Academic pathologist admits there is a glut.

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One of the attendings at my academic program freely admits that we (as a country) are training too many pathologists. Apparently every once in a while when our program's resident workload is brought up at a meeting or something, the possibility of increasing our class size is often suggested...a suggestion that this attending vigorously fights against.
 
Entgegen said:
One of the attendings at my academic program freely admits that we (as a country) are training too many pathologists. Apparently every once in a while when our program's resident workload is brought up at a meeting or something, the possibility of increasing our class size is often suggested...a suggestion that this attending vigorously fights against.
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That is a horrible way to gauge whether you need more residents. "The programs workload". I saw one program (UNC) who reportedly only has 26Kspecimens according to a poster on here, with 30 residents and fellows (via their website)!!!

Many groups do that with a handful of pathologists without any residents or fellows.

This place looks to have a staff of 100 (on their website). Utterly ridiculous.

Programs should be looking to the market as to whether we need more pathologists. I also had a very rare faculty tell me to flee this field as he and his friends had worked for corporate pathology. Since his recommendation, things have gotten steadily worse.😡😡
 
Thrombus said:
That is a horrible way to gauge whether you need more residents. "The programs workload". I saw one program (UNC) who reportedly only has 26Kspecimens according to a poster on here, with 30 residents and fellows (via their website)!!!

Many groups do that with a handful of pathologists without any residents or fellows.

This place looks to have a staff of 100 (on their website). Utterly ridiculous.

Programs should be looking to the market as to whether we need more pathologists. I also had a very rare faculty tell me to flee this field as he and his friends had worked for corporate pathology. Since his recommendation, things have gotten steadily worse.😡😡
Click to expand...
Do you know of anyone who has switched specialties for this reason?
 
Thrombus said:
That is a horrible way to gauge whether you need more residents. "The programs workload". I saw one program (UNC) who reportedly only has 26Kspecimens according to a poster on here, with 30 residents and fellows (via their website)!!!

Many groups do that with a handful of pathologists without any residents or fellows.

This place looks to have a staff of 100 (on their website). Utterly ridiculous.

Programs should be looking to the market as to whether we need more pathologists. I also had a very rare faculty tell me to flee this field as he and his friends had worked for corporate pathology. Since his recommendation, things have gotten steadily worse.😡😡
Click to expand...

Dude, learn to read.

I looked at their web site. There may be 100 faculty, but only 25 of them are anatomic pathologists. That list included PAs, PhDs in the department doing research, forensics, and the CP people.

The list of residents was also heavy with PhDs and CP only.

Keep whining and building straw men on this forum though. Other than raising your blood pressure it does no one any good. You want fewer residents to go into path? All your griping does is scare away good candidates. Those spots will just be filled with less desirable candidates, ultimately giving us less leverage and relative importance in the medical community.
 
I will freely admit there are FAR too many trainees for Pathology. This is in my professional opinion an academically/politically engineered crisis that shows no sign of abating.

I will also freely admit I plan to to use this oversupply to locate jr. staff who desire to work for a chill boss but at a reduced salary level from historical averages.

The door is definitely closed to the "layer cake" founding partnership ranks, perhaps for the next 20-30 years, but I dont think current residents/fellows will suffer too greatly under this new, more kind and transparent LADOC managment scheme.

Resident/fellows will know what they are getting themselves into: employee positions with generally flexible hours/schedules (1/2 time equivalents for example) at fixed wages with reasonable benefits. You wont be rolling around in a Porsche and spreading out in a estate home, but you wont be trapped in an apartment forever either.

Sorry if I turned this into a recruiting thread, the topic is on my mind atm.
 
You guys are far too mixed in with the "lab" types for anyone to give you real respect. The students that reject your specialty today are the attendings that disrespect your contributions tomorrow.

What the academic types need to do is lay off partnering with basic science buffoons and PhDs. Maybe they could also use to stop doing CP at all. Automated test QA isn't medicine, its tech work.

The lowering of standards to get gross-monkeys from Nazulbahn University of the Caribbean who obtained their MBDS 20 years ago is a horrible thing. What student would want to be part of a specialty that has its standards so low that someone whose medical training is perfunctory and outdated can get in? Path, primary care, psych. Those are the usual suspects.

LADoc00, I wonder about your plan. Sure, you can get a few gross-monkey crap-head pathologists to work for peanuts, but they'll probably be substandard. I wonder if the costs of paying for their screw-ups are more than what they bring in.
 
Substance said:
You guys are far too mixed in with the "lab" types for anyone to give you real respect. The students that reject your specialty today are the attendings that disrespect your contributions tomorrow.

What the academic types need to do is lay off partnering with basic science buffoons and PhDs. Maybe they could also use to stop doing CP at all. Automated test QA isn't medicine, its tech work.

The lowering of standards to get gross-monkeys from Nazulbahn University of the Caribbean who obtained their MBDS 20 years ago is a horrible thing. What student would want to be part of a specialty that has its standards so low that someone whose medical training is perfunctory and outdated can get in? Path, primary care, psych. Those are the usual suspects.

LADoc00, I wonder about your plan. Sure, you can get a few gross-monkey crap-head pathologists to work for peanuts, but they'll probably be substandard. I wonder if the costs of paying for their screw-ups are more than what they bring in.
Click to expand...

Substance,
Why don't you take your drivel to the medicine or FM boards, since they have even lower standards there? Maybe they will welcome your annoying and pointless criticisms (that are completely baseless since you have probably just as little understanding of their field as you do pathology) and not see your posts mere pollution to the already bloated blogosphere.
 
Substance said:
LADoc00, I wonder about your plan. Sure, you can get a few gross-monkey crap-head pathologists to work for peanuts, but they'll probably be substandard. I wonder if the costs of paying for their screw-ups are more than what they bring in.
Click to expand...

This is a pretty naive viewpoint and fairly detached from the realities current fellows face and will face in the coming decades.

Im not saying peanuts, what Im saying is the days of 250K salaries with 400K+ partnership pie in the sky dreams are done for current residents. Kiss that off. Try closer to half time slots at 100K.

I still think you have the $ to pay off loans and obligations and raise a family btw on that, maybe not at my level but you will have plenty of time to spend with kids and family etc.

First off, I would never hire pathologists at 100K+ to be gross monkeys. Ever. That is what techs are for. I dont value grossing really more than say 60-70K/year FULL TIME and they would be cutting FSections and doing IHC as well for that.

I can pretty much GUARANTEED hire excellent people willing to do what I want for what I will pay. There are too many young trainees willing to do anything to live in desirable locations with little to no chance of actually getting hired here.

If I was in East Texas, yes perhaps I would need to get partnership track jr staff to get them to come to some forsaken geographic spot, but I dont.

Also you are confused how jr staff exist in the Pathology Hospital Contract/OPat world. They are cogs. If a cog fails to perform, they are thrown under the bus. They almost never and I mean NEVER endanger the primary contract holders with their screw ups.

Im not saying I will beat jr staff behind the proverbial barn if they screw up a case, but what I am saying is that the current cultural of contracts almost never holds the Medical Director/Sr. Staff accountable for jr. staff debacles.

I could chat for longer hours over some drinks about this but suffice it to say our Glorious Leaders in Pathology have produced a world in which hiring lower quality staff has very little risk and lots of $ reward. The same often holds true for large Nat labs.

Basically if you are a jr. staff at an academic job or perhaps some hot fellow at Brigham or JHU etc, you need to seriously reconsider what you are bringing to the table because often it is far far less than you expected.

Im not trying to be Debbie Downer or knock some poor GI fellow at Emory off his or her pedestal. Just trying to be real here and perhaps save some heartache.

The reality is as follows:
1.) I can pay 100K, I can 300K, I can pay more. The quality of the applicants will NOT particularily change to degree I would at all care. I have no intention of doing a derm operation and thus really dont care fellowship training at all, work experience being far superior.
2.) If the quality of the pool doesnt change much from 100-->alot higher, why would I pay more? If you can hire a manager for the local Hertz rental car location for 50K, why would you pay 150K? right??

the above is directly linked to overtraining. There are a TON of trainees desperate for work in my geographic location who are well trained (or trained as much as any trainee...). Im not even sure that is the road I want to go down as there are even more experienced types with 10+ years of experience having made their $ elsewhere looking to exit from crappy geographic locations or from industry jobs/crappy Kaiser or state positions etc.

To address your other more obviously confused point: I will never surrender Clinical Lab duties. Never. Clinical lab management is required by law. Clinical lab management is what prevents my work from being done by "NightHawks" crap. I do some QA for automated instrumentation, but what I provide is leadership, vision and consultation on the medical value of lab decisions and I am very well paid for this, thanks.\

When all primary care docs are replaced by nurses with PhDs and all radiology is done in India, I will still be a lab executive. I will exist, I will bill and grow prosperous for decades to come long after my friends in other specialities have fallen to the sword.
 
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LADoc00 said:
This is a pretty naive viewpoint and fairly detached from the realities current fellows face and will face in the coming decades.

Im not saying peanuts, what Im saying is the days of 250K salaries with 400K+ partnership pie in the sky dreams are done for current residents. Kiss that off. Try closer to half time slots at 100K.

I still think you have the $ to pay off loans and obligations and raise a family btw on that, maybe not at my level but you will have plenty of time to spend with kids and family etc.

First off, I would never hire pathologists at 100K+ to be gross monkeys. Ever. That is what techs are for. I dont value grossing really more than say 60-70K/year FULL TIME and they would be cutting FSections and doing IHC as well for that.

I can pretty much GUARANTEED hire excellent people willing to do what I want for what I will pay. There are too many young trainees willing to do anything to live in desirable locations with little to no chance of actually getting hired here.

If I was in East Texas, yes perhaps I would need to get partnership track jr staff to get them to come to some forsaken geographic spot, but I dont.

Also you are confused how jr staff exist in the Pathology Hospital Contract/OPat world. They are cogs. If a cog fails to perform, they are thrown under the bus. They almost never and I mean NEVER endanger the primary contract holders with their screw ups.

Im not saying I will beat jr staff behind the proverbial barn if they screw up a case, but what I am saying is that the current cultural of contracts almost never holds the Medical Director/Sr. Staff accountable for jr. staff debacles.

I could chat for longer hours over some drinks about this but suffice it to say our Glorious Leaders in Pathology have produced a world in which hiring lower quality staff has very little risk and lots of $ reward. The same often holds true for large Nat labs.

Basically if you are a jr. staff at an academic job or perhaps some hot fellow at Brigham or JHU etc, you need to seriously reconsider what you are bringing to the table because often it is far far less than you expected.

Im not trying to be Debbie Downer or knock some poor GI fellow at Emory off his or her pedestal. Just trying to be real here and perhaps save some heartache.

The reality is as follows:
1.) I can pay 100K, I can 300K, I can pay more. The quality of the applicants will NOT particularily change to degree I would at all care. I have no intention of doing a derm operation and thus really dont care fellowship training at all, work experience being far superior.
2.) If the quality of the pool doesnt change much from 100-->alot higher, why would I pay more? If you can hire a manager for the local Hertz rental car location for 50K, why would you pay 150K? right??

the above is directly linked to overtraining. There are a TON of trainees desperate for work in my geographic location who are well trained (or trained as much as any trainee...). Im not even sure that is the road I want to go down as there are even more experienced types with 10+ years of experience having made their $ elsewhere looking to exit from crappy geographic locations or from industry jobs/crappy Kaiser or state positions etc.

To address your other more obviously confused point: I will never surrender Clinical Lab duties. Never. Clinical lab management is required by law. Clinical lab management is what prevents my work from being done by "NightHawks" crap. I do some QA for automated instrumentation, but what I provide is leadership, vision and consultation on the medical value of lab decisions and I am very well paid for this, thanks.\

When all primary care docs are replaced by nurses with PhDs and all radiology is done in India, I will still be a lab executive. I will exist, I will bill and grow prosperous for decades to come long after my friends in other specialities have fallen to the sword.
Click to expand...

Thanks for replying.

I think I was misunderstood when I called the paths you want to hire "gross monkeys". I was not suggesting you hire them as PAs when you can get a real PA without the ego for half the price. I was merely saying that their residency training amounted to little more than being gross monkeys, and their lack of real diagnostic experience would render them liabilities rather than profit-centers.

Based on what you are saying, your lab is in an extremely desirable location, and you're betting on that to attract experienced pathologists and ones with good training/good pedigrees to work for what you're willing to pay. It might be successful, given your location. Other labs in less desirable areas would have trouble attracting good people at that rate, so would have to settle for the rejects, and that would be risky. We all talk about the job market being saturated, and some mention that the cream rises to the top, but since the unemployment rate for pathologists is virtually zero, the bozos have to be working somewhere.

As for clinical lab, I know you make a good amount of money on it, but the trend that I've seen is that hospitals are transitioning those duties to laboratory techs/PhDs, who are cheaper but practically just as effective, so why pay extra for someone who can do the same work for less? I can't see CP existing far into the future as something physicians do given the future of rationing, which is why I can't really get behind your last comment 100%.

You're right about academia. It's pretty cutthroat and lacking in honor. Pathology seems to be the worst of the specialties in this regard. Not only can it not attract the best and brightest, but it attracts people with pathological ambitions, pardon the pun. Same thing here in Canada: look up the names Olive Williams and Barbara Heartwell. One of them is a surgeon, one is a pathologist. One screwed up, one didn't. Guess which one got shafted? Guess which one's professional organization didn't defend her?
 
LADoc00 said:
I could chat for longer hours over some drinks about this but suffice it to say our Glorious Leaders in Pathology have produced a world in which hiring lower quality staff has very little risk and lots of $ reward. The same often holds true for large Nat labs.
Click to expand...

Ditto in-office labs.
 
Dont know where you got that bit of info but the unemployment rate for Boarded Pathologists is far from zero. I have several souls on my personal cell phone who can definitely attest to it. They might be doing something medically related to earn some cash but I would not call them employed Pathologists by any stretch.

The situation has become (or has been all along?) very analogous to Law School graduates, some practice at firms, many dont.

I also dont think other specialities especially surgeons are any more insulated from what is coming. On the contrary, most surgeons own buildings, have huge capital investments etc that will fall to sword in the coming decade of Obama damage.

My overhead is LESS than 10% total and that includes billing costs as the largest share, you would hard pressed to find another M.D. type operating their own business who is that lean.
 
WEBB PINKERTON said:
Kaiser will dominate the California market very soon. Have fun working for them...

Obama sure has high praise for them.


http://mydoctor.kaiserpermanente.org/ncal/facilities/region/awards/recognition/praise/archive/
Click to expand...

they already do, dont know from where you crawled out from recently..

the question is given the dominance of such entities, how can you grow, command respect and earn money to fit your lifestyle and ambitions.

I am more nimble than Kaiser and in a real sense, I have already beat them (at least their slaveship Pathologists..). Ergo, I dont see them as a threat at all personally.
 
LADoc00 said:
Dont know where you got that bit of info but the unemployment rate for Boarded Pathologists is far from zero. I have several souls on my personal cell phone who can definitely attest to it. They might be doing something medically related to earn some cash but I would not call them employed Pathologists by any stretch.

The situation has become (or has been all along?) very analogous to Law School graduates, some practice at firms, many dont.

I also dont think other specialities especially surgeons are any more insulated from what is coming. On the contrary, most surgeons own buildings, have huge capital investments etc that will fall to sword in the coming decade of Obama damage.

My overhead is LESS than 10% total and that includes billing costs as the largest share, you would hard pressed to find another M.D. type operating their own business who is that lean.
Click to expand...


What is going to happen to these SurgCenters?

http://www.surgcenter.com/

We have had some of these pop up in the area, taking a lot of business from local hospitals. Unfortunantly the path went with it, due to the surgeons hatred of the local hospitals and everyone associated with them. The local gas men even got shut out and coverage is coming from a group many miles away.
 
WEBB PINKERTON said:
What is going to happen to these SurgCenters?

http://www.surgcenter.com/

We have had some of these pop up in the area, taking a lot of business from local hospitals. Unfortunantly the path went with it, due to the surgeons hatred of the local hospitals and everyone associated with them. The local gas men even got shut out and coverage is coming from a group many miles away.
Click to expand...

Local hospitals will destroy these ill conceived capitalistic ventures. I have shouted this from the roof tops and only some have listened.

Hospitals and the AHA are already crafting the perverted mirror image of the Emancipation Proclamation with soulless politicians in dimly lit rooms around D.C. that will be our utlimate demise. Along the way, these sad edifices will be bereft of patients and income leaving only pitiful debt and ruin.
 
gbwillner said:
Dude, learn to read.

I looked at their web site. There may be 100 faculty, but only 25 of them are anatomic pathologists. That list included PAs, PhDs in the department doing research, forensics, and the CP people.

The list of residents was also heavy with PhDs and CP only.

Keep whining and building straw men on this forum though. Other than raising your blood pressure it does no one any good. You want fewer residents to go into path? All your griping does is scare away good candidates. Those spots will just be filled with less desirable candidates, ultimately giving us less leverage and relative importance in the medical community.
Click to expand...

25 AP pathologists for 26K specimens and 30 residents?

That all could be handled by 5 pathologists or 4 pathologists and 4 residents.

Next.
 
Thrombus said:
25 AP pathologists for 26K specimens and 30 residents?

That all could be handled by 5 pathologists or 4 pathologists and 4 residents.

Next.
Click to expand...

Huh? 26K specimens could be handled by THREE pathologists and 2 PAs.
 
WEBB PINKERTON said:
What is going to happen to these SurgCenters?

http://www.surgcenter.com/

We have had some of these pop up in the area, taking a lot of business from local hospitals. Unfortunantly the path went with it, due to the surgeons hatred of the local hospitals and everyone associated with them. The local gas men even got shut out and coverage is coming from a group many miles away.
Click to expand...

The AHA has said anyone can run a new hospital (or expand an old one) EXCEPT for a physician. This was the ultimate screw job for all of us physicians by Obamacare and destroys any leverage we think we had.
😡😡😡
 
Thrombus said:
25 AP pathologists for 26K specimens and 30 residents?

That all could be handled by 5 pathologists or 4 pathologists and 4 residents.

Next.
Click to expand...

Well - presumably a lot of them are doing significant amounts of research, teaching, and other academic things. I'm sure if you added up all of their percent efforts in service duties there would be significantly less than the equivalent of 25 pathologists.
 
LADoc00 said:
yah I wanted to say 1 LADOC but didnt want to come across as pretentious.
Click to expand...

You would another LADoc to cover you when you are on the golf course in the afternoon👍👍

Long Nuance Communication (popped nicely last night)

I would probably pay for a PA or two (possibly 3 so they wouldn't complain too much) also
 
Enkidu said:
Well - presumably a lot of them are doing significant amounts of research, teaching, and other academic things. I'm sure if you added up all of their percent efforts in service duties there would be significantly less than the equivalent of 25 pathologists.
Click to expand...

If we actually used technology in our bricks and mortar education system, we would only need a handful of medical professors across the country.

Most "academic things" can be handled by admin.

Most "research" can be handled by PhD's (and the tens of thousands of postdocs that this system exploits).

Next.
 
This April fool's joke of a thread seems to have gotten out of hand.
 
Thrombus said:
If we actually used technology in our bricks and mortar education system, we would only need a handful of medical professors across the country.

Most "academic things" can be handled by admin.

Most "research" can be handled by PhD's (and the tens of thousands of postdocs that this system exploits).

Next.
Click to expand...

Well, do you think that pathologists shouldn't be *able* to do research or teaching if they want to? Just because other people could do it as well? That's an odd position.
 
Enkidu said:
Well, do you think that pathologists shouldn't be *able* to do research or teaching if they want to? Just because other people could do it as well? That's an odd position.
Click to expand...

Certainly. They can also vacuum the floor if they want to.

Research is a way over saturated field, and you can find people to work for 15$ an hour to do it.

The US education system, including medical education, would benefit if it moved into the 21st century as other fields have done, which could provide 4 year degrees for a fraction of what they go for now.
 
Thrombus said:
25 AP pathologists for 26K specimens and 30 residents?

That all could be handled by 5 pathologists or 4 pathologists and 4 residents.

Next.
Click to expand...
That may be true but try living in the world of the ACGME. Residents aren't workers, they are learners. Just complying with the drivel requires a lawyer on staff.
 
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