Compensation Survey Results

[Napoleon1801]

You all might find this mildly interesting:

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[hurrycane]

I wonder what is the geographical distribution of these pathologists?

 

[mike-sheree]

If you believe any of this you have taken a red pill(or a blue pill or SOME pill). EVERYONE poor-mouths(or should). These have not been accurate since i was a first year trainee in the late 70’s.

 

[SunBakedTrash]

If you believe any of this you have taken a red pill(or a blue pill or SOME pill). EVERYONE poor-mouths(or should). These have not been accurate since i was a first year trainee in the late 70’s.

Most pathologists are employed now and I doubt most make much above 400k anymore. These are getting more accurate as unique situations and sweet gigs die off.

 

[mike-sheree]

Times have indeed changed and I’ve now been out of the game for 11 years. Long enough for a 1st yr med student to be a neurosurgeon!

 

[coroner]

I think the graph is a reasonably representative distribution, with the bulk of positions in the 300-450K range.

If you believe any of this you have taken a red pill(or a blue pill or SOME pill). EVERYONE poor-mouths(or should). These have not been accurate since i was a first year trainee in the late 70’s.

Sure, some people may exaggerate or misrepresent themselves, but not everyone. I do agree pathologists are notorious for poor-mouthing, but from my experience that is more common in-person, maybe less so anonymously because there's no repercussion/stigma from someone in their hospital thinking they make to much since it's an anonymous survey to begin with. These salary surveys are like political polls: they won't tell you exact [voting] results; so, they're more of a gauge than anything.

Most pathologists are employed now and I doubt most make much above 400k anymore. These are getting more accurate as unique situations and sweet gigs die off.

True, regarding more pathologists (and physicians) are employed now. And, a lot of physicians who are employed have their salaries determined by physician compensation data e.g. MGMA and RVU metrics which means an employed pathologist can only earn so much as determined by the hospital.


As a side note, the "sweet gigs" have their income ceilings too. Even in a PP which offers financial parity to all partners putting them in the upper income percentiles their ceilings are only as high as the amount of glass they push also (excluding some kind of insane Part A). This may seem obvious, but the point is: Financially, the PP pathologist with the sweet gig isn't necessarily better off than the employed pathologist. Let's take an example of a pathologist in the "eat what you kill" model of PP who is making bank (for example, 800K). They are most likely pushing a lot of glass to earn this. Again, this is excluding outliers like having 80%+ private insurance payor mix or a Part A of 20K/mo per pathologist. Then, take an employed pathologist who is making the same amount per year. The principle still applies that the employed pathologist would still have to be generating enough RVU's to earn that equivalent income of the PP pathologist. Again, excluding the outliers that could pertain to their situation e.g. being in a rural area at a hospital that pays physicians in the 90th percentile based on comp data.

So, who's better off financially if they're both making the same salary? I guess the main factors would then come down to how much glass they have to push i.e. weekly work hours to earn that income and vacation/time off per year. Then, take into account lesser factors such as retirement plan, other benefits, etc.

There are some pathologists who have been in both types of jobs and feel they are better off employed than they were in PP because they have a guaranteed base salary every year with a bump depending on RVUs vs in PP with lower base and wildly fluctuating bonus which may or may not ever materialize if they don't have financial parity. This is particularly true for those who have been in exploitative groups which we all know about or heard of. These may be a "sweet gig" for the senior partners, but not so much for the rookies.

 

[WEBB PINKERTON]

If you want to be at the top of that graph you better hawk tuah and go rural.

 

[ChicagoPath]

If you want to be at the top of that graph you better hawk tuah and go rural.

Very impressive you know of hawk tuah.

Yes jobs like that can be had in rural. It’s unfortunate that in pathology, these jobs you have to go rural to obtain, when in other specialties you can get a “top of that graph job” easily in a large city and there are plenty of jobs to choose from.

Says a lot about pathology. Depressed salaries and limited number of jobs in large cities has been my observation.

 

[WEBB PINKERTON]

Very impressive you know of hawk tuah.

Yes jobs like that can be had in rural. It’s unfortunate that in pathology, these jobs you have to go rural to obtain, when in other specialties you can get a “top of that graph job” easily in a large city and there are plenty of jobs to choose from.

Says a lot about pathology. Depressed salaries and limited number of jobs in large cities has been my observation.

Rural is better. Live like a king on hundreds of acres. Have more money than you know what to do with. Retire early. The sad part is how few rural jobs there are. Someone offers me a job in a high cost of living big city and I will spit on that thang.

 

[ChicagoPath]

Rural is better. Live like a king on hundreds of acres. Have more money than you know what to do with. Retire early. The sad part is how few rural jobs there are. Someone offers me a job in a high cost of living big city and I will spit on that thang.

Seen some jobs in Wyoming and Montana. They probably pay well and rural.

 

[WEBB PINKERTON]

Seen some jobs in Wyoming and Montana. They probably pay well and rural.

Take them jobs then and hope a supervolcano doesn't erupt and wipe out your land.

 

[coroner]

The sad part is how few rural jobs there are. Someone offers me a job in a high cost of living big city and I will spit on that thang.

Well, of course there's going to be fewer rural jobs. By definition, rural means sparsely populated. Therefore, you need fewer pathologists per person in underpopulated areas and vice versa in metropolitan areas.

Rural is better. Live like a king on hundreds of acres...Someone offers me a job in a high cost of living big city and I will spit on that thang.

OK, we've all heard you preach many a time about going rural, living like a king on a hundred acres, and truffle hunting with a pig 🐷 as a side hustle. Glad it worked out for you, but it's not for everybody. And I've worked in a rural area and metropolitan city, so I can speak from experience. There's just as many people (if not more) who would prefer living in a big city than BFE...Beauty is in the eye of the beholder.

 

[Zarniwoop]

Webb's right, but rural isn't a sure thing - just a better bet.

IMO there is also greater risk because it looks less bad when you are kicked out of an urban practice. Sadly, that is what is supposed to happen.

However, because of the kinder and gentler stereotype associated with rural practices, you are more likely to be perceived as the wrongdoer when your job doesn't work out, and this will hurt you when searching for your next disappointment.

 

[WEBB PINKERTON]

Well, of course there's going to be fewer rural jobs. By definition, rural means sparsely populated. Therefore, you need fewer pathologists per person in underpopulated areas and vice versa in metropolitan areas.


OK, we've all heard you preach many a time about going rural, living like a king on a hundred acres, and truffle hunting with a pig 🐷 as a side hustle. Glad it worked out for you, but it's not for everybody. And I've worked in a rural area and metropolitan city, so I can speak from experience. There's just as many people (if not more) who would prefer living in a big city than BFE...Beauty is in the eye of the beholder.

Specimens are in fixative. Doesn't matter where the patients are. Set yourself up in a low cost of living area and then let the money roll in.

I doubt your "rural" job was really rural. You wanna see rural, I can send a plane and I will show you rural.

 

[ChicagoPath]

Specimens are in fixative. Doesn't matter where the patients are. Set yourself up in a low cost of living area and then let the money roll in.

I doubt your "rural" job was really rural. You wanna see rural, I can send a plane and I will show you rural.

Some rural jobs make as much as some good private groups in larger cities. In other words rural does not always equal more money.

 

[Zarniwoop]

Some rural jobs make as much as some good private groups in larger cities. In other words rural does not always equal more money.

Maybe not always, but probably 95% of the time. Plus your money goes further when locally you only have a Dollar General and a gas station to spend your money.

 

[Pathological_Liar]

Partners at my former, poorly-run, large metro area group maxed out at 350k TC.

They had probably 10+ hospitals staffed by senior partners (with PAs and assistants) with nothing to do after 11am, subsidized by 5 high volume rural hospitals.

I own my own practice now, and am at the very top end of this salary data set seven years out of fellowship. S/o probably 4-5k surgicals annually (mostly gi) and get a ridiculous part A. 15+ weeks pto annually.

Honestly, I always assumed most pp partners were at least >600k assuming they're not super lazy/poorly optimized. I'm guessing this survey skews a bit low due to heme/molecular having a slight academic bias?

Anyway, the financial and lifestyle incentive for entrepreneurial millennials to pry these hospital contracts from scletotic greedy boomers is definitely there, and I'm curious if it's happening on a larger scale at all.

 

[Dave CX]

Well, of course there's going to be fewer rural jobs. By definition, rural means sparsely populated. Therefore, you need fewer pathologists per person in underpopulated areas and vice versa in metropolitan areas.


OK, we've all heard you preach many a time about going rural, living like a king on a hundred acres, and truffle hunting with a pig 🐷 as a side hustle. Glad it worked out for you, but it's not for everybody. And I've worked in a rural area and metropolitan city, so I can speak from experience. There's just as many people (if not more) who would prefer living in a big city than BFE...Beauty is in the eye of the beholder.

Agree. I've been sick of the broken record for a long time.

 

[octopusprime]

Partners at my former, poorly-run, large metro area group maxed out at 350k TC.

They had probably 10+ hospitals staffed by senior partners (with PAs and assistants) with nothing to do after 11am, subsidized by 5 high volume rural hospitals.

I own my own practice now, and am at the very top end of this salary data set seven years out of fellowship. S/o probably 4-5k surgicals annually (mostly gi) and get a ridiculous part A. 15+ weeks pto annually.

Honestly, I always assumed most pp partners were at least >600k assuming they're not super lazy/poorly optimized. I'm guessing this survey skews a bit low due to heme/molecular having a slight academic bias?

Anyway, the financial and lifestyle incentive for entrepreneurial millennials to pry these hospital contracts from scletotic greedy boomers is definitely there, and I'm curious if it's happening on a larger scale at all.

I think there is a dearth of entrepreneurial millennials that go into pathology (and "entrepreneurial Gen Z or younger" seems counterintuitive unless you're talking about instagram and 'influencers'), but I certainly can see the crusty old pathologists doing one of two things: the 'easy money' motive keeping them in practice until they are 90yo, or hiring more people to spread out the workload--since they've already made their mint, they don't care about maxing out at 350k if it means a cake "part time" work schedule. Either scenario is not good for new hires.

 

[Pathological_Liar]

I think there is a dearth of entrepreneurial millennials that go into pathology (and "entrepreneurial Gen Z or younger" seems counterintuitive unless you're talking about instagram and 'influencers'), but I certainly can see the crusty old pathologists doing one of two things: the 'easy money' motive keeping them in practice until they are 90yo, or hiring more people to spread out the workload--since they've already made their mint, they don't care about maxing out at 350k if it means a cake "part time" work schedule. Either scenario is not good for new hires.

Yeah I'm just talking about normal "form a medical corp. and submit an RFP for a hospital contract" entrepreneurship, which I agree is shockingly absent from the job landscape discussion. The only debates I ever hear are "should I take garbage academic job #1 or garbage employed private job #2 in a slightly larger city?"

My previous boomer group used to pay $5k/year med director stipends to non-shareholders while pocketing the passive $50k/mo CP payments flowing from those laboratories. Of course 70+yo pathologists will stay in their position as long as unaware millennials accept this as normal.

I'd guess most non-partner pathologists have no idea how lucrative the CP professional payments + med director stipend combo can be. I've never seen a hospital or a private practice offer a meaningful share of this revenue to a non-partner, but it literally doubles my AP income. Business ownership also opens up new tax-efficiency strategies like fully maxed out 401k ($69k pretax this year), cash balance plan ($100-200k pretax), payroll savings on distributions vs w2, etc. In bigger groups with pathologists already taking RMDs (lol), it's almost impossible to get everyone onboard with these aggressive tax strategies. But it's the only effective way to catch up to tech, big law, finance, etc, after 10 years of medical training.

My expectation is that upward wage expectations will continue to put pressure on these groups to the point that they literally can't hire good people anymore. Their hospital "clients" get angry about quality and/or turnover, and start entertaining alternatives. Millennial group then comes in with an RFP emphasizing a more equitable business structure that will entice good pathologists to join/stay.

 

[octopusprime]

Cash balance plans are great for older-ish members but if you need cash flow, have younger partners with more debt, or variable monthly income, they can be challenging. Rather expensive to maintain as well. But yes, if your > 20% savings rate isn't putting you well into 6 digits of savings annually, you're likely employed or academic.

 

[Pathological_Liar]

If I were an employed pathologist earning $250-300k FT, I would seriously consider recurring locums positions instead. It's not uncommon for me to get offers for 15-20 weeks/year at ~$1800/day. Try a few positions, and pick 1-2 that you like the most. Do 30 weeks/year to generate $250-270k in income, and spend the other 22 weeks/year in an infinity pool on Sukhumvit road. Run the income through an S corp to benefit from a solo 401k and other tax advantages.

That's my plan if I ever lose my current contract. There's zero possibility of me going back to 8-5, 48 weeks/year as an employee.

 

[KeratinPearls]

If I were an employed pathologist earning $250-300k FT, I would seriously consider recurring locums positions instead. It's not uncommon for me to get offers for 15-20 weeks/year at ~$1800/day. Try a few positions, and pick 1-2 that you like the most. Do 30 weeks/year to generate $250-270k in income, and spend the other 22 weeks/year in an infinity pool on Sukhumvit road. Run the income through an S corp to benefit from a solo 401k and other tax advantages.

That's my plan if I ever lose my current contract. There's zero possibility of me going back to 8-5, 48 weeks/year as an employee.

Sukhumvit road in Bangkok. I know what you are talking about! 5 star hotels for at least $150-$250 a night. Amazing service.

With a 250-270K income in the states, you can live very well in Bangkok.

 

[Guest8]

If I were an employed pathologist earning $250-300k FT, I would seriously consider recurring locums positions instead. It's not uncommon for me to get offers for 15-20 weeks/year at ~$1800/day. Try a few positions, and pick 1-2 that you like the most. Do 30 weeks/year to generate $250-270k in income, and spend the other 22 weeks/year in an infinity pool on Sukhumvit road. Run the income through an S corp to benefit from a solo 401k and other tax advantages.

That's my plan if I ever lose my current contract. There's zero possibility of me going back to 8-5, 48 weeks/year as an employee.

All well and good as a single dude with no family. Doesn't work for the majority of people with spouses that have jobs and kids in schools, though.

 

[octopusprime]

All well and good as a single dude with no family. Doesn't work for the majority of people with spouses that have jobs and kids in schools, though.

True, though I think inertia is the biggest obstacle to overcome in those circumstances. Yes, you will have to move; yes, there's a little uncertainty; yes, your kids will have to switch schools. Fear of the unknown and complacency can be hard things to overcome.

 

[Guest8]

True, though I think inertia is the biggest obstacle to overcome in those circumstances. Yes, you will have to move; yes, there's a little uncertainty; yes, your kids will have to switch schools. Fear of the unknown and complacency can be hard things to overcome.

I don't think most families can do 30 weeks traveling the country for locums work and 22 weeks in Thailand. That's got single guy life written all over it.

 

[octopusprime]

I don't think most families can do 30 weeks traveling the country for locums work and 22 weeks in Thailand. That's got single guy life written all over it.

Yeah I'm talking about looking elsewhere for a job or at least owning the fact that one is getting sufficiently bent over; I couldn't do locums as a parent but I sure wouldn't take 235k either.

 

[shikimate]

Locum rates are 1800 a day in USA now? The rate in Canada is still like 1600CAD a day. Damn do I ever wish they included physicians in the TN visa lol. Why were physicians not included in NAFTA? AMA doesn't want Canadians making a few bucks down south?

 

[KeratinPearls]

Locum rates are 1800 a day in USA now? The rate in Canada is still like 1600CAD a day. Damn do I ever wish they included physicians in the TN visa lol. Why were physicians not included in NAFTA? AMA doesn't want Canadians making a few bucks down south?

1200-2000$ per day. Better than the $700 a day we had years ago.