Extremely Depressing

[Cesar]

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Its articles like this that make me totally freakkkkkkk out.

http://pathologyoutlines.com//management/ness200503.html

any comments.

 

[LADoc00]

Its articles like this that make me totally freakkkkkkk out.

http://pathologyoutlines.com//management/ness200503.html

any comments.

I have seen this comin during my entire residency. In my opinion it will only be a subset of pathology groups that get affected and so far its only been in those areas where pathologists are already the best compensated in the country (Texas for example). In my current group, Im completely insulated from such crap but if I did plan to branch out it would be a procedural related operation. I think the key is getting as much experience in DOING bone marrows, FNA, US guided FNAs (these are being captured from rads now) and even breast biopsies if you can and building around that. I made a big mistake focusing purely on diagnostics.

 

[bananaface]

I notice this passage: "About 2 years ago the GI’s took a 25% pay cut from Medicare on their clinical services. No clinician can see another 25% caseload increase without endangering patient health and safety."

The dude who wrote this article needs to go back and retake pre-algebra.

 

[LADoc00]

Holy fck me:

According to data compiled by the American Society of Plastic Surgeons, there's been a 700 percent increase in cosmetic plastic surgery procedures from 1992 to 2004. There were more than 9 million U.S. procedures last year, compared to an estimated 75,000 in the United Kingdom. (Note, of course, the U.S. population totals 297 million vs. the U.K.'s 60 million.)

Ummm time to change fields.

 

[bananaface]

I wonder how much a boob job costs now relative to then. One of my friends got them done for high school graduation. What a ****ed up way for parents to legitimize a young woman's existing self esteem issues. She was one of those girls whose mother taught her to wear a matching bra and panties so that she would not be embarassed if she ever ended up having to be seen in them by an emergency physician. Remember, honey, you aren't smart, you just work really hard. 😡

 

[yaah]

Its articles like this that make me totally freakkkkkkk out.

http://pathologyoutlines.com//management/ness200503.html

any comments.

I just think this country is headed towards (or is at) a crossroads. Costs are continuing to skyrocket, and patient demands for cheaper insurance as well as better care are skyrocketing as well. I do not know where these two demands will meet and compromise. Physicians are going to have to bear some of the brunt of this, I am afraid, as cost cutters and "consultants" like this guy determine that cutting physician salaries is the most public-relations friendly. There will be a small percentage who make a lot of money - turning into the business world where the CEO makes like 500 times the regular employee. I don't get it, but then again, I tend to think I actually have common sense.

So I don't think changes are limited to pathology. Specialization is going to become pretty important over the next few years, maybe even more than it currently is. But I wonder what will happen when patients (and maybe insurance companies) get fed up with everything being so specialized that getting to the doctor and taking care of your different conditions becomes something akin to a full time job - going to this center for your prostate, that one for your colon, over there for your skin, etc etc. Entrepreneurs will do this because it can make a tidy profit, but when people get fed up enough, things may change again. I just can't see things, any time soon, getting to the point where the need for diagnostic pathology gets a whole lot less.

 

[drPLUM]

Radiologists still seem to be in demand eventhough many physicians can preliminarily read their own films. For instance, ICU and pulmonary docs read their own chest films, neurosurgeons read their own CT's, and orthopods read their own MR's. They all send these to radiology for a final read eventhough they often proceed with a treatment plan based on their own reading. I wonder what keeps specialty practices from hiring their own radiologist in a "pod reading room" sort of situation?

 

[QuietSylph]

Its articles like this that make me totally freakkkkkkk out.

http://pathologyoutlines.com//management/ness200503.html

any comments.

This article doesn't freak me out. In my (limited) experience, physicians are more likely to feel comfortable reading radiology images than they are comfortable with reading pathology slides. (They probably miss a lot of findings that a radiologist wouldn't, but that's a side issue.) Pathology apparently seems more "mysterious" to most, which reduces my concern that suddenly a ton of GI docs will insist on reading their own slides. So ultimately, some of us might end up in a group with GI docs or urology docs. Is that really so bad? At least it offers more opportunities for subspecialization in the private practice market, which I consider a good thing.

As far as the comments about reaching out to your "customers" ... I think the article is right on. We are consultants. That means that we depend on other docs to send business our way. To encourage them to keep sending that business our way, we need to provide excellent service. We need to be indispensable - give them the color photos, the easy-to-read reports, the helpful website. Ultimately, we need to make it easier for the clinician to provide great patient care.

Pathology requires more business acumen than most medical students realize when deciding on a specialty. Fortunately, I enjoy the business end of things too. 👍

 

[mcfaddens]

I have seen this comin during my entire residency. In my opinion it will only be a subset of pathology groups that get affected and so far its only been in those areas where pathologists are already the best compensated in the country (Texas for example). In my current group, Im completely insulated from such crap but if I did plan to branch out it would be a procedural related operation. I think the key is getting as much experience in DOING bone marrows, FNA, US guided FNAs (these are being captured from rads now) and even breast biopsies if you can and building around that. I made a big mistake focusing purely on diagnostics.

HI Im New here and wanted to know if it was during residency that one gains procedural experence, and depending on the region of the country you are in can you market yourself as a provider of these procedures ( east caost heme/onc usually does bone marrow) and as far as FNA what did you mean about being captured from radiology and where would a pathologist be trained in ultrasound FNS's? do you have to do a cytopath fellowship?