any content diagnostic pathologists?

[KeratinPearls]

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Yeah, as yaah said, the internet is generally where people go to semi-anonymously bi%ch and complain about stuff. The happy pathologists are going to work, doing their job, then going home to their families and are not participating on this forum. I'm on here because it helps me remain vaguely connected to the world of diagnostic path, and because I find such discussions interesting. But it's very disheartening reading all the negatively felt by those on here about the situation out there for community/private practice pathology.

Yup, within the past five years the same posters on SDN moan and groan. I can name less than five off the top of my head. There are a lot of happy pathologists out there for sure that make a decent to great living. It's just the same posters who moan and groan who make this forum miserable. I wonder if these ppl are generally unhappy ppl.

The ppl you really want to listen to are those looking for jobs. They can give you a better picture of the pathology market.

 

[2121115]

Pathologists make a decent living.

Yes, they do.

Some work 5 hours a day. Most are out by 5 pm, some by 4 pm. Not bad at all.

Not in my experience. Actually, I have never been around pathologists who are out by 4 or 5pm. In training, my attendings all worked into the evening (6-7pm). Now I am in private practice and we are logging 10-11 hour days.

Residents and fellows surf the SDN all day like myself.

Only if you are on a clinical pathology rotation.

 

[WEBB PINKERTON]

Having read all three of these message boards I would characterize them as discussing issues in pathology that deserve attention, rather than negative. I follow one of these, the medscape blog, and it specifically covers several pathology related issues such as proficiency testing, molecular testing and the important role of pathologists in patient management.

Medical students considering a career in pathology are encouraged to read these blogs or message boards and see how pathologists make contributions to healthcare.

Those forums would scare a lot of people away. They are mostly negative especially when it comes to the business of lab medicine, the job market, interaction with other physicians, CAP, fear of mid-levels taking their jobs, etc.
Heck just read the discussion that followed when someone posted an ad for a path assistant job on this site:
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2012-August/thread.html
Lets see, one pathologist said he cant find work, another pathologist said labs (or maggots and parasites as he referred to them) are looking to replace us with cheaper staff, another implied pathologists are lazy. Yea, I can really feel the positivity there.....

I encourage students to study the business of lab medicine and not just the science before making a decision.

 

[smallcat]

Yes, OK, fine, you've pulled me out of lurker status to answer.

Yes, I have a job and yes, I am happy.

I finished residency under the old 5-year rule and did no (not a one) fellowship. Then I took a few years off and had some babies. Then I did some locums work for a couple more years, and when I decided I wanted to go back to work full-time, I got four interviews and three offers within the span of about 5 months. Yes, I did have to move- while I did have an offer in my preferred location, it was not the best offer and I chose to move instead.

I am now a partner in a private practice which is affiliated with a medical school in a small urban area. I teach medical students on occasion but primarily sign out surgical pathology. We have a great mix of esoteric and bread and butter cases, and my colleagues are a delight to work with. We show each other cases all the time, everyone is very collegial, and we have a full complement of molecular testing and flow cytometry available in house. My starting salary was around $200K and now that I am partner my yearly income is around $350K. Compared to the glory days of pathology, I suppose that's a disappointment, but it's more than enough for my family and I to live on- and prosper. Surgeons might make more, but I work 8-5 with call once a week and rare weekends. Call is light- rarely do I have to leave home and come back in- and my time is worth more to me than money anyway.

Did I get lucky? probably, to some degree. But you asked if anyone's content, and I sure am. I didn't expect to cherry pick my ideal job in a perfect location- I was willing to move and maybe that would be a real factor of discontent for others, I don't know. Now I'm in the position of trying to recruit a new person to our practice, and it's surprisingly hard to find someone who is both capable diagnostically and a good communicator.

 

[KeratinPearls]

Yes, OK, fine, you've pulled me out of lurker status to answer.

Yes, I have a job and yes, I am happy.

I finished residency under the old 5-year rule and did no (not a one) fellowship. Then I took a few years off and had some babies. Then I did some locums work for a couple more years, and when I decided I wanted to go back to work full-time, I got four interviews and three offers within the span of about 5 months. Yes, I did have to move- while I did have an offer in my preferred location, it was not the best offer and I chose to move instead.

I am now a partner in a private practice which is affiliated with a medical school in a small urban area. I teach medical students on occasion but primarily sign out surgical pathology. We have a great mix of esoteric and bread and butter cases, and my colleagues are a delight to work with. We show each other cases all the time, everyone is very collegial, and we have a full complement of molecular testing and flow cytometry available in house. My starting salary was around $200K and now that I am partner my yearly income is around $350K. Compared to the glory days of pathology, I suppose that's a disappointment, but it's more than enough for my family and I to live on- and prosper. Surgeons might make more, but I work 8-5 with call once a week and rare weekends. Call is light- rarely do I have to leave home and come back in- and my time is worth more to me than money anyway.

Did I get lucky? probably, to some degree. But you asked if anyone's content, and I sure am. I didn't expect to cherry pick my ideal job in a perfect location- I was willing to move and maybe that would be a real factor of discontent for others, I don't know. Now I'm in the position of trying to recruit a new person to our practice, and it's surprisingly hard to find someone who is both capable diagnostically and a good communicator.

There is an issue of a good communicator coming up often. Are there a lot of ppl who have issues communicating? I mean are you talking about IMGs? I mean Ive worked with IMGs who, although they have accents, I can understand them. Or are you talking about applicants being antisocial? Or applicants who dont like to work as a team?

Did you have issue with getting a position after taking time off to have a child?

 

[2121115]

There is an issue of a good communicator coming up often. Are there a lot of ppl who have issues communicating? I mean are you talking about IMGs? I mean Ive worked with IMGs who, although they have accents, I can understand them. Or are you talking about applicants being antisocial? Or applicants who dont like to work as a team?

Dude. This is code. If you haven't figured it out already, just pay attention.

 

[lipomas]

Not in my experience. Actually, I have never been around pathologists who are out by 4 or 5pm. In training, my attendings all worked into the evening (6-7pm). Now I am in private practice and we are logging 10-11 hour days.

OK, well I'm in private practice and I leave between 4:45 and 5:15 every day I am not call (which is >90% of the time). My anecdote trumps your anecdote.

I don't know where the hell you work but apparently where you work all the pathologists work 10-11 hour days for low pay, they are **** on by every clinicians they meet, and you are constantly under threat of lost business even though you "only do 1-2 hours of admin work per week." And apparently you don't get partner equity and someone is screwing you out of income. Oh, and apparently you get thousands of applications for any jobs you advertise despite the fact that your job sounds like one of the poorer ones that I have heard of (unless you are exaggerating the negatives, which is a distinct possibility). Meanwhile I have a great job and we apparently get fewer applications than you and actually had a reasonably difficult time finding an appropriate person to hire last time.

 

[lipomas]

There is an issue of a good communicator coming up often. Are there a lot of ppl who have issues communicating? I mean are you talking about IMGs? I mean Ive worked with IMGs who, although they have accents, I can understand them. Or are you talking about applicants being antisocial? Or applicants who dont like to work as a team?

Did you have issue with getting a position after taking time off to have a child?

All of the above.

IMGs do face a certain prejudice but you are correct, a competent IMG pathologist will almost certainly be fine. The usual barrier is the first job. The less than competent IMG pathologist will bounce around from job to job.

The competent english speaking AMG however has no similar excuse, however unlike an IMG who has communication or cultural issues and works to resolve those issues, the AMG with an attitude problem usually has total lack of insight into their own issues.

 

[2121115]

OK, well I'm in private practice and I leave between 4:45 and 5:15 every day I am not call (which is >90% of the time). My anecdote trumps your anecdote.

I don't know where the hell you work but apparently where you work all the pathologists work 10-11 hour days for low pay, they are **** on by every clinicians they meet, and you are constantly under threat of lost business even though you "only do 1-2 hours of admin work per week." And apparently you don't get partner equity and someone is screwing you out of income. Oh, and apparently you get thousands of applications for any jobs you advertise despite the fact that your job sounds like one of the poorer ones that I have heard of (unless you are exaggerating the negatives, which is a distinct possibility). Meanwhile I have a great job and we apparently get fewer applications than you and actually had a reasonably difficult time finding an appropriate person to hire last time.

Ok, this post made me LOL, so nice work. There are true and not true things there. We are paid quite well actually (better than most), but we earn it by working hard. We often see clinicians when we are leaving in the evenings as they are leaving, and get comments like "hey, I thought pathologists are supposed to leave by 3:30 everyday". We keep similar hours to them, and they respect that. In fact, I don't know any pathologists in our city who routinely leave at 4-5pm. Are you in a small town? We are located in a large city (top 5 or so population-wise in the US) and there is fierce competition for specimens from every group in town so the TAT's are crucial to keeping business (hence the later hours and late runs of immunos/specials). All the groups here are that way. That may explain some of the differences, as our cultures may be different. Someone who wanted to leave at 4 or 5pm everyday would not really work out well here. And yes, we do get CV's cold-sent all the time, sometimes several per day from everywhere in the US.

However, you are right that we are constantly under the threat of losing income and having to compete and race to the bottom to keep specimens. It is good to hear that at your practice the specimens flow like wine and a clinician who calls your office at 5:15 won't expect a return call until the next day. There are certainly advantages to lifestyle-oriented practices like yours and I do sometimes wonder if I should pursue a route like that someday. But I am young and you have to make hay while the sun shines.

 

[2121115]

OK, well I'm in private practice and I leave between 4:45 and 5:15 every day I am not call (which is >90% of the time). My anecdote trumps your anecdote.

Also, according to the 2011 practice characteristics survey of the CAP (not anecdote), the average pathologist works 50.4 hours per week. That is just over 10 hours per day. So at your practice you work less than average hours. Kudos!

 

[malchik]

This thread seems to be highlighting the heterogeneity of pathology practices in this country. People who are seeing a poor market, long hours, and disappearing partnership opportunities might be describing their local situation, while those seeing more plentiful opportunities and better lifestyles may be accurately describing theirs, like blind people describing an elephant. Now people just need to come out and say what area they are practicing in to see if there is any truth in this.

 

[BrainPathology]

Not in my experience. Actually, I have never been around pathologists who are out by 4 or 5pm. In training, my attendings all worked into the evening (6-7pm). Now I am in private practice and we are logging 10-11 hour days.

Everyone here is out by 5, unless we are on call then we stay until 6pm as a matter of policy to be available for frozen section. And me of course.. I'm still a little slow compared to others and stay pretty late some days (5:30-6:00pm). I also come in early (7am) to get work done without interruptions.. so in defference to your point I DO work 10-11 hour days at the moment. I'm perfectly thrilled to have an average of a 50 hour work week though.

 

[deleted314957]

I generally get to work from 7:30-8:00 and leave by 4:30. On call for 6-7 one week blocks per year and almost never get any calls (one or two in the past year)

 

[2121115]

Everyone here is out by 5, unless we are on call then we stay until 6pm as a matter of policy to be available for frozen section. And me of course.. I'm still a little slow compared to others and stay pretty late some days (5:30-6:00pm). I also come in early (7am) to get work done without interruptions.. so in defference to your point I DO work 10-11 hour days at the moment. I'm perfectly thrilled to have an average of a 50 hour work week though.

It isn't my point. It is CAP data. 10+ hour days are average for a pathologist. Even our most senior partners work 10 hour days. With a heavy surgical and biopsy load and CP duties and administration (non-business related) as well as business time, it takes that long to get the work done. But we are compensated quite well for our time (50 hours per week oh my!) and we live in an great city, so I have no complaint about the hours as a trade off. It is just weird to be accused of spreading these so-called depressing falsities about work hours when it is pretty normal based on CAP data.

 

[2121115]

This thread seems to be highlighting the heterogeneity of pathology practices in this country. People who are seeing a poor market, long hours, and disappearing partnership opportunities might be describing their local situation, while those seeing more plentiful opportunities and better lifestyles may be accurately describing theirs, like blind people describing an elephant. Now people just need to come out and say what area they are practicing in to see if there is any truth in this.

I agree. I also find it interesting that the same people who say they have a hard time finding quality candidates to fill job openings are also the one's who say that it wasn't hard for them to find a job (at that same practice) and that the job market is good. Probably a correlation there. I, for one, think there is marked regional variation.

 

[malchik]

Great city in top 5 population with harder-working, more competitive culture = Philadelphia.
Tell me I'm wrong.

Ok, this post made me LOL, so nice work. There are true and not true things there. We are paid quite well actually (better than most), but we earn it by working hard. We often see clinicians when we are leaving in the evenings as they are leaving, and get comments like "hey, I thought pathologists are supposed to leave by 3:30 everyday". We keep similar hours to them, and they respect that. In fact, I don't know any pathologists in our city who routinely leave at 4-5pm. Are you in a small town? We are located in a large city (top 5 or so population-wise in the US) and there is fierce competition for specimens from every group in town so the TAT's are crucial to keeping business (hence the later hours and late runs of immunos/specials). All the groups here are that way. That may explain some of the differences, as our cultures may be different. Someone who wanted to leave at 4 or 5pm everyday would not really work out well here. And yes, we do get CV's cold-sent all the time, sometimes several per day from everywhere in the US.

However, you are right that we are constantly under the threat of losing income and having to compete and race to the bottom to keep specimens. It is good to hear that at your practice the specimens flow like wine and a clinician who calls your office at 5:15 won't expect a return call until the next day. There are certainly advantages to lifestyle-oriented practices like yours and I do sometimes wonder if I should pursue a route like that someday. But I am young and you have to make hay while the sun shines.

 

[BrainPathology]

It isn't my point. It is CAP data. 10+ hour days are average for a pathologist. Even our most senior partners work 10 hour days. With a heavy surgical and biopsy load and CP duties and administration (non-business related) as well as business time, it takes that long to get the work done. But we are compensated quite well for our time (50 hours per week oh my!) and we live in an great city, so I have no complaint about the hours as a trade off. It is just weird to be accused of spreading these so-called depressing falsities about work hours when it is pretty normal based on CAP data.

I got that..I was saying if you start early a 10 hour day still gets you out at 430 or 5...no one seems to be saying when they are starting.. just when they finish.

 

[TMZ2007]

Great city in top 5 population with harder-working, more competitive culture = Philadelphia.
Tell me I'm wrong.

Funny, I was thinking Philly too...

 

[smallcat]

There is an issue of a good communicator coming up often. Are there a lot of ppl who have issues communicating? I mean are you talking about IMGs? I mean Ive worked with IMGs who, although they have accents, I can understand them. Or are you talking about applicants being antisocial? Or applicants who dont like to work as a team?

Did you have issue with getting a position after taking time off to have a child?

I'm not talking only about IMGs- accents are not a problem. We just hired an IMG who has a thick accent but is a fantastic pathologist who has no problems communicating with other clinicians. Yes, there are some IMGs whose accents are so thick that it's difficult to imagine how they even got through residency, but those folks are rare. It's more the people who just want to read slides all day and are unable to answer questions from surgeons, communicate our limitations effectively at tumor boards, generally be a part of a clinical team. We've also seen our share of arrogant recent grads who look great on paper and are clearly intelligent but spend half of the interview talking about how unfairly they were treated in residency or how they caught diagnostic errors made by their attendings. Or who are only willing to sign out hemepath/cyto/dermpath/you name it, not any general surg path.

Taking time off to have children didn't seem to have impacted my final job search- the caveat being that I only took about four years off before going back to some kind of part-time work. Any longer, and I think I would have had more trouble or been forced to go back for another fellowship. Prospective employers did ask about it, of course, but I was honest and told them why I took the time off and why I was ready to get back into it and it was always accepted at face value without a lot of judgment- at least that I could perceive. Having kept up my networks (kept in touch with fellow graduates and former attendings, kept going to meetings) helped a great deal in that regard.

 

[2121115]

Great city in top 5 population with harder-working, more competitive culture = Philadelphia.
Tell me I'm wrong.

I won't say that you are wrong, but I do not wish to post specifically where my practice is located.

 

[pathstudent]

I won't say that you are wrong, but I do not wish to post specifically where my practice is located.

DIdn't Phoenix surpass Philly for 5th biggest city? I bet you are in the competive culturally rich bustling urban metropolis of Phoenix.

 

[yaah]

Most pathologists I know are done by 5pm. Quite a few are done earlier than that. The ones that are done later are usually done by 530. I often have to call outside pathologists around 4pm for some issue or another, they are often gone by then. But in smaller groups they take more call, so when they are on call they work longer hours.

"50 hours/week" is probably accurate, on average. Don't forget that some pathologists will include early morning hospital committee meetings, or late meetings, or call duties.

My day is about 8-5 (or 730-5), thus "45 hours" per week. But since i am on call 4-5 weeks per year (when I stay until usually 7-8pm) and I have 7am meetings a couple of times a month, it ends up being a bit more than 50 hours a week.

No one is (as far as I can tell) spreading falsehoods about the work hours.

 

[lipomas]

Ok, this post made me LOL, so nice work. There are true and not true things there. We are paid quite well actually (better than most), but we earn it by working hard. We often see clinicians when we are leaving in the evenings as they are leaving, and get comments like "hey, I thought pathologists are supposed to leave by 3:30 everyday". We keep similar hours to them, and they respect that. In fact, I don't know any pathologists in our city who routinely leave at 4-5pm. Are you in a small town? We are located in a large city (top 5 or so population-wise in the US) and there is fierce competition for specimens from every group in town so the TAT's are crucial to keeping business (hence the later hours and late runs of immunos/specials). All the groups here are that way. That may explain some of the differences, as our cultures may be different. Someone who wanted to leave at 4 or 5pm everyday would not really work out well here. And yes, we do get CV's cold-sent all the time, sometimes several per day from everywhere in the US.

However, you are right that we are constantly under the threat of losing income and having to compete and race to the bottom to keep specimens. It is good to hear that at your practice the specimens flow like wine and a clinician who calls your office at 5:15 won't expect a return call until the next day. There are certainly advantages to lifestyle-oriented practices like yours and I do sometimes wonder if I should pursue a route like that someday. But I am young and you have to make hay while the sun shines.

Well I guess we're laughing at each other then. I am especially laughing at the fact that you think I have a "lifestyle' practice since I usually leave about 5pm. I get calls at random times, clinicians who need some sort of immediate answer sometimes page me after 5pm. Someone is on call anyway so if they call the lab they can always get connected to the on call pathologist. Most of our clinicians have respect for other physicians so they don't abuse us or test us by calling at 4:50 to see if we're still here.

And I will tell you this, my group is not small, we are not really rural, and I really don't know many pathologists in other places either who are consistently working much past 5pm. The ones who are are usually just starting out and being extra careful and trying to figure lots of things out.

Like others have said, things happen off hours sometimes. Early morning meetings mostly.

Your practice may be different, things may happen later. In that case maybe you come in later than I do. I have no idea. It doesn't really matter. I know that I work hard and so does everyone I work with. There are practices who do a lot more work in the afternoon and evening because of specimen delivery and processing issues, that's fine. It's just different.