Attendings. How many hours do you work? What setting? How much do you make?

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I'm starting residency, but a family friend who is an attending told me this:

50-55 hours
Surgpath, big city, 2nd year in PP
220k


40-45 hours
General path/everything
2nd year in community practice
~250k
3 year partner track
 
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1st yr associate $100k
1st yr partner $725k
Final yr as employee $450k
Always ~45 hr/wk. Community ~180 bed hospital metro suburb
All except neuro/transplant/medical renal

This was over a ~25 yr period. Been retired 4 yrs.
This is a great example of how extremely variable things can be
 
40 hours per week
Academic institution
450K

laugh7.gif
 
Unless you are Chairman or vice chair I will believe you or the head of a busy dermpath service at the professor level.

Or your name is John Goldblum.
Nope. Academic institution associated with a major reference lab business with standardized salaries.
 
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I'm starting residency, but a family friend who is an attending told me this:

50-55 hours
Surgpath, big city, 2nd year in PP
220k

-40-50h/week: Rural, PP and an average Joe. General path with alot of clinical path and administrative lab and medical staff meetings.
-35 hours path and 10-15ish hours of hospital meetings and administrative work. All of surgical path except medical kidney (50ish), borderline melanomas (only a handful, otherwise bread and butter), flow goes out, bone tumors (2 or 3 a year?, mostly all metastatic stuff). Newly diagnosed mesotheliomas get outside consult b/c of liability issues, although fairly easy to diagnose.
Oh yeah, I forgot no gyn cytology....never want to see another pap, ever.
Year 1-3 varied from 165k to 215k. After year 3 >700k
 
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40-45 hours/week
Dermpath only, big city, 4th year in PP
Salary 500K
 
40-45 hrs/wk
Dermpath and general path, hospital-based PP, major metro area
Started $250K, now full partner ~$500K
 
-40-50h/week: Rural, PP and an average Joe. General path with alot of clinical path and administrative lab and medical staff meetings.
-35 hours path and 10-15ish hours of hospital meetings and administrative work. All of surgical path except medical kidney (50ish), borderline melanomas (only a handful, otherwise bread and butter), flow goes out, bone tumors (2 or 3 a year?, mostly all metastatic stuff). Newly diagnosed mesotheliomas get outside consult b/c of liability issues, although fairly easy to diagnose.
Oh yeah, I forgot no gyn cytology....never want to see another pap, ever.
Year 1-3 varied from 165k to 215k. After year 3 >700k

Do you get a hefty medical director stipend?
 
Do you get a hefty medical director stipend?
No stipend for hospital labs, I eat what I kill. I do get stipend for an outside lab I have. Seems to make you a target for outside groups. I've seen other specialties get booted out for minimal stipends or subsidization of the contract.
 
I'm having trouble understanding these $500K+ partner salaries. Do you have a pyramidal system, with sizable numbers of non-partners supporting those salaries? Do you have revenue lines that most pathologists don't have access to? Terrifically high volumes?
 
I don't think that's unreasonable...a good payor mix, anywhere between coasts where you're getting good PC reimbursement, maybe some lab directorship, 500 isn't unreasonable/unheard of...unless you're academic / pathmill (labcorps, ameripath, etc), 500 seems more common, even from the employed positions i've seen. IF (and that's a big "if") you know how and where to look and are ok not living in a sprawling metropolis.
 
The only people I see making $500K+ that work in path mills are those that have to push an unbelievable amount of glass working on a bonus structure. No life. Yes, you take home $500+K/year but your company is making way more money on top of your overhead.

You can't have it both ways unless you're in a situation where you have hired cheap minions to do your grunt work or have a sprawling clinical lab to support your group (but that dream is probably coming to an end soon so get prepared with some lube). Still, you're still going to have to bust your ass anyway to make things function properly.
 
PP compensation -> holy cow! I really need to get out of academia. Not like I have protected time, a research grant, or 8 weeks PTO.

I guess one has to make partner, though, to make that kind of bank - more likely I would get strung along for three years and then dismissed.
 
In my group, the vast majority of the pathologists become shareholders, so no pyramid there. Also, our medical director fees are extremely modest, and until recently, we had to fight to get paid anything for Part A.
 
We only have shareholders in my group. Short employment period to make sure you're not a psycho, then if you're voted in as a shareholder it's a ladder for a few years until you reach 100%. Only way you're not 100% after that is if you want to work less days, which some partners do. So then your percentage is tallied according to how many days you work compared to 100% share. Our part A from the hospitals we cover was just cut, so things may go down a bit. But it wasn't a huge chunk of our pay. We do have very favorable reimbursement rates through our affiliation with the hospitals.
 
I wouldn't take too much stock in the perception that everyone in PP makes 500. I know PP groups in roughly the same geographic setting, same number of people, but different states & different payer mix that run the gamut of low 300s up to near 7 figures. I'm right in between those numbers. Huge variability. But ultimately, if you haven't heard of one of these magical positions by now, chances are you're never going to...word of mouth & personal connections mean WAY more for these jobs than an Ivy league residency, 2 fellowships and 3 yr jr faculty position.
 
PP compensation -> holy cow! I really need to get out of academia. Not like I have protected time, a research grant, or 8 weeks PTO.

Academics suck. They are just as bad as the mills for underpaying you and overworking you. Plus you may have to waste your time doing the most worthless/useless "research" so you look productive.

But ultimately, if you haven't heard of one of these magical positions by now, chances are you're never going to...word of mouth & personal connections mean WAY more for these jobs than an Ivy league residency, 2 fellowships and 3 yr jr faculty position.

Very true statement. And oh man do I feel sorry for anyone who had to do 3yr junior faculty position, what a scam academics is.
 
As obvious it may seem, for the aforementioned incomes that are “above the mean”, people’s output (work) is at minimum equilibrating to their revenue generated. Or in some cases, exceeding it e.g. slide mills. No successful business model can sustain itself in the long run without doing so.

In other words, as long you’re a grunt i.e. not owning multiple labs/practices and working for “the man”, you still might be working 50+ hrs/wk and never get a sniff past 250K. But, if you want to have the “lifestyle within a lifestyle” job, and work 9-3 with 12 weeks of vacation, don’t bet on making 500K. These jobs are like White Walkers. They’re out there, but since hardly anyone ever sees them, they think they don’t exist.
 
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Great jobs do exist and I have one of them. Sharing as a data point - not to brag.

35 hours/week average
10 weeks vacation
PP at the edge of large metro area - signing out pretty much everything except medical kidney and nerve/muscle (6 years into practice, partner after 5)
Salary would rather not say, but higher than the other numbers so far in thread.

We have one non-partner and three partners. Plan on 5 year partnership track for associate.
 
Great jobs do exist and I have one of them. Sharing as a data point - not to brag.

35 hours/week average
10 weeks vacation
PP at the edge of large metro area - signing out pretty much everything except medical kidney and nerve/muscle (6 years into practice, partner after 5)
Salary would rather not say, but higher than the other numbers so far in thread.

We have one non-partner and three partners. Plan on 5 year partnership track for associate.

I believe LNS was also extremely geographically-restricted in his job search but found this unicorn job anyway. And I find it amusing that an academic pathologist posts a salary of $450k only to be accused of being "fake news". While I agree with coroner that many pathologists will have to choose between killing it (moneywise) and lifestyle, some people will end up with both and some people will end up with neither.

Caveat emptor: Between the expansion of hospital systems and government regulation, it may be only a matter of time until all MD's are employees and not owners. As a partner, I would love to know more about what threats LNS currently sees to his practice (though I hope there are none and I wish him the best!). If you are an employee, you will never earn as much as if you are an owner - but some people do not want to be responsible and be the owner. This is an element that is lacking in our pathology training programs.

There are academicians who work at places that give them a lot of time off and take no cut of their side hustle. They drive nice cars. At the same institutions, there are faculty who drive crappy cars but sleep on their couches half the year.

Re: Ivy vs. connections. Connections beat Ivy, but Ivy typically have large programs with fellowship programs and larger faculty with turnover. A non-wallflower resident at a large program is gonna know a lot of pathologists by the time they are done. At the biggest programs, they could easily be friends with practicing pathologists in most states by the time they start fellowship. If no one likes you, connections probably work against you. Your co-residents will be your worst enemies when it comes to finding a job. The problem with large programs is that they typically have at least a few residents who never should have been accepted to medical school in the 1st place.

A friend of mine once told me that it was amazing how little he has to work each day for how much $$ he makes. I told him not to tell the government that. Compared to primary care, we are lucky in pathology. On average, the applicants we match are terrible. They may be good and intelligent people, but they are not competitive on paper compared to other specialities. Yet the average income exceeds that of primary care with better lifestyle. Should we close path programs? I haven't heard a good argument against this. The only requirement seems to be that we complete 50 autopsies a year, which can be shared with other residents, yet there is no requirement for # of specimens we gross or preview? Programs where residents leave at 2PM everyday? Programs where residents have to prepare cytospins? Hello CAP, I want you to meet the ABP?

Finally, money is not everything to every person. If your success is defined by the $$ you make, there is nothing wrong with that, and successful people will find success. There are more jobs in industry these days for pathologists, and those can be lucrative if you cannot find a good clinical job. As has been mentioned numerous times in this forum, every job (academic, non-academic, PP, non-PP) is different and hard to compare. Even mills (where you'll probably make the least % of what you bill) appeal to those who simply want to push glass and do nothing else.
 
6th yr in practice. PP. Dermpath only. Partner. 40-45 hr wk. Year end compensation. More than all the numbers mentioned above. Saying this not to brag but for the residents and fellows. Good jobs do exist. You will do just fine.
 
6th yr in practice. PP. Dermpath only. Partner. 40-45 hr wk. Year end compensation. More than all the numbers mentioned above. Saying this not to brag but for the residents and fellows. Good jobs do exist. You will do just fine.

This thread is important. Trainees and jr. pathologists, DO NOT UNDERVALUE YOUR ABILITY. Whether we are overtrained or not, there is only a small fraction of people who can do what we can do. Do not sell out to the lowest bidder.
 
These responses are nuts. You would never think pathologists were underpaid/undervalued with the responses in this thread. Impressive.
 
There is a wide variance in money but plenty of cheap labor. Certainly no shortage.

I know lot of folks in PP that make 700K and plenty that make 300K.
I worked at one groups that made 350-375 K. They could of made 500K +. They keep hiring pathologists rather than a good PA to gross among other things.
It might mean going from 8 weeks off to 6 however. They were not lazy just inefficient and too old school.

Also, I know things have been getting tougher at that practice and many others as insurers drop payments. Smaller practices are likely getting hit harder.
The above practice is in an area with traditional higher reimbursement.
 
Large regional medical center, non-academic, >1000 beds; fairly generous Part A $
PP group, 8 Paths, 4 PAs, plus admin personnel.
30K surgicals, high complexity, mostly 88307 and 88309 work.
High non-GYN FNA work.
High frozen work / on call AP issues
Autopsy load ~ 15-20/yr per Pathologist
Work: 45-60 hrs/week, 9 weeks vacation
Full share partner $500-550k income, plus 401k/profit sharing/medical/life/etc (~$100k) on the side package
 
Large regional medical center, non-academic, >1000 beds; fairly generous Part A $
PP group, 8 Paths, 4 PAs, plus admin personnel.
30K surgicals, high complexity, mostly 88307 and 88309 work.
High non-GYN FNA work.
High frozen work / on call AP issues
Autopsy load ~ 15-20/yr per Pathologist
Work: 45-60 hrs/week, 9 weeks vacation
Full share partner $500-550k income, plus 401k/profit sharing/medical/life/etc (~$100k) on the side package

Now that's a busy practice! Especially with the concentration in 88307 and 88309 cases, frozens, and on call work.
 
PP in a general community setting. 40-45 hours per week. See 3-4k surgicals/year and about 300 cytos. Some CP duties. Income 400-450k.

I heard a lot of chatter on this forum about how I would never get a good job, but ended up in a practice in my desired geographic location in a job I love. Maybe income wont always be this good, but I would have never imagined that I would make this much.

I know I cant speak for everyone, but I definitely believe the best jobs are the community private practice ones where you can see an average volume like mine and earn ~400k or earn even more if you want to work harder. I know some in the path mills may earn similar to me but probably need to sign out 8-10k cases to do so. Finally, unless is research is your thing, academics is a joke...the staff that I trained with signed out just as many cases as I do and earned maybe 50-60% of what I do, and had to do research on top of that. Sure if you are dept chair you might get my income or maybe even more, but that is a long ladder to climb and I would imagine a stressful job to have
 
As obvious it may seem, for the aforementioned incomes that are “above the mean”, people’s output (work) is at minimum equilibrating to their revenue generated. Or in some cases, exceeding it e.g. slide mills. No successful business model can sustain itself in the long run without doing so.

In other words, as long you’re a grunt i.e. not owning multiple labs/practices and working for “the man”, you still might be working 50+ hrs/wk and never get a sniff past 250K. But, if you want to have the “lifestyle within a lifestyle” job, and work 9-3 with 12 weeks of vacation, don’t bet on making 500K. These jobs are like White Walkers. They’re out there, but since hardly anyone ever sees them, they think they don’t exist.
They exist...
 
One factor I've not seen mentioned on these posts is whether or not the posters' income includes technical component reimbursement from an interest in the tissue/slide processing/preparation. If these income figures are based solely on professional component (plus in some cases director fees, etc), then based on the volume I'm seeing posted, there must be a boatload of immunos being performed, some serious coding differences, or some unknown factors. Would appreciate those who post including whether or not they share in the technical reimbursement.
 
One factor I've not seen mentioned on these posts is whether or not the posters' income includes technical component reimbursement from an interest in the tissue/slide processing/preparation. If these income figures are based solely on professional component (plus in some cases director fees, etc), then based on the volume I'm seeing posted, there must be a boatload of immunos being performed, some serious coding differences, or some unknown factors. Would appreciate those who post including whether or not they share in the technical reimbursement.

No TC for my group, only PC. Hospitals get the TC.
 
CP26 is also a factor I am assuming. When I was with my old pp group, it added 50k or so to my annual salary. this was around 2005 - 2010. Not all insurance companies would pay it though.
 
Community based solo practice and employeed at a small hospital with a moderate regional pull. Around 25-30 cases/day. I hustle...many side jobs, including a teaching position, but don't exceed 40 hrs/week, 3 weeks of vacation and weak 401K match. Overall compensation 750+. Good jobs are out there, but rare. I just got (really) lucky.
 
CP26 is also a factor I am assuming. When I was with my old pp group, it added 50k or so to my annual salary. this was around 2005 - 2010. Not all insurance companies would pay it though.

I have the option of CP26, with about the same yearly reimbursement that you are stating. I find it somewhat risky from a litigation standpoint. Anyone else participate in CP26 and find it worthwhile?
 
Community based solo practice and employeed at a small hospital with a moderate regional pull. Around 25-30 cases/day. I hustle...many side jobs, including a teaching position, but don't exceed 40 hrs/week, 3 weeks of vacation and weak 401K match. Overall compensation 750+. Good jobs are out there, but rare. I just got (really) lucky.
Wow! Can I have your job when you retire?
 
CP26 is totally legal and CAP has support this through several court challenges. That does not mean insurers like to pay it 🙂
 
Yes, I've got a list of potential insurers that have a history of paying CP26 through my retired partner. I might have to look into it further.
 
Professional component on the clinical pathology side of the lab.
 
I'm not sure you all understand CP26. It is analogous to medicare part A. The big difference is that medicare pays one lump bundled non-itemized pile of cash directly to your hospitals and then you have to negotiate for your share. It is likely that the hospitals never really know how much they are getting paid as part A. There are CPT codes for every clinical lab test and they can be broken down into technical and professional components (basically like what medicare considers part A). The PC is small, generally a few dollars or less, but the volume is very high. You can bill the private insurers for the PC, which would otherwise be unbilled. It requires cooperation between your billing company and hospital LIS, and sometimes hospitals balk, but it is a legitimate and legal form of billing. CP26 does NOT refer to the PC that you bill for interpreting a transfusion reaction or an electrophoresis. You leave serious money on the table if you don't pursue CP26. That being said, the main Blue Cross administrator in my state refuses to pay it.

I have the option of CP26, with about the same yearly reimbursement that you are stating. I find it somewhat risky from a litigation standpoint. Anyone else participate in CP26 and find it worthwhile?
 
Every hospital I've been to had a Part A built into our contract. I even know some hospitals that don't pay subcontracted groups any Part A at all. If that were the case, or if the group declined to accept a Part A because they felt it was too low, could they forego accepting it and directly bill insurers for CP or would that be considered double dipping?

Yes, rural. Only place to shop is Walmart.

That's actually pretty good. Now come see the "real" America where all you've got is a Dollar General...
 
Yes, that's all there is outside of "town". It's either an IGA or a Dollar General. The Wal-Mart brings in the crowds from the surrounding 50 miles radius for the "high-dollar" shopping (funny, but absolutely not joking).
 
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