help me dissect these job ads

[Anfield rd]

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Members do not see this ad.

These are real job ads, and I'd like to know what all you grizzled vets out there think.

Here is what I think:

#1
What they say:

- National commercial lab seeks a well-trained Dermatopathologist for their midwest or east coast practice
- The ideal candidate will be Board Certified in Anatomic and Clinical Pathology and have an extroverted personality to help in selling services to clients
- Financial offers will include a competitive salary with full benefits and relocation allowance


What they mean:
- Looking for a salaried employee for a pathmill type job
- You should actively be bringing the business in, else boot




#2
What they say:



Group of 12 pathologists seeks additional dermatopathologists

Practice has digital photomicrography and a multi-head scope.

Monday-Friday 8:30am-5:00pm

Great benefits, with dollar for dollar matched 401k

Competitive salary


Sunny Florida



What they mean:
- you'll be a fully replacable cog, with no chance for partnership
- we've already got a dermpath person, but we need another one to carry extra load

​

 

[LADoc00]

National Commericial Lab=Ameripath.
Pass.

2nd option looks interesting if only to work there for a year, meet and greet some of their clients, befriend clients and then start your own business with that client base.

Read up on Florida non-compete clauses and business law. Consult an attorney.

As a dermpath your career path should look like:
1.) join big cumbersome group, often with no business sense and sloppy organization
2.) find dissectable niche in dermpath, group of dermatologists who personally trust and like you
3.) secure funding for outpatient histology lab, continue consulting your attorney, save as much $$$ as you possibly can
4.) announce to group that it isnt working out and you are going your own way. This is best accomplished if you take with you the other, if any, dermpath people as well. That will leave the group effectively crippled and unable to counterstrike. If that isnt possible, wait until the other dermpath is retiring/leaving and strike then but often timing doesnt work out.
5.) Immediately send out letters/brochures explaining to derm clinicians you are a separate corporate entity. You must barrage their staff with marketing immediately, get out there and meet/greet 4+ hours a day like a drug rep.
6.) Group is angered, hires attorney who sends you ******ed threatening letters to cease and desist. You let your attorney talk to them, redouble your marketing efforts while they are in chaos. Maybe convince a junior surg path person to also betray to the dark side further crippling their morale.
7.) Profit.

 

[DrBloodmoney]

National Commericial Lab=Ameripath.
Pass.

2nd option looks interesting if only to work there for a year, meet and greet some of their clients, befriend clients and then start your own business with that client base.

Read up on Florida non-compete clauses and business law. Consult an attorney.

As a dermpath your career path should look like:
1.) join big cumbersome group, often with no business sense and sloppy organization
2.) find dissectable niche in dermpath, group of dermatologists who personally trust and like you
3.) secure funding for outpatient histology lab, continue consulting your attorney, save as much $$$ as you possibly can
4.) announce to group that it isnt working out and you are going your own way. This is best accomplished if you take with you the other, if any, dermpath people as well. That will leave the group effectively crippled and unable to counterstrike. If that isnt possible, wait until the other dermpath is retiring/leaving and strike then but often timing doesnt work out.
5.) Immediately send out letters/brochures explaining to derm clinicians you are a separate corporate entity. You must barrage their staff with marketing immediately, get out there and meet/greet 4+ hours a day like a drug rep.
6.) Group is angered, hires attorney who sends you ******ed threatening letters to cease and desist. You let your attorney talk to them, redouble your marketing efforts while they are in chaos. Maybe convince a junior surg path person to also betray to the dark side further crippling their morale.
7.) Profit.

I'm intrigued and I'd like to subscribe to your newsletter.

 

[paleman]

National Commericial Lab=Ameripath.
Pass.

2nd option looks interesting if only to work there for a year, meet and greet some of their clients, befriend clients and then start your own business with that client base.

Read up on Florida non-compete clauses and business law. Consult an attorney.

As a dermpath your career path should look like:
1.) join big cumbersome group, often with no business sense and sloppy organization
2.) find dissectable niche in dermpath, group of dermatologists who personally trust and like you
3.) secure funding for outpatient histology lab, continue consulting your attorney, save as much $$$ as you possibly can
4.) announce to group that it isnt working out and you are going your own way. This is best accomplished if you take with you the other, if any, dermpath people as well. That will leave the group effectively crippled and unable to counterstrike. If that isnt possible, wait until the other dermpath is retiring/leaving and strike then but often timing doesnt work out.
5.) Immediately send out letters/brochures explaining to derm clinicians you are a separate corporate entity. You must barrage their staff with marketing immediately, get out there and meet/greet 4+ hours a day like a drug rep.
6.) Group is angered, hires attorney who sends you ******ed threatening letters to cease and desist. You let your attorney talk to them, redouble your marketing efforts while they are in chaos. Maybe convince a junior surg path person to also betray to the dark side further crippling their morale.
7.) Profit.

ok i am impressed. you hit the nail on the head with that.

 

[LADoc00]

I didnt invent this Ive merely witnessed it happen in numerous towns. Probably happened in dozen+ urban settings in California with only minor variations in how it falls out in the past decade.

The worst is when people get personal and really feel betrayed. This is BUSINESS. Groups that exploit junior pathologists should expect nothing less than a revolt.

As I told CompHealth today, head hunters continue to "pack the slave ship Amistad" like there are no consequences...there are.

Beat on people long enough and you'll get Pirate Yoda.

 

[yaah]

I'd personally be wary of any job that actually advertises the hours you are supposed to work.

 

[paleman]

starting in academics, leaving and taking clients with you by offering shorter turn-around + personal access to pathologist makes for even more interesting business shenanigans. though, you might have to sleep with a loaded rifle under your pillow for the rest of your life.

 

[mlw03]

am i the only one who absolutely HATES the business aspects of medicine? i picked a scientific field because i don't like this type of stuff. i understand there is money to be made in medicine - lots of money - and i certainly don't like to see doctors taken advantage of by business people. but i also don't like the idea of a doctor changing his/her focus away from the medicine and science, and instead towards maximizing profit for themselves. it's a tenuous line. i think part of my interest in a forensic pathology career is that i like the idea of working for a ME or coroner's office, getting my paycheck every 2 weeks, and being able to focus entirely on providing the best forensic pathology service i can. i see lots of doctors, academia and private practice, pathologists and clinicians, spending far more of their day dealing with office managers, drug reps, and insurance personnel than i ever want to spend.

 

[Faebinder]

National Commericial Lab=Ameripath.
Pass.

2nd option looks interesting if only to work there for a year, meet and greet some of their clients, befriend clients and then start your own business with that client base.

Read up on Florida non-compete clauses and business law. Consult an attorney.

As a dermpath your career path should look like:
1.) join big cumbersome group, often with no business sense and sloppy organization
2.) find dissectable niche in dermpath, group of dermatologists who personally trust and like you
3.) secure funding for outpatient histology lab, continue consulting your attorney, save as much $$$ as you possibly can
4.) announce to group that it isnt working out and you are going your own way. This is best accomplished if you take with you the other, if any, dermpath people as well. That will leave the group effectively crippled and unable to counterstrike. If that isnt possible, wait until the other dermpath is retiring/leaving and strike then but often timing doesnt work out.
5.) Immediately send out letters/brochures explaining to derm clinicians you are a separate corporate entity. You must barrage their staff with marketing immediately, get out there and meet/greet 4+ hours a day like a drug rep.
6.) Group is angered, hires attorney who sends you ******ed threatening letters to cease and desist. You let your attorney talk to them, redouble your marketing efforts while they are in chaos. Maybe convince a junior surg path person to also betray to the dark side further crippling their morale.
7.) Profit.

Man... LaDoc00, you are scary and I'm not even going to pathology.

 

[Anfield rd]

I didnt invent this Ive merely witnessed it happen in numerous towns. Probably happened in dozen+ urban settings in California with only minor variations in how it falls out in the past decade.

The worst is when people get personal and really feel betrayed. This is BUSINESS. Groups that exploit junior pathologists should expect nothing less than a revolt.

As I told CompHealth today, head hunters continue to "pack the slave ship Amistad" like there are no consequences...there are.

Beat on people long enough and you'll get Pirate Yoda.

I don't get it. How can you just blatantly ignore non-compete clause and merrily backstab your old group and steal their business?

 

[LADoc00]

I don't get it. How can you just blatantly ignore non-compete clause and merrily backstab your old group and steal their business?

Ask an attorney. In many states including California, no-compete clauses with non equity partners are NOT enforceable. Even in cases where they might be enforceable there are innnumerable ways to burn them out.

How can people do this? I dont know...but guess what that is how Intel Corp and half the Silicon Valley got started.

I not here to give lazy people free legal advice. Sorry.

I prevent this from happening to me by making fellow pathologists equity partners immediately/quickly, treating people with respect and sharing the decision making but most other pathology groups dont get it. And frankly they deserve to be used as human pinatas.

 

[The Lars]

LADOC-

Im close to what you are suggesting. I know its been done, and sometimes very successfully. Othertimes, careers have died. It is quite a risk.
To get the loan, buy a place , get the tissue processor, parraffin embeddor, atleast 2 middle-aged techs to cut and stain, along with a manager is quite expensive (probably atleast $800k) to get started. Not to mention your lawyer, marketing help, business advise, and marketing help.

This is what I want, but one also has to consider what happens if I want to take a vacation. So hire another dermpath.

It is quite a risk, and business is not so not with most pathologists.

Break it down for me....

 

[LADoc00]

LADOC-

Im close to what you are suggesting. I know its been done, and sometimes very successfully. Othertimes, careers have died. It is quite a risk.
To get the loan, buy a place , get the tissue processor, parraffin embeddor, atleast 2 middle-aged techs to cut and stain, along with a manager is quite expensive (probably atleast $800k) to get started. Not to mention your lawyer, marketing help, business advise, and marketing help.

This is what I want, but one also has to consider what happens if I want to take a vacation. So hire another dermpath.

It is quite a risk, and business is not so not with most pathologists.

Break it down for me....

During the housing boom people bought and sold property at huge profits with little money down and almost no personal risk. Currently in California there are more millionaires that resulted from this sort of short churn RE strategy than both technology/internet and agribusiness COMBINED.

Many people realized that leveraged buying could turn a penniless high grad into a multimillionaire.

Starting a lab is really no different although the players are changed from RE speculation. You can "play" using other peoples' $$$ if let them share in the profit, that is the catch. I could literally start a lab in almost any city in America with less than 10 grand, which really would only be used to put the down on a lease and pay the retainers for the legal team.

A dedicated, entreprenurial pathologist with charisma would bowl over almost any standing pathology group if they really were willing to go the distance.

 

[Click Here!]

It is quite a risk. To get the loan, buy a place, get the tissue processor, parraffin embeddor, atleast 2 middle-aged techs to cut and stain, along with a manager is quite expensive (probably at least $800k) to get started. Not to mention your lawyer, marketing help, business advise, and marketing help.

am i the only one who absolutely HATES the business aspects of medicine? i picked a scientific field because i don't like this type of stuff. . . i see lots of doctors, academia and private practice, pathologists and clinicians, spending far more of their day dealing with office managers, drug reps, and insurance personnel than i ever want to spend.

How much time/money/headache is it worth to be your own boss? How much of the revenue that you generate is fair to pay other people to take care of all those issues?

Even if you lay aside the FMG/Community trained pathologists, this is why there will always be people who find an Ameripath-type job attractive (at least on paper).

 

[mlw03]

How much time/money/headache is it worth to be your own boss? How much of the revenue that you generate is fair to pay other people to take care of all those issues?

Even if you lay aside the FMG/Community trained pathologists, this is why there will always be people who find an Ameripath-type job attractive (at least on paper).

i can't put a specific number on it, but it's worth plenty to me. we live in a service economy, and i'm willing to make less money to have people provide me with the service of dealing with all the financial crap i want no part of.

 

[mcfaddens]

i can't put a specific number on it, but it's worth plenty to me. we live in a service economy, and i'm willing to make less money to have people provide me with the service of dealing with all the financial crap i want no part of.

I finance is crap to you then why dont you work for free. Im sure your significant other and kids will love that move.

 

[mlw03]

I finance is crap to you then why dont you work for free. Im sure your significant other and kids will love that move.

yeah, that's an intelligent suggestion.

people on here make such extreme suggestions sometimes. like i've said numerous times before, it's about balance. but mcfaddens, feel free to work an extra 20 hours each week dealing with the business aspect of pathology so you can make $300K a year while I may make only $180K to go in, do my job, and go home. i'm sure YOUR family will love seeing you less; having that lexus instead of the camry is well worth it, right? why watch your kid's little league game saturday morning when you can make even more money by using that time to deal with business stuff? how much is enough, and at what sacrifice of your time? will your life be that much better making that extra "bank"?

i've seen clinician groups where the partners are staying long after patient care is done to deal with the business, and have no interest in being that person. that doesn't mean i don't think the service i'll provide has a fair value that i'll expect to be paid.

 

[mcfaddens]

yeah, that's an intelligent suggestion.

people on here make such extreme suggestions sometimes. like i've said numerous times before, it's about balance. but mcfaddens, feel free to work an extra 20 hours each week dealing with the business aspect of pathology so you can make $300K a year while I may make only $180K to go in, do my job, and go home. i'm sure YOUR family will love seeing you less; having that lexus instead of the camry is well worth it, right? why watch your kid's little league game saturday morning when you can make even more money by using that time to deal with business stuff? how much is enough, and at what sacrifice of your time? will your life be that much better making that extra "bank"?

i've seen clinician groups where the partners are staying long after patient care is done to deal with the business, and have no interest in being that person. that doesn't mean i don't think the service i'll provide has a fair value that i'll expect to be paid.

You’ve got to be kidding me. You have no clue of what you are talking about, have you even started residency yet, or have you ever visited a private pract path group? Do you even know what business stuff is?, no its not accounting. For someone going into path you should know that the business end is much different that the clinical side of things. I will spare you a real good thrashing at the moment due to your naivety. But to put it this way: (I being the business guy in the group) You will be the one in the Camry driving home 4 to hrs after im gone, Ill be making more than you and your kids will call me daddy. The second you give me attitude Ill just replace you with someone who doesn’t. ( personally if I were sharp enough I wouldn’t have hired you in the first place, I don’t agree with using people then dropping them)That will be easy because there are too many people with your attitude concerning business out there. If you don’t add another dimension to the practice that is absolutely essential then you’re as replaceable as a lab rat.

 

[pathstudent]

i can't put a specific number on it, but it's worth plenty to me. we live in a service economy, and i'm willing to make less money to have people provide me with the service of dealing with all the financial crap i want no part of.

You have the perfect personality profile to go work for a pod lab or a reference lab. Have fun making other people more money than you make for yourself.

Hopefully you'll do academics. There you don't have to worry about "the business", but you may not get the "clock in clock out" life you desire. Some days are quite long in academics.

 

[LADoc00]

There is no need to argue this crap here, no one is going to convince anyone else $$$ is more or less important in their life. One could easily argue and I think often win with the mantra that life is finite and you arent taking anything to afterlife, contrary to what the ancient Egyptians believed...

We need all types in society: Indians AND Chiefs.


suum cuique tribuere

 

[mlw03]

There is no need to argue this crap here, no one is going to convince anyone else $$$ is more or less important in their life. One could easily argue and I think often win with the mantra that life is finite and you arent taking anything to afterlife, contrary to what the ancient Egyptians believed...

We need all types in society: Indians AND Chiefs.


suum cuique tribuere

very well said, LA.

pathstudent: i'm not necessarily saying i want a punch-the-clock type of thing, rather i want to focus on the medicine, not the business. academics is something i would consider for that, among other, reasons.

mcfaddens: we'll make this easy. don't hire me, and i won't ever apply to work for you. see LA's post.

 

[Pingu]

people on here make such extreme suggestions sometimes. like i've said numerous times before, it's about balance. but mcfaddens, feel free to work an extra 20 hours each week dealing with the business aspect of pathology so you can make $300K a year while I may make only $180K to go in, do my job, and go home. i'm sure YOUR family will love seeing you less; having that lexus instead of the camry is well worth it, right? why watch your kid's little league game saturday morning when you can make even more money by using that time to deal with business stuff? how much is enough, and at what sacrifice of your time? will your life be that much better making that extra "bank"?

Actually, being involved with the business side of things as a partner can allow you to make changes to how your lab is run, which can lead to increased efficiency and therefore MORE time to spend with my family. Issues with your tissue processing, crappy sections and staining, and staffing issues can ALL be dealt with more or less directly when you are dealing with the business side. Not so much when you are a replaceable cog in giant path machine. I would prefer to have that control over my life and career.

Do you even have any idea what 'business stuff' entails? I'm kind of thinking no. Quite honestly, it is attitudes like yours that have allowed large labs into pathology. 😡 Stop being intimidated. Your life will be better for it.

will your life be that much better making that extra "bank"?[/

To answer this in one word: YES

To answer in more than one word: When you consider the tax benefits of owning a business, the gap between 180 and 300 starts to widen even more. But don't worry yourself about that silly 'business stuff'. Pay the government every penny and then some. And you can DEFINITELY make more than 300 as a partner.

The extra money will also come in handy by allowing you to 'outsource' the tedious chores in your life, leaving even more time to spend with your family. Maids, lawn service, nannies, etc lessen your household stress and free up your time. But I'm sure your wife/husband (sorry don't know your gender and don't want to stereotype) will absolutely love busting their butt taking care of the kids/laundry/house/yard/cars while you pontificate on how glad you are you don't spend time dealing with 'business stuff'

 

[DrBloodmoney]

But the question is how do you learn? It certainly isn't taught during residency. For someone interested in learning more about practice management and the business side of things, does anybody have any resources they can share?

 

[LADoc00]

But the question is how do you learn? It certainly isn't taught during residency. For someone interested in learning more about practice management and the business side of things, does anybody have any resources they can share?

tough one, it isnt taught in residency because academic pathologists dont know/understand the mechanics of a modern healthcare business so it would have to be outsourced.

Given that most residencies are at least within distance of a community college, I would advise finding well recommended business, business law and tax classes and taking those on months of easy rotations.

 

[mlw03]

clearly some of ya'll have different opinions than me, and perhaps mine will change over time. right now my priority is learning pathology, not learning how to run a pathology practice. after i get comfortable with the medicine, then maybe i'll start to care about those other business issues, which i'll freely admit i do NOT understand what that exactly entails. what bothers me on here is how so many of the discussions seem to gravitate towards money. is that what pathology is becoming? there's also a lot of anger on this forum - why? life can't be that bad.

 

[Click Here!]

As a first year resident in a university program, I freely admit my naivete regarding the business side of things. Though I'm not a politically savvy schmoozer and don't have an entrepreneurial bone in my body, I'd like to learn as much as I can so I can make better decisions down the road. Most important to me: which route would give me more time with my family?

My earlier questions were not entirely rhetorical.

To those of you in private practice:

How much do you spend on things like marketing, legal fees, administrative support, office overhead, lab costs, etc? What percentage of your time is devoted to those issues?

Personality wise, are you the type that always wants to be in charge, a natural leader, if you will? Or could you ever envision being content as an employee?

Are the non-medical aspects of your job interesting to you? Did you already have the necessary skills, or enjoy acquiring them? Is there anyone out there running a business, but hating everything but the pathology?

So even though I'm probably a kindred spirit of mlw's, I'm asking these questions in the spirit of a learner. Please refrain from judgmental responses for now.

 

[mcfaddens]

very well said, LA.

pathstudent: i'm not necessarily saying i want a punch-the-clock type of thing, rather i want to focus on the medicine, not the business. academics is something i would consider for that, among other, reasons.

mcfaddens: we'll make this easy. don't hire me, and i won't ever apply to work for you. see LA's post.

right now my priority is learning pathology, not learning how to run a pathology practice. after i get comfortable with the medicine, then maybe i'll start to care about those other business issues, which i'll freely admit i do NOT understand what that exactly entails..

Sorry I came off a little harsh but this is something that you have to keep in the back of your mind, I see you have entertained changing your tune about the subject, but at your level I personally would not go the anti business route, you should find out what it really entails before you decide that you want no part of it. Really its pretty easy and as Pingu said it kind of breaks down to how much of your future you want control over. You've made it this far in life, you obviously have the drive and the brains, I just don't get why some intelligent people are easy to turn over their potential fate to someone else, over something silly like business practice. Yes we need chiefs and indians, but it seems to me its turning into a 100000:1 indian to chief ratio.
Also its not really an issue of money and greed. In the future, its kind of breaking down to survival of the speciality. Personally I wouldnt spend the 9+ yrs training to work for a Wal Mart like corp.

 

[Matte Kudesai]

clearly some of ya'll have different opinions than me, and perhaps mine will change over time. right now my priority is learning pathology, not learning how to run a pathology practice. after i get comfortable with the medicine, then maybe i'll start to care about those other business issues, which i'll freely admit i do NOT understand what that exactly entails. what bothers me on here is how so many of the discussions seem to gravitate towards money. is that what pathology is becoming? there's also a lot of anger on this forum - why? life can't be that bad.

These are angry times....

Gas is up...
Homes ain't selling
We are at the brink of a new administration with record debt and record strain on the healthcare system.

We're not in Kansas anymore... You will learn your pathology in residency. That is inevitable.
You must learn as much as you can about the business aspects of your profession.

Academics is not necessarily an easier way out. There are expectations such as publishing and attempting to write grants. This is as difficult to learn as the business side of pathology. Actually it is more difficult to learn and much more competitive. It will be impossible to move up in academics (promotion. tenure etc.) without being academically productive.... At least at a program that would make it worthwhile to stay in academics. Also you will be evaluated quarterly on your progress.

 

[LADoc00]

what bothers me on here is how so many of the discussions seem to gravitate towards money. is that what pathology is becoming? there's also a lot of anger on this forum - why? life can't be that bad.

Actually it can be that bad. Im not going to write you a treatise on exactly what is happening but lets leave at Pathology has been in a literal Great Drepression since the 90s. Actually at its height the unemployment numbers far exceeded those seen in the national data for 1929-1933. We basically live in age of Rockefellers and Okie Dustbowlers, there is very little in between.

 

[Pingu]

what bothers me on here is how so many of the discussions seem to gravitate towards money. is that what pathology is becoming? there's also a lot of anger on this forum - why? life can't be that bad.

Sorry if I came off angry, I was in a very grouchy mood yesterday. To me it's not all about money. It's more about having things done the way I want them done. Think about the times your sections or stains looked like crap or the times your cases came out late because histo was understaffed. While you may not be able to fill your practice with unicorns and rainbows, you will, in a partnership position, have a greater chance of changing things that you don't like.

Another huge thing to me is the tax benefits. I started working at a young age and the first time I got a paycheck and saw that my 5 or 6 dollars an hour was cut into for FICA and social security, I was pretty po'ed. I had skanky clothes to buy and the government was taking MY money that I worked for. When you start looking into ALL the things you can do with taxes as a business owner, you will be amazed at what you can do to reduce your tax liability. It does not matter if you go into private practice or academics, almost every single one of us WILL be in the highest tax bracket sooner or later. I've seen the government spend money....they're not all that good at it.

As for learning about it, I second LADoc's suggestion about taking some courses...there are also some good books out there...look at some general small business books. While they won't be entirely tailored to pathology and what you will be doing, they will have basic information about running a small business. There are also some magazines out there that are medicine specific and deal with running a practice. I get several of them, but I'll have to look at some and see what the exact titles are.