Nov 30, 2009
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Has anyone else read the discussions over in pathology about health care reform? The predictions about the future of pathology are really scary. I was wondering if anybody had any information on what the future of dermatology might be like under this new health care law.
 

Chemiosmotic

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Feb 26, 2008
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Has anyone else read the discussions over in pathology about health care reform? The predictions about the future of pathology are really scary. I was wondering if anybody had any information on what the future of dermatology might be like under this new health care law.
I think it's really tough to say exactly what things will be like, but there are a few things that are more likely to come down the pipe than others.

Less reimbursement across the board secondary to cuts associated with premalignant/malignant lesions (especially freezing AK's from what I have been told). Mohs will likely see the most dramatic cuts. Ditto for Dermpath, but if they are in a large referral area they can probably make up for it better than the Mohs guys by increasing the number of specimens/slides read.

If things get to be too complicated, then I believe that Dermatology as well suited as any field to become a Cash/Barter Practice. One of the dermatologists who I really look up to does this back home. He manages to make a living, pay his staff and mix in a reasonable amount of charity/barter work within the community. In 25 years of seeing him as a patient, and 8+ years volunteer/shadowing/work I've never seen him turn away a patient who has walked in the door.
 

Cirrus83

Too old for this
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May 31, 2006
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If things get to be too complicated, then I believe that Dermatology as well suited as any field to become a Cash/Barter Practice. One of the dermatologists who I really look up to does this back home. He manages to make a living, pay his staff and mix in a reasonable amount of charity/barter work within the community. In 25 years of seeing him as a patient, and 8+ years volunteer/shadowing/work I've never seen him turn away a patient who has walked in the door.
Wow, that's like old school medicine with the bartering :D
Do people bring him really crazy stuff? I have the image of people bringing chickens and random knick-knacks to him in my head lol.

It's pretty hard to get good information on what the future cuts are really going to be since they haven't really set anything up yet, but I think much of the cryosurgery you mentioned are fairly obvious targets if they decide to adjust the RVUs for dermatology. But who knows, as it is right now as long as they can get rid of the medicare cut it looks like dermatology reimbursements will go up ever so slightly more than most fields and I honestly have no idea how they make these decisions in Washington. It would be pretty neat to be brought random stuff once in a while though, haha.
 
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