jkdoctor

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Apr 29, 2013
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I recently received this email (names have been replaced by X)

Dr. X:


I hope you are enjoying what’s left of summer! I’ve been trying to track down some pathology work and have struggled to track anything down. Please let me know if you or anyone you know is looking for any extra help.


Sincerely,

X

Client Developer | Pathology

Locum Tenens Division


X


My comment:
So now we have a major locums company asking pathologists and pathology practices for help finding work for locum pathologists.
In other fields the practices go to the locums company asking for help getting a doc to provide coverage.
How messed up is that?
 
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veo1

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Sadly, I received the same e-mail. Not a fabrication and it is a major locums service
 

WEBB PINKERTON

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We haven't even hit rock bottom yet is the sad part. Better be preparing a nice nest egg ASAP.
 

univlad

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I, too, received the same email.

I recently received this email (names have been replaced by X)

Dr. X:


I hope you are enjoying what’s left of summer! I’ve been trying to track down some pathology work and have struggled to track anything down. Please let me know if you or anyone you know is looking for any extra help.


Sincerely,

X

Client Developer | Pathology

Locum Tenens Division


X


My comment:
So now we have a major locums company asking pathologists and pathology practices for help finding work for locum pathologists.
In other fields the practices go to the locums company asking for help getting a doc to provide coverage.
How messed up is that?
 

cmz

Pathology Wannabe
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Sep 6, 2001
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It is pretty damn common in my neck of the woods... in fact, I'm looking for a pathologist for a permanent position who can sit and read GI all day...
 
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It is pretty damn common in my neck of the woods... in fact, I'm looking for a pathologist for a permanent position who can sit and read GI all day...
Where are you located and how can I find out more about this position?
 

nr-xxx

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I did locums work in the 1990's for 8 years, My observations now with all the ads and the emails from former agencies is this: Get into some other field other than pathology. Try Internal medicine if you want to do diagnostic work. Locums work is NOT DESIGNED to be a "safe haven" or a place to go if no permanent job. it is not designed to be self supporting. it is really for retirees who have time on their hands and have a pension for their income. I really hope no one did as I had done and did locums fro 8 years hoping I would get a practice. it did not work out. I ended up financing all those groups who had no intention of hiring me. I was deluded by false ads in CAP TODAY that recommended doing it for 5 years. they were mistaken I foolishly believed them. I only wish I had left the US to go to Canada or new Zealand and/or gotten into Primary care when I was in my 40's . Sadly I waited to long and at age 50 they would not take me. so I say to anyone NEVER do locums more than 1-2 years. if you are at that point GET INTO ANOTHER FIELD try Primary care also I am told Occupational and Safety health takes older applicants. DO NOT delude yourself into thinking if I do locums long enough I shall get a practice. You WILL NOT. The field is shrinking due to automation, digital pathology and insurance cut backs. the days of the large groups are over with. most of the good ones have been bought out by Quest, Lab Corp or Aurona labs. what is left shall 'die on the vine" Please listen to me GET OUT NOW GET INTO something else. locums work is Not the way to go. I did it and it failed. do not make my mistake . try Primary care or Internal medicine
 

Alteran

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Feb 10, 2008
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Yes, the pathology market is terrible and we've known this for a long long time. All markets eventually correct themselves and it would appear that pathology is beginning to correct itself not from the supply side but from the demand side, as in medical students are beginning to avoid pathology. This latest round of CMS is going to hit hard with hemepath looking to get the hardest blow (17% cut to flow cytometry professional reimbursement). If you're hemepath and all you do is only hemepath, I'd start refreshing my general surgical pathology skills real quick.

But the grass isn't always greener on the other side. All hospital based specialties are getting the double whammy of CMS cuts and hospital administration "re-negotiations". Case in point, I thought my group got hit hard until I was overhearing the critical care/pulmonology group in the doc lounge (it wasn't a subtle or quiet conversation...could easily be understood from the other end of the room) about how they were royally and utterly devastated by hospital admin. So yes, in pathology things have been bad, are currently bad, and aren't looking to get any better for a long time. But then again, its much the same for a lot of other specialties as well.
 

Unty

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Cmon seriously. Locums for 8 years. I know of residents who failed their boards and got a job. I know a fellow who failed his cyto boards and still got a job with no problems although two had to do 2 fellowships. Seriously, I dont think its as bad as you make it out to be. Again not saying the job market is great, but locums for 8 years? Seriously?
 

Path or bust

I like meat
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But the grass isn't always greener on the other side. All hospital based specialties are getting the double whammy of CMS cuts and hospital administration "re-negotiations". Case in point, I thought my group got hit hard until I was overhearing the critical care/pulmonology group in the doc lounge (it wasn't a subtle or quiet conversation...could easily be understood from the other end of the room) about how they were royally and utterly devastated by hospital admin.
Those are situations where some hospital based specialties are getting "subsidized" by the hospital so that group will accept the contract. You have to be careful if you are getting subsidized because you are a target for takout from outside groups who are willing to take no subsidy for the contracted services. Our group is not subsidized and we eat what we kill. Hospital admin has no influence on what or how we bill.

Over the years I have seen almost every subsidized group either replaced or undergo "aggressive renegotiation".
 

stickyshift

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Those are situations where some hospital based specialties are getting "subsidized" by the hospital so that group will accept the contract. You have to be careful if you are getting subsidized because you are a target for takout from outside groups who are willing to take no subsidy for the contracted services. Our group is not subsidized and we eat what we kill. Hospital admin has no influence on what or how we bill.

Over the years I have seen almost every subsidized group either replaced or undergo "aggressive renegotiation".
You wouldn't consider a Part A payment as a subsidy, would you?
 

nr-xxx

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Cmon seriously. Locums for 8 years. I know of residents who failed their boards and got a job. I know a fellow who failed his cyto boards and still got a job with no problems although two had to do 2 fellowships. Seriously, I dont think its as bad as you make it out to be. Again not saying the job market is great, but locums for 8 years? Seriously?
yes seriously fro 8 yeas, the job market in 1994-2002 was very bad, plus I hade a lot of bad politics that worked against me. still I am philosophical I outlived my enemies avoided some serious snake pits ( very bad jobs that would have led to financial ruin or worse) and I am still alive. knowing what I know now, I would have left the country or tried tog et into primary care. Politics can be a very very bad problem sometimes without going into the whys and wherefores I recently got a security clearance which includes a 6 month FBI background check and all that was concluded was "some man did not like me" but I would wager even money that man or his colleagues prevented me from getting a job and on more than none occasion I only hope no one ever has to face that. I did and survived. all the best yes it went on for 8 years. really despite looking at jobs in 6 states, dealing with some 300 recruiting firms, listing on Monster, CareerBuilder's, JAMA,NEJM, Science, Nature, ASCP,CAP,AACC ,Med2020, Medzilla plus direct applications to at least 20 drug companies and at least 20 academic departments . No one would answer me but it is over all the best
 
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Path or bust

I like meat
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You wouldn't consider a Part A payment as a subsidy, would you?
I would definitely not consider part A payment, which hospitals are supposed to pay, a subsidy. However hospitals consider this a subsidy.
CMS does not enforce this.
 

Path or bust

I like meat
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yes seriously fro 8 yeas, the job market in 1994-2002 was very bad, plus I hade a lot of bad politics that worked against me. still I am philosophical I outlived my enemies avoided some serious snake pits ( very bad jobs that would have led to financial ruin or worse) and I am still alive. knowing what I know now, I would have left the country or tried tog et into primary care. Politics can be a very very bad problem sometimes without going into the whys and wherefores I recently got a security clearance which includes a 6 month FBI background check and all that was concluded was "some man did not like me" but I would wager even money that man or his colleagues prevented me from getting a job and on more than none occasion I only hope no one ever has to face that. I did and survived. all the best yes it went on for 8 years. really despite looking at jobs in 6 states, dealing with some 300 recruiting firms, listing on Monster, CareerBuilder's, JAMA,NEJM, Science, Nature, ASCP,CAP,AACC ,Med2020, Medzilla plus direct applications to at least 20 drug companies and at least 20 academic departments . No one would answer me but it is over all the best
Great story. I am really glad things worked out, despite those obstacles. People are really nasty and I've had those individuals cross my path as well. Your resilience is ultimately what will get you past that. I can think of no better individual who went through failure and obstacles and was able to overcome trials to become one of the most successful and most influential individuals in human history, Abraham Lincoln.

I wonder if he would've achieved so much had he not suffered and failed so much.
 

WEBB PINKERTON

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"8 years a locum" sounds like a good movie about the plight of the pathologist.

This poster has multiple usernames and was telling us that pathology specimens are being outsourced to other countries, while quoting salaries that didn't seem real accurate.
 

Unty

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Isnt this that same guy who was a forensic pathologist from Texas who complained about the job market?
 

WEBB PINKERTON

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Yes, called himself Knighmare3000 and probably has other names. He apparently found a VA to hire him at some point. Also seems to know a pathologist doing Bosley hair transplants. Wish that guy would post here. I have some questions for a buddy of mine.
 

nr-xxx

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I would just say this anyone that thinks they will make a huge profit in pathology is largely mistaken. you might get something nice but do not count on it. it seems some members of this board are 'delusional" or harken back to an era when all you had to do is "wink your eye at Bettina martin ( chief tech SUNY Upstate) and you were made Chief of pathology somewhere" well those days are over with. it seems some departmental chairmen are also delusional or feed a pack of lies tor resident to keep a cheap labor force on board. To me with the insurance cutbacks if you don't see housestasff cutback or faculty forced to get R O 1 grants in lieu of a salary then I am an unwed mother it you live in a delusion then I am sorry I clash with reality. don't say you were not warned
 

jupiterianvibe

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Mar 3, 2016
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can't really blame the guy. the market is pretty bad out there and the available work is generally undesirable. i have been looking for work in a better locale for a while and can't find any leads so i'm preparing an application for the match at the same time to go into something else just in case this doesn't work out.
 
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AZpath

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Nov 1, 2012
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It has been a buyers market for pathologists for decades. Our labor is cheap and plentiful.
CMS cuts will force more consolidation. It is dog eat dog. Money is coming out of basic pathology to pay for more esoteric testing and drugs.

The story for the last decade has been displacement of traditional small group practices.
Money is going into new pockets such as in office practices and new corporate labs chasing big bucks. Most of this is fueled by profit margins.
This allows the large corporate labs to afford a large management and sales force. In office practices get rich by pumping up the small biopsies volume and then siphon off the extra cash.

Now a lot of cash is being pulled out by insurance and CMS. This makes supply and demand worse. It forces the business into larger hands with less cash to pathologists.
I don't see it getting any better in the next decade. I agree we are far from rock bottom.

I have been getting cold calls from the locum agencies for the about the last year or so. Work is not plentiful in the temp or perm market.
I am not looking for job so it hard to judge if it is worse in the last few years.
 

yaah

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Correct me if I'm wrong, but small hospital groups (1-3 pathologist groups) are shrinking. This is where locums coverage usually applied. These are shrinking because of hospital and system consolidation, so most hospitals are covered by larger pathology groups now. So fewer groups even need locums coverage now.
 

nr-xxx

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I Like what AZ path says. confirms my beliefs. All I can say is that in the past 20 yeas I have seen the jobs offered drop off from about 20 month in the CAP listing service to now maybe 1-2 per year on the major journals like NEJM. locums vary and sometimes are frivolous requests. many are done without agencies by word of mouth and are filled by people who already have jobs not residents or those actively seeking employment . I predict with the insurance cutbacks--esp. Heme path with 17% cut to flow cytometer ,etc..--that there may even be lay offs i. e .those that hired hem path fellowship types now do not get re-imbursed so get rid of them. also Academic types then they will require the new ones to get
R O 1 research grants for their salary . With R O 1 your chances are about 1 in 3 to 1 in 4 that it will be approved. so many academics may get laid off . For housestasff when I was at MD Anderson they had a monthly disclaimer that if Medicare funds did not come in then salary would be cut so if the house staff get no paycheck due to cutbacks in re-imbursements then I think they should look for another program and another specialty
pathology is done for.
don't go down on the Titanic
bail out get into something like Internal medicine or Primary care
 

AZpath

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Nov 1, 2012
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It has not got that much worse.
If it were really bad, experienced pathologists would cut from groups. They would be cold calling other groups. I don't see this happening.
 

pathslides

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Aug 7, 2016
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I Like what AZ path says. confirms my beliefs. All I can say is that in the past 20 yeas I have seen the jobs offered drop off from about 20 month in the CAP listing service to now maybe 1-2 per year on the major journals like NEJM. locums vary and sometimes are frivolous requests. many are done without agencies by word of mouth and are filled by people who already have jobs not residents or those actively seeking employment . I predict with the insurance cutbacks--esp. Heme path with 17% cut to flow cytometer ,etc..--that there may even be lay offs i. e .those that hired hem path fellowship types now do not get re-imbursed so get rid of them. also Academic types then they will require the new ones to get
R O 1 research grants for their salary . With R O 1 your chances are about 1 in 3 to 1 in 4 that it will be approved. so many academics may get laid off . For housestasff when I was at MD Anderson they had a monthly disclaimer that if Medicare funds did not come in then salary would be cut so if the house staff get no paycheck due to cutbacks in re-imbursements then I think they should look for another program and another specialty
pathology is done for.
don't go down on the Titanic
bail out get into something like Internal medicine or Primary care
Dude you are crazy. No wonder it was so hard for you to get a job. Your social skills are subpar. You and your RO1 grant necessity is rubbish. Path outlines lists job offers every day. It is where I found my job. Why are you checking sites like nejm for jobs.
 

LADoc00

Gen X, the last great generation
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A letter? A mere letter? I get a call literally every month because I once, ONE TIME threw these companies a lead and actually told them of a group that might be interested in a pathologist as a locums, maybe..and for that good deed I am plagued by calls if I know anyone, even in ISIS-controlled Syria who might need a locums pathologist. Its almost as if they are trying to pity sell me some complete zero of a human being over the phone and if I dont help, they are going to euthanize the pathologist for lack of a place to stick him/her. I get more respectable calls from the Humane Shelter in town. It's totally out of control.
 

nr-xxx

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I occasionally ( i mean about once every 4-6 months) about pathology locums ( most recent 2 weeks ago about outfit in Montana) Compare that to a field like ER where they emailing people almost weekly. yes I did locums work for 8 years. bad job market and I am also choosy I don't take what is always given Why? bad outfits out there. I see now on the internet places I could have gone to with major malpractice or major scandals. I could have gotten sucked into a snake pit . if it involves criminal activity ( e. g Up coding which is a felony) saying you were not involved when the group used your Medicare or NPI number to bill is not going to wash with the US attorney prosecuting the case. all it takes is one mishap like that to end a career so I look before I leap maybe I was too cautious but then again when I got my new job I also got a Security Clearance that meant I gave 2 sets of Fingerprints plus I survived a 6 month FBI background check and was "clean as a whistle" that alone is its own reward. all the best to anyone who reads my posts