CAP and ASCP etc recommend GME INCREASE path residency training/spots

[LADoc00]

Which is good for pathologists (and doctors in general) because if prices were truly set by a free market we'd all be broke. Nobody is going to pay $36 to have their biopsy read plus a few $42 charges for immunostains. Not for a doctor they never see. Good luck collecting that in a free market.

Of course they will.

Do you see the mechanic charging you 150/hr to work on your BMW? Or do you just drop your car off at the dealership and pay the bill afterwards?

I would love a true free market, love it. I would easily make 2x what I bring home now.

Better yet, I would create a concierge style practice complete with office hours where people could discuss their results directly with me, for a fee of course.

Free market is based on a supply v. demand. Yeah, if you are an idiot practicing in a place with 500+ Pathologists (Boston, NYC etc), you are probably gonna get 10 bucks for an 88305.

But in a free market, specimens wouldnt flow out to even price across geographic regions. Shipping costs are HUGE. For that 88305 to get a reasonable TAT, you are looking at 40+ bucks per case for S+H. The only reason it works for stuff like Uropath, is that each case is 12+ 88305s. For Clarient, each block is 4+ IHCs+FISH etc. You cant employ a bx-->ship model for the entire speciality, its just not practical.

This is before you even begin to consider Free Market+Exclusive Contracts. For us, this is the best of all worlds. It would almost be a Standard Oil style of monopoly. That appendix you got taken out by coming into the emergency room, yah that would be 150 bucks to analyze. Given that is probably <3% of the total hospital stay, I can guarantee people would pay it.

No, a free market would be very good indeed.

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[lipomas]

The only reason it works for stuff like Uropath, is that each case is 12+ 88305s. .

Not anymore!

Now it's 88305 x 5 or 6 (can't remember) no matter how many specimens.

 

[lipomas]

THIS. Everyone wants everything done, especially since they don't really have to pay the bill in the end- it's medicare/medicaid/insurance footing 99% of the bills. We are up the creek much of the time because we cannot deny services just because someone can't pay. And there is no real market since the prices are pre-set by medicare. It's a catch-22. Or course I am not talking about Path but all of medicine.

I think it's also a cultural problem- when people are really sick and dying, even those with terminal chronic disease- they insist on being full code and wasting resources. We should be teaching people to die in peace at home. No one dies at home anymore- they all die in the ICU now.

/end rant

Yeah I saw this chart today, totally backs that up (the second paragraph).

here: http://theincidentaleconomist.com/w...-day-health-care-spending-by-age-and-country/

 

[pathstudent]

I think it's also a cultural problem- when people are really sick and dying, even those with terminal chronic disease- they insist on being full code and wasting resources. We should be teaching people to die in peace at home. No one dies at home anymore- they all die in the ICU now.

/end rant

It is even more of a cultural problem with physicians. We advise patients to do everything all the time. I don't really blame the patients for it. A lot of the time they don't understand what their health condition really means.