Dermatopath - How come they get paid so much?

[Thaitanium]

From the pathologyoutlines.com website:

How come dermatopaths get paid so much relative to other pathology subspecialties?

Sunny Southern California Dermatopathology Opening

15068CM



Specialty: Dermatopathology

Candidate type: MD, DO, DO-Allopathic

J1 Acceptable: No

Certification: Board Certified, Board Eligible



The Practice:



Employed Position
Salary + Incentive= $300k-$500k
Comprehensive Benefit Package
NO CALL
Work Monday through Friday; No Weekends
6 Weeks Vacation



Free Standing Lab
Generous Relocation Package



The Area:



Near Beverly Hills and Malibu
Beaches Only Minutes Away
Professional Sports
Beautiful Golf Courses and Tennis Centers



Contact:



Clark Meyers, Consultant
PracticeMatch Services
800-489-1440 ext: 6627
Email: [email protected]

www.PracticeMatch.com



[27 September 2006, still open as of 19 February 2007]

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Members don't see this ad.

 

[pathstudent]

You can make a lot of money in Dermpath because you can read lots of cases in one day.

That ad sounds like a "pod lab" or reference lab spot. 300-500K may sound like a lot of money, but if you are reading out one hundred derm cases a day, then you are generating much more money than 300K-500K per year.

 

[LADoc00]

Because the way medicine is reimbursed is totally OUT OF WHACK. Because we are bogged down in an idiotic war and are dependant on foreign oil. Because every always thinks they have THE solution even though they have an IQ of 98 but a look that can get them elected in politics.

Follow me here:
88305-skin biopsy, 140 bucks
time for grossing: 10 seconds
time to read and dictate: 20 seconds
Number of blocks (a proxy for the overhead of the specimen): 1

88309-mastectomy, 200 bucks
time to gross: 10 min
time to read and dictate: 30 min
blocks: 20+

NOW, multiple those numbers by several thousand TIMES.

Obviously, the system is totally being abused when you separate those doing 88309 work and those seeing purely 88305s.

PATHOLOGY REIMBURSEMENT IS BROKE. Im seeing this with my own eyes, up close. The whole thing is FUBAR. If you want to want $2,000 in an hour, all you have to do is shower a suspicious lymphoid infiltrate with 88342s (aka IHCs), read some GI biopsies or do skin. Silly.

 

[jayman]

FTS.

When the healthcare system hits rock bottom, and the idiots who have their stranglehold on us now (lawyers, politicians, "*****s for free healthcare united", journalists, the ignorant/angry/frustrated public) beg us to save what we have let them destroy, then there will be a new system in place that makes a lot more sense. Until then, keep pissing in the wind and hope you don't splatter too much.

 

[jayman]

Oh, and don't forget about doctors whoring other doctors in the ass. These pricks will the first ones to go down (pod lab junkies, doc-for-expert-testimony-for-hire, etc).

 

[Thaitanium]

Number of blocks (a proxy for the overhead of the specimen): 1

Sorry, but I am not sure what you mean by "blocks".

 

[Thaitanium]

FTS.

When the healthcare system hits rock bottom, and the idiots who have their stranglehold on us now (lawyers, politicians, "*****s for free healthcare united", journalists, the ignorant/angry/frustrated public) beg us to save what we have let them destroy, then there will be a new system in place that makes a lot more sense. Until then, keep pissing in the wind and hope you don't splatter too much.

For a newbie in the path arena, I am clueless with what is happening in the path ology field and the whole healthcare system. Can you tell me what is it that is pissin' everyone off?

 

[anencephalic]

Sorry, but I am not sure what you mean by "blocks".

I'd tell you that blocks are what you submit tissue for processing in after they're grossed in, but then you'd ask me what "grossed in" means, right?

 

[anencephalic]

For a newbie in the path arena, I am clueless with what is happening in the path ology field and the whole healthcare system. Can you tell me what is it that is pissin' everyone off?

It's a fairly complicated matter and not something that can adequately be summarized in a simple paragraph. For starters, check out the www.ascp.org for current trends and events that impact the practice of pathology.

Or you could just tune in and see what LADoc is currently ranting about...

 

[anencephalic]

88305-skin biopsy, 140 bucks
time for grossing: 10 seconds
time to read and dictate: 20 seconds
Number of blocks (a proxy for the overhead of the specimen): 1

God bless the 88305's. But realistically, what kind of volume do you need to put through a day to make reimbursement lucrative? Are we talking like 300 skins daily...'cause that's alot of glass.

 

[LADoc00]

God bless the 88305's. But realistically, what kind of volume do you need to put through a day to make reimbursement lucrative? Are we talking like 300 skins daily...'cause that's alot of glass.

300 skins per day would generate over 10 MILLION dollars in charges/year. That is at least 4-5 7-figure incomes for what MAYBE 2 full time dermatopathologists could sign out. The system is totally broke. You have one guy making millions and another making 200K if he is lucky merely because someone abitrarily created CPTs codes and then put a dollar value to each. I guarantee GUARANTEE this will change, trust me which is the biggest reason I didnt go into dermpath. Either they will nerf derm 88305s to pennies on the dollar OR change the entire CPT coding scheme for pathology. And trust me, they can do it with a 30 day notice. Flow cyto is a great example, at one point you could get 90 bucks PER marker, meaning a 32-antibody panel was over 3 grand, and I can read em in maybe 5 minutes. Wanna know what it is now: Medicare allowable CAPS at 125 bucks, that is a reduction of 96%!!!!!!!!!!!!!!!!!!!!!!!

this is the interesting thing: most pathologists dont realize that even the ad above, the employer is probably make SICK amounts of money off the pathologist. Even if you paid a dermpath person 800K (almost double what they are offering), you can work them and make over 1.4mil off their labor. Meaning 600K for staying home and whacking off to internet porn while Dr. Clueless is slaving away at 125 skins/day. Interesting when the fog is removed from your eyes isnt it?

 

[Thaitanium]

Meaning 600K for staying home and whacking off to internet porn while Dr. Clueless is slaving away at 125 skins/day.

Is that why you have Rated XXX under your name? Thanks for the post...informative.

 

[deleted113029]

because skin cancer is the most common cancer to afflict humans.

 

[djmd]

because skin cancer is the most common cancer to afflict humans.

Why are Basal cell CA's worth something?

 

[pathstudent]

Even if you paid a dermpath person 800K (almost double what they are offering), you can work them and make over 1.4mil off their labor. Meaning 600K for staying home and whacking off to internet porn while Dr. Clueless is slaving away at 125 skins/day. Interesting when the fog is removed from your eyes isnt it?

Or they could be like our GI colleagues, paying for theirs kid's college tuition and buying second homes, by offering a pathologist "300,000, No weekend, no call!" to read out 100 GI biopsies a day.

People don't be stupid. Don't work for Pod Labs, Don't work for reference labs. No matter how good your deal is, you are taking it in the ass and disrespecting your profession.

 

[Thaitanium]

Or they could be like our GI colleagues, paying for theirs kid's college tuition and buying second homes, by offering a pathologist "300,000, No weekend, no call!" to read out 100 GI biopsies a day.

People don't be stupid. Don't work for Pod Labs, Don't work for reference labs. No matter how good your deal is, you are taking it in the ass and disrespecting your profession.

What's the reimbursement of GI biopsies? Which path subspecialty reads these biopsies? The surgical paths?

 

[macrocyte]

Or they could be like our GI colleagues, paying for theirs kid's college tuition and buying second homes, by offering a pathologist "300,000, No weekend, no call!" to read out 100 GI biopsies a day.

People don't be stupid. Don't work for Pod Labs, Don't work for reference labs. No matter how good your deal is, you are taking it in the ass and disrespecting your profession.

Unfortunately the Pod labs and pathmills are not the only entity that is taking advantage of us newly trained pathologists, it is also the private practice groups that pay us 170 to work much worse hours than the path mills and also take their CP call and do the autopsies and gross and then they NEVER make you partner. With the huge surplus in newly tained pathologists what is to stop them from taking advantage of us. Why would I care if the private groups will lose money by not getting the lucrative specimens if I'm not going to be partner. What comes around goes around and if the best offer is a Pod lab then that's where I go .

 

[Phishfood]

why don't you guys open up a pod lab then? what's stopping you, if its as easy to rake in massive amounts of money 'jerking off to internet porn'

 

[LADoc00]

What's the reimbursement of GI biopsies? Which path subspecialty reads these biopsies? The surgical paths?

ALL biopsies (with rare exceptions like those that are decalcified) are 88305s, be they breast, endometrial, prostate, GI or derm.

Thus 12 quadrant prostate biopsy is 88305x12

An 88305 fee varies from as low as 80 to as high 300 per, what insurance pays is totally different tho realize. Do some homework on what the medicare allowable is for each CPT code in pathology BEFORE you decide on a speciality area.

 

[TheMightyAngus]

it is also the private practice groups that pay us 170 to work much worse hours than the path mills and also take their CP call and do the autopsies and gross and then they NEVER make you partner. With the huge surplus in newly tained pathologists what is to stop them from taking advantage of us. Why would I care if the private groups will lose money by not getting the lucrative specimens if I'm not going to be partner.

This is the case with private practice for any specialty.

 

[yaah]

Or they could be like our GI colleagues, paying for theirs kid's college tuition and buying second homes, by offering a pathologist "300,000, No weekend, no call!" to read out 100 GI biopsies a day.

People don't be stupid. Don't work for Pod Labs, Don't work for reference labs. No matter how good your deal is, you are taking it in the ass and disrespecting your profession.

Unfortunately, though, those jobs can be appealing to some. You are basically an employee, you have less administrative issues to deal with. Some people just want to punch in and punch out and if they can make a lot of money they're happy to let someone else make more.

Some of you keep talking about a huge surplus in newly trained pathologists - from my experience people in my program are getting multiple job offers (if not being solicited for them without inquiring). While some of them are crap jobs, to be sure, they are also being contacted by department heads and private groups. Is there tangible evidence that there is a surplus of newly trained pathologists? I mean, it makes SENSE to me that there should be, given that there are probably 15-20 path residents finishing their training in my state every year and I highly doubt there are 15-20 job openings in the state every year, but is there real evidence? Or is it mostly felt by candidates that aren't that great (for whatever reason)?

 

[LADoc00]

Is there tangible evidence that there is a surplus of newly trained pathologists? I mean, it makes SENSE to me that there should be, given that there are probably 15-20 path residents finishing their training in my state every year and I highly doubt there are 15-20 job openings in the state every year, but is there real evidence? Or is it mostly felt by candidates that aren't that great (for whatever reason)?

It is a very hard thing to assess from inside the Ivory Tower. Stastically, there is a huge oversupply. This oversupply is being absorbed in other very insidious fashions, like mills, POD labs and huge ref labs. I think job offers/resident is almost meaningless. A far better indicator would be #fellows reaching equity partnership within 3-4 years. My guess UMich's numbers would seriously drop off using that indicator.

 

[Thaitanium]

How much are dermatopaths making nowadays? Seems as if the starting salary is 250K. Forget the extremes like LeBoit and Ackerman. How about your typical dermatopath in private practice. I've read in this forum, a dermatopath making 750K working his tail off in Texas. What would you guys say is the average for the private practice dermatopath working the average path hours of 50 hours/week and weekends off? How about those that bust their arses and work more hours than your typical pathologist?

Looking at the jobs in pathologyoutlines, it looks like there are jobs paying 350K-500K but it looks as if it is a podlab type deal. So, if a dermpath was to go out and start his own practice, how difficult is it to start up your own practice, and maybe later on, a group?

How does the future look for dermatopath guys in terms of salary, hours, etc.? Seems as if this field will always make a good living based on the fact that the volume is high and the number of dermpaths out there are few as compared to a general pathologist.

Thanks for any input.

 

[Primate]

why don't you guys open up a pod lab then? what's stopping you, if its as easy to rake in massive amounts of money 'jerking off to internet porn'

This, despite the somewhat unsavory comparison, seems like a question that cuts to the heart of the matter.

Any takers?

P

 

[LADoc00]

How much are dermatopaths making nowadays? Seems as if the starting salary is 250K. Forget the extremes like LeBoit and Ackerman. How about your typical dermatopath in private practice. I've read in this forum, a dermatopath making 750K working his tail off in Texas. What would you guys say is the average for the private practice dermatopath working the average path hours of 50 hours/week and weekends off? How about those that bust their arses and work more hours than your typical pathologist?

Looking at the jobs in pathologyoutlines, it looks like there are jobs paying 350K-500K but it looks as if it is a podlab type deal. So, if a dermpath was to go out and start his own practice, how difficult is it to start up your own practice, and maybe later on, a group?

How does the future look for dermatopath guys in terms of salary, hours, etc.? Seems as if this field will always make a good living based on the fact that the volume is high and the number of dermpaths out there are few as compared to a general pathologist.

Thanks for any input.

"Average" dermpath is a misnomer as the distribution is very bimodal. The low end group predominates by sheer numbers and consists of employees of VA, County Hospitals, Kaiser type HMOs, Quest/Ameripath etc. Those people start in the low 200s and top near 300-350, if that. (And once I post that, there will be someone who posts how a fellow from their program got a job for Kaiser making 350 starting base salary...BS...total BS...Im quite familiar with the KPorg scale)

~I would say average dermpath 4 years out is making around 250-350 with roughly 8 weeks of vacation+sickleave and a 40K/year pension/401K.

Not too impressive huh? Youre right.

Now...a small business owner who owns a practice, be it a close S-corporation or sole prop., could (and does often) pull down 7 figures. It is definitely possible but we need to separate out what is possible versus what will likely happen with a new fellow out of the gates in the coming years. The outpatient market is SERIOUSLY impacted, there just isnt the room for someone to set up shop now wherever they like, where maybe 5-10 years ago there was.

things have changed, alot.

Now, you could also just join a private group but realize you will be taking the same call with the same buyin and the same surg path responsibilities as someone who is a generalist. Being dermpath boarded merely "buys you a ticket" to sit in the group, nothing more. In addition, about 90% of the old timers that run private groups have less business sense than the guys who sell churros from the carts in East LA. You will sink or swim based on their poor readings of medical economics until you are an equity partner and can vote on the corporation's (if the group is one..) board of directors. What many people dont realize is that almost ALL old timers retain 51% share interests, meaning you cant get rid of them, they leave when they want to leave.

 

[CameronFrye]

What many people dont realize is that almost ALL old timers retain 51% share interests, meaning you cant get rid of them, they leave when they want to leave.

In other words, when they croak.


As for the original question, I agree with LADoc. I've heard the experiences of a few dermpath people going through the job search, and it's not like they're getting offered twice the amount of the heme and cyto boarded people. It does seem like they have more doors open up for them or they're offered more perks (more vacation or days off), but the actual dollar amounts aren't obscene. The highest salary I've heard for a newbie pathologist was someone who had zero fellowships, but was joining a one person group and was being named a lab director (rural location).

 

[EUA]

There is a reason why that job in Malibu has been open for well over six months!

When it all sounds too good to be true.........................