Dare I ask about $?

[bellgirl]

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Any knowledge of PP starting salaries in Texas? Perhaps any difference with surgpath & heme & all three board certification?

I don't know a soul in TX but considering taking mine there...

Thx

 

[KCShaw]

That's a fairly specific location. Still, with all things salary, it really varies -- particularly in the private practice setting. Assuming we're talking about a newbie/first job, in some practices you might have a hard time getting $120k while others might start you closer to $300k, but as I hear it seems like a lot of private start somewhere in the 200's. Not that I know a lot, I just listen a little, and have no particular knowledge of the Texas market.

 

[bellgirl]

Thanks...Yes, it's expressly because of the specificity that I'd like to get a handle on the variability.

 

[turtle1966]

Thanks...Yes, it's expressly because of the specificity that I'd like to get a handle on the variability.

Think about income over the long haul rather than in the first year. Is this a partnership position? Is the area growing economically?

Income in the South (especially in rural South) tends to higher than in the NE because it is a growing, less regulated and less structured part of the country. The difference can be Very High to Huge; this is to say the "beta" is high. It is a fact that NEaster have difficulty in believing because they are "provincial" in their own way.

I have heard from 50k to over 300k for the first year.

 

[cmz]

Any knowledge of PP starting salaries in Texas? Perhaps any difference with surgpath & heme & all three board certification?

I don't know a soul in TX but considering taking mine there...

Thx

I am starting a job in South TX (where I am from originally) this summer. When I was looking around for work, I had a hard time scoping out the types of practices in that local. I will say that starting salary is around 200K-360K per year. Couple that with the lowest cost of living in the country...

 

[cjw0918]

It really depends on the group. Some groups work like dogs and have high salaries. Others want a better lifestyle, like to spread the work around, but make less.
Find a group with a similar personality as yours. Don't worry about the money right now. A GOOD fit is the most important thing or the job will never last anyway.

 

[BU Pathology]

It may be worthwhile to hire an attorney to review the contract. Try to find a local attorney who works with local physicians, even if they are not pathologists. A knowledgeable attorney can be very helpful in determining many aspects of your contract, not just compensation.

You should not view this as hiring an attorney who will be a pitbull for you during discussions, rather a wise resource who can say that is not typical practice in our area.

Good luck, and presumably congratulations on securing a job.

 

[trichrome]

It really depends on the group. Some groups work like dogs and have high salaries. Others want a better lifestyle, like to spread the work around, but make less.
Find a group with a similar personality as yours. Don't worry about the money right now. A GOOD fit is the most important thing or the job will never last anyway.

I agree with the above opinion. Find a group that is collegial and supportive with good opportunities for growth. Make sure you fit into the culture of the group. Starting salaries in the 150-200K range is common, and Texas has no state income tax, along with one of the lowest cost of living in the nation. I've spent my entire career practicing here in TX and absolutely love it here. Make sure you join the TSP (Texas Society of Pathologists) as well. Best of luck~!

 

[LADoc00]

I am starting a job in South TX (where I am from originally) this summer. When I was looking around for work, I had a hard time scoping out the types of practices in that local. I will say that starting salary is around 200K-360K per year. Couple that with the lowest cost of living in the country...

360K starting is insane. I dont buy that.

FYI I spent about 2 hours on the phone with a variety of professional staffing companies just last week. Why they all call me to ask advice is a mystery to me AND Ive never used them, but I guess I do spin a good yarn about the current market.

The AVERAGE daily rate they were paying experienced pathologists for locums coverage was 650/day. 650 per day translates into less than 150K per year assuming a reasonable vacation alotment.

And that is across the nation. Realize that 650 per diem is unbenefited aside from malpractice coverage. UNBENEFITED.

So the fact that someone is proposing some unnamed group is paying applicants 2.5x that national rate and I assume full benefits "right out of the gates" is ludacris. I realize there maybe pockets of geographical isolation that defy national trends, but I spent 2hrs arguing the very minimum should be 1K per diem, which still is nowhere near your mythical 360 starting gig. That would be a north of 1600-1700+ per diem when you factor in benefits.

Frankly there is no one in Pathology even worth 360K unless they brought in absolute ton of new consults or biz or something. Is your name Juan Rosai? No, then you are not worth 360K...

Lets not dive this deep into a rabbithole. You would have to have the looks of Megan Fox, the personality of Vince Vaughn and business mind of Warren Buffet to pry 360 from me Im afraid...

 

[Silent Cool]

360K starting is insane. I dont buy that.

FYI I spent about 2 hours on the phone with a variety of professional staffing companies just last week. Why they all call me to ask advice is a mystery to me AND Ive never used them, but I guess I do spin a good yarn about the current market.

The AVERAGE daily rate they were paying experienced pathologists for locums coverage was 650/day. 650 per day translates into less than 150K per year assuming a reasonable vacation alotment.

And that is across the nation. Realize that 650 per diem is unbenefited aside from malpractice coverage. UNBENEFITED.

So the fact that someone is proposing some unnamed group is paying applicants 2.5x that national rate and I assume full benefits "right out of the gates" is ludacris. I realize there maybe pockets of geographical isolation that defy national trends, but I spent 2hrs arguing the very minimum should be 1K per diem, which still is nowhere near your mythical 360 starting gig. That would be a north of 1600-1700+ per diem when you factor in benefits.

Frankly there is no one in Pathology even worth 360K unless they brought in absolute ton of new consults or biz or something. Is your name Juan Rosai? No, then you are not worth 360K...

Lets not dive this deep into a rabbithole. You would have to have the looks of Megan Fox, the personality of Vince Vaughn and business mind of Warren Buffet to pry 360 from me Im afraid...

650 per day? That's nuts. I know new dental school grads making that much. New orthodontists make 1000 per day at chains. The oversupply issue is a real problem.

 

[BamaAlum]

360K starting is insane. I dont buy that.

FYI I spent about 2 hours on the phone with a variety of professional staffing companies just last week. Why they all call me to ask advice is a mystery to me AND Ive never used them, but I guess I do spin a good yarn about the current market.

The AVERAGE daily rate they were paying experienced pathologists for locums coverage was 650/day. 650 per day translates into less than 150K per year assuming a reasonable vacation alotment.

And that is across the nation. Realize that 650 per diem is unbenefited aside from malpractice coverage. UNBENEFITED.

So the fact that someone is proposing some unnamed group is paying applicants 2.5x that national rate and I assume full benefits "right out of the gates" is ludacris. I realize there maybe pockets of geographical isolation that defy national trends, but I spent 2hrs arguing the very minimum should be 1K per diem, which still is nowhere near your mythical 360 starting gig. That would be a north of 1600-1700+ per diem when you factor in benefits.

Frankly there is no one in Pathology even worth 360K unless they brought in absolute ton of new consults or biz or something. Is your name Juan Rosai? No, then you are not worth 360K...

Lets not dive this deep into a rabbithole. You would have to have the looks of Megan Fox, the personality of Vince Vaughn and business mind of Warren Buffet to pry 360 from me Im afraid...

I agree. 360K is pretty crazy for a starting salary. I would say in most locales 180-220K is more typical. Where I practice $1,000 per day is the standard rate for locums coverage.

 

[cmz]

360K starting is insane. I dont buy that.

Frankly there is no one in Pathology even worth 360K unless they brought in absolute ton of new consults or biz or something. Is your name Juan Rosai? No, then you are not worth 360K...

I can only quote what I have been told. I agree that it is an absurd number. I signed for a figure nowhere near 360K in the same area.

Lets not dive this deep into a rabbithole. You would have to have the looks of Megan Fox, the personality of Vince Vaughn and business mind of Warren Buffet to pry 360 from me Im afraid...

If I had all of the above, I can tell you that I wouldn't be doing pathology... that number would be sand off a beach...

 

[LADoc00]

650 per day? That's nuts. I know new dental school grads making that much. New orthodontists make 1000 per day at chains. The oversupply issue is a real problem.

That is what I said as I have family members who are in the dental field....

Comp Health actually tried to sell me on helping them find people for 600/day. I laughed. ROCKBOTTOM is 1K a day in my opinion. The lowest I have ever paid is 800 but I think now it really is around 1K a day.

When I heard they were actually nabbing people for 600/day I was floored. I knew it was bad, but not THAT bad.

Of course these services are probably selling these poor souls out for 1K/day making a tidy 40% profit for doing essentially nothing.

 

[Thrombus]

That is what I said as I have family members who are in the dental field....

Comp Health actually tried to sell me on helping them find people for 600/day. I laughed. ROCKBOTTOM is 1K a day in my opinion. The lowest I have ever paid is 800 but I think now it really is around 1K a day.

When I heard they were actually nabbing people for 600/day I was floored. I knew it was bad, but not THAT bad.

Of course these services are probably selling these poor souls out for 1K/day making a tidy 40% profit for doing essentially nothing.

The pathology brokerage business is booming. We know of individuals who are brokering specimens. Groups are getting paid 90% of medicare rate losing business to groups who will take 80% and pay the broker 4%. Group gets business back to get 75% of Medicare and pay broker 6%. And so on and so forth. Broker likely gets cut from both group and client (lab/clinician group) he deals with.

If this isn't evidence of a ridiculous oversupply, I don't know what is.😱😱😱

 

[Silent Cool]

That is what I said as I have family members who are in the dental field....

Comp Health actually tried to sell me on helping them find people for 600/day. I laughed. ROCKBOTTOM is 1K a day in my opinion. The lowest I have ever paid is 800 but I think now it really is around 1K a day.

When I heard they were actually nabbing people for 600/day I was floored. I knew it was bad, but not THAT bad.

Of course these services are probably selling these poor souls out for 1K/day making a tidy 40% profit for doing essentially nothing.

That sucks.

It sounds like pathologists are the new pharmacists. How much lower can incomes go?
Think of this: if someone went to UOP dent (3 years), they would make as much or more $$ than a pathologists who trained for a minimum of 3 TIMES as long! Factor in interest on loans over that extra 6 years (minimum) and....my god. Who in their right mind would train in Path these days?

 

[turtle1966]

That sucks.

It sounds like pathologists are the new pharmacists. How much lower can incomes go?
Think of this: if someone went to UOP dent (3 years), they would make as much or more $$ than a pathologists who trained for a minimum of 3 TIMES as long! Factor in interest on loans over that extra 6 years (minimum) and....my god. Who in their right mind would train in Path these days?

Who in their right mind would train in Path these days?

Those absolutely without options and those ensnared my the siren songs of the likes of Boston BU to whom Pathology has a wonderful, bright future and jobs aplenty.

Yesterday, CAP had a webinar about IVM (in vivo microscopy) where microscopic diagnosis is rendered in vivo, during endoscopy or intraoperatively. The summary was
1-potentially, in the near future, IVM could replace frozens and biopsies.
2-if pathologists did not actively participate in IVM, pathologist would lose this burgeoning area to GI, derms, etc.

After listening to Webinar, I had the following thoughts:
1-I do not know how widely and how soon IVM will be adopted, however, can see derms and GI's , viewing IVM as another revenue source, thereby, reading cases themselves or cherry picking them (reading easy ones and giving pathologists difficult ones) or hiring a pathologist to read them.

2-IVM could be read as a telemedicine (telepathology and teleradiology)! It would be a perfect medium for an over-supplied field such as pathology

3-I see telepathology, as another medium that could be used to drive down further pathologist's revenue as well.

4-Pathology as a field is like a drowning fellow, i.e., it is helpless and hopeless! It is oversupplied with pathologists, blind to the reality, deaf to cries of their trainees and surrounded by those eager to take advantage of its plight!

5-How is it logical to training for 10 years (4+4+2) post college only to be forced to move to another city, another state and another country for a job that may even not be a secure or rewarding ???!! Wake up !! Wake up!!!

 

[jp123ok]

360K starting is insane. I dont buy that.

The AVERAGE daily rate they were paying experienced pathologists for locums coverage was 650/day. 650 per day translates into less than 150K per year assuming a reasonable vacation alotment.

$360k starting doesn't sound that strange to me. I just received a job offer starting at $300k which will bump up to $500k after a year (first job out of fellowship, single fellowship). So what if some pathologists are willing to work per diem for a salary equivalent to $150k /year or less. There are lots of academics who are willing to work for this sort of salary too. It is not news that there are plenty of mediocre residency programs churning out graduates who may have trouble finding decent jobs. The only take home message from this for me is that you need to be selective about where you go for residency/fellowship training in pathology and you need to network to get a good job that pays well.

 

[rollwithit]

Who in their right mind would train in Path these days?

Those absolutely without options and those ensnared my the siren songs of the likes of Boston BU to whom Pathology is a wonderful, bright future and jobs aplenty.

Yesterday, CAP had a webinar about IVM (in vivo microscopy) where microscopic diagnosis is rendered in vivo, during endoscopy or intraoperatively. The summary was
1-potentially, in the near future, IVM could replace frozens and biopsies.
2-if pathologists did not actively participate in IVM, pathologist would lose this burgeoning area to GI, derms, etc.

After listening to Webinar, I had the following thoughts:
1-I do not know how widely and how soon IVM will be adopted, however, can see derms and GI's , viewing IVM as another revenue source, thereby, reading cases themselves or cherry pick them (reading easy ones and giving pathologists difficult one) or hiring a pathologist to read them.

2-IVM could be read as a telemedicine (telepathology and teleradiology)! It would be a perfect medium for an over-supplied field such as pathology

3-I see telepathology, as another medium that could be used to drive further the pathologist's revenue as well.

4-Pathology as a field is like a drowning fellow, i.e., it is helpless and hopeless! It is oversupplied with pathologists, blind to the reality, deaf to cries of their trainees and surrounded by those eager to take advantage of its plight!

5-How is it logical to training for 10 years (4+4+2) post college only to be forced to move to another city, another state and another country for a job that may even not be a secure or rewarding ???!! Wake up !! Wake up!!!

Those who do not embrace change get left behind.

 

[WEBB PINKERTON]

Who in their right mind would train in Path these days?

Those absolutely without options and those ensnared my the siren songs of the likes of Boston BU to whom Pathology is a wonderful, bright future and jobs aplenty.

Yesterday, CAP had a webinar about IVM (in vivo microscopy) where microscopic diagnosis is rendered in vivo, during endoscopy or intraoperatively. The summary was
1-potentially, in the near future, IVM could replace frozens and biopsies.
2-if pathologists did not actively participate in IVM, pathologist would lose this burgeoning area to GI, derms, etc.

After listening to Webinar, I had the following thoughts:
1-I do not know how widely and how soon IVM will be adopted, however, can see derms and GI's , viewing IVM as another revenue source, thereby, reading cases themselves or cherry pick them (reading easy ones and giving pathologists difficult one) or hiring a pathologist to read them.

2-IVM could be read as a telemedicine (telepathology and teleradiology)! It would be a perfect medium for an over-supplied field such as pathology

3-I see telepathology, as another medium that could be used to drive further the pathologist's revenue as well.

4-Pathology as a field is like a drowning fellow, i.e., it is helpless and hopeless! It is oversupplied with pathologists, blind to the reality, deaf to cries of their trainees and surrounded by those eager to take advantage of its plight!

5-How is it logical to training for 10 years (4+4+2) post college only to be forced to move to another city, another state and another country for a job that may even not be a secure or rewarding ???!! Wake up !! Wake up!!!

Disruptive technology is hardly ever talked about but it is a huge threat. I could easily see the number of specimens sent to path dropping dramatically. Some speciality labs would be needed for difficult cases.

Our pulmonologists love the new gadgets and joke that they still need us at this point when showing off Cell-Visio to visiting pulmonologists. It sure is a good feeling when they joke about our jobs disappearing. 🙄

I think some people in the lab industry love client billing and profit sharing with specialists because it keeps technology at bay. Why take on risk and invest in new technology when you can just exploit pathologists? Maybe we better quit fighting in-office labs and client billing. Keep the status quo! At least we are involved in the process, exploited but involved.

 

[michaelrack]

$360k starting doesn't sound that strange to me. I just received a job offer starting at $300k which will bump up to $500k after a year (first job out of fellowship, single fellowship). So what if some pathologists are willing to work per diem for a salary equivalent to $150k /year or less.

Agree that there is little correllation between locums payment in a field and a full-time salary (at least that has been my experience in psychiatry)

 

[Silent Cool]

That is what I said as I have family members who are in the dental field....

Comp Health actually tried to sell me on helping them find people for 600/day. I laughed. ROCKBOTTOM is 1K a day in my opinion. The lowest I have ever paid is 800 but I think now it really is around 1K a day.

When I heard they were actually nabbing people for 600/day I was floored. I knew it was bad, but not THAT bad.

Of course these services are probably selling these poor souls out for 1K/day making a tidy 40% profit for doing essentially nothing.

LAdoc,

Given the insane cost of dental school these days and the cost of buying a dental practice, do you still think dentistry is a better gig than medicine overall?

 

[LADoc00]

LAdoc,

Given the insane cost of dental school these days and the cost of buying a dental practice, do you still think dentistry is a better gig than medicine overall?

Yes. Somewhere between 110 and 150% sure on that one..

In terms of tracking locums pay vs. full time pay, I agree sometimes they dont track but one trend is clear: Locums pay is almost always on average HIGHER than annualized than FT pay. There is literally no field in healthcare where the opposite trend is clear. NONE.
For example, a CLS in my area average pay is roughly $40/hr. Locums coverage for a CLS is priced out at $75-80/hr
Nursing is the same thing.
Different for physicians you say?
Moving on higher level medical fields. Hospital based neurosurgical pay is around $400-450,000 but annualized locums coverage is priced out at over $625,000 (over $2,500 per diem) .

The inverse Locums: FT pay relationship within Pathology is an incredibly negative trend I dont think Ive seen anyone mention outloud yet. But it will absolutely affect new hire pay levels in negative and real way soon. If I can get locums coverage for 1/2 the price tag of a new hire, why the hell would hire YOU?

Locums are superior in almost all ways:
1.) I can dump a locums very quickly if the personalities are a bad fit or it just doesnt work for some reason, there is literally no risk
2.) Im not paying for ANY benefits, meaning no significant re-jigging of 401Ks to create safe harbors etc
3.) Locums have often significant experience meaning they leap into jobs and dont require 3 months of hand holding

and the best part: If I feel like working extra hard for X period of time and making some extra scratch for some stretch goal (say a down on a house in Maui), I just dont bring the Locums in at all!

This is catastrophe for trainees IMO. The math just isnt there anymore.


In business terms what Pathology staffing is experiencing is a "Death's Cross" variant from investing. The irony of course is none of this will translate into lower prices for payors/insurers. There is no way for them to access this oversupply to re-settle prices in their favor. The way medicine is organized, those lucky few with contracts essentially can monopolize the product. With growing vertical and horizontal practice integration it is an even more invincible fortress.

Lets say in an area Aetna drops global (and thus TC as well as PC) Pathology reimbursement rates. In this area, there is not only a Pathology group at the local hospital, there is a podlab spead to local GI, GU and Derm offices. The local Path group drops Aetna and the local subspec practices not to be outdone and lose revenue also drop Aetna. Aetna, now at risk of losing vastly more than they bargained for, relents to prior rates OR just leaves the market (or even worse stays in causing their customers to get soaked for massive out of network charges for 4 different medical fields, not just 1).

Vertical/Horizontal practice integration, ACOs etc will make those lucky few with contracts an Iron Fortress.

 

[vistaril]

Lets not dive this deep into a rabbithole. You would have to have the looks of Megan Fox, the personality of Vince Vaughn and business mind of Warren Buffet to pry 360 from me Im afraid...

vince vaughn has a likable personality?

 

[jp123ok]

Locums are superior in almost all ways:
1.) I can dump a locums very quickly if the personalities are a bad fit or it just doesnt work for some reason, there is literally no risk
2.) Im not paying for ANY benefits, meaning no significant re-jigging of 401Ks to create safe harbors etc
3.) Locums have often significant experience meaning they leap into jobs and dont require 3 months of hand holding.

Your arguments are classic republican/ free market BS. The reason why they are BS is because they don't take into account the most important consideration for clinicians and pathology groups which is quality. Reputation is paramount for pathologists and clinicians. Yes, you can cut corners here and there but ultimately you get what you pay for. If price is the only consideration then quality suffers. How many misdiagnoses do you think it'll take for practices to lose clients and go out of business?

 

[WEBB PINKERTON]

vince vaughn has a likable personality?

His character in the movie INTO THE WILD does. That would be an easy person to get along with.

 

[pongo]

$360k starting doesn't sound that strange to me. I just received a job offer starting at $300k which will bump up to $500k after a year (first job out of fellowship, single fellowship). So what if some pathologists are willing to work per diem for a salary equivalent to $150k /year or less. There are lots of academics who are willing to work for this sort of salary too. It is not news that there are plenty of mediocre residency programs churning out graduates who may have trouble finding decent jobs. The only take home message from this for me is that you need to be selective about where you go for residency/fellowship training in pathology and you need to network to get a good job that pays well.

Ditto to this post. One of the benefits of avoiding places like California.

 

[vistaril]

$360k starting doesn't sound that strange to me. I just received a job offer starting at $300k which will bump up to $500k after a year (first job out of fellowship, single fellowship). So what if some pathologists are willing to work per diem for a salary equivalent to $150k /year or less. There are lots of academics who are willing to work for this sort of salary too. It is not news that there are plenty of mediocre residency programs churning out graduates who may have trouble finding decent jobs. The only take home message from this for me is that you need to be selective about where you go for residency/fellowship training in pathology and you need to network to get a good job that pays well.

Im pretty sure the pathologist who contracts out with my fiance's(large GI practice) group and several other GI groups in town makes > 500k. He doesn't actually work at the in office labs himself but rather hires pathologists to move glass for him. So the pathologists who are actually signing out the cases have(it's very high volume) have already had 2 people(the GI group and the pathologist who employs them) already taking a handsome cut of the revenue before they even pull up their chair to the scope.

 

[LADoc00]

Your arguments are classic republican/ free market BS. The reason why they are BS is because they don't take into account the most important consideration for clinicians and pathology groups which is quality. Reputation is paramount for pathologists and clinicians. Yes, you can cut corners here and there but ultimately you get what you pay for. If price is the only consideration then quality suffers. How many misdiagnoses do you think it'll take for practices to lose clients and go out of business?

That is a false narrative. "Quality". It invades every part of healthcare today.

I would ask this: when you spend 95K on a 911 Porsche you know what you are getting, a 95K sports car. Every Porsche that rolls off the assembly line in Germany is roughly equivalent. Yeah there are minor issues here and there, but they warranty Porsches. JHU or BWH or Baylor etc doesnt warranty trainees, right?

Are you telling me that QUALITY is somehow commoditized in our field? That every JHU grad coming out of a GU fellow is worth x dollars?

You are living in the fictitious academic narrative that your pedigree can somehow overcome the basic economic principles of modern medicine. Even more dangerous, simply going to Harvard undergrad or Stanford Medical School (or Heaven's forbid, places of lesser stature!) insulates you from mistakes even though you have ZERO real world experience.

No. You do not get what you pay for sir, this isnt Costco. When a group plops down 300K for a green trainee you have no real clue what that trainee is bringing to the table.

I would take a carpet bagger who is a grizzled veteran of 100 Locum assignments any day of the week over that.

Plus with new hires you can never really read their intentions, many get there dont like the geography, the schools for their kids, their wife has no friends etc.

You're gonna burn real money on seeing if that really works? Cause Im not...

The IRONY of all this is you are wrong on the very foundation of your argument: that high dollar numbers bring in better applicants. This isnt true for Pathology (medicine in general? dunno) anymore. New MD's want lifestyle. They want to call in sick whenever they want. They want flexibility.

I dont need to pay $ when I offer that, I will have hundred of highly capable applicants beating down my door for 2 days off a week to watch their kids.

 

[deleted314957]

Your arguments are classic republican/ free market BS. The reason why they are BS is because they don't take into account the most important consideration for clinicians and pathology groups which is quality. Reputation is paramount for pathologists and clinicians. Yes, you can cut corners here and there but ultimately you get what you pay for. If price is the only consideration then quality suffers. How many misdiagnoses do you think it'll take for practices to lose clients and go out of business?

In my 35 years experience i have seen clinicians pay a lot of lip service to "quality" as re: pathology. However, universally, such concern goes right down the shi**er when there is ANY money to be made.

 

[LADoc00]

In my 35 years experience i have seen clinicians pay a lot of lip service to "quality" as re: pathology. However, universally, such concern goes right down the shi**er when there is ANY money to be made.

Haha aint that the truth!!

Quality is an often used convenient excuse for clinicians..

Like the urologists who say, "well I NEED to podlab because the local quality wasnt there.."

translation: I wanted a few extra bucks so I threw together this podlab in back closet...

 

[emergentmd]

Wow, reading these threads makes me wonder why anyone would go into pathology. Working for 600/dy, can't find job after residency/fellowships, having to go get another fellowship b/c you can't find a job, being happy getting a job making 180k/yr, not being trained well enough to work after residency.

how ridiculous.

I don't know about other fields but EM looks like paradise compared to Path. you guys really need to do something about this and do it now.

I know EM docs would never settle for 600/day. My partners are getting moonlighting shifts and offered base $3600/12hr shift. On desperate days, they are getting $400/hr.
No ED Doc needs a fellowship to work in any ED and our training is 3 years. Getting a job is quite easy. I still get emails and calls weekly asking me if there are docs available.

What is wrong w/ you guys. Why are pathologist settling for this type of work environment.

 

[LADoc00]

Im pretty sure the pathologist who contracts out with my fiance's(large GI practice) group and several other GI groups in town makes > 500k. He doesn't actually work at the in office labs himself but rather hires pathologists to move glass for him. So the pathologists who are actually signing out the cases have(it's very high volume) have already had 2 people(the GI group and the pathologist who employs them) already taking a handsome cut of the revenue before they even pull up their chair to the scope.

Werent you the guy trying to get your wife to lowball the in office pathologist to take like 2 bucks an 88305 or something? Posted on here "How can I convince my wife to lowball her contractor to squeeze even more pofit out for ME?"...dude that was an insta-classic and proves my point.

Its like the battle of leeches or something. I love it.

Howd that work out btw?

Vistaril that was you! I looked it up:

My fiance is a GI fellow graduating in 5 months, and she is debating between a few different offers from large GI groups.

The group that she thinks is the best 'fit' for her has a current compensation package in years 1-2 that is 5-10% less than the other two groups, but the group states that this difference will be made up by the time she starts. Apparently they are very high volume in terms of biopsies(huge outpt scoping center) and have an onsite path lab. My fiance and I already know about the cut in TC reimbursements, and this is factored in with their estimated offer.

The issue is that this group states that they will be able to make up some of the portion of difference in starting salaries by renogotiating with the pathology group when their contract runs out in a few months. Right now they are paying the pathologists $19 per. Not per pt/case, but for each billing code. They state they expect the new negotiated rate to be be between 9 and 12 dollars, and that this savings in cost will make up the differences in offers(since they do so much volume)....

Howd that work out?? Did they lowball the pathologist into 9 bucks a case?

And how does it feel going to med school but entering psychiatry and therefore be dependent on the girlfriend GI for cash?

 

[LADoc00]

Wow, reading these threads makes me wonder why anyone would go into pathology. Working for 600/dy, can't find job after residency/fellowships, having to go get another fellowship b/c you can't find a job, being happy getting a job making 180k/yr, not being trained well enough to work after residency.

how ridiculous.

I don't know about other fields but EM looks like paradise compared to Path. you guys really need to do something about this and do it now.

I know EM docs would never settle for 600/day. My partners are getting moonlighting shifts and offered base $3600/12hr shift. On desperate days, they are getting $400/hr.
No ED Doc needs a fellowship to work in any ED and our training is 3 years. Getting a job is quite easy. I still get emails and calls weekly asking me if there are docs available.

What is wrong w/ you guys. Why are pathologist settling for this type of work environment.

Nice. Couldnt get to the ED's restroom in time so you swung over and dumped here. Nice.

Keep it classy San Diego.

 

[emergentmd]

Nice. Couldnt get to the ED's restroom in time so you swung over and dumped here. Nice.

Keep it classy San Diego.

Not Dumping at all. I thought about this field in my 2nd year lab. But seriously. $600 a day is less than what our PAs make

 

[jp123ok]

Are you telling me that QUALITY is somehow commoditized in our field? That every JHU grad coming out of a GU fellow is worth x dollars?

No, clearly people are not machines. However, if you take 20 graduates from Hopkins and 20 from a mediocre training program of your choice you can be supremely confident that by any measure you care to choose - IQ, USMLE scores, RISE scores or whatever, the Hopkins graduates will, on average, score way higher than the graduates of the no-name brand program. Would you rather hire someone smart or someone dumb? You seem to be saying that it doesn't matter to you and you'd take experience over intelligence.

You are living in the fictitious academic narrative that your pedigree can somehow overcome the basic economic principles of modern medicine.

Every pathoogist is subject to market forces. However, if you go to a top program you will always be able to command a better salary than if you didn't.

Even more dangerous, simply going to Harvard undergrad or Stanford Medical School (or Heaven's forbid, places of lesser stature!) insulates you from mistakes even though you have ZERO real world experience.

No, clearly everyone is fallible and I am definitely no exception which is why I am joining a group with lots of dermpaths to show challenging cases to. Having said that, I know that my training with two of the preeminent dermatopathologists in the country will be a strong foundation as I start my career and it has certainly helped me secure a great job even though I have not even started my fellowship yet.

When a group plops down 300K for a green trainee you have no real clue what that trainee is bringing to the table.

It depends on whether the trainee has done electives with your group or not. If so then the group should have a very good idea of what they are getting.

 

[MOHS_01]

Your arguments are classic republican/ free market BS. The reason why they are BS is because they don't take into account the most important consideration for clinicians and pathology groups which is quality. Reputation is paramount for pathologists and clinicians. Yes, you can cut corners here and there but ultimately you get what you pay for. If price is the only consideration then quality suffers. How many misdiagnoses do you think it'll take for practices to lose clients and go out of business?

You're kidding yourself. 🙁

 

[jp123ok]

You're kidding yourself. 🙁

What is up with this forum. So much negativity. Anyway, I have my $300k job for next year and this will rise to $500k the year after that. Don't you worry about me buddy.

 

[Tissue issue]

What is up with this forum. So much negativity. Anyway, I have my $300k job for next year and this will rise to $500k the year after that. Don't you worry about me buddy.

Out of curiosity, how many derm cases do you have to sign out in your new job? Does your group get PC and TC or just PC?

 

[Silent Cool]

Not Dumping at all. I thought about this field in my 2nd year lab. But seriously. $600 a day is less than what our PAs make

emergentmd,

What do your PAs make per diem?

Just curious.

thanx.

😎

 

[emergentmd]

emergentmd,

What do your PAs make per diem?

Just curious.

thanx.

😎

They make 650 per 10 hr shift Plus Benifits.

 

[Silent Cool]

What is up with this forum. So much negativity. Anyway, I have my $300k job for next year and this will rise to $500k the year after that. Don't you worry about me buddy.

jp,


I appreciate your contribution to this forum. Nevertheless, you must admit that your overall sentiment directly contradicts the feeling of most pathologists on this forum. As such...

...Please tell us:
-Where (what part of the country--if possible the state) you work.
-What kind of group you work for (corporate, private practice small group, academic...you get the idea).
-How you acquired your job (Did Grandaddy bequeath you 'The Practice'?)
-If you have partners (by that I mean....are there other Path's making $$$ off other Path's).
-Number of specimens and what kind you read/process per year.
-Why the overwhelming 'career outlook' on this forum is more negative than it is on any other specialty forum on SDN.


peace
😎

 

[vistaril]

Werent you the guy trying to get your wife to lowball the in office pathologist to take like 2 bucks an 88305 or something? Posted on here "How can I convince my wife to lowball her contractor to squeeze even more pofit out for ME?"...dude that was an insta-classic and proves my point.

Its like the battle of leeches or something. I love it.

Howd that work out btw?

Vistaril that was you! I looked it up:


Howd that work out?? Did they lowball the pathologist into 9 bucks a case?

And how does it feel going to med school but entering psychiatry and therefore be dependent on the girlfriend GI for cash?

I think the pathologist they contracted out with gets like 18 per case....but again, he isnt the one actually reading. I don't know how much he is paying the people he hires to actually do the work though.

As for being dependent on girlfriend....it's fairly easy to make 230-250ish working 45 hrs/week starting out in psych. Which is not nearly as much as the fiance, but it's enough for me. the enjoyment of some of the jobs is another matter.

 

[WEBB PINKERTON]

In my 35 years experience i have seen clinicians pay a lot of lip service to "quality" as re: pathology. However, universally, such concern goes right down the shi**er when there is ANY money to be made.

Did you consider quality when you sold out?

 

[Substance]

Getting paid less than a PA for what amounts to taking responsibility for a final diagnosis is laughable and sad at the same time.

Instead of complaining on internet forums about how poor the job market is, why not band together and become politically active? I am sure the CAP or USCAP has positions which you can apply for and participate in to make changes. Isn't yours the only field where a large percentage of practitioners work for, not with, either corporate outfits or other physician colleagues?

The Canadian Urology Association recently wrote a paper about how their specialty is becoming less competitive, and how that is a very concerning, negative thing. Pathology, being at the bottom of the barrel for so long, has accepted their unpopularity as being the status quo. That's gotta change before anything meaningful happens.

A few suggestions: the clinical internship year should return in path. If the day comes where the oversupply abates, and the demand for "interventional" pathology arises, its gonna be hard for your field to try to participate in that without any prior clinical work. Cutting programs is also a good idea, but what I think would be a good start is changing your examination from a multiple choice exam(which anyone can pass if they study hard enough), to an oral one(which only those who study and have good experience can pass). I know here in Canada the Royal College exams are all oral exams and are all tough as nails.

 

[Animus]

360K starting is insane. I dont buy that.

I am sure it is rare, but there are places that start there. I know of one personally(may not mean anything to you, but never the less does exsist). Now getting a job at one of these places is even more rare, definitely have to have a connection.

 

[LADoc00]

Having said that, I know that my training with two of the preeminent dermatopathologists in the country will be a strong foundation as I start my career and it has certainly helped me secure a great job even though I have not even started my fellowship yet.

You actually used the word "preeminent" to described your training...you did it, you went full ******. Never go full ******. Never.

Now Im curious...there is a very short list of completely self absorbed narcissistic-type DP professors who would actually refer to themselves as "preeminent" ..given the crew at MGH would never do that as they are quite humble from my experience...you must have trained with a certain gentlemen with French surname in San Francisco...

dunno, maybe that Cockrell guy in TX walks around referring to himself as preeminent, Ive never met him.

I also want to point out that Dermpath is the most narrow and easy of a field as you can possibly get in all Path...so dont pat yourself on the back too hard.

I have heard rumors of the RUC committee planning to utterly nuke Derm and GI biopsies into the dirt at some point in the next 5 years (perhaps less on the PC side but more on the TC where many DP groups make a tidy bundle of cash, 88305 TC for 14.99 anyone?). Hence why I would never recommend new trainees to sole focus on niche markets atm.

Good luck preeminent one.

 

[emergentmd]

What I can't wrap my head around is why a residency trained Pathologist (4 yrs right) do not have the experience/training to just jump out and work at 90% of the open positions. Why do you have to have more training just to be more marketable?

After ER training, we can work in 99.9% of the EDs out there. Gen Surgeons can work as a gen surgeon in any open jobs. Dermatologist, psychiatrist, FP, Ped, IM.

That is akin to telling a 3 Yr ED trained doc that you have to get a fellowship to work in a community/academic hospital. This would be ridiculous. Actually, doing a fellowship like toxicology would add absolutely nothing to my resume when looking for 99.9% of the jobs out there.

 

[2121115]

What I can't wrap my head around is why a residency trained Pathologist (4 yrs right) do not have the experience/training to just jump out and work at 90% of the open positions. Why do you have to have more training just to be more marketable?

After ER training, we can work in 99.9% of the EDs out there. Gen Surgeons can work as a gen surgeon in any open jobs. Dermatologist, psychiatrist, FP, Ped, IM.

That is akin to telling a 3 Yr ED trained doc that you have to get a fellowship to work in a community/academic hospital. This would be ridiculous. Actually, doing a fellowship like toxicology would add absolutely nothing to my resume when looking for 99.9% of the jobs out there.

Well, there are two possible options...

1) Pathology is just more difficult than those other fields and it is more challenging to become competent.

2) Pathology training programs do a horrible job of training residents.

Hmm... which one do you think it is?

 

[icpshootyz]

What I can't wrap my head around is why a residency trained Pathologist (4 yrs right) do not have the experience/training to just jump out and work at 90% of the open positions. Why do you have to have more training just to be more marketable?

It has nothing to do with your knowledge and training. It has everything to do with oversaturation in the market. Why hire a newly graduated pathologist with zero experience for your open position when you can hire someone with subspecialty fellowship training or even 5-10years of experience, likely at the same low salary? None of us NEED more training to be competent, we need it to compete with all the other pathologists applying for the same jobs. Similar to why so many jobs "require" a college degree that really have nothing to do with what you learn in college. Because the pool of applicants is so large, you might as well take from the top. Personally I found a great job with only one fellowship, but that fellowship was in the specific area of path that I find fascinating. I had no desire to do just general path so I didn't plan on applying right out of residency.

If someday your field trains far too many ED docs you might find yourself in the same boat.

 

[vistaril]

What I can't wrap my head around is why a residency trained Pathologist (4 yrs right) do not have the experience/training to just jump out and work at 90% of the open positions. Why do you have to have more training just to be more marketable?

After ER training, we can work in 99.9% of the EDs out there. Gen Surgeons can work as a gen surgeon in any open jobs. Dermatologist, psychiatrist, FP, Ped, IM.

That is akin to telling a 3 Yr ED trained doc that you have to get a fellowship to work in a community/academic hospital. This would be ridiculous. Actually, doing a fellowship like toxicology would add absolutely nothing to my resume when looking for 99.9% of the jobs out there.

to top it all off, other fields can make good money working *during* residency. Internal medicine residents are moonlighting midway through their second year. I know you guys all practically moonlight during third year at 1300 bucks and upwards a shift. I was making 140/hr by the end of my second year(and doing a decent number of hours)......This year as a resident I made(counting 50k residents salary) 160k or so....heck some of the new attending pathologists are barely making that, much less residents.

the worst part about a ridiculous 4 year residency + 3 years worth of fellowships is that (unlike almost every other resident/fellow) there doesnt appear to be any way to actually make decent money moonlighting as an upper level resident.