Great jobs in pathology (new)

[exPCM]

5 directors + 7 other pathologists = 12 pathologists - seems about right by looking at the web page. It looks like most of the other faculty are non-physicians or adjuncts or VA employees.

I am not going to explain line by line how to read the financial statement.

I think the information presented is quite adequate for my comprehension.

If you want to try to prove the world is flat don't let me stop you.

One thing I will add is that faculty members attached to academic medical centers/med schools often do receive modest teaching stipends for giving lectures to the first and 2nd year med students, etc. However at some med schools they actually let pathology residents give lectures to the med students instead of attendings - e.g. Arizona - http://residency.pathology.arizona.edu/teaching.htm
Vermont- http://www.med.uvm.edu/pathology/TB8+BL+I.asp?SiteAreaID=565

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Members don't see this ad.

 

[v112233s]

exPCM & parts unknown: please don't be upset

We young students/residents are just starting and need these info. All we've been exposed to are books & clinics, and it takes a bit time to catch up. Better early than late.

I can understand why exPCM is frustrated, though. If you look at his past posts, he has been saying the same things over and over, but some people don't believe him, I guess. Many insist the job market is great. I think the tax forms provide pretty solid evidence for academic pay. The Stony Brook tax form looks very similar to the KS form, and I think those figures are probably standard for academic jobs.

In regard to the bucket of gold, I guess if you head the Rainbow Ave direction, you could find it in the home of radiologists.

 

[raider]

When you give someone bad news like cancer or something similiar it takes some time to accept the news. People try to find all sorts of reasons not to believe from conspiracy theories against them to what not. I believe it is similiar with some of the medical students/fellows here.
For anyone who has been in the workforce for a couple of years, it is very clear

(1) Surplus of board cetified pathologists. This gives universities and private practices the opportunity to exploit. Every advertised position gets numerous applications. When you will interview they will basically throw it in your face how many people applied for the job and how lucky you are to be considered for this 120k job. Not only that, you will be worked to death by being made to look at a gazillion slides and over that forced to publish x number of papers each year. This really breaks ones spirit. I know some of the staff at KU, not only is there pay that low, I have been told (horse's mouth) that they sign out a lot. Why don't they see the revenue they generate. Feels like pure and simple exploitation.

(2) Your counterparts in radiology on the other hand are actively recruited,handsomely treated and paid AT THE MINIMUM DOUBLE OR MORE of what you are getting in "so called" ACADEMIC CENTERS.

(3) I think some of the people pointed out THE NEGATIVE IMAGE ASSOCIATED WITH PATHOLOGISTS. It is true the other specialities think PATHOLOGISTS ARE POORLY DRESSED BETA TYPE INTROVERTS who ARE ILL AT EASE EXCEPT AT THE MICROSCOPE. Very tragic, since I believe anyone truly interested in such an excellent field is an ideal combination of a scientist, philosopher and artist and should dress and act accordingly.


(4) The saddest part however is that the PATHOLOGY DEPARTMENT IS ONE OF THE HIGHEST SOURCES OF INCOME FOR ANY HOSPITAL. However, many pathologists never see the INCOME THEY GENERATE ALL BECAUSE OF A TERRIBLE JOB MARKET.

I HOPE THIS TERRIBLE EXPLOITATION COMES TO AN END.

ALL OUR SO CALLED PROFESSIONAL ORGANISATIONS HAVE ABANDONED US. THEY HAVE CREATED A DOG EAT DOG WORLD WHERE WE ARE CONTENT WITH FIGHTING EACH OTHER FOR SCRAPS. PATHETIC!

 

[Parts Unknown]

5 directors + 7 other pathologists = 12 pathologists - seems about right by looking at the web page. It looks like most of the other faculty are non-physicians or adjuncts or VA employees.

Here is my concern: the financial statement does not look like that of a pathology department. It looks more like a spin-off endeavor such as OSU Pathology Services, LLC, which is a mechanism for the Ohio State University Department of Pathology to bill for professional component of CP services.

As such, the compensation listed for, say, Dr. Cunnigham in said statement might accurately reflect how much he receives from UPA, but it may not represent his entire remuneration package.

A very good friend of mine is an assistant professor of pathology, and she literally gets two paychecks, one from the academic department and one from the private department affiliate. Looking at either in isolation tells only half the story.

If you want to try to prove the world is flat don't let me stop you.http://www.med.uvm.edu/pathology/TB8+BL+I.asp?SiteAreaID=565

At no point have I said you are wrong, I just want a more rigorous analysis.

 

[Parts Unknown]

Take heart, it could be worse. You could be on the board for KUMC Obstetrics & Gynecology:

President: $94,781
Trustee: $99,522
Secretary: $81,692

 

[v112233s]

some of the people pointed out THE NEGATIVE IMAGE ASSOCIATED WITH PATHOLOGISTS. It is true the other specialities think PATHOLOGISTS ARE POORLY DRESSED BETA TYPE INTROVERTS who ARE ILL AT EASE EXCEPT AT THE MICROSCOPE. Very tragic, since I believe anyone truly interested in such an excellent field is an ideal combination of a scientist, philosopher and artist and should dress and act accordingly.

I was about to post a sample image of what I saw pathologists wear/dress, but decided not to. To be honest, I am not even sure if I could find similar outfits at the local salvation army. I agree that pathologists should dress and act accordingly.

 

[v112233s]

(4) The saddest part however is that the PATHOLOGY DEPARTMENT IS ONE OF THE HIGHEST SOURCES OF INCOME FOR ANY HOSPITAL. However, many pathologists never see the INCOME THEY GENERATE ALL BECAUSE OF A TERRIBLE JOB MARKET.

I heard about this too. Why is the money not going to the pathologists?

 

[Gyric]

Here is my concern: the financial statement does not look like that of a pathology department. It looks more like a spin-off endeavor such as OSU Pathology Services, LLC, which is a mechanism for the Ohio State University Department of Pathology to bill for professional component of CP services.

As such, the compensation listed for, say, Dr. Cunnigham in said statement might accurately reflect how much he receives from UPA, but it may not represent his entire remuneration package.

A very good friend of mine is an assistant professor of pathology, and she literally gets two paychecks, one from the academic department and one from the private department affiliate. Looking at either in isolation tells only half the story.



At no point have I said you are wrong, I just want a more rigorous analysis.

I suspect that is what is going on; try putting some of them into this public database of salaries (http://www.kansascity.com/InfoCentral/story/568233.html), they are not similar (for example Pearson is listed as making 68k, D. Zhang 42k), perhaps they do represent different salary sources? That being said, it is best to get local knowledge, which Raider apparently has, so not sure. They have a dermpath on staff, so he makes less than 100k, wow. Looking at their staff page, one of their professors is the vice chancellor of the whole med center, the link says her salary is >500k, you would think she would look out for her department and that U kansas pathologists would be relatively well compensated?

 

[yaah]

I was also wondering about two sources of income - if a university contracts with a private group (like "university pathology associates") there could be income to the pathologists from "university pathology associates" as well as from the school of medicine (for being a professor or whatever). I dunno. It would not surprise me. It's not that I don't believe the numbers though.

 

[LADoc00]

Hmmm, I *would* have initially guess that the UKansas list is the director fees those individuals are getting for running various subsections. In addition to this, they are also getting billings for professional services like reading marrows and flows.

BUT, the thing that is throwing me for a loop is the 40hrs/week. Makes it appear as if that is a FT salary.

That and directly contrasting it to the Radiology ones makes it look ridiculous.

 

[mrjames]

I was just contacted by a search firm that has multiple positions available now for pathologists. Unfortunately, I was not able to help her because all of our fellows and trainees have jobs. The list of jobs ranged from the West Coast to the Northeast.

At the risk of repetition, there are lots of good jobs for excellent candidates.

Dan Remick, M.D.
Professor and Chair of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center

Dr. Remick

what about pathologists in your department, are they paid better? What do you mean excellent candidates? do you mean top 5%, 10%, 20% 50% or 90%?

 

[LADoc00]

this thread makes me think perhaps I was being too generous in my initial thoughts about an associate position.

Given where I am is a insanely more desirable of place to live than Kansas City, I could probably offer a simple loan repayment program, 1000/week for work performed and free 3-dollar meals at McDonald's and get a star candidate!

Woohoo! I win!

 

[SpinachPizza]

I don't think we can take those documents as reflecting the entirety of those pathologists' income. All these statements show is the amount they received from UPA.

I am not affiliated with the KU path department, but I practice in the area.

They are under appointment from University of Kansas, which is a separate legal and business entity from the KU Medical Center. My assumption is that they receive $$ from the University for being professors, and then additional $$ through professional services, I suppose, billed by UPA. I would bet that UPA has a contract with KU Medical Center, to provide pathology services.

So in other words, I wouldn't jump to any conclusions based on those Schedule A forms.

ps: Mark Cunningham is a very nice and knowledgeable guy. KU did send a couple of them to a posh resort in Puerto Rico a few years ago for a hemepath conference (where I met him).

 

[v112233s]

I don't think we can take those documents as reflecting the entirety of those pathologists' income. All these statements show is the amount they received from UPA.

I am not affiliated with the KU path department, but I practice in the area.

Yet, there is still a 4x gap when compared to statements from the radiologists. I assume they have similar methods of reporting.


Correct me if I am wrong, but I was told that pathologists can generate comparable, if not more, revenue as the radiologists. Then, I really can't understand why pathologists should be content with any package less ideal than of the radiologists. The type of work and the revenue generated are similar, or so I heard. It is completely understandable from a private practice employer's perspective, if young pathologists can settle for a 100k salary, why should employers offer much more?

 

[2121115]

Yet, there is still a 4x gap when compared to statements from the radiologists. I assume they have similar methods of reporting.


Correct me if I am wrong, but I was told that pathologists can generate comparable, if not more, revenue as the radiologists. Then, I really can't understand why pathologists should be content with any package less ideal than of the radiologists. The type of work and the revenue generated are similar, or so I heard. It is completely understandable from a private practice employer's perspective, if young pathologists can settle for a 100k salary, why should employers offer much more?

JMO, but the radiology department probably has to pay their academic docs a competitive wage to keep them from leaving for private practice. The pathology department doesn't have to worry about their doc's leaving so there is no incentive. In any given town there may be 3 or 4 (or more) radiology practices that have the volume growth to hire a new radiologist. This keeps the academic institutions honest. But in that same town there may be one pathology practice that can absorb the volume they have without hiring additional staff. Meanwhile there are 3 pathology residency programs nearby, each turning out a fine supply of new grads every year. Think about it like this - if a new associate at a pathology group signs out, what, 30 cases a day (likely more?), a group of 10 pathologists only have to sign out an additional 3 cases per day in order to not need to hire anyone.


Edit: Hit the Freida link ( http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-online.shtml )On that note, check out these states that are cranking out way more pathology residents than there are good jobs. For instance...

Texas, Illinois, Ohio - look how many training programs there are! How many residents are finishing every year? Are there that many good jobs available in the local areas there?

Or look at Massachusetts and California! Training program proliferation, IMO

Or how about these southern states...

Alabama - 3 pathology residencies in the state - 15 new trainees finish every year
Tennessee - 4 pathology residency programs - 18! new trainees finish every year
North Carolina - 4 pathology residency programs - 16 new trainees finish every year
LOL! Are there 18 good jobs in Tennessee every year? 15 good jobs in Alabama every year? 16 good jobs in North Carolina every year?

Thoughts to ponder....

 

[v112233s]

The pathology department doesn't have to worry about their doc's leaving so there is no incentive...... This keeps the academic institutions honest.

Great post to think about.

I personally think there should be incentive for every pathologist. An overly saturated market affects everyone. But... never mind.

 

[Parts Unknown]

JMO, but the radiology department probably has to pay their academic docs a competitive wage to keep them from leaving for private practice.

I have a radiologist in the family and this is very true.

Believe it or not, the overproduction of radiology residents is a big topic of discussion in those circles. Most people are expecting imaging reimbursement to take a huge hit no matter what reform measures are passed. The days of any rads resident finding a cake job anywhere in the country are already largely gone. Suffice to say, things could go down the crapper for them really fast.

 

[Pathwrath]

Texas, Illinois, Ohio - look how many training programs there are! How many residents are finishing every year? Are there that many good jobs available in the local areas there?

Or look at Massachusetts and California! Training program proliferation, IMO

Or how about these southern states...

Alabama - 3 pathology residencies in the state - 15 new trainees finish every year
Tennessee - 4 pathology residency programs - 18! new trainees finish every year
North Carolina - 4 pathology residency programs - 16 new trainees finish every year
LOL! Are there 18 good jobs in Tennessee every year? 15 good jobs in Alabama every year? 16 good jobs in North Carolina every year?

No, that is why many of those residents will be leaving their state after training or entering a string of fellowships to postpone the inevitable.

 

[SpinachPizza]

Correct me if I am wrong, but I was told that pathologists can generate comparable, if not more, revenue as the radiologists.

The only way I know of this having a chance of being true is if the pathologist group owns a laboratory. I know of a group that owns its lab, and they do a bunch of commercial drug testing for local employers, as well as run of the mill AP/CP. (And they have to deal with all the headaches that come with owning and running a business like that). They reportedly make in the neighborhood of 650k as partners. Of course the buy in is over a million.

 

[mobmw325i]

Yeah we already know

Top 0.01% get great jobs
10% get ok jobs
10% get humiliating, pathetic jobs
The rest don't get a job but they are probably FMGs so it doesnt matter.

so if you are top 20% in a population of the top 0.0001% of the US you will get a job. Unlikely a very good job but at least you get a job. Think of the poor cardiothoracic surgeons and plz dont apply to dermatology.

As a physician on a medicine message board, this post is insulting. I know the bad math stereotype, but Iserson's has a 75% number for path grads getting jobs (on last one i checked). I know of a residency program with 80% FMG's and every single one goes on to fellowship and finds a job. (except for a couple that got pregnant and wanted to be housewives...)

 

[LADoc00]

ps: Mark Cunningham is a very nice and knowledgeable guy. KU did send a couple of them to a posh resort in Puerto Rico a few years ago for a hemepath conference (where I met him).

I dont think a single person here is saying anything about Dr. Cunningham that disparages him at all. The blame lays at the feet of the state of Kansas and UKansas for this vile usury!

 

[v112233s]

The only way I know of this having a chance of being true is if the pathologist group owns a laboratory.

Understand now. I didn't ask for further detail when I heard about how much revenue can pathologists generate in a hospital setting.


For problems with oversupply, has it been brought up in a more formal way to your professional meetings/societies/ACGME/whoever in charge? "Leaving their state (presumably AL, TN, CA, MA, NC......) after training or entering a string of fellowships to postpone the inevitable" seems dire enough for someone to speak up.

 

[pathologic]

I'm getting pretty tired of all the doom and gloom. My PD emails us job openinigs almost weekly. I'm not buying into the BS of no jobs. If you're willing to work hard and earn your stripes, the money is out there.

 

[LADoc00]

I'm getting pretty tired of all the doom and gloom. My PD emails us job openinigs almost weekly. I'm not buying into the BS of no jobs. If you're willing to work hard and earn your stripes, the money is out there.

Im paying 25 bucks an hour+all the McDonalds you can eat, please be triple board certified from a top 10 program. PM me. Im serious. I would like to spend more time tending my investments.

 

[Granular]

I'm getting pretty tired of all the doom and gloom. My PD emails us job openinigs almost weekly. I'm not buying into the BS of no jobs. If you're willing to work hard and earn your stripes, the money is out there.

You might be right; but you can't get to it, even if you earn it. At the academic hospital where I am training, the 8 or 9 FTE surgical pathologists/cytologists sign out >30K surgicals and 50K cytology cases per year. The hospital keeps an excess of over $1 million of what is collected in billing for PC of AP. I think the hospital can get away with underpaying these pathologists each (on average) over $100K/year less than they earn because they have no place else to go. v112233s and 2121115 are correct - if the academic pathologists had any bargaining power by threatening to leave, they could get more of what they earned. Bottom line is they have zero bargaining power; the department could hire three triple-boarded, freshly-minted pathology grads overnight. When they did advertise and needed to hire, they were swamped with applications. I believe there are "job openinigs"(sic), but many of those hiring just want to exploit you.

mobmw325i references Iserson to tell us that 75% of pathology grads get fellowships and jobs. Apparently, he or she thinks this is acceptable. Are you kidding me? Anything short of 99.8% job placement for the 500 annual grads is unacceptable. We have a long way to go to fix this, if that is even possible.

Perhaps AP can be eliminated as a specialty in entirety. The surgeons and gastroenterologists should just train to recognize the histology/pathology of the organs they operate on, and we can pass the field of anatomic pathology entirely to them, just like derm. Also, I think the old school hem/oncs learned to read peripheral bloods and marrows; they can probably learn to read their own stuff again. Precedent for elimination of a field exists: Lab medicine has already been essentially snuffed out as a career for MDs or DOs, and is being taken over by lower paid PhDs with some clinical fellowships. When AP work pays little enough, it will disappear too. Too bad so many of us have invested so much in it.

 

[Nilf]

this thread makes me think perhaps I was being too generous in my initial thoughts about an associate position.

Given where I am is a insanely more desirable of place to live than Kansas City, I could probably offer a simple loan repayment program, 1000/week for work performed and free 3-dollar meals at McDonald's and get a star candidate!

Woohoo! I win!

You're going straight to hell.

 

[Gyric]

Easy there Granular, for your first post you are taking this board a bit too seriously. Arguably this form of communication selects for a negative perspective. Check out any other physician forum, you will see the same thing, maybe it is more commonplace on the pathology forum, but that does not mean that our specialty is on the road to ruin anymore than the rest of medicine.

As for your faculty, are they really that dispensable? If so, I am sorry you lack better role models. The pathology faculty I have worked with are an integral part of the patient care team and are very well respected; if a senior member of the department left because they were not treated fairly, the surgeons and oncologists would go after the CEO with pitchforks. Oh yeah and several of the hospital’s leaders are pathologists, I am sure they are just getting walked all over…

Eliminate AP … have gastroenterologists read their own biopsies … is this your first month of residency?

 

[Granular]

… have gastroenterologists read their own biopsies … is this your first month of residency?

Maybe I don't understand what dermatopathologists do.

 

[APCPPathologist]

Perhaps AP can be eliminated as a specialty in entirety. The surgeons and gastroenterologists should just train to recognize the histology/pathology of the organs they operate on, and we can pass the field of anatomic pathology entirely to them, just like derm. Also, I think the old school hem/oncs learned to read peripheral bloods and marrows; they can probably learn to read their own stuff again. Precedent for elimination of a field exists: Lab medicine has already been essentially snuffed out as a career for MDs or DOs, and is being taken over by lower paid PhDs with some clinical fellowships. When AP work pays little enough, it will disappear too. Too bad so many of us have invested so much in it.

I don't know if Granular was trying to be sarcastic, but s/he may be correct. This has come out from time to time in the past decade as a exercise, but a real threat now exists in the current and next generation of confocal endoscopes and MRIs. In the past 5 to 8 years a lot of research papers have demonstrated that confocal endoscopes and 6 to 8 Tesla MRIs (Current generation 1.5 to 3T) have micron resolution. I have started to see a number of industry symposia as well as occasional papers that have indicated that these technologies have micron resolution of clinical utility. Plus, I've started to see large companies start to endorse these technologies as new sources of revenue. If a body of literature demonstrates equivalency get ready for things to be diagnosed by the given speciality: pulmonary, gastroenterology, radiology. There is no way a gastroenterologist is going to take a micron level imaged and then pass it on to the pathologist--it will go to a gastroenterologist with some new subspeciality training; same goes for rads. There will still be a resection- but you may not get 10 sets of 88305s for barrett's or ibd surveil. This is the end in slow motion---think 15 to 20 years before these fields start to seriously errode AP.

 

[exPCM]

You might be right; but you can't get to it, even if you earn it. At the academic hospital where I am training, the 8 or 9 FTE surgical pathologists/cytologists sign out >30K surgicals and 50K cytology cases per year. The hospital keeps an excess of over $1 million of what is collected in billing for PC of AP. I think the hospital can get away with underpaying these pathologists each (on average) over $100K/year less than they earn because they have no place else to go. v112233s and 2121115 are correct - if the academic pathologists had any bargaining power by threatening to leave, they could get more of what they earned. Bottom line is they have zero bargaining power; the department could hire three triple-boarded, freshly-minted pathology grads overnight. When they did advertise and needed to hire, they were swamped with applications. I believe there are "job openinigs"(sic), but many of those hiring just want to exploit you.

mobmw325i references Iserson to tell us that 75% of pathology grads get fellowships and jobs. Apparently, he or she thinks this is acceptable. Are you kidding me? Anything short of 99.8% job placement for the 500 annual grads is unacceptable. We have a long way to go to fix this, if that is even possible.

Yes and if you look at the CAP career center ( http://www.healthecareers.com/site_templates/cap/index.asp?aff=cap&spld=cap ) there are now only 36 jobs advertised for those 500+ graduates. I believe this number of 36 represents the lowest since I have been looking at the site for the past 5 years.

By comparison there are 217 openings advertised at the American College of Radiology site:
http://jobs.acr.org/search.cfm

 

[Pathwrath]

If a body of literature demonstrates equivalency get ready for things to be diagnosed by the given speciality: pulmonary, gastroenterology, radiology. There is no way a gastroenterologist is going to take a micron level imaged and then pass it on to the pathologist--it will go to a gastroenterologist with some new subspeciality training; same goes for rads. There will still be a resection- but you may not get 10 sets of 88305s for barrett's or ibd surveil. This is the end in slow motion---think 15 to 20 years before these fields start to seriously errode AP.

This is a really interesting topic and one I've spent some time considering! When I was younger, I assumed physicians were more or less the same across the board and would react to these market incentives/pressures in predictably similar ways.

As I get older, I've become much more interested in the differences in temperament between specialists, first because I think they are very real and second because I think these differences explain a great deal why the specialties are in the variable conditions they are in. Let me explain. There is a lot of sweeping and potentially insulting generalization here, but they are the result of years of observation.

Radiologists make a lot of money and do want to keep it that way. However, they are risk-averse and in general prefer obvious or vague-hedgy BS reports over specific difficult diagnoses with immediate serious implications. They are not in the business of sticking their necks out. I just don't see them becoming cancer diagnosticians anywhere on a par with pathologists, regardless of their new nifty technology. It is not in their nature.

IM and its anal-retentive subspecialists are trained in and absolutely require scorched earth, circle-jerk test-ordering to reach a final diagnosis. They need lab voodoo to buttress their clinical decisions. Gastros are probably the least ruminative of this lot, but even they count on pathologists to take responsibility for the bottom-line cancer diagnosis.

There is a difference between ordering or even performing a test and signing on the bottom line.

Now what about dermatopathologists? Doesn't that refute the argument? Well, we anatomical pathologists still get every single skin lymphoma our local huge dermpath group receives, because they are terrified of anything that strays from their dermatitis/BCC/nevus/melanoma/trivial pursuit diagnoses, and with good reason. And that is only skin! Gastros handling the gamut of gut or radiologists the entire body? I don't see it.

 

[Pathwrath]

Oh, and one more thing about gastros--the whole point of setting up a scope mill is to maximize profit and minimize thinking. Mindless billable procedure over mentation.

Due to the pathologist glut (the result of pathologists' natures, by the way), scope mills can in-source pathologists for a profit. Why in God's name would they take on the poorly compensated extra responsibility of actually rendering a diagnosis?

 

[LADoc00]

You're going straight to hell.

Hmmm, I would think that would be more of requiring an "extra" effort of young female associates on the (rough) road to partnership.

Ive heard (heresay..) of other subspec groups that have such arrangements, the Devil's work for sure.

 

[Granular]

Radiologists make a lot of money and do want to keep it that way. However, they are risk-averse and in general prefer obvious or vague-hedgy BS reports over specific difficult diagnoses with immediate serious implications. They are not in the business of sticking their necks out. I just don't see them becoming cancer diagnosticians anywhere on a par with pathologists, regardless of their new nifty technology. It is not in their nature.

IM and its anal-retentive subspecialists are trained in and absolutely require scorched earth, circle-jerk test-ordering to reach a final diagnosis. They need lab voodoo to buttress their clinical decisions. Gastros are probably the least ruminative of this lot, but even they count on pathologists to take responsibility for the bottom-line cancer diagnosis.

There is a difference between ordering or even performing a test and signing on the bottom line.

Now what about dermatopathologists? Doesn't that refute the argument? Well, we anatomical pathologists still get every single skin lymphoma our local huge dermpath group receives, because they are terrified of anything that strays from their dermatitis/BCC/nevus/melanoma/trivial pursuit diagnoses, and with good reason. And that is only skin! Gastros handling the gamut of gut or radiologists the entire body? I don't see it.

Due to the pathologist glut (the result of pathologists' natures, by the way), scope mills can in-source pathologists for a profit. Why in God's name would they take on the poorly compensated extra responsibility of actually rendering a diagnosis?

Point(s) taken. I realize that AP is not going away - endoscopy, preparing that slide with a polyp on it, and H&E staining is still cheap compared to some fancy MRI, so we'll probably be in business a little while longer. Not to mention the responsibility aspects you discussed. I just was thinking out loud about the long term impact of junior pathologists getting little pay and/or respect, both within and outside of pathology. Will people keep coming thru the ranks, will word get out about the conditions, and how will other fields of medicine exploit/adapt to the possible changes in pathology?

 

[2121115]

Pathology is the only specialty in an academic medical center that generates huge profits but the physicians make in the low 100k range. At my medical center (a prestigious academic name) the pathologists make less than family medicine and general pediatrics. All those 88305's go straight into the pocket of the hospital.

 

[yaah]

Pathology is the only specialty in an academic medical center that generates huge profits but the physicians make in the low 100k range. At my medical center (a prestigious academic name) the pathologists make less than family medicine and general pediatrics. All those 88305's go straight into the pocket of the hospital.

At my residency pathologists made more than internists, pediatricians, family physicians, psych, neurology, (all by ~10% or so by equivalent faculty rank) about equivalent to some IM specialists. Surgeons made more (sometimes a lot more). Radiologists made more. Anesthesia. Not sure about ER. The highest paid physicians in this hospital were the neurosurgeons and the heart surgeons.

 

[Giemsa]

At my residency pathologists made more than internists, pediatricians, family physicians, psych, neurology, (all by ~10% or so by equivalent faculty rank) about equivalent to some IM specialists. Surgeons made more (sometimes a lot more). Radiologists made more. Anesthesia. Not sure about ER. The highest paid physicians in this hospital were the neurosurgeons and the heart surgeons.

I'm in Canada, and it's about the same here:

Family, general internal med, peds (particularly neonatal, don't ask me why!) and psych are all paid the least, in general. But there's real shortage of psychiatrists here, so maybe that will change.

Path, neurology, general surg, nuc-med are in the middle. Anesthesia, ER, less-sexy IM specialties are upper middle.

Rads and the sexy IM specialties are upper. Surgical specialties here, too. Stratosphere: Cardio. Derm. Optho.

 

[TMZ2007]

I'm in Canada, and it's about the same here:

Family, general internal med, peds (particularly neonatal, don't ask me why!) and psych are all paid the least, in general. But there's real shortage of psychiatrists here, so maybe that will change.

Path, neurology, general surg, nuc-med are in the middle. Anesthesia, ER, less-sexy IM specialties are upper middle.

Rads and the sexy IM specialties are upper. Surgical specialties here, too. Stratosphere: Cardio. Derm. Optho.

So in the Canadian single-payer system, there is a stratification in compensation for the various specialties? Is physician income salary-based or on a piecemeal basis?

Interesting (to me), only because when I rotated in England, I noticed that the NHS paid all consultants about the same (+/- cost-of-living/location factors). You could make more money with a side practice that accepts private insurance.

 

[tantrum]

So in the Canadian single-payer system, there is a stratification in compensation for the various specialties? Is physician income salary-based or on a piecemeal basis?

Interesting (to me), only because when I rotated in England, I noticed that the NHS paid all consultants about the same (+/- cost-of-living/location factors). You could make more money with a side practice that accepts private insurance.

When I was working in Canada, it's single-payer (usually by province) but it's still fee-for-service (some opt for salaried positions). All procedures have codes (without any relation to CPT codes) and procedure-oriented specialties still makes more. The primary care docs are SO BUSY they still make a lot (GP's).

 

[medicomel]

i know i'm hijacking this thread but i'd like an opinion on what the benchmark of an acceptable salary is. we may all have differing opinions. i, for instance, want to pay off my state school loans and buy a modest home with a used luxury car.

i'm applying to residency programs in pathology this year, and it's making me think twice.

do we need to be scared about not breaking $100K or 200K?

please advise. i just want to make a decent living doing what i enjoy; i don't crave an opulent lifestyle.

 

[Psychopathology]

do we need to be scared about not breaking $100K or 200K?

please advise. i just want to make a decent living doing what i enjoy; i don't crave an opulent lifestyle.

100K would scare me if I was working full-time. In residency, you'll make half of that and barely makes ends meet You probably will not be able to put much of anything away for retirement and depending on where you live and with whom you live, you may be able to afford a mortgage or a vehicle. That's okay for a few years if you are young, healthy, and are not saving up for someone else's college fund. To double your resident salary as an attending and pay greater taxes, at the tender age of whatever (some of us will be mid thirties plus) doesn't leave you with a lot to work with. You will not have an opulent lifestyle on 100K out of residency and fellowship. Don't get me wrong, 100K is an extraordinary salary for someone three years out of college with a liberal arts degree and very little debt, but our investment, time, and expertise demand more... or at least they should.

We all want to attract top people to our field and feel confident with our decisions to pursue this career. Money won't make you happy, but the absence of it will make you miserable... and drive prospective colleagues away.

 

[raider]

Pathology job market is terrible. Excellent talent is being exploited/abused because of it and our organizations are full of beta type losers who are content with being at the bottom of the food chain of physicians. What we need is NEW LEADERSHIP that takes step to make pathologists the LEADERS OF OTHER PHYSICIANS AND A FORCE IN THE HOSPITAL.

Here is another example of someone lamenting about the terrible market
http://members.tripod.com/runker_room/ap/ap_jobs.htm

 

[v112233s]

Pathology is the only specialty in an academic medical center that generates huge profits but the physicians make in the low 100k range. At my medical center (a prestigious academic name) the pathologists make less than family medicine and general pediatrics. All those 88305's go straight into the pocket of the hospital.

Forgive my naiveness, who determines the pathologist salary in a hospital setting? I heard that some depts can negotiate with the hospital and do a % share on the revenues generated. Is this true? So what are pathologists doing about this? When you can't get to the cash you generate, that sounds like pure usury and slavery.


A 100k salary is not enough to pay back your student loans, mortgage, car loans and live comfortably. You also have to factor in kid's tuition since your income will not qualify for any financial aid. If pathologists can't generate any revenue, that's one thing, but if they can, not fighting for proper compensation is another. I find it hard to understand this. Instead of fighting for what you deserve, people are wondering what's the minimum they can go by to do the "only they can imagine themselves doing." Yes, every specialty in medicine is suffering now. However, radiologists have to get a 75% slash in salary to live like their pathology colleagues on 100k. Say at their entry income of 400k, if they get a 20% slash in salary EVERY year starting TODAY, it will takes 6 years for radiologists to make 100k. During this time, they will take home at least 300k more than their pathology colleagues after a 40% tax. That's a very good retirement saving already.


exPCM- Interesting. 36 positions aren't even enough to support all the graduating residents/fellows from top 5 programs.? I would think there should already be a revolt given your current job market & salary level. Wouldn't this at least deserve some serious discussion at your professional meetings? How about ACGME? I am sure ACGME is looking for ways to cut funding support. 100k/resident (according to what people say here) is a lot of money. If the leadership in your field is not helping you out, what can you do about it? BTW, are you guys paying fees/dues to support your professional societies?

 

[v112233s]

As for your faculty, are they really that dispensable? If so, I am sorry you lack better role models. The pathology faculty I have worked with are an integral part of the patient care team and are very well respected; if a senior member of the department left because they were not treated fairly, the surgeons and oncologists would go after the CEO with pitchforks. Oh yeah and several of the hospital's leaders are pathologists, I am sure they are just getting walked all over…

You mentioned senior faculty are being very well respected, but being well-respected might not equal to being fairly compensated. The entry level radiologists would think they are completely mistreated at anything <400k! How about pathologists? What is "treated fairly" anyway? Would the surgeons/onc go after the CEO with pitchforks in support of their respected pathology colleagues who threaten to leave b/c 100k is not commensurate with their expertise or the revenue they generate?

 

[yaah]

Wouldn't this at least deserve some serious discussion at your professional meetings?

Unfortunately, serious discussion has not happened much at national meetings, there are several reasons I have noted for this:

1) Residents who ask these questions often end up throwing tantrums or going on and on, and therefore embarassing themselves and making everyone uncomfortable.

2) Most of the residents at national meetings seem to be finding good jobs (say what you want, it's true), or are younger and have not started looking, so they are less concerned. I have talked to several residents and fellows who have witnessed these screamfests with me, and they often say, "I have heard others complain about the job market, but I didn't have any trouble. But I can see why he/she did."

3) Panelists are often those who are only peripherally connected to job market issues (thus, they may not be aware of a lot of the difficulties). And when they become aware of difficulties, it is often in the form of one of the residents in #1 above, which is a lot easier to overlook and explain.

4) Once people get a job they are happy with, they seem to lose any concern they might have had about the job market.

 

[malchik]

As for your faculty, are they really that dispensable? If so, I am sorry you lack better role models. The pathology faculty I have worked with are an integral part of the patient care team and are very well respected; if a senior member of the department left because they were not treated fairly, the surgeons and oncologists would go after the CEO with pitchforks. Oh yeah and several of the hospital’s leaders are pathologists, I am sure they are just getting walked all over…

Hmmm, interesting. Most of the attendings where I am, actually pretty much all of them, could be replaced and the surgeons wouldn't bat an eye, IMO. And we have some famous people, this is widely considered a good program. In fact, many of the younger attendings appear to be on a 3-4 year cycle, where they get overworked until they can't take it anymore, then just get replaced. I have always wondered what it's like elsewhere. Anyone else care to comment on the level of respect you perceive your attendings command?

 

[JPR22]

The true solution for this problem would be to significantly reduce training spots, and lengthen training. I can only imagine why this wont happen. Looking to realistic solutions, and I know these wont be popular, theres a few ideas:
-Have pathologists take do some of the work being done by PAs, or simply be PAs if the situation becomes dire
-Use extra time in residency/fellowship to train for another occupation to keep one afloat during times of un/underemployment
-work part-time during residency, to save up money/pay of student loans so that not receiving a high salary will be more tolerable

 

[2121115]

Hmmm, interesting. Most of the attendings where I am, actually pretty much all of them, could be replaced and the surgeons wouldn't bat an eye, IMO. And we have some famous people, this is widely considered a good program. In fact, many of the younger attendings appear to be on a 3-4 year cycle, where they get overworked until they can't take it anymore, then just get replaced. I have always wondered what it's like elsewhere. Anyone else care to comment on the level of respect you perceive your attendings command?

Actually, the attendings at my program get along really well the the surgeons and there is a mutual respect. There may be many problems in pathology, but at my program this isn't one.

The true solution for this problem would be to significantly reduce training spots, and lengthen training. I can only imagine why this wont happen. Looking to realistic solutions, and I know these wont be popular, theres a few ideas:
-Have pathologists take do some of the work being done by PAs, or simply be PAs if the situation becomes dire
-Use extra time in residency/fellowship to train for another occupation to keep one afloat during times of un/underemployment
-work part-time during residency, to save up money/pay of student loans so that not receiving a high salary will be more tolerable

I'd love to see an academic pathologist actually pick up a specimen and gross it. Ha! You see, everyone says this skill is very important, so important in fact that no attendings take the time to do it.

 

[LADoc00]

What we need is NEW LEADERSHIP that takes step to make pathologists the LEADERS OF OTHER PHYSICIANS AND A FORCE IN THE HOSPITAL.

The self-selection bias in the pathologist towards lemminghood is huge. We are a group who collectively brown-nosed our way to where we are, at least to some degree (and dont claim you are any different..). There is no Pathology King Leonidas ready to lead his 300 Spartans to demand better pay and working conditions for us. There is no Gen. George Patton leading the charge to maintain the meager compensation for 88305s.

Pathology is dominated by self interest and the mad panic to make a quick buck before the next floor falls out from underneath you. It permeates every conversation Ive had for the last 2 years:
~get paid now, there is no tommorrow
~save everything you can
~plan an exit strategy

Honestly in my day to day life I feel more and more like a pirate running from the British Navy (aka the gubberment).

 

[KluverB]

If all else fails, there is always a Plan B...

http://www.cnn.com/2009/US/08/03/new.york.jobless.graduate/index.html