How much more beating can pathologists withstand?

[Nilf]

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Kind of old news, but puts things in a perspective.

http://www.g2reports.com/issues/advisory/advisory/joe_plandowski/189-1.html

The good thing is that the Congress did halt the cut. The bad news is the figure 1.

 

[Arctic Char]

radiology merging with pathology? thats a first for me. interesting. hmm . . . out of pure curiosity, i wonder in which direction this would swing the income - or would it more or less equilibrate the typical incomes of the two fields?

 

[Neddy]

radiology merging with pathology? thats a first for me. interesting. hmm . . . out of pure curiosity, i wonder in which direction this would swing the income - or would it more or less equilibrate the typical incomes of the two fields?

Huh. I don't get this. There are plenty of similarities between the fields (focus on diagnosis, extremely broad scope, lack of longitudinal patient care responsibilities etc) but the trend in both fields, as in every field in medicine is for further subspecialization - splitting rather than lumping. The more jobs you ask any one person to do, the worse they will be at any of them. Both fields need large support staffs and technological resources, but there is no overlap between the skills or technology, so there's no synergy there. And this isn't even taking into consideration the logistical challenge of restructuring two entire fields worth of training programs. This sounds like a strange concoction of cytologists with delusions of grandeur. If radiologically guided FNA's and core biopsies ever became the majority of the workload in both fields then this might make sense, otherwise it sounds crazy to me.

 

[Sean2tall]

The way the article is phrased, I assumed they meant forming one governing organization for the purpose of lobbying etc. For example, merging ACR and CAP or something of that nature. I wouldn't think the daily activities of either specialty would be merged at all, but I don't know the source info that the quote is coming from.

 

[LADoc00]

Yeah I see alot of pathologists getting HUGE cuts in pay in the future. I think the groups billing globally with their own histo lab will mitigate the loss to some degree but not alot. Def. its a grim prognosis esp. as the country sinks into debt.

The key will be implementing new technologies with a pro billing code ASAP and milking those as hard and as long as you can to build nest eggs.

Also jettisoning all low or non paying activities such as autopsies, grossing, actually doing FNAs or marrows and excessive admin stuff to keep pathology groups lean and mean.

 

[superdevil]

Yeah I see alot of pathologists getting HUGE cuts in pay in the future. I think the groups billing globally with their own histo lab will mitigate the loss to some degree but not alot. Def. its a grim prognosis esp. as the country sinks into debt.

The key will be implementing new technologies with a pro billing code ASAP and milking those as hard and as long as you can to build nest eggs.

Also jettisoning all low or non paying activities such as autopsies, grossing, actually doing FNAs or marrows and excessive admin stuff to keep pathology groups lean and mean.

totally honest question: if i was entertaining the idea of becoming a pathologist, would you try to convince me otherwise? you've always seemed very knowledgeable, but at the same time, your posts stand out as being particularly bear-ish on a message board that already seems dominated by negativity.

is there any hope for an MS3 who is considering path? is the field really that sh*tty? should pathologists really just refuse to do poorly-reimbursing work? i'm not trying to challenge what you're saying, i just don't know much about path or the business aspect of path so i don't have any context for the stuff i'm always reading on SDN. to this outsider, it seems like the sky is falling.

cheers.

 

[Arctic Char]

totally honest question: if i was entertaining the idea of becoming a pathologist, would you try to convince me otherwise? you've always seemed very knowledgeable, but at the same time, your posts stand out as being particularly bear-ish on a message board that already seems dominated by negativity.

is there any hope for an MS3 who is considering path? is the field really that sh*tty? should pathologists really just refuse to do poorly-reimbursing work? i'm not trying to challenge what you're saying, i just don't know much about path or the business aspect of path so i don't have any context for the stuff i'm always reading on SDN. to this outsider, it seems like the sky is falling.

cheers.

i continually get the same impression, and share your feelings. i'm also a third year, and despite the fact that i just can't think of anything i would rather do as a career (which will keep me pursuing my path career regardless, i just think its the coolest job out there for me), i feel like i could use some suggestions about how to approach the issues that seem to be challenging the profession.

to LAdoc's defense, i think its always good to have some perspective even if it comes in the form a jagged little pill. he's always outspoken, but it seems like the points that are brought up are legitimate concerns, despite equivocal responses in other posts. and i'd rather be warned beforehand, and prepare myself accordingly, than to get nothing but rosy invitations to a field that is in jeopardy.

so i'll echo your question and ask: what is the best thing i can do now to best prepare myself for a career in path? i mean right now i just want to match at a program where i am comfortable and that will provide good training and put me in a position to get a good fellowship. but what else should i be doing? anything?

 

[yaah]

is there any hope for an MS3 who is considering path? is the field really that sh*tty? should pathologists really just refuse to do poorly-reimbursing work? i'm not trying to challenge what you're saying, i just don't know much about path or the business aspect of path so i don't have any context for the stuff i'm always reading on SDN. to this outsider, it seems like the sky is falling.

What I see on these forums and what I see in the real world are a bit different. Bear in mind I am not really that much into the real world yet, however. As I have said, people from my program keep getting multiple job offers and good jobs doing what they want, I can't quite figure things out. They are not delusional. They are not lying. They are not even superstar individuals. They are just solid residents. I mean, I was calling back a private practice guy about a consult a couple of weeks ago and he basically offered me a job over the phone without me bringing anything like that up. I don't think the sky is falling. The job market has seen better days. Medicine itself has seen better days. It is not really as lucrative as it once was unless you are a board member at a private insurance company. There is also a lot of uncertainty about just what will happen as costs continue to skyrocket but demand also continues to skyrocket, and the current health insurance system becomes untenable. Cutbacks will have to happen. They will happen everywhere, including physician salaries.

But people are not going to stomach going to Dr Discount, M.D. for their health care needs. They all still want "the best."

From my perspective as a senior resident, the job market is pretty good for people who have something the job market wants. That may include certain fellowships, or it may include special skills (like in business) or it may just be excellent communication skills and hard work. But if you are not as competitive a candidate for whatever reason, it becomes tougher and you may have to settle. There are a lot of subpar jobs out there. Megalabs are taking over the world, they are all learning from the Walmart school of thought, where you don't necessarily have to be the best at something as long as you do it cheaply, efficiently, and spew forth platitudes that make people feel better.

The point is, if you enjoy pathology and are passionate about it, and work hard at it, you are unlikely to have significant trouble. No one is going to throw money at you right out of residency. I think a lot of this comes from unrealistic expectations.

 

[superdevil]

What I see on these forums and what I see in the real world are a bit different. Bear in mind I am not really that much into the real world yet, however. As I have said, people from my program keep getting multiple job offers and good jobs doing what they want, I can't quite figure things out. They are not delusional. They are not lying. They are not even superstar individuals. They are just solid residents. I mean, I was calling back a private practice guy about a consult a couple of weeks ago and he basically offered me a job over the phone without me bringing anything like that up. I don't think the sky is falling.

From my perspective as a senior resident, the job market is pretty good for people who have something the job market wants. That may include certain fellowships, or it may include special skills (like in business) or it may just be excellent communication skills and hard work. But if you are not as competitive a candidate for whatever reason, it becomes tougher and you may have to settle. There are a lot of subpar jobs out there. Megalabs are taking over the world, they are all learning from the Walmart school of thought, where you don't necessarily have to be the best at something as long as you do it cheaply, efficiently, and spew forth platitudes that make people feel better.

i suppose my intuition would lead me to believe this. i'm sure the path residency grads at my home institution (WashU) aren't becoming vagrants living off handouts at the subway station. i'm sure the strong applicants (good training pedigree, fellowships, shining recs) will always have good jobs available to them. and i'm sure a marginal path grad from a marginal program (however that's defined) will have to face the possibility of settling.

i guess my hesitation to further investigate path comes from the whole "gather your acorns now, everyone will suffer!!!" attitude here and elsewhere. i'm not above working my *** off to ensure a positive outcome (good job, good salary, etc). my problem is that if the odds of finding a cherry career are already significantly limited the second i enter into a field, well, **** that.

thanks for the thoughts, yaah.

 

[Nilf]

I'm sharing Ladoc's pessimism. The reimbursements will keep falling, because there will only so much money available for healthcare. Whenever new hot medical technology shows up, the folks to divide the $$$ have to take it away from somebody else... The medical insurance premiums cannot keep climbing as they have been. If specialty X starts doing a new procedure that becomes the standard of care, medicare will start funding it, and will take money away from specialty Y. The question remains open whether pathology will have sufficient technological edge AND political muscle to keep our field growing and flourishing. However, if you look back and examine the figure from the link, the future doesn't seem rosy.

 

[docbiohazard]

I also think that as future pathologists, its not in our self-interest to attract people to the field with promises of good pay and easy living. Even if it were true, if we bragged about it on online forums, we'd ruin it for ourselves in the long run. 🙂

BH

 

[CameronFrye]

Yeah, my pessimism isn't pathology specific. All fields are going to take hits in the future. Thankfully, I have a low debt burden and started saving for retirement years ago.