forward (and for the better might I add).
 
The problem with the blockchain is that it might be a way to reduce corruption and rent-seeking behavior from politicians. Therefore it's a threat to them.
 
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