First Job Offers for Four Fellows

[Napoleon1801]

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[KeratinPearls]

Nice I never was offered anything more than 200k when I interviewed. 300-375k starting? Maybe dermpath? Who the hell is offering that much for a general pathologist (when you can pay someone 200k).

I did interview at a 350k job but that was middle of nowhere upstate NY.

I interviewed at a 400-600k partner job at a busy community hospital. Starting salary was 180k lol with increase in salary with time. Full shareholder status in 6-7 years (still not sure what that meant? Partner?).

Unless something has changed, starting salaries are going up compared to when I was looking.

 

[cmz]

Starting salaries are going up. Expect at least 300K. Recruiters are trying to help sweeten deals by offering "commencement bonuses" and "retention bonuses"...

 

[KeratinPearls]

Starting salaries are going up. Expect at least 300K. Recruiters are trying to help sweeten deals by offering "commencement bonuses" and "retention bonuses"...

Interesting. Is it because of pathologists retiring due to Covid and a resulting supply demand shift? Funny how things change so quickly.

 

[cmz]

Interesting. Is it because of pathologists retiring due to Covid and a resulting supply demand shift? Funny how things change so quickly.

I think the driving force is Covid. There are also a lot of older pathologists who are probably tired of the game and finding out that every facet of medicine is changing. This seems like it will be a temporary thing, but maybe not. Millennials who want to only do subspeciality sign-out? We shall see how everything plays out.

 

[deleted314957]

This is, on average, so far below 30 years ago ( in today dollars) it makes me sick. I’d still be working and paying a effing mortgage!

 

[Alteran]

I would need to know more about this sample size of 4. I'm going to guess they're from a prestigious institution with an in-demand specialty or skill set.

I would also guess that those jobs paying above the $300K mark are either in the middle of nowhere or are total sweatshop style practices to justify that kind of salary. In our experience, unless a fellow trained at a place with high-volume and was afforded a great degree of autonomy, they won't generate that kind of billing for a few years.

 

[octopusprime]

This is, on average, so far below 30 years ago ( in today dollars) it makes me sick. I’d still be working and paying a effing mortgage!

This needs to be repeated and understood by all who are looking for a job. There's no way around medicare and private insurance cutting reimbursement rates for our CPT codes, cutting payments entirely for CP billing, and healthcare becoming more consolidated. But there are other factors at play that contribute to the race to the bottom as have been discussed ad nauseum on this forum and even in this thread. Be aware of what they are before you enter the job market and ideally before choosing pathology as a career.

 

[cmz]

This is, on average, so far below 30 years ago ( in today dollars) it makes me sick. I’d still be working and paying a effing mortgage!

It's getting more difficult to be reimbursed for generally every CPT. Billing companies are having to appeal more and more denials. PC-CP? That pie is starting to shrink even more. Some carriers are not paying anymore. Certain carriers are capping payments. You have to be on the constant hunt for the next flavor of the month when it comes to path billing. Once that well dries up, you need to move to the next.

 

[caffeinegirl]

Mick Raich posted recently that more cuts are coming:
"Last EWC update: The cuts are coming. PAMA is looking at making labs take a 15% cut in 2023 and 2024 barring any further intervention. Pathologists are looking at a cut of 9% starting in 2023. These are very real payment issues for a industry locked into set pricing by the payers, add on inflation and you have a perfect storm of negative. Be prepared!"

 

[deleted314957]

It's getting more difficult to be reimbursed for generally every CPT. Billing companies are having to appeal more and more denials. PC-CP? That pie is starting to shrink even more. Some carriers are not paying anymore. Certain carriers are capping payments. You have to be on the constant hunt for the next flavor of the month when it comes to path billing. Once that well dries up, you need to move to the next.

What is amazing is that the money used to be in clin path. We gave away(figuratively at the time) AP to get the CP!

A week before I started my residency in 1981 a mentor told me “ any money you make in pathology will come from the clinical lab. any reputation you make will come from AP”.
At the time, it was true. You made money every time that Coulter Counter clicked.

 

[caffeinegirl]

Just to reiterate - for those hospital-based positions where a pathology group contracts with the health system - these further cuts are concerning. The hospital administration sees the lab as a cost center, and if they lose more money they are more enticed to sell it off. Even if your group has a "strong" relationship with the hospital admin, your position is still not secure as they will look to sell off as much of the lab as possible (AP especially). There are several examples of this happening that have already been described on this forum. It's a trend that will continue to accelerate as these cuts continue to come. That's just another reason why pathology is very different from other specialties in medicine - many times you do not have autonomy over your volume/revenue stream.

 

[gbwillner]

This certainly argues for an improving marketplace, and follows the locums info that they can't find anyone for the common low rates.

 

[gbwillner]

Mick Raich posted recently that more cuts are coming:
"Last EWC update: The cuts are coming. PAMA is looking at making labs take a 15% cut in 2023 and 2024 barring any further intervention. Pathologists are looking at a cut of 9% starting in 2023. These are very real payment issues for a industry locked into set pricing by the payers, add on inflation and you have a perfect storm of negative. Be prepared!"

PAMA is the self-immolation of the lab industry. Be wary of getting what you ask for.

 

[LADoc00]

There are some mid careers job opportunities I have looked at that are simply unprecedented. Even I had a hard time saying no.

1.5-2m/year + 4% equity stakes.

Not sure where these jobs have been my last 16+ years. Inflation? Tech boom?

Doubt it will last though. Went to a meeting where a company pitched this and the waitress overhead the conversation and wrote "R U SINGLE??" on the tab. hahaha.

 

[HeyDalaron]

There are some mid careers job opportunities I have looked at that are simply unprecedented. Even I had a hard time saying no.

1.5-2m/year + 4% equity stakes.

Not sure where these jobs have been my last 16+ years. Inflation? Tech boom?

Doubt it will last though. Went to a meeting where a company pitched this and the waitress overhead the conversation and wrote "R U SINGLE??" on the tab. hahaha.

Hold up. What industry is pushing those kinds of numbers?

 

[LADoc00]

Hold up. What industry is pushing those kinds of numbers?

MolTech

 

[Med Director New England]

Just to reiterate - for those hospital-based positions where a pathology group contracts with the health system - these further cuts are concerning. The hospital administration sees the lab as a cost center, and if they lose more money they are more enticed to sell it off. Even if your group has a "strong" relationship with the hospital admin, your position is still not secure as they will look to sell off as much of the lab as possible (AP especially). There are several examples of this happening that have already been described on this forum. It's a trend that will continue to accelerate as these cuts continue to come. That's just another reason why pathology is very different from other specialties in medicine - many times you do not have autonomy over your volume/revenue stream.

Great points ^^

Another problem for hospital based paths who are employed by a large multi speciality medical group, which is common in New England, is that path depts are fighting for dollars with other depts. so a highly coveted specialists like ENT, urology, etc or even PCPs will get more of the pie/dollars

Glad to hear things are improving for some but I am still seeing new docs in high demand specialities get 50 k sign on / 150 k in loan assistance - while the same medical group doesn’t doesn’t do this for new path hires and still pays no where close to the numbers others are calling out