Disturbing tendency

[raider]

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I am seeing more and more of a very disturbing tendency (ofcourse our crap organization C"R"AP and its pathetic leadership is talking about everything else but this):

More and more so called companies, following the Quest model, are jumping into the arena of what was formerly small private practice pathology, like ravenous wolves. With their well developed attributes of sycophancy (aka so called interpersonal skills) they are able to get contracts from hospitals (which are run by greedy scumbag admin types, again only talented in sycophancy, with no sense of what really constitutes quality in medicine and only interest in the bottom line-money). Then these talentless w-ore admin leeches hire some desperate pathologists at low salaries to do a ton of work. Essentially the pathologists are doing busy private practice pathology at one-third or less the salary they deserve based on the revenue they generate. Moreover, they are treated as inferiors by the scumbag admin. types.

Why is this phenomenon becoming rampant in pathology? What needs to be done to end it? When will we as pathologists wake up and say "enough is enough".

 

[KeratinPearls]

I am seeing more and more of a very disturbing tendency (ofcourse our crap organization C"R"AP and its pathetic leadership is talking about everything else but this):

More and more so called companies, following the Quest model, are jumping into the arena of what was formerly small private practice pathology, like ravenous wolves. With their well developed attributes of s--king c--k (aka so called interpersonal skills) they are able to get contracts from hospitals (which are run by greedy scumbag admin types, again only talented in s--king c--k, with no sense of what really constitutes quality in medicine and only interest in the bottom line-money). Then these talentless w-ore admin leeches hire some desperate pathologists at low salaries to do a ton of work. Essentially the pathologists are doing busy private practice pathology at one-third or less the salary they deserve based on the revenue they generate. Moreover, they are treated as inferiors by the scumbag admin. types.

Why is this phenomenon becoming rampant in pathology? What needs to be done to end it? When will we as pathologists wake up and say "enough is enough".

Who heads these companies? Are they pathologists or MBA types? Thats really sad. These guys are taking advantage of this supply demand problem of overtraining then.

 

[WEBB PINKERTON]

Get used to it because it is getting MUCH worse. We had a locum a while back that can't find any job in the area except Ameripath. You are really a slave making peanuts working for them.

 

[JasonS]

Get used to it because it is getting MUCH worse. We had a locum a while back that can't find any job in the area except Ameripath. You are really a slave making peanuts working for them.

Wow. Are the starting salaries at these megalabs in the 100-120k range?

 

[2121115]

Wow. Are the starting salaries at these megalabs in the 100-120k range?

If you are a medical student and already at this point, then don't go into pathology.

 

[Art]

Wow. Are the starting salaries at these megalabs in the 100-120k range?

One of the people at my institution just took a job like this, the offered salary was 250 to 300K per year. No call, no weekends, but no benefits either. Malpractice was provided (he's an employee so it would be a business expense).

They came looking for him, because they needed a pathologist. The position was never posted.

 

[rockit]

One of the people at my institution just took a job like this, the offered salary was 250 to 300K per year. No call, no weekends, but no benefits either. Malpractice was provided (he's an employee so it would be a business expense).

They came looking for him, because they needed a pathologist. The position was never posted.

Just thought I'd point that out again.

 

[Cleavername]

Just thought I'd point that out again.

what does benefit usually mean? vacation time? if so, what else is there?

 

[2121115]

what does benefit usually mean? vacation time? if so, what else is there?

Health insurance, 401k, other...

 

[2121115]

One of the people at my institution just took a job like this, the offered salary was 250 to 300K per year. No call, no weekends, but no benefits either. Malpractice was provided (he's an employee so it would be a business expense).

They came looking for him, because they needed a pathologist. The position was never posted.

These types of places tend to pay a higher starting salary but there is not much room for it to go up. Whereas in general private practice starting salaries are generally a bit lower and then go really high if/when you become a partner.

 

[bronx43]

I am seeing more and more of a very disturbing tendency (ofcourse our crap organization C"R"AP and its pathetic leadership is talking about everything else but this):

More and more so called companies, following the Quest model, are jumping into the arena of what was formerly small private practice pathology, like ravenous wolves. With their well developed attributes of s--king c--k (aka so called interpersonal skills) they are able to get contracts from hospitals (which are run by greedy scumbag admin types, again only talented in s--king c--k, with no sense of what really constitutes quality in medicine and only interest in the bottom line-money). Then these talentless w-ore admin leeches hire some desperate pathologists at low salaries to do a ton of work. Essentially the pathologists are doing busy private practice pathology at one-third or less the salary they deserve based on the revenue they generate. Moreover, they are treated as inferiors by the scumbag admin. types.

Why is this phenomenon becoming rampant in pathology? What needs to be done to end it? When will we as pathologists wake up and say "enough is enough".

There's really no one to blame but the field being on the wrong end of the supply curve. Pathologists and the service they provide are largely commoditized (and this is true for many other specialties). When the supply of that commodity increases with demand being stagnant, then price will inevitably go down. And in the situation you are describing, a third party is stepping in and being the middle man between you (commodity) and the hospital (consumer). However, it doesn't HAVE to be that way. The middle man, outside of whatever administrative work he can do, adds no value. Hospital administrators love to get their c***s s**ked, but they love saving money even more. Therefore, if you can do your own administrative work or find a cheap alternative, then you can squeeze them out. I mean, it still wouldn't promise you riches, given the sheer reality of the market, but at least you would have the contract.

 

[Substance]

This is just the result of the field being composed of mainly adulating sycophants who like to complain a whole bunch but never step up to the plate.

You'd think radiology would be the first to suffer this fate, given that all of their images can be digitally distributed to the lowest bidder, but no. They actually have balls.

I guess any doc/MBA/janitor can make a fortune by opening up a lab with some investor buddies and hiring a bunch of triple-fellowship-wielding pathologists to work for 80k/year.

Move the meat, beotches!

 

[KluverB]

One of the people at my institution just took a job like this, the offered salary was 250 to 300K per year. No call, no weekends, but no benefits either. Malpractice was provided (he's an employee so it would be a business expense).

They came looking for him, because they needed a pathologist. The position was never posted.

Just thought I'd point that out again.

So, just like being partner, but perhaps without voting rights, and no buy-in, minimal responsibilities, etc.?

 

[2121115]

So, just like being partner, but perhaps without voting rights, and no buy-in, minimal responsibilities, etc.?

And no autonomy.

And about 1/3 of the pay.

 

[KluverB]

And no autonomy.

And about 1/3 of the pay.

What exactly is autonomy in this day-and-age? Your *ss is owned by the hands that feed you, be it the Megapodlab, the hospital, the insurance companies, Medicare/aid, the surgeons, etc.

Show me someone who is making $750k - $900k per year straight out of training and I'll be sure to call shenanigans. Heck, show me someone who's making that much being out of training some 5-10 years.

 

[2121115]

What exactly is autonomy in this day-and-age? Your *ss is owned by the hands that feed you, be it the Megapodlab, the hospital, the insurance companies, Medicare/aid, the surgeons, etc.

Show me someone who is making $750k - $900k per year straight out of training and I'll be sure to call shenanigans. Heck, show me someone who's making that much being out of training some 5-10 years.

Of course no one is making that straight out of training.

Think about it. By your standards, no small business owners have autonomy and they are just slaves to their customers and the prices their customers are willing to pay. But if you want to work as an employee that is fine. Nothing wrong with that. Plenty of people in the world do this. Academics do this too. Totally cool.

 

[Cleavername]

Health insurance, 401k, other...

oh @$%^ thats gonna cost an arm and a leg.

 

[rockit]

I'm blown away that you don't know what benefits entail. No wonder pathologists get taken advantage of.

 

[Art]

I'm blown away that you don't know what benefits entail. No wonder pathologists get taken advantage of.

I hear about benefits, but I also hear about indirect costs in some discussions about paying residents. You see graduate medical education (GME) and indirect medical education (IME). Is IME the same as benefits?

 

[rockit]

38 seconds on Google told me that GME is the institution educating post-gratuate students, and IME is the adjustment that Medicare gives to hospitals based on their ratio of interns to beds. Neither has anything to do with your salary and benefits package. Additionally, the attending-level position mentioned above has no connection to either GME or IME.

 

[Cleavername]

I'm blown away that you don't know what benefits entail. No wonder pathologists get taken advantage of.

oh, i am a pre-med, just am interested in pathology so i participate in this forum here and there asking questions about things i don't understand.

 

[rockit]

oh, i am a pre-med, just am interested in pathology so i participate in this forum here and there asking questions about things i don't understand.

That's understandable, but I was more concerned that the fellow doesn't know any of these things.

 

[lipomas]

Why is this phenomenon becoming rampant in pathology? What needs to be done to end it? When will we as pathologists wake up and say "enough is enough".

When they stop offering partners obscene amounts of money to give up control of their practice.

 

[SaltySqueegee]

When they stop offering partners obscene amounts of money to give up control of their practice.

This is my understanding too. From a group practice that I rotated with during a clerkship elective. A "small" hospital practice that has a volume of ~16-20K specimens/yr in our area complete with clinical lab will fetch each partner (with a total of 4 partners) around 12 to 15 million for a buy out. Now I don't know the specifics. This was just lunch cafeteria talk. But I consider 12-15 million pretty obscene. Now consider these people are already making a hefty annual salary. Sheesh! The buy out would have still contracted there group to the hospital and they still would have been making a salary.

However, they were not going to sell. Still.

 

[pathstudent]

This is my understanding too. From a group practice that I rotated with during a clerkship elective. A "small" hospital practice that has a volume of ~16-20K specimens/yr in our area complete with clinical lab will fetch each partner (with a total of 4 partners) around 12 to 15 million for a buy out. Now I don't know the specifics. This was just lunch cafeteria talk. But I consider 12-15 million pretty obscene. Now consider these people are already making a hefty annual salary. Sheesh! The buy out would have still contracted there group to the hospital and they still would have been making a salary.

However, they were not going to sell. Still.

The general guidelines is that that they will pay about 4-5 times the group's annual revenue. So it sounds like that group's revenue was about 3 million a year.

That sounds awesome but once you sell, they pay you a salary so that they make back their investment in 7 years. So if you are about ready to retire, selling the group is awesome. If you are a young partner and plan on working for another 25 years it probably isn't a good idea as you will make far less over your career. Who I feel sorry for are new hires who only work a year or two before the sale and end up getting totally shafted. They don't get the huge pay-out and they have to settle for the reduced salary and the threat of a non-compete clause if they try to move to another job in the same city.

 

[SaltySqueegee]

The general guidelines is that that they will pay about 4-5 times the group's annual revenue. So it sounds like that group's revenue was about 3 million a year.

That sounds awesome but once you sell, they pay you a salary so that they make back their investment in 7 years. So if you are about ready to retire, selling the group is awesome. If you are a young partner and plan on working for another 25 years it probably isn't a good idea as you will make far less over your career. Who I feel sorry for are new hires who only work a year or two before the sale and end up getting totally shafted. They don't get the huge pay-out and they have to settle for the reduced salary and the threat of a non-compete clause if they try to move to another job in the same city.

You're assessment of the younger vs older partners was part of the dynamic I observed during my rotation. Some of the older partners a few years away from retirement were considering the sell out while the younger "partner-track" pathologists were hoping not. As if the youngins' had a vote. There was some concern on the part of the older partners about a legacy and that the people to whom the business would be sold to would not foster the types of personal relationships in the local community that they had generated.

Eh. It is what it is. Someone will eventually tip the scales and sell out.

 

[SaltySqueegee]

The general guidelines is that that they will pay about 4-5 times the group's annual revenue. So it sounds like that group's revenue was about 3 million a year.

That sounds awesome but once you sell, they pay you a salary so that they make back their investment in 7 years. So if you are about ready to retire, selling the group is awesome. If you are a young partner and plan on working for another 25 years it probably isn't a good idea as you will make far less over your career. Who I feel sorry for are new hires who only work a year or two before the sale and end up getting totally shafted. They don't get the huge pay-out and they have to settle for the reduced salary and the threat of a non-compete clause if they try to move to another job in the same city.

And, why is your signature just WINNING!!!, and not Bi-WINNING!!! ?

 

[pathstudent]

And, why is your signature just WINNING!!!, and not Bi-WINNING!!! ?

Tri-Winning, it is Captain Tri-Winning.