Denver Job Market

[Lagunamonster]

HI

Longtime lurker.

My spouse wants us to settle in Denver Colorado. I have done a little research on my own and have seen jobs for or found information about

Ameripath (Quest)
Apex Pathology (LabCorp)
Forward Pathology Solutions (employed by Hospital Corporation of America/HCA and based in Florida???)
Kaiser (all outpatient)
University of Colorado/Denver Health
VA

I was hoping to join a traditional private practice. All of these seem like ones where you are an employee forever. Are there any traditional private practices in Denver? I know what University and the VA would be about but does anyone have any experience with the above?

Thanks in advance!

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[LADoc00]

HI

Longtime lurker.

My spouse wants us to settle in Denver Colorado. I have done a little research on my own and have seen jobs for or found information about

Ameripath (Quest)
Apex Pathology (LabCorp)
Forward Pathology Solutions (employed by Hospital Corporation of America/HCA and based in Florida???)
Kaiser (all outpatient)
University of Colorado/Denver Health
VA

I was hoping to join a traditional private practice. All of these seem like ones where you are an employee forever. Are there any traditional private practices in Denver? I know what University and the VA would be about but does anyone have any experience with the above?

Thanks in advance!

Colorado even though it is a CPM state has always been heavily settled by poorly paid managed care entities and commercial labs so almost all your options there suck in Denver.

You are left with:
1.) looking outside Denver
2.) VA which is I think is the best of the above options
3.) New spouse, especially if spouse is already throwing out "I want to live here" B.S. might be your best option.

 

[Alteran]

The little that I know about the university (which was from about 5 years ago) isn't all that flattering. From multiple residents and practicing pathologists I've talked with I'm told it's not a happy place.

 

[deleted314957]

The VA may not pay as well but it is a cushy job, good benefits and decent income. You must be the type who is happy to “ nod and smile” and not want to be the nail that sticks up in the VA bureaucracy.

 

[WEBB PINKERTON]

Only choose a job that is rural. Stay away from Denver. VA jobs should be last resort.

 

[path24]

Yep job market is great. Good luck in the mill.

 

[deleted314957]

Only choose a job that is rural. Stay away from Denver. VA jobs should be last resort.

As re: rural jobs. A former lab manager of mine is now CEO of a rural Eastern Colorado hospital and I am quite sure knows a bit about the path job market in that area of the State. PM me and I can give you his name, etc. It is the Haxton hospital district, truly in the boondocks of northeast colorado. If you said I referred you he would try to be most helpful.

 

[Zarniwoop]

VA job plus no spouse is the right choice for a long quiet life.

 

[LADoc00]

VA job plus no spouse is the right choice for a long quiet life.

This maybe as prophetically true as what can be achieved on SDN.

Wake up 8am
Get to VA at 9am
Drink coffee from coffee bar until 10am while checking emails
Sign out 10am until noon
noon-1pm lunch
1-3pm finishing signing out and grossing
3pm leave for gym
5pm hit local cafe for dinner and peruse Tinder/dating app offerings in your area
8pm night cap of mid range whiskey like Blanton's
Throw in occasional date nights with local single ladies
Rinse repeat from age 32-55
Age 55 leave VA, move to low COLA location/Thailand with life long pension
Die age 105 having fully beat the system

 

[deleted314957]

Path’s top out at 336K salary in the VA in 2021. This is exclusive of other payments/ bennies and should certainly be achievable after the example of 23 years LA limned. Not bad if you can tolerate a federal bureaucracy.

 

[WEBB PINKERTON]

Working at a VA will make time go slower thus your life will seem longer

 

[Dave CX]

Ditch the Princess Bride. Wives like that will NEVER be happy no matter what you do!!!
Regarding the options, the VA is the best one. Absolutely essential to start your career in a hospital, the busier the better.

 

[LADoc00]

Ditch the Princess Bride. Wives like that will NEVER be happy no matter what you do!!!
Regarding the options, the VA is the best one. Absolutely essential to start your career in a hospital, the busier the better.

I am constantly shocked at what I think this a crisis of physicians with such low dating self esteem they are trapped in relationships that are baffling.

#Financialslaveryisreal

 

[caffeinegirl]

What is eye-opening to me, is that the OP couldn't find private practice locations in a metropolitan area. Does this mean that all pathology has been consolidated? I would double check who is staffing the pathology departments in the hospitals in that area.

 

[Lagunamonster]

What is eye-opening to me, is that the OP couldn't find private practice locations in a metropolitan area. Does this mean that all pathology has been consolidated? I would double check who is staffing the pathology departments in the hospitals in that area.

First off my spouse and I each got a huge laugh out of suggestion #3 by LADOC. LOL!

The above is what I find perplexing and have come to the conclusion that it is the truth. There are no private practices left in Denver...well there is one possibility. A hospital called Boulder Community isn't affiliated with HCA, APEX or Ameripath.

I can't do the VA and I can't deal with rural life. And my spouse's career interests require being in the city.
Forward Pathology Services/HCA pathology is offering multiple jobs but I found out from an insider that it is a bit of a ****show with 4 people resigning the last couple months and almost complete turnover of all pathologists in the organization the last few years.
It seems Apex and Ameripath are the most stable operations.

I heard Portland is the same as Denver, no.private practice left. My spouse also threw it out as an option before settling on Denver. I wonder what percentage of private practices are left in urban areas over the last 30 years.

Thanks for the comments all.

 

[caffeinegirl]

Thanks for the followup Lagunamonster - I had no idea that there was consolidation at such scale occurring in these metropolitan areas - it's just a matter of time before that spreads. For those of you following and considering a career in pathology - this is definitely something to note.

 

[path_spouse]

There are no private practices left in Denver...well there is one possibility. A hospital called Boulder Community isn't affiliated with HCA, APEX or Ameripath.

I can't do the VA and I can't deal with rural life. And my spouse's career interests require being in the city.

Spouse here (not a doctor). When we moved to Desirable Coastal City for my husband’s fellowship, I lucked out and found the perfect job. So when his fellowship ended, we decided to try and stay.

In our city, there are a couple of really stable, reputable private practices but they have their pick of experienced people. The remaining private groups are either ones that make the employed options you list look relatively attractive, or they are out in exurbs 1.5 hours or more from the city center.

I’m not familiar with Denver but maybe
exurbs might be an option? We did something like that for a couple of years, where I worked near the city center and my husband worked in an exurb. The commute was unpleasant, but we didn’t have to live in a really remote area.

Making our careers work together has always required a lot of flexibility and compromise. Best of luck!

 

[Med Director New England]

Thanks for the followup Lagunamonster - I had no idea that there was consolidation at such scale occurring in these metropolitan areas - it's just a matter of time before that spreads. For those of you following and considering a career in pathology - this is definitely something to note.

I’ve been noticing this and pointing this out on SDN for some time now.

there are very few remaining pathologist owned private groups near me. Even fewer that I would consider stable. I bet > 90% of paths are now employed and not partners / owners.

 

[deleted314957]

First off my spouse and I each got a huge laugh out of suggestion #3 by LADOC. LOL!

The above is what I find perplexing and have come to the conclusion that it is the truth. There are no private practices left in Denver...well there is one possibility. A hospital called Boulder Community isn't affiliated with HCA, APEX or Ameripath.

I can't do the VA and I can't deal with rural life. And my spouse's career interests require being in the city.
Forward Pathology Services/HCA pathology is offering multiple jobs but I found out from an insider that it is a bit of a ****show with 4 people resigning the last couple months and almost complete turnover of all pathologists in the organization the last few years.
It seems Apex and Ameripath are the most stable operations.

I heard Portland is the same as Denver, no.private practice left. My spouse also threw it out as an option before settling on Denver. I wonder what percentage of private practices are left in urban areas over the last 30 years.

Thanks for the comments all.

Be very careful. I don’t know about the other outfits but Ameripath actively courts hospital contracts and provides the medical director. The hospital contract can change QUICKLY. Over a 25 year period I was the medical director at one hospital as an associate of a large PP group, as an equity partner in the same group, as an Ameripath employee after they bought us and as a Quest employee when they bought Ameripath. All in the same hospital as med director doing the same thing. You should try to check into how rapidly Denver has been consolidating. The hospital you mentioned may just turn out to be the last domino to fall. And you sure as hell do not want HCA to be the one to topple that domino.

 

[deleted314957]

I just checked their hospital and some numbers are strange. It is an ~160 bed hospital with 4 pathologists one of whom has to be at least 78 y.o. based on med school graduation.
I was solo at ~ same size hospital. I don’t know how you can support that many and have a decent income, even if grandpa doesn’t do anything.

 

[Zarniwoop]

Rural and VA are out? Those are the only paths for success that lie north of "snowball chance in hell".

The only other path I can think of would be to take the AmeriPath job (or something like it) and do an MBA with healthcare focus at night. Who knows, maybe even a behemoth organization like AmeriPath would help fund it (tuition assistance?).
When done with MBA, move into AmeriPath management or hospital management elsewhere.
If you can't beat them, join them.

To me though, this is a lot of effort for an outcome that isn't measurably better. I still would vote for a VA job, and use some of your free time (of which you'll have plenty and it is the most valuable resource in life) to stand in front of a mirror chanting "I love my VA job - wouldn't change for the world. I love my VA job - wouldn't change for the world."

Good luck!

 

[Spikebd]

This maybe as prophetically true as what can be achieved on SDN.

Wake up 8am
Get to VA at 9am
Drink coffee from coffee bar until 10am while checking emails
Sign out 10am until noon
noon-1pm lunch
1-3pm finishing signing out and grossing
3pm leave for gym
5pm hit local cafe for dinner and peruse Tinder/dating app offerings in your area
8pm night cap of mid range whiskey like Blanton's
Throw in occasional date nights with local single ladies
Rinse repeat from age 32-55
Age 55 leave VA, move to low COLA location/Thailand with life long pension
Die age 105 having fully beat the system

To any med students who think this is just a joke, believe me it is not. The healthcare Titanic has already struck the iceberg, and a VA job like that is one of the few available lifeboats.

 

[LADoc00]

To any med students who think this is just a joke, believe me it is not. The healthcare Titanic has already struck the iceberg, and a VA job like that is one of the few available lifeboats.

Im starting to kinda regret mentioning it because I want that lifeboat to be there for me once I downshift to "lazy mode" in a few years.

Let's not mention VA going forward.....

 

[Zarniwoop]

Im starting to kinda regret mentioning it because I want that lifeboat to be there for me once I downshift to "lazy mode" in a few years.

Let's not mention VA going forward.....

LADoc00 at the VA is like James Bond joining a Neighborhood Watch group in the Cotswolds.

 

[Lagunamonster]

I just checked their hospital and some numbers are strange. It is an ~160 bed hospital with 4 pathologists one of whom has to be at least 78 y.o. based on med school graduation.
I was solo at ~ same size hospital. I don’t know how you can support that many and have a decent income, even if grandpa doesn’t do anything.

The Boulder group isn't advertising.

I found another group (summit) that serves hospitals north of the city that I think might still be physician owned.

So my choice is Quest or LabCorp owned operations or this physician owned one with an hour long commute each way.

I am going to apply to all three and see which one is the best fit.

 

[Nilf]

The Boulder group isn't advertising.

I found another group (summit) that serves hospitals north of the city that I think might still be physician owned.

So my choice is Quest or LabCorp owned operations or this physician owned one with ONE HOUR COMMUTE EACH WAY.

I am going to apply to all three and see which one is the best fit.

Don't do it dude. At least live halfway between jobs and split the commute with the spouse. If she wants to live there so badly, let her drive.

 

[Path-oh]

Forward Pathology Services/HCA pathology is offering multiple jobs but I found out from an insider that it is a bit of a ****show with 4 people resigning the last couple months and almost complete turnover of all pathologists in the organization the last few years.
It seems Apex and Ameripath are the most stable operations.

Correction: 5 people have resigned. Some who were very recent hires. There are a couple more actively interviewing as of now. They have lots of openings and more coming! Stay tuned for the s**** show to get worse.

 

[path_spouse]

So my choice is Quest or LabCorp owned operations or this physician owned one with an hour long commute each way.

Non-doctor married to pathologist. About the one hour commute, note that often the pathologist's contract requires him or her to live within some distance of the hospital, plus sometimes things like organ harvests require being at the hospital at like 2 a.m. There can be frequent 7 a.m. meetings/tumor boards/etc. These are things to consider when you look at a job an hour away, especially in a place prone to weather that can interfere with driving.

 

[caffeinegirl]

@path_spouse is spot on - 1 hour+ commutes only work for outpatient only/biopsy work. They don't work if you have call and work in a hospital. Many of these jobs do have requirements for distance/time to hospital.

 

[deleted314957]

Im starting to kinda regret mentioning it because I want that lifeboat to be there for me once I downshift to "lazy mode" in a few years.

Let's not mention VA going forward.....

One of the old guy founders of my pre Ameripath group retired at 65 and went to work for the local VA for a couple years and had a ball. He had to retire from us because at 65 you could no longer be on the B.O.D. and therefore no longer a partner. He still wanted to practice for awhile more though and did not want to hang around as a non partner.
You should really, really look at the VA.

 

[deleted314957]

@path_spouse is spot on - 1 hour+ commutes only work for outpatient only/biopsy work. They don't work if you have call and work in a hospital. Many of these jobs do have requirements for distance/time to hospital.

At the VA it’s no biggie if you roll in an hour late from time to time. Just call to check the OR schedule. Cushy life.

 

[Vicinal]

What’s the LIS at the VA?

 

[path24]

You know your specialty is killing it when the VA is the good job. Yep things are looking amazing for the field. Great future.

 

[deleted314957]

VA may offer an opportunity to sign cases out. It might be the most like the way medicine is practiced in other countries. Since pathology has a large number of IMGs practicing here, it may feel like practicing at country of origin. Single payer, minimal merit except title changes and doing less work and/or managing the bureaucracy as you move “up”. Being rewarded by getting out of actually working and passing the buck. Low salary and mediocre benefits. It seems like a better place to finish up than to start. Is it really that bad out there? Wow the field is utterly decimated. Academics is likely even worse.

It’s not decimated. But like I said years ago, y’all are going to be employees of something/someone with rare exception.
There are two ways out:
1) figure out how to be a concierge pathology practice.
2) figure out how to hold your diagnoses in escrow until you get YOUR fee.

 

[LADoc00]

What’s the LIS at the VA?

Typically 3 hole punched college ruled paper.

 

[ReedSternburg]

@path_spouse is spot on - 1 hour+ commutes only work for outpatient only/biopsy work. They don't work if you have call and work in a hospital. Many of these jobs do have requirements for distance/time to hospital.

I've lived 1 hour from work my entire career (15+ years). The on-call requirement is to be within 1 hour of hospital, so it works out. On average, I go into the hospital after hours once a year. The commute kinda sucks, but I feel its a reasonable tradeoff for living where I want to live. Over the years, the administrative responsibilities have increased so I have many more 7:30 and 7 AM meetings than when I started. On the other hand, I have a much nicer car than when I started which helps make the commute more tolerable.

 

[Lagunamonster]

Correction: 5 people have resigned. Some who were very recent hires. There are a couple more actively interviewing as of now. They have lots of openings and more coming! Stay tuned for the s**** show to get worse.

That's more than a "s&!^show" That is officially a "s&!^show at the f#(& factory!" The worst kind of **** show!

 

[Lagunamonster]

I've lived 1 hour from work my entire career (15+ years). The on-call requirement is to be within 1 hour of hospital, so it works out. On average, I go into the hospital after hours once a year. The commute kinda sucks, but I feel its a reasonable tradeoff for living where I want to live. Over the years, the administrative responsibilities have increased so I have many more 7:30 and 7 AM meetings than when I started. On the other hand, I have a much nicer car than when I started which helps make the commute more tolerable.

2 hours is a lot to spend a day driving. That's 10 hours a week. Maybe you listen to audiobooks or something to make you a better person, but imagine taking 10 hours a week and working out or learning an instrument or something like that.

I don't think I could do it.

 

[Lagunamonster]

LOL. HCA pathology is advertising this position in Denver on pathoutlines:
The ideal candidate is a strong surgical pathologist with fellowship training in Cytopathology, Head & Neck Pathology and Gynecologic Pathology

LOL. How many people have done Cytopathology, head and neck and gyn? LOL. GOOD LUCK finding your ideal candidate.

 

[deleted314957]

The Boulder group isn't advertising.

I found another group (summit) that serves hospitals north of the city that I think might still be physician owned.

So my choice is Quest or LabCorp owned operations or this physician owned one with an hour long commute each way.

I am going to apply to all three and see which one is the best fit.

Just my intuition and 40 yr experience but that “ physician owned” practice may
not be in the near future. And you would probably be real pissed if the owners decided to cash out prior to your equity partnership. And do you have ANY idea if they are entertaining that prospect. Worth asking, although i doubt you would get the unvarnished truth.

 

[cmz]

Correction: 5 people have resigned. Some who were very recent hires. There are a couple more actively interviewing as of now. They have lots of openings and more coming! Stay tuned for the s**** show to get worse.

I have an HCA contract and they keep mentioning "ForwardPath" to me. I would be surprised if they showed up now. I kinda think they need to figure their own internal stuff out and maybe I will see them in 2024.

 

[ThatSerb]

Path’s top out at 336K salary in the VA in 2021. This is exclusive of other payments/ bennies and should certainly be achievable after the example of 23 years LA limned. Not bad if you can tolerate a federal bureaucracy.

Seems like in the VA, with path at least, salary is very geographically dependent. Top salary I see online for a CA pathology position is 108K

 

[deleted314957]

Seems like in the VA, with path at least, salary is very geographically dependent. Top salary I see online for a CA pathology position is 108K

It is not geographically limited. It does differ by specialty. The ~300,000$ figure was tops for a pathologist. Anywhere in the USA.

 

[ThatSerb]

It is not geographically limited. It does differ by specialty. The ~300,000$ figure was tops for a pathologist. Anywhere in the USA.

In your experience, does working at the VA as a pathologist make it harder to be successful in private/hospital settings afterward? Some claim that the slower and lax nature of things at the VA makes for a hard transition to more fast-paced environments. And additionally that some of your skills may atrophy while at the VA. Any thoughts on that?

 

[deleted314957]

In your experience, does working at the VA as a pathologist make it harder to be successful in private/hospital settings afterward? Some claim that the slower and lax nature of things at the VA makes for a hard transition to more fast-paced environments. And additionally that some of your skills may atrophy while at the VA. Any thoughts on that?

I think you can approach the VA in three ways.

1. Work there for a couple years( no more than that) after training so you have PERSONAL RESPONSIBILITY SIGN OUT EXPERIENCE then go get a better job.

2. Make it a laid back career with great benefits, early retirement and OK ( but not more) income.

3. Older folks who are aged out of equity partnership can chill there for a few years if they still have the work bug. One of the guys in my group did that. Turned 65 and could no longer be a partner and wanted to slow down. So, he worked at the local VA for a couple years. He just liked hospitals, labs and light work. He was already a multimillionaire.

 

[ThatSerb]

I think you can approach the VA in three ways.

1. Work there for a couple years( no more than that) after training so you have PERSONAL RESPONSIBILITY SIGN OUT EXPERIENCE then go get a better job.

2. Make it a laid back career with great benefits, early retirement and OK ( but not more) income.

3. Older folks who are aged out of equity partnership can chill there for a few years if they still have the work bug. One of the guys in my group did that. Turned 65 and could no longer be a partner and wanted to slow down. So, he worked at the local VA for a couple years. He just liked hospitals, labs and light work. He was already a multimillionaire.

Thanks so much for the response. I am still in med school, but I am doing the VA HPSP. I am locked in for 6 years with the VA after residency/fellowships, and after that, I can stay or leave. So I really appreciate it when people with experience there give their thoughts on working there. Cheers

 

[Nilf]

I think you can approach the VA in three ways.

1. Work there for a couple years( no more than that) after training so you have PERSONAL RESPONSIBILITY SIGN OUT EXPERIENCE then go get a better job.

2. Make it a laid back career with great benefits, early retirement and OK ( but not more) income.

3. Older folks who are aged out of equity partnership can chill there for a few years if they still have the work bug. One of the guys in my group did that. Turned 65 and could no longer be a partner and wanted to slow down. So, he worked at the local VA for a couple years. He just liked hospitals, labs and light work. He was already a multimillionaire.

Apropos #2, didnt' the VA benes take a big cut recently?

I find #3 inspirational.

 

[deleted314957]

Apropos #2, didnt' the VA benes take a big cut recently?

I find #3 inspirational.

As re bennies, you may well be right. My perspective is often clouded by time. One would certainly need to verify any bennies before any job. And, the place is a big time bureaucracy and a political football.

 

[Drifter76]

First off my spouse and I each got a huge laugh out of suggestion #3 by LADOC. LOL!

The above is what I find perplexing and have come to the conclusion that it is the truth. There are no private practices left in Denver...well there is one possibility. A hospital called Boulder Community isn't affiliated with HCA, APEX or Ameripath.

I can't do the VA and I can't deal with rural life. And my spouse's career interests require being in the city.
Forward Pathology Services/HCA pathology is offering multiple jobs but I found out from an insider that it is a bit of a ****show with 4 people resigning the last couple months and almost complete turnover of all pathologists in the organization the last few years.
It seems Apex and Ameripath are the most stable operations.

I heard Portland is the same as Denver, no.private practice left. My spouse also threw it out as an option before settling on Denver. I wonder what percentage of private practices are left in urban areas over the last 30 years.

Thanks for the comments all.

Every Forward Pathology Solutions/HCA operation is a ****show, whether it is Florida (where they started), Texas, Kansas City, Carolinas, Denver or any of their other operations. I know that from experience. If you go on their website, you’ll see that they have over 20 pathologists listed in Florida and every single one is a foreign grad.
Any labcorp practice will be an even bigger ****show, if that is possible. Quest/Ameripath is now about as bad as labcorp. If those were my options, I would absolutely stay the hell away from Denver. Of course, there aren’t too many places any more that are a whole lot better.