Has anyone heard of IRL pathology?

[pathstudent]

they are owned by HCA out of Nashville with a directive to take over all 160 HCA hospitals.

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[WEBB PINKERTON]

Corporations making money off of people, I had no idea that went on....

Blame those that came before us, who sold their souls, and the programs for keeping a never ending supply of labor available.

I am starting to see Radiologists being let go and replaced with national radiology companies in my area. Looks like they are heading down the same path we have already traveled.

Surgeons will be demanding and getting 25 percent of bundled payments so the money has to come from somewhere. 25 percent is the maximum one entity can receive and there will lot of competition from hospitals for specialists in demand.

Flee pathology now!

 

[AZpath]

They have 28 pathologist in Florida.
Not that big folks.

 

[ermonty]

I interviewed with IRL / HCA about two years ago for a position in western Florida. IRL did very well in the southeast Florida market and (at the time I interviewed) they were moving into the west coast of Florida market. Basically anywhere HCA has bought out a hospital, IRL takes over the laboratory operation. Usually this involves absorbing the current pathology group that provides service to the hospital. If I recall, something like 10 or more hospitals in the western Florida division were taken over, and all of the labs were taken over by IRL, resulting in I'd say probably ~70% or so of the pathologists in those positions leaving/retiring, and ~30% rolling into IRL employment. The labs in each hospital were smaller to mid size in volume, two employed pathologists per lab (one 'lead' position with admin responsibility, one straight employed). The entire western market was broken up into separate regions (based around Tampa), with a centralized laboratory for gross processing as well as other technical testing (molecular, etc). Call was shared amongst all pathologists within a region (to lessen the call burden). Same thing with vacation, some cross over between hospitals. Overall, the package (salary/benefits) was decent as far as employment goes. I ultimately passed on the job offer (took a private practice job in the NE).

 

[pathstudent]

They have 28 pathologist in Florida.
Not that big folks.

Not true

 

[univlad]

they are owned by HCA out of Nashville with a directive to take over all 160 HCA hospitals. Supposedly they pay 250k a year but only offer 4 weeks vacation. They generate roughly 500k-1M a year per hospital by paying the pathologists less than they generate. In other words they do what quest/ameripath have been doing to pathologists for years. Given HCA has 160 hospitals they will eventually earn about 100,000,000 a year of the backs of pathologists. Awesome for them.

What is the benefit for HCA to own a separate path group rather than just have each hospital employee two pathologists and cross cover?

 

[Path or bust]

What is the benefit for HCA to own a separate path group rather than just have each hospital employee two pathologists and cross cover?

Many states don't allow hospitals to directly hire physicians. By starting this independent subsidiary path group, they get around those laws.

 

[turtle1966]

What is the benefit for HCA to own a separate path group rather than just have each hospital employee two pathologists and cross cover?

As a business principle, you hire an "employee" expecting him to generate more income than his pay. It is a truism that "independent private practice pathologists" earn far more than "employed pathologists".

The HCA is practicing the "cut out the middle man" principle of business. It has happened with the so called physician office labs or independent office labs. I would predict that in the future this would be considered quite a "norm." I would do the same if I were in their "shoes."

How much of cut? At least 50% or more.

 

[univlad]

As a business principle, you hire an "employee" expecting him to generate more income than his pay. It is a truism that "independent private practice pathologists" earn far more than "employed pathologists".

The HCA is practicing the "cut out the middle man" principle of business. It has happened with the so called physician office labs or independent office labs. I would predict that in the future this would be considered quite a "norm." I would do the same if I were in their "shoes."

How much of cut? At least 50% or more.

Yeah..I understand why they want to have employed pathologists to make money, but why aren't they just employed by HCA rather than HCA creating a separate company they own to employ them.

 

[turtle1966]

Yeah..I understand why they want to have employed pathologists to make money, but why aren't they just employed by HCA rather than HCA creating a separate company they own to employ them.

For internal reasons known only to them. However, one could list management efficiency and commercial potential of an independent lab entity.

 

[pathstudent]

Yeah..I understand why they want to have employed pathologists to make money, but why aren't they just employed by HCA rather than HCA creating a separate company they own to employ them.

They are employed by HCA. It's not a separate company

 

[pathstudent]

Irl has taken tover the HCA hospitals in Colorado.

 

[deleted314957]

Irl has taken tover the HCA hospitals in Colorado. The main casualty is ameripath who was forced out and will lost TC and PC revenue.

Poor babies. Quest really f***ed up Ameripath over the years. Labcorp similarly
f***ed up Dianon. In my experience, the 2 clin path giants just really were not able to maintain the degree of quality the hospital in patient population and med staff and pathologists needed as we were able to under pre-Quest Ameripath and certainly not of the degree we could in our pre- Ameripath private practice structure. They are OK in the test-tube shakin' business for doc's offices, clinics, esoterica, etc. but not
hospital anatomical path with services provided by some giant histo lab
60 miles away run by folks who see no difference between a hospital pathologists job
from the job of one of their marginal players, in house, pushing cervical bx's who hasn't been
in a hospital since residency.

This seems to have happened to LOTS of the medical profession. It's too bad.

 

[WEBB PINKERTON]

Poor babies. Quest really f***ed up Ameripath over the years. Labcorp similarly
f***ed up Dianon. In my experience, the 2 clin path giants just really were not able to maintain the degree of quality the hospital in patient population and med staff and pathologists needed as we were able to under pre-Quest Ameripath and certainly not of the degree we could in our pre- Ameripath private practice structure. They are OK in the test-tube shakin' business for doc's offices, clinics, esoterica, etc. but not
hospital anatomical path with services provided by some giant histo lab
60 miles away run by folks who see no difference between a hospital pathologists job
from the job of one of their marginal players, in house, pushing cervical bx's who hasn't been
in a hospital since residency.

This seems to have happened to LOTS of the medical profession. It's too bad.

You sure had no problem taking Quest's money when it came time to sell.

 

[jupiterianvibe]

You sure had no problem taking Quest's money when it came time to sell.

 

[deleted314957]

You sure had no problem taking Quest's money when it came time to sell.

You are damned right! Not only did I take Quest's money when they
bought Ameripath (I had Ameripath stock from our PP sale to Ameripath),
but I took Ameripath's money and PRE-IPO stock when we sold our
PP to the new entity in the 90's. Lots of money, decades, and effort were
expended to build that practice into a behemoth. We saw the handwriting on
the wall and we did what was in our best interest as the owners of
a BUSINESS. We would NEVER have made an associate in our
practice into an equity partner if (s)he did not understand this fundamental
type of BUSINESS decision. Sorry if you don't like capitalism.
Instead of bitching about this and your disgust with pathology as a job which,
apparently damned near killed you with a DVT and PE, you should just retire to your
farm which seem like a nice gig. You always tell people to find something else.
That's exactly what I did. Get off your "nobility" high horse.

 

[pathstudent]

Hate the game. Not the players.

Congrats Mike Sheree, better for the docs to walk away with cash than the VCs and PEFs

 

[AZpath]

I agree. Well played Mike.
It sucks that big corporations often now rule the day but walking away from a great deal is only a stupid move. Right now the powers in medicine favor large scale.

 

[octopusprime]

Hate the game. Not the players.

Congrats Mike Sheree, better for the docs to walk away with cash than the VCs and PEFs

There would be no "game" if there were no "players."

Yes medicine is a business, but we don't sell f*****g widgets, we sell our ability to diagnose & treat sick people by assuming the risk it entails. Tell me what other area of capitalism provides a similar service with a similar risk...

I'm as much of a Hayek-reading free-market supporter as any red-blooded capitalist out there, and while we can't blame individuals for taking the opportunities presented them, our profession is where it is as a direct result of the people who have led & represented it.

If your attitude is "that's the way the game is played," how are the administrators, CEOs, et al non-clinicians any less "players" in this game and equally justified to play it?

 

[deleted314957]

There would be no "game" if there were no "players."

Yes medicine is a business, but we don't sell f*****g widgets, we sell our ability to diagnose & treat sick people by assuming the risk it entails. Tell me what other area of capitalism provides a similar service with a similar risk...

I'm as much of a Hayek-reading free-market supporter as any red-blooded capitalist out there, and while we can't blame individuals for taking the opportunities presented them, our profession is where it is as a direct result of the people who have led & represented it.

If your attitude is "that's the way the game is played," how are the administrators, CEOs, et al non-clinicians any less "players" in this game and equally justified to play it?

With all respect, the CEO's, admins, et al ARE justified to play in this "game" and are damned good at it. In my experience they are usually much better at it than their professional medical foils. It behooves one to learn the rules well.

 

[WEBB PINKERTON]

You are damned right! Not only did I take Quest's money when they
bought Ameripath (I had Ameripath stock from our PP sale to Ameripath),
but I took Ameripath's money and PRE-IPO stock when we sold our
PP to the new entity in the 90's. Lots of money, decades, and effort were
expended to build that practice into a behemoth. We saw the handwriting on
the wall and we did what was in our best interest as the owners of
a BUSINESS. We would NEVER have made an associate in our
practice into an equity partner if (s)he did not understand this fundamental
type of BUSINESS decision. Sorry if you don't like capitalism.
Instead of bitching about this and your disgust with pathology as a job which,
apparently damned near killed you with a DVT and PE, you should just retire to your
farm which seem like a nice gig. You always tell people to find something else.
That's exactly what I did. Get off your "nobility" high horse.

Whoa, back off Warchild, seriously.

Where did I say I hated capitalism? Maybe you shouldn't complain about how Quest runs things after you sell out. Everyone knows how the large labs run their AP operations. Strip it and hope to hang on to some business. You can't have you cake and eat it too.

 

[octopusprime]

Whoa, back off Warchild, seriously.

Where did I say I hated capitalism? Maybe you shouldn't complain about how Quest runs things after you sell out. Everyone knows how the large labs run their AP operations. Strip it and hope to hang on to some business. You can't have you cake and eat it too.

Mike ate all the cake he could stuff his face with. So did everyone in his generation. Problem is whether Mike sold out or not, Quest et al would have come in anyway and just underbid his contracts...maybe not right away, depends on Quest's presence in the area.
Where the blame should be placed is the inability of our predecessors to cement, or at least work towards, stability in our field. First and foremost is the simple issue of "supply and demand"--the oversupply of trainees provides a cheap labor force of which national labs can take advantage. Shrinking redundant programs and eliminating low-yield programs (1 or 2 residents) would have done WONDERS 10-15 years ago. It's just a complete joke that we churn out as many graduates annually as we do.

 

[WEBB PINKERTON]

Is HCA really working with Quest in Colorado?

http://www.modernhealthcare.com/article/20160531/NEWS/160539993

 

[Doormat]

Follow up for IRL pathology. Hospital corporation of America (HCA) is now advertising IRL-employed physician pathologist medical director positions for all 7 of its hospitals in Colorado. They are advertising and posting these positions all at once.

Check it out on HCA's website. Go to careers, pathology, and then Colorado.

Existing pathology private practices in Colorado will loose their contracts with HCA-owned hospitals. The original reply for this thread states the IRL is "owned by HCA out of Nashville with a directive to take over all 160 HCA hospitals." This is spot on. If any of you have an HCA-hospital contract then expect to lose it.

Pathologists -- a complete and utter commodity.

 

[Thrombus]

Follow up for IRL pathology. Hospital corporation of America (HCA) is now advertising IRL-employed physician pathologist medical director positions for all 7 of its hospitals in Colorado. They are advertising and posting these positions all at once.

Check it out on HCA's website. Go to careers, pathology, and then Colorado.

Existing pathology private practices in Colorado will loose their contracts with HCA-owned hospitals. The original reply for this thread states the IRL is "owned by HCA out of Nashville with a directive to take over all 160 HCA hospitals." This is spot on. If any of you have an HCA-hospital contract then expect to lose it.

Pathologists -- a complete and utter commodity.

Big Academia has destroyed the profession. What a mess we are in for!!!

 

[path24]

Consolidation...consolidation. Fewer and fewer pathologists needed in the future. Where is that massive shortage????????