Big Moves by Quest and Labcorp

[Napoleon1801]

I keep noticing some bold moves by both Quest and Labcorp eating up hospital lab services. Are we all destined to be their employees at this rate? This is a very concerning trend and I don't see a good way to defend against it. I've been impacted twice now. I recently left a job where Quest bought out all the outpatient work, only to start work at another hospital system, who subsequently sold out to Labcorp within the same year.



"First, Ascension will sell its hospital laboratory outreach business at a number of locations to Labcorp. Second, Labcorp will manage the inpatient laboratories of many Ascension hospitals."


"In managing inpatient labs, Labcorp is in a position to direct tissue specimens to its own pathologists, particularly the more complex cancer cases that require extensive workups and multiple diagnostic procedures. That would reduce case referrals to the local pathology groups currently serving Ascension hospitals."


"The company’s free cash flow for 2021 was $2.6 billion. A substantial portion of that free cash flow was generated by COVID-19 testing. For that reason, Labcorp has a big war chest of cash it can use to go out and do more deals with hospitals and health systems."

• In 2017, Labcorp bought the lab outreach business of Mount Sinai Health System in New York City. (See TDR, Jan. 30, 2017.)
• In 2013, the owners of Genesis Clinical Laboratory in Berwyn, Ill., sold their lab outreach business to Labcorp. (See TDR, July 29, 2013.)
• In 2020, it acquired the clinical ambulatory laboratory business of Franciscan Missionaries of Our Lady Health System in Baton Rouge, La. (See TDR, Sept. 14, 2020.)

Labcorp to Buy Outreach, Manage Ascension Labs

This is the largest lab transaction in 50 years involving a major healthcare system and a big commercial lab.

www.darkintelligencegroup.com

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[WEBB PINKERTON]

Sonic recently bought ProPath in the last month or so. A pretty big deal that flew under the radar.

Ascension labs are run by Quest in one of our territories. They weren't included in the deal with labcorp.

Best way to defend against it is to diversify. Start businesses, buy up land etc. Otherwise, you will be like this guy more than you would like

 

[KeratinPearls]

I keep noticing some bold moves by both Quest and Labcorp eating up hospital lab services. Are we all destined to be their employees at this rate? This is a very concerning trend and I don't see a good way to defend against it. I've been impacted twice now. I recently left a job where Quest bought out all the outpatient work, only to start work at another hospital system, who subsequently sold out to Labcorp within the same year.



"First, Ascension will sell its hospital laboratory outreach business at a number of locations to Labcorp. Second, Labcorp will manage the inpatient laboratories of many Ascension hospitals."


"In managing inpatient labs, Labcorp is in a position to direct tissue specimens to its own pathologists, particularly the more complex cancer cases that require extensive workups and multiple diagnostic procedures. That would reduce case referrals to the local pathology groups currently serving Ascension hospitals."


"The company’s free cash flow for 2021 was $2.6 billion. A substantial portion of that free cash flow was generated by COVID-19 testing. For that reason, Labcorp has a big war chest of cash it can use to go out and do more deals with hospitals and health systems."

• In 2017, Labcorp bought the lab outreach business of Mount Sinai Health System in New York City. (See TDR, Jan. 30, 2017.)
• In 2013, the owners of Genesis Clinical Laboratory in Berwyn, Ill., sold their lab outreach business to Labcorp. (See TDR, July 29, 2013.)
• In 2020, it acquired the clinical ambulatory laboratory business of Franciscan Missionaries of Our Lady Health System in Baton Rouge, La. (See TDR, Sept. 14, 2020.)

Labcorp to Buy Outreach, Manage Ascension Labs

This is the largest lab transaction in 50 years involving a major healthcare system and a big commercial lab.

www.darkintelligencegroup.com

We are destined to be a minion in the future as corporations start gobbling up business. Everyone will get paid 250-300k to read 100 biopsies a day. Corporations like HCA will employ you in their hospitals.

 

[wholeheartedly]

ugh.

 

[deleted314957]

We are destined to be a minion in the future as corporations start gobbling up business. Everyone will get paid 250-300k to read 100 biopsies a day. Corporations like HCA will employ you in their hospitals.

They already are, big time. They even have residency programs to make their own minions.

 

[Med Director New England]

I’ve been pointing out consolidation in the lab industry here for a while now as a driver for decreasing future need of pathologists.

hospital labs / hospital admins selling out are not malicious toward pathologists it just comes down to selling something that is a financial liability.

The technical piece of AP is a money loser for many labs. Esp hospital based labs b/c of case mix. This is why Q and LC typically buy only outreach AP (office based biopsies) and stay away from hospital based AP completely OR will only perform hospital based AP tc work on a per block contract for cassette’ed tissue OR only get into this if a huge amount of other work (typically CP) is coming with….

 

[WEBB PINKERTON]

Yea, good luck investing in the future (molecular and maybe digital) with such low margins. Everyone knows it is going to be next to impossible and are selling out fast.

Get those side hustles going. You can make thousands each day just cutting down a tree or two.

 

[KeratinPearls]

Webb, people are taking tree cutting into their own hands.

Rick Ross a well known very wealthy rapper was given an estimate of $10,000 to cut down 10 trees. Do you know what he did? He bought a chainsaw and cut them down himself. Lol.

 

[coroner]

Get those side hustles going. You can make thousands each day just cutting down a tree or two.

Don't forget tattoo removal parlor...😉

 

[WEBB PINKERTON]

I paid a lot of money to get my DNA strand tattoo removed. Big money in that.

I'm glad that man didn't get hurt. He should have hired a professional to cut down those trees.

 

[Drifter76]

I keep noticing some bold moves by both Quest and Labcorp eating up hospital lab services. Are we all destined to be their employees at this rate? This is a very concerning trend and I don't see a good way to defend against it. I've been impacted twice now. I recently left a job where Quest bought out all the outpatient work, only to start work at another hospital system, who subsequently sold out to Labcorp within the same year.



"First, Ascension will sell its hospital laboratory outreach business at a number of locations to Labcorp. Second, Labcorp will manage the inpatient laboratories of many Ascension hospitals."


"In managing inpatient labs, Labcorp is in a position to direct tissue specimens to its own pathologists, particularly the more complex cancer cases that require extensive workups and multiple diagnostic procedures. That would reduce case referrals to the local pathology groups currently serving Ascension hospitals."


"The company’s free cash flow for 2021 was $2.6 billion. A substantial portion of that free cash flow was generated by COVID-19 testing. For that reason, Labcorp has a big war chest of cash it can use to go out and do more deals with hospitals and health systems."

• In 2017, Labcorp bought the lab outreach business of Mount Sinai Health System in New York City. (See TDR, Jan. 30, 2017.)
• In 2013, the owners of Genesis Clinical Laboratory in Berwyn, Ill., sold their lab outreach business to Labcorp. (See TDR, July 29, 2013.)
• In 2020, it acquired the clinical ambulatory laboratory business of Franciscan Missionaries of Our Lady Health System in Baton Rouge, La. (See TDR, Sept. 14, 2020.)

Labcorp to Buy Outreach, Manage Ascension Labs

This is the largest lab transaction in 50 years involving a major healthcare system and a big commercial lab.

www.darkintelligencegroup.com

The best way to defend against it is to avoid the field of pathology, like the plague. You are almost certainly NOT destined to be a labcorp or quest employee if you aren’t a pathologist to begin with. If you are a medical student, don’t even think about going into this field. People need to understand that it makes absolutely no sense whatsoever to work hard to get into a good medical school, then spend 4 years working hard to get through medical school and do well while also racking up thousands of dollars (hundreds of thousands for most) in student loan debt, then 5 or 6 years or more of postgraduate training, just so you can spend your career stuck in a third rate job being exploited by labcorp, quest, HCA, or even some of the private groups that are running a two tiered system. You have to be either extremely naive/ignorant of the situation or the most extreme form of masochist to take the kind of deal you will get, going into pathology.

 

[KeratinPearls]

The best way to defend against it is to avoid the field of pathology, like the plague. You are almost certainly NOT destined to be a labcorp or quest employee if you aren’t a pathologist to begin with. If you are a medical student, don’t even think about going into this field. People need to understand that it makes absolutely no sense whatsoever to work hard to get into a good medical school, then spend 4 years working hard to get through medical school and do well while also racking up thousands of dollars (hundreds of thousands for most) in student loan debt, then 5 or 6 years or more of postgraduate training, just so you can spend your career stuck in a third rate job being exploited by labcorp, quest, HCA, or even some of the private groups that are running a two tiered system. You have to be either extremely naive/ignorant of the situation or the most extreme form of masochist to take the kind of deal you will get, going into pathology.

Some people don’t mind it. 250-300k for 8 hour day no weekends but making much more in revenue for the company. 100 cases a day is what I was told is the quota spread across cyto, biopsies. Do the math.

Most pathologists are foreign grads. 250-300k a year is A LOT compared to what they would make working in their own countries.

The bar is set low allowing those who are less competitive gain entry into a field where the bar should be set high (serious consequences of a missed diagnosis) like in Derm. Foreign grads are looking for a spot in the US. Pathology allows them a spot due to the less competitive nature similar to Family Practice.

By the way, welcome back Drifter.

 

[WEBB PINKERTON]

You are going to be exploited no matter what specialty you pick it appears. The others are just showing up late to the party. Pathology was one of the first to arrive. Over 50 percent of practices (across the board) are owned by hospitals or VC now and it is increasing fast.

 

[Med Director New England]

You are going to be exploited no matter what specialty you pick it appears. The others are just showing up late to the party. Pathology was one of the first to arrive. Over 50 percent of practices (across the board) are owned by hospitals or VC now and it is increasing fast.

I think it’s closer to 90%

 

[ScubaV]

You are going to be exploited no matter what specialty you pick it appears. The others are just showing up late to the party. Pathology was one of the first to arrive. Over 50 percent of practices (across the board) are owned by hospitals or VC now and it is increasing fast.

Agreed. I think there is a lot of downward pressure on medicine in general, any specialty. Long term I suspect being a physician will be much like being an engineer or similar, but perhaps with slightly higher pay and a much longer training pathway.

Still not going rural though... Maybe I'll start up a CountryLyfe (tm) NFT or crypto and be rural in spirit instead.

 

[Drifter76]

You are going to be exploited no matter what specialty you pick it appears. The others are just showing up late to the party. Pathology was one of the first to arrive. Over 50 percent of practices (across the board) are owned by hospitals or VC now and it is increasing fast.

I agree to an extent that many of the negative forces causing pathology to be a crap specialty are also having an adverse effect on most other specialties, but I think there is a difference in degree. Pathology is just worse than the others. But there is definitely an increasingly valid argument to be made that it is best to avoid medicine altogether.
It helps some if you are in a specialty with leadership that wants to maintain some reasonable supply demand balance in the job market. I knew an ENT guy who was a department chair and the head of one of their major organizations. I did a rotation with him in med school and he went on and on with me one day about the job market and how they didn’t want more than one ENT for every 30k or 40k population in the U.S. The orthopods had screwed up, according to him, and let their numbers get too high and it was hurting them. Will we ever hear anyone in pathology leadership have that kind of discussion? I never have. There are too many of us and we are too easily replaceable.

 

[Drifter76]

Some people don’t mind it. 250-300k for 8 hour day no weekends but making much more in revenue for the company. 100 cases a day is what I was told is the quota spread across cyto, biopsies. Do the math.

Most pathologists are foreign grads. 250-300k a year is A LOT compared to what they would make working in their own countries.

The bar is set low allowing those who are less competitive gain entry into a field where the bar should be set high (serious consequences of a missed diagnosis) like in Derm. Foreign grads are looking for a spot in the US. Pathology allows them a spot due to the less competitive nature similar to Family Practice.

By the way, welcome back Drifter.

My first job was with a corporate ref lab, and I can assure you that no one there was working those kinds of hours. The idea of a corporate job that is 8-5 with reasonable workload is a myth, as best I can tell. The bean counters and executives want their financial statements/annual report to look amazing. That involves dumping an amazing amount of work on you.

 

[KeratinPearls]

My first job was with a corporate ref lab, and I can assure you that no one there was working those kinds of hours. The idea of a corporate job that is 8-5 with reasonable workload is a myth, as best I can tell. The bean counters and executives want their financial statements/annual report to look amazing. That involves dumping an amazing amount of work on you.

Everything I mentioned is true. 8 hour days reading a preset quota. No one is going to work 12 hours a day. That’s a setup for making mistakes. The people I know who work there are happy. They don’t complain. The people they work with are pleasant but that may just be specific to this location.

Different corporate labs may work you harder but that’s what I was told directly from my friends.

I’ve been told to stay away from some Quest branches, so your story may be true. I’d recommend everyoneto ask around before joining a corporate lab to learn about working conditions, etc. you don’t want to feel like your working in a sweatshop.

 

[Drifter76]

Everything I say is true. 8 hour days reading a preset quota. No one is going to work 12 hours a day. That’s a setup for making mistakes.

Different corporate labs may work you harder but that’s what I was told directly from my friends.

I’ve been told to stay away from some Quest branches, so your story may be true.

Why would they care about mistakes? To these corporations, it is just part of the cost of doing business. They don’t think like we do, and you are giving them way too much credit by assuming they have some modicum of integrity. I know what happens in these places because I have been there and I have lived it. I wasn’t just told by someone, I actually was the someone.

 

[KeratinPearls]

Why would they care about mistakes? To these corporations, it is just part of the cost of doing business. They don’t think like we do, and you are giving them way too much credit by assuming they have some modicum of integrity. I know what happens in these places because I have been there and I have lived it. I wasn’t just told by someone, I actually was the someone.

Well that sucks for you. I talk to my friends everyday and they aren’t miserable. Like I said I’m sure there are some sweatshop type places out there I’m not refuting that. The director is a pathologist and from what I hear he’s a decent guy. Everyone would leave or there would be high turnover if they were worked to the bone. Your making it sound like every job is some factory based in China and that’s not the case.

Your story is your experience. Not everyone in corporate has a sh$ty job.

 

[Drifter76]

Well that sucks for you. I talk to my friends everyday and they aren’t miserable. Like I said I’m sure there are some sweatshop type places out there I’m not refuting that. The director is a pathologist and from what I hear he’s a decent guy. Everyone would leave or there would be high turnover if they were worked to the bone. Your making it sound like every job is some factory based in China and that’s not the case.

Your story is your experience. Not everyone in corporate has a sh$ty job.

Not any more- I left that place almost a decade ago. And it sucked for a lot more people than just me. If this is a corporate lab environment you are talking about and the conditions are actually reasonable, as you claim, then I can assure you that it is a rare exception rather than the rule.
The turnover isn’t as high in some of these places as you might think. In order to leave, most people have to have something to go to. With a bad job market, many people have been trapped in these jobs. And even when people are able to get out, their replacements are far too quickly and easily found.

 

[Med Director New England]

I agree to an extent that many of the negative forces causing pathology to be a crap specialty are also having an adverse effect on most other specialties, but I think there is a difference in degree. Pathology is just worse than the others. But there is definitely an increasingly valid argument to be made that it is best to avoid medicine altogether.
It helps some if you are in a specialty with leadership that wants to maintain some reasonable supply demand balance in the job market. I knew an ENT guy who was a department chair and the head of one of their major organizations. I did a rotation with him in med school and he went on and on with me one day about the job market and how they didn’t want more than one ENT for every 30k or 40k population in the U.S. The orthopods had screwed up, according to him, and let their numbers get too high and it was hurting them. Will we ever hear anyone in pathology leadership have that kind of discussion? I never have. There are too many of us and we are too easily replaceable.

Ophthalmology does the same thing. Actively compressing training spots to insure huge demand for their services….

Corporate isn’t all bad btw..some of the most ruthless employers are academic chairs as I’ve said before