Avg case load per year.

[pathslides]

For those in practice:
1) what is your average/expected individual case load per year ? This includes surgicals, cytology, autopsies, bone marrows.

2) how many FTEs in your group?

For me:
~4500 cases
6 FTE in my group.

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[WEBB PINKERTON]

Surgicals 10,000+
We rotate screening roughly 20 Pap smears a day, which used to be like 50 cases a day till guidelines changed.
Few hundred FNA a piece, including those annoying Mediastinal lymph node staging cases which can be upwards of 50 slides.

It is known as the embolism lab because so many people have had DVT and emboli.

 

[deleted314957]

~12000/yr surgicals (heavy outreach and hospital endoscopy center GI). No grossing. ~800 frozens/yr(mostly derm outreach) with tech assist. Hospital generated FNA's fell off over the years and tissue cores predominated (part of the 12k number). Autopsies rare(PA assist). NO paps for years.(they got shuttled off to the cyto boarded folks ). Solo medical director (~175 bed community hospital) with "float" vacation coverage from my group 6 wk/yr. (data from ~4 yrs ago).

Webb buddy, you need to retire! Life is too short for the s*** you put up with. That farm of yours is calling.

 

[SEpathguy]

~5,000 surgicals/year.
~100 bone marrows/year.
No cytology and no autopsy.
4 FTE in our group.

 

[coroner]

Surgicals: low 4,000s
Cytology: 500 non-gyns (Review paps too, don't know how many)
Frozens: 100
Grossing: Everything but bxs
BMs/Autopsies: None
Solo practice at my hospital, but other FTEs in group

 

[Path2009]

Wouldn't it be a little more specific to discuss in terms of RVU's?

 

[Cellpathology]

Wouldn't it be a little more specific to discuss in terms of RVU's?

YES, ABOUT 9.5 K RVUS PER YEAR FOR ME

 

[musom]

Solo (employeed) practice. Community hospital based. Medical directorships. 2 FT histotechs and 0.8 FTE secretarial/administrative assist. ~6300 cases/yr not including about 800 non-gyn cyto. No paps. No autopsies. No bone marrows. In-house IHC. More than average frozens. RVU's average around 9500-11000.

 

[musom]

Any one dare to discuss their $ value/RVU?!

 

[SEpathguy]

I wish I knew. I'm not given access to these numbers, as I'm employed by an academic institution. I think I'm doing around 7,000 RVUs/yr, but might be way off on that number. I've heard each RVU is worth around $45-50, but I'm sure depends on payer mix, etc.

 

[musom]

Yes, that's about averagish. I think it's very regionally dependent, too as each state has it's own bankrupt Medicaid. I have to track my own RVU's, which is systematically a pain.

 

[SEpathguy]

What's about an average number of expected RVUs for a full time pathologist? (I know the numbers will vary widely)

 

[musom]

Not sure, but I'll tell you this...My base salary is based on a 5k rvu goal with a 4200 rvu floor and I end up in bonusville after my base is paid (5k rvu). If i don't hit my floor value, they could potentially shrink my base salary.

 

[LADoc00]

People on here claiming to clear out 10K surgicals a year? As in 10K surgical accessions or what?

10K general surgical accessions per year is MAD VOLUME. In fact I have seen that in person only once in my entire life in the middle of nowhere rural hospital and I think the pathologist pulling that died like 1-2 years after my visit when I interviewed.

3000-4000 General Surgical Accessions/yr = Average Normy Pathologist FTE
5000-6000 = Heavymode Ironman Pathologist
7000-9000 range = Beastmode Pathologist
>10K = Godmode

In terms of JUST biospy work like Dermpath you have double those numbers so Godmode DP is >20K.

The Hopkins Epstein trainee who was at Healthtronics during their heyday was fully in Godmode and pulled down around 2-2.5 per annum. Its relatively rare to pull down that level of green by your labor though, a vast majority of the time you can only do that by using the traditional "minion model" of Pathology.

 

[musom]

LADOC -

I'll do about 6400 surgicals and around 500 non-gyn cytology cases this year. That doesn't include four medical directorships, a teaching gig and two other side hustles. I don't necessarily feel like I'm operating in beast mode as truthfully I'm no more than 45 hours/week and no weekend stuff whatsoever. I feel like I could easily go to 8-9k a year without much more trouble. Truthfully, my ultimate goal is 10k (combined surgical and cytology cases) per anum. That should push the overall compensation to 7. Maybe that's a little too ambitious, but 35-40 cases/day does not give me anxiety.

 

[stickyshift]

I'm the only pathologist at my hospital, but I'm part of a large group (24 pathologists)

5000 surgicals/year
400 FNAs
500 NGC
100 bone marrows (and I perform almost all of these)

No autopsies, no paps

 

[musom]

Sticky shift.....you're a full partner? What's your compensation model like? Our volumes seem comparable.

 

[AZpath]

You should be making 700K on AP

 

[LADoc00]

LADOC -

I'll do about 6400 surgicals and around 500 non-gyn cytology cases this year. That doesn't include four medical directorships, a teaching gig and two other side hustles. I don't necessarily feel like I'm operating in beast mode as truthfully I'm no more than 45 hours/week and no weekend stuff whatsoever. I feel like I could easily go to 8-9k a year without much more trouble. Truthfully, my ultimate goal is 10k (combined surgical and cytology cases) per anum. That should push the overall compensation to 7. Maybe that's a little too ambitious, but 35-40 cases/day does not give me anxiety.

Yah from that volume ASSUMING:
you are not in "poverty opiate epidemic USA" town, that should easily be cashflowing 100g per mo.

Do NOT try to push Godmode. This is from bitter experience, when the volumes get crazy there is a much higher chance of human error. Stay below the radar where you are now and live wayyyyy below your means and invest in solid rental properties. When you get to my level, sure buy a 911 Turbo S and the vacation home at the beach, but until then go under the radar.

Stickyhift- you should be fairly close to 7 figs with that volume, maybe 900ish depending on your payor mix.

Once again, some guys/gals can push 5000 surgical accessions/yr and many many cannot. Dont exceed your safe practice volume under any circumstance. You would shudder at the stories I have collected of solid Ivy League trained guys who get into gambling debt, coke shenanigans or sex addiction who ramp up the volumes to try to stay ahead of the curve only to implode in a ball of flames and end up running a prostate massage clinic near the Mexican border (true story).

 

[stickyshift]

You should be making 700K on AP

You are just making me feel bad (I'm nowhere close to the quoted figure.).
About 70% of our practice is comprised of full partners (I'm one.). We throw all of our collections into one big pot and split the profits at the end of the year.
I sign out more than most of my partners (who are more typically in the 3500-4000 case range), but as a practice we should still be doing better. On the other hand, we have a large Medicare/Medicaid volume . . .

 

[stickyshift]

Yah from that volume ASSUMING:
you are not in "poverty opiate epidemic USA" town, that should easily be cashflowing 100g per mo.

Do NOT try to push Godmode. This is from bitter experience, when the volumes get crazy there is a much higher chance of human error. Stay below the radar where you are now and live wayyyyy below your means and invest in solid rental properties. When you get to my level, sure buy a 911 Turbo S and the vacation home at the beach, but until then go under the radar.

Stickyhift- you should be fairly close to 7 figs with that volume, maybe 900ish depending on your payor mix.

Once again, some guys/gals can push 5000 surgical accessions/yr and many many cannot. Dont exceed your safe practice volume under any circumstance. You would shudder at the stories I have collected of solid Ivy League trained guys who get into gambling debt, coke shenanigans or sex addiction who ramp up the volumes to try to stay ahead of the curve only to implode in a ball of flames and end up running a prostate massage clinic near the Mexican border (true story).

Our practice is based in the greater metropolitan area of a major city. So, no, not an impoverished locale. Pretty middle class, actually.

 

[AZpath]

An average is totally different on 3700 cases and the mix of CPT codes are important.
Unless you are getting stiffed on Part A. Partners should be able to do 450-500K on that volume with an average payor mix.
Sounds like your big enough to get some good contracts too.
Btw are you doing CPT coding yourself or does your biller abstract it from your reports?

 

[stickyshift]

An average is totally different on 3700 cases and the mix of CPT codes are important.
Unless you are getting stiffed on Part A. Partners should be able to do 450-500K on that volume with an average payor mix.
Sounds like your big enough to get some good contracts too.
Btw are you doing CPT coding yourself or does your biller abstract it from your reports?

If we could reliably break into $400K territory, we would be ecstatic.
We get Part A, but it's not a lot.

We do our own CPT coding, and take it quite seriously. We dictate our cpt codes, check and correct them in SoftPath, and review the cpt codes again the day after the report is signed out. We might be losing money in other places, but not because of undercoding.

 

[LADoc00]

SS- the numbers of what are doing and what are you receiving isnt adding up. Just ballpark there is a big problem.

This could be an outright collection issue ie fraud or embezzlement by a partner or third party.

This could also be a shadowy hand reaching into the cookie jar you are unaware of like a former partner who is still on the books as a "creditor" and getting regular siphons.

Regardless, get access to the books, pull out the spreadsheets of the billings pathed to the collection receipts and get an EPIC pot of coffee and just figure it out this weekend.

 

[stickyshift]

Thanks, LADoc. I've thought the same things you've thought and it makes me feel insane. But feeling underpaid for the work that we do also drives me insane. Thanks for your advice and encouragement!

 

[gungho]

I think I've asked this question before but don't recall seeing a response-the numbers that are tossed around here re: revenue/income-are these inclusive of technical components or just professional fees-if these are pro fees only, I'm way undercoding (though I can't see how)-although we do use IHC sparingly. Thanks for feedback.