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Corporate/Pod Labs - Is It Really That Bad?

Discussion in 'Pathology' started by Enkidu, Jul 24, 2011.

  1. Enkidu

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    A lot of posters on this forum have emphasized how bad the job market is by pointing to corporate labs and pod labs. I recognize that there is a loss of autonomy and a lower salary that smaller private practice labs, but is it really that bad? Are the hours incredibly long? Is the pay actually low, or just lower than it should be?
     
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  3. Thrombus

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    It is sad that you have to ask this? You are basically reduced to a P.A. in terms of autonomy/respect; the pay is lower than it should be as your profit margin is not yours; and there is a downward trend that is only beginning
     
  4. Enkidu

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    Well, I'm trying to put the situation in perspective. Do pathologists in these situations work more and earn less than family practice docs? Are they still signing out interesting cases and impacting patients lives?

    I like pathology more than any other field of medicine. If pathologists make less than they used to because of pod labs, but are still making reasonable salaries within the community of physicians... then I think it's still not a bad gig. Not ideal given historical standards, but I can't pass over my favorite field just because things aren't as good as they used to be.

    If pod lab pathologists were working 70 hours a week for $100K, then I might pass... but If they're working 40 hours a week for $150K, then it still sounds okay. I guess that Raider's generation of pathologists made millions, but I'd be happy just to have a job that excites my imagination and curiosity and allows me to impact people's lives with my passion. If I can do this while still making above the average salary for physicians... I may just do it.
     
  5. Thrombus

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    How is this -- say you end up with a pod lab which by the way is the way pathology is trending -- you may be signing out 98% of your cases with 20 different diagnoses. Does that "impact people's lives with passion"? Does that "excite your imagination and curiosity"? If you work for a GYN or GU group you may only use 10 different diagnoses 98% of the time, signing out cases that a 9th grader can be trained to do.

    Bread and butter pays the bills but the tough cases provide the wonder. Unfortunately jobs that provide both are decreasing at an alarming rate.
     
  6. Enkidu

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    Yeah, I guess I was thinking that there would also be tough cases in pod labs. I guess there are more tough cases in academia, and that's really where I'm hoping to stay... but if working for a pod lab is the worst case scenario, then I just want to understand how bad it really is, not in comparison to the history of pathology, but in absolute terms. Even if they're mostly signing out boring cases... is it more boring than being the clinician seeing those patients? If you're signing out every case from the practice, then you must be seeing more interesting things than any of the clinicians.
     
  7. yaah

    yaah Boring
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    No personal experience, but from what I have heard experience varies. Some work long hours and work on signing out the requisite volume to reach a "bonus." At others, hours not so bad and probably better than most private practices. Pay is also competitive. It's like other specialties. People can say what they want but the paycheck, hours, and lack of call are going to attract people to reference lab jobs whether there are lots of open jobs or not a lot of open jobs. Private practice partnership-type jobs are NOT for everyone. If you are in a partnership you are in a sense working for yourself and your group, which means you have to produce, which means you have to sustain and grow the business. If you're in a reference lab other people do that for you, I imagine it can reduce a lot of stress.

    As for whether you see "tougher" cases or not, tough cases happen no matter where you practice. They are concentrated in higher volume and academic centers because that is where the tough cases end up, but they can start anywhere. Of course, if you're not a very good pathologist or you're working too quickly you can miss the neat stuff.
     
  8. Torsed

    Torsed Deo Vindice.
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    :luck:
    Look in our town there is a big fat gastroenterologist who pays some local pathologist 25 dollars a CASE, not per biopsy mind you to look at all of his GI biopsies and collects not only the technical fee, but also the professional fee.

    This essentially translates to worse than slave labor for the charges that would be applied an any normal pathology charge for a private group. One GI contract can make or break some pathology groups. It takes away from the profession and marginalizes us (as pathologists) as janitorial work for greed (in my opinion). I do not believe CAP inspects pod labs either, that may be done by endoscopy certification groups (but from what I hear is pretty stringent). Certainly I believe that these groups have a right to earn an income, but what if I owned a surgery center and paid the endoscopist 50 bucks for EGD or colonoscopy? Would they think that is fair market value for their services? Is overutilization a concern for GI groups in a pod lab? If I got paid an 88305 for every odd piece of mucosa I chunked out wouldn't I chunk out more? Is the Pope catholic?

    I think the only thing that will change this is legislation, probably centered around some high profile case involving the children of high profile person. I think too many people have their hand in the cookie jar for it to be any other way. I am sure there are some pod pathologist who make more than the fool in our town, I would like to hear their retort if feasible. :luck:
     
  9. Torsed

    Torsed Deo Vindice.
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    Crap man, come to my practice for a day. I tell MD Anderson the answer and they copy my diagnosis in their report. I get some bizarro stuff down in this neck of the woods.

    So let it be written.....so let it be done. :luck:
     
  10. 2121115

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    Totally agree that academics do not have tougher cases than a good private practice job (not a bad one).
     
  11. Enkidu

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    I'm glad to hear that. So the disadvantage of being in a corporate or pod lab is not that the cases are boring, and it's not that the pathologists are especially poorly paid. Maybe it's not as good as being a partner in your own practice... but there must also be less administrative stress as well, right?

    Edit: Oh, you mean that corporate and pod labs are bad practices, so they have worse cases? Why would that be? Corporate labs get a lot of tissue from around the country, right? Must be some cool stuff in there.
     
    #10 Enkidu, Aug 1, 2011
    Last edited: Aug 1, 2011
  12. 2121115

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    A corporate lab will have you signing out the same things all the time. I know pathologists who work for LabCorps and only sign out pap smears. Every day, all day. Same with exfoliative cytology. Maybe there are a few interesting ones, but it sounds really boring. Every diagnosis comes off a speedphrase list.
     
  13. mlw03

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    I enter this discussion cautiously, and as a forensic pathologist won't be dealing with these issues.

    I hear conflicting complaints. One, folks complain there aren't any jobs available. Then two, they complain about the nature of some of the jobs available (ie, the pod labs). I don't think you can have it both ways. The business model of pathology is changing, and it seems tougher and tougher for medium sized private groups to continue to exist. Is there not an element of buyer beware? That is, shouldn't people know about the job market in their field before choosing a residency? IF pathologists as a group decided the overall conditions were so bad as to not work in these labs, then they'd cease to exist. But the lack of other better jobs forces people to take pod lab jobs, right? And the cycle perpetuates. We're all adults, and that means making tough choices. Perfect job in ideal location just isn't available to most young pathologists, and if someone doesn't like that, they're certainly entitled to try and go back for another residency.

    That said, looking at pap smears all day long wound make me put an icepick through my eye - that's why I'm an FP.
     
  14. Thrombus

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    Yes you can have it both ways.

    Pod Lab jobs put you in a job where you somewhat efficiently signout cases in your area. You will see a rare interesting case but you will pull down your diagnosis from a tab and populate your report with text. GI biopsies all day, all week, all year. GU biopsies all day all week all year. Paps all day all week, all year.....you pick your specialty. And you do it for pennies on the dollar....but you are efficient because you sign these 20 diagnoses from your pull down tab in your sleep. BORING!!!! Congratulations you are bored, a commodity, a robot, and probably hate your job. You have no leverege and you have lost your eye for any other organ so you are stuck in your dead end job. The job market sucks anyway so you should probably just stick it out for 35 years.

    The above is the end result of :diebanana: CAP, USCAP, ASCP, GME, ABP and all the stooges in academia that will also soon see their funding dry up and jobs get cut as the country goes bankrupt. :laugh::laugh:
     
  15. Thrombus

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    A few private groups do still exist and may have a decent lifespan left.

    That being said, hospital jobs are probably a good second option as you can still see quite a bit of variety/interesting cases and deal closely with and get to know clinicians on a personal basis. Will be less stressful than private practice but you will see a significant cut out of your paycheck at least under the current system of reimbursement.

    The bottom line is we have too many pathologists and as a result we all lose whether it be losing business to pod labs/corporate labs, or losing leverage with our employers/hospitals. We are bottom of the food chain and I would advise someone to enter medicine at the top of the food chain if they are able.
     
  16. yaah

    yaah Boring
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    So, in other words, be an administrator and not a physician at all.
     
  17. Enkidu

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    What is at the top of the food chain? I guess I don't even know. Is it the ROAD specialties. With the exception of radiology, they all seem pretty uninspiring. I guess that I've always just thought about going into fields that are interesting.
     
  18. path24

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    Pathologists became employees of corporate labs....now pathologists becoming employees of physicians offices....prediction....pathologists become employees of hospitals after hospitals buy up all the different private practice groups (OB, GI...). Essentially corporate hospital systems with central location of specimens at the anchor hospital. All while a decrease in private practice pathology groups.

    How are we not on the bottom? Are we trying to beoome employees of physicians after wanting to be employees of corporate labs? To eventually head back into the basement. Who is not controling the future of pathology and hasn't been for awhile....pathologists. If this is us being in control of our profession....we suck!

    Pathologists are a dime and a dozen....physicians have figured it out and thats why you have in office labs. Physicians are trying to maintain there pay with lower reimbursements and have found that they can exploit their local pathologist. (I have yet to hear of a group of pathologists to say no and turning down the work) They get the technical component and part of the pathologist professional...no problem. This will just continue to grow and grow.

    If we were at the "top" we would be so busy we would have to turn down specimens. I predict I will never hear about group that has to turn down specimens or even say it will take us at least a week before we can process them because we are too busy. Will NEVER happen with the oversupply and us being on the bottom. Its ok for the patients to wait for appointments, but a specimen....never will happen. Specimens are apparently more important....or just state the obvious...pathologist oversupply.
     
  19. pathstudent

    pathstudent Sound Kapital
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    I think the top of the food chain would be specialties that generate big money for hospitals and that would include ortho, spine, ent, transplant surgeons, neurosurg, gyn-onc, interventional rads, interventional cardiology, urology. In other words the surgical subspecialties and interventional medical subspecialties. These are the groups that used to get big time payola from hospitals, pharmaceutical companies and hardware companies. They still do, but not like the old days due to regulations.
     
  20. 2121115

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    Bingo. Newsflash for pathology residents: You may be excited to have learned how to sign out CIN-2 or whatever and pass your boards and you may think you've accomplished something. But there are 1,000 you's out there who can do the same thing. Get ready for a race to the bottom.
     
  21. TSasser

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    This could probably be said for any specialty if you talk to them. :confused:
     
  22. lipomas

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    Why does no one on this forum seem to grasp the fact that every type of physician is becoming an employee more frequently? I am not sure I know of many true private practice cardiologists anymore. Orthopedic surgeons are being hired as employees. Radiologists too. What world do you live in?

    This is medicine. This is the future. Consolidation and increasing administration. Fascinating that a lot of people who bemoan this are the same whining about labor unions. Really? It's a free market! This is what you all hath wrought. You want more market freedom and less government intervention, you're getting it. There is less room for small private groups in a true free market, because they can't compete on price, quality, and turnaround time all at once.

    Goddamn, people on here are so two faced. We need more realists and fewer tea partiers on here.

    To get to the original question - are corporate lab jobs so bad? It depends! Big shock. You can make upwards of $300k for a job where you don't take call and probably work 50 hours a week. And it might be a very focused job where you don't deal with CP or stuff you don't like. It's not that bad, depending on what you want out of a career. Now, I know that job doesn't appeal to everyone but for the love of god you all need to admit that it just might appeal to some people. And that is not "PROOF THAT THE JOB MARKET SUCKS." It is proof that there are people with different career desires first and foremost, job market suckitude plays in there at some point but it is not the most important.
     
  23. lipomas

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    Oh shush. That comment makes too much sense, and is therefore evidence of your bias, ignorance, or inexperience. And it must be excluded in favor of something more loud and forceful. JOB MARKET SUCKS KTHNXBAI.


    By the way, I make this comment not to minimize the job market situation. It isn't great. There are too many subpar programs out there churning out residents. I make this comment to make light of the weak cadre of posters on here who do nothing except make broad sweeping complaint statements.
     
    #22 lipomas, Aug 10, 2011
    Last edited: Aug 10, 2011
  24. TSasser

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    :thumbup:
     
  25. member0007

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    I think that we need to stop being our own worst enemies. The field of pathology is extremely important and shouldn't be diluted by conflicts of interests on the part of individual pathologists, pod labs, administrators, other physicians etc etc. I am all for taking out the TC/PC deal where the clinicians can hire a pathologist to sign out their stuff... There is so much conflict of interest here other than the obvious quid pro quo issue relating to payment. The diagnosis, over treatment or unnecessary medical intervention for the wrong reason, i.e. biopsy everything and nothing, etc will add to cost of healthcare and increase the overall cost. I think pathologists should have more autonomy, we should bill according to the work that is done and get paid accordingly, we should avoid getting into contracts with physicians office to make a quick buck and essentially stick together to ensure that the profession is not abused by people trying to make money fast, and if there are instances of abuse it should be reported to medicare or appropriate officials....who oversees these matter? I don't think that there are too many pathologists, it's just the idea that we need to work 60 hrs a week and sign out a million cases a day that's really screwed up.
     
  26. 2121115

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    No offense dude, but it is obvious you have not been out in the "real world" of pathology yet.
     
  27. member0007

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    [delete
     
    #26 member0007, Oct 12, 2011
    Last edited: Oct 12, 2011
  28. 2121115

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    Too real, my man. All too real.
     
  29. member0007

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    you are not making a point, other than to mock my position. here is the deal, make a statement or point and argue for it or refute my point. if you do not not want to engage in a discussion, it may be better if you did not respond with a personal attack.
     
  30. 2121115

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    I am so real people call me the 50 cent of pathology because I got the path game in a choke hold. I got my money on my mind, got a scope at my desk and a gleam in my eye. I'll tell you what banks tell me go ahead and switch the style up and if gastroenterologists hate then let 'em hate and watch the money pile up. I'm diagnosin'... they hatin'... they tryin' to catch me diagnosin' dirty.
     
  31. mlw03

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    ha.. nice.

    member - you post is full of "should"s, but how do you propose making those things happen? i don't have the answer either, nor will i (i'm a FP, so i do not deal with the issues most diagnostic pathologists have to deal with). but i care because i am a pathologist first and i hope to see our field strong for the duration of my career. from what i've heard from friends in the diagnostic path world, the situation is not good. not good for pathologists, not good for patient care.
     

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