Job interview with CEO

[ChicagoPath]

Hello,

I have an interview which consists of an interview with administration (CEO and VP). What kind of questions should I be asking?

Some questions I thought about:

1. Opportunities for leadership positions on hospital boards for in house physicians
2. Maybe hospital growth and future plans
3. Financial state of hospital

Thanks!

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[mike-sheree]

Interview for what? You need to be a whole lot more specific. In all seriousness, there are many of us on the board who could give you her/his (prepared) answers right now. And we know squat about any of it.

 

[ChicagoPath]

Pathology private practice job interview. Smaller group employed by community hospital. Will be interviewing with administrators.

Around 15,000 surgicals. Have to cover some smaller hospitals as well. Not sure what questions would be important to ask admin especially coming from a pathologist.

Thanks for any advice!

 

[WEBB PINKERTON]

15 thousand surgicals? A two man group? That isn't much of a workload. I'd be worried that place won't be around.

 

[Med Director New England]

Is this hospital part of a larger group or affiliated with a bigger hospital (you could prolly google this). If so how are the labs intertwined if at all.
Hospitals / labs around this size - the biggest risk is affiliating with a larger (usually academic) place with major changes to the lab model.

15K of hospital AP + cytologies + frozens + CP labs actually sound appropriate for 2 paths to me.

 

[Guest8]

Is this hospital part of a larger group or affiliated with a bigger hospital (you could prolly google this). If so how are the labs intertwined if at all.
Hospitals / labs around this size - the biggest risk is affiliating with a larger (usually academic) place with major changes to the lab model.

15K of hospital AP + cytologies + frozens + CP labs actually sound appropriate for 2 paths to me.

Agreed. We have 6 hospital-based pathologists and around 30K surgicals (+ cytology, frozens, CP, etc). We're already working 9-10 hr days and will be hiring soon.

 

[ChicagoPath]

15 thousand surgicals? A two man group? That isn't much of a workload. I'd be worried that place won't be around.

3 pathologists, sorry not a group but I would be a hospital based salaried employee.

 

[ScubaV]

Probably depends on a few factors. I interviewed with the VP overseeing the lab division. It was more of a vibe check than anything, to make sure I was normal. If you're interested in leadership roles or possibly joining admin at some point, then you'll need to be more active with building rapport and getting an "in". Firm handshake, yachts, supercars, stuff that CEO's like.

Agreed. We have 6 hospital-based pathologists and around 30K surgicals (+ cytology, frozens, CP, etc). We're already working 9-10 hr days and will be hiring soon.

Yep, we were there at one point (around 5K surgicals per person + the rest). As someone who's pretty fast, I could get it done within 8 hours but it was mentally exhausting and not sustainable for long periods.

 

[coroner]

15 thousand surgicals? A two man group? That isn't much of a workload. I'd be worried that place won't be around.

15K of hospital AP + cytologies + frozens + CP labs actually sound appropriate for 2 paths to me.

I don't know how fast you guys sign out, but this is not sustainable long term for 2 pathologists. That's 7500 surgicals per year for each pathologist. Plus, as New England said, ROSE, frozens, tumor conferences, other admin/CP meetings.

There are 3 big X-factors:
1. If there's a PA. Even with [a PA] it's still unsustainable long term. If there is no PA, forget about it...
2. Case mix. If it's just GI bx's or derm at a POD lab, then it can be done with a PA. I don't know the case mix at this place, but from my estimate, even a medium-sized community-based hospital with 15K surgicals is going to have its fair share of big cases/cancer resections.
3. Vacation: Assuming you and your other partner take 6+ weeks off, you're going to sign out the equivalent of 15K surgicals for those six weeks (or more). Sure, all this is possible if you wanna work 60+ hrs a week and make 800K, but that kind of lifestyle is a recipe for burnout...

From my experience of either working at or interviewing at several small to mid-sized community hospitals (Midwest & mid-Atlantic region), here's a small sample size of volume and coverage to give a breakdown:
1) Hospital A: 9500 surgicals/yr, 2 pathologists, no PA, tech grossing smalls, private practice (pp) (moderately busy, worked about 8:00 - 4:30)
2) Hospital B: 6K, 2 paths, pp, no PA (these guys worked from about 9-4:30, part of an 8 person group covering other hospitals)
3) Hospital C: 16K, 4 paths, PA, pp (average schedule i.e. 9-5)
4) Hospital D: 6K, 2 paths, PA, pp (this was cush)
5) Hospital E: 13-16K, 4 paths, PA, hospital employed (I think they started around 7:30 to 8 until 4-5)
6) Hospital F: 9K, 2 paths, tech grosses smalls, pp (8:30-5)
7) Hospital G: 10K, 2 paths, hospital employed. No PA initially, after they got one, the pathologist literally told me it was a "godsend"
8) Hospital H: 7-7.5K, 1 path, pp, not sure about PA or his schedule. He was making a killing doing solo path (~$800K) and was able to do this briefly; but, guess what...he got burnt out after a couple of years and eventually hired a part-time pathologist to help.

There are many others, but they all fall within the above range. On average, for hospital-based pathology these places were doing anywhere from 3K to 5K surgicals/yr per pathologist i.e. not anywhere close to the 7500/yr. I've never seen a hospital (not POD lab) with 15K surgicals/yr covered long term by 2 pathologists. It just ain't happenin' folks, unless you're signing out everything as 'benign' or 'malignant'...

 

[ChicagoPath]

I don't know how fast you guys sign out, but this is not sustainable long term for 2 pathologists. That's 7500 surgicals per year for each pathologist. Plus, as New England said, ROSE, frozens, tumor conferences, other admin/CP meetings.

There are 3 big X-factors:
1. If there's a PA. Even with [a PA] it's still unsustainable long term. If there is no PA, forget about it...
2. Case mix. If it's just GI bx's or derm at a POD lab, then it can be done with a PA. I don't know the case mix at this place, but from my estimate, even a medium-sized community-based hospital with 15K surgicals is going to have its fair share of big cases/cancer resections.
3. Vacation: Assuming you and your other partner take 6+ weeks off, you're going to sign out the equivalent of 15K surgicals for those six weeks (or more). Sure, all this is possible if you wanna work 60+ hrs a week and make 800K, but that kind of lifestyle is a recipe for burnout...

From my experience of either working at or interviewing at several small to mid-sized community hospitals (Midwest & mid-Atlantic region), here's a small sample size of volume and coverage to give a breakdown:
1) Hospital A: 9500 surgicals/yr, 2 pathologists, no PA, tech grossing smalls, private practice (pp) (moderately busy, worked about 8:00 - 4:30)
2) Hospital B: 6K, 2 paths, pp, no PA (these guys worked from about 9-4:30, part of an 8 person group covering other hospitals)
3) Hospital C: 16K, 4 paths, PA, pp (average schedule i.e. 9-5)
4) Hospital D: 6K, 2 paths, PA, pp (this was cush)
5) Hospital E: 13-16K, 4 paths, PA, hospital employed (I think they started around 7:30 to 8 until 4-5)
6) Hospital F: 9K, 2 paths, tech grosses smalls, pp (8:30-5)
7) Hospital G: 10K, 2 paths, hospital employed. No PA initially, after they got one, the pathologist literally told me it was a "godsend"
8) Hospital H: 7-7.5K, 1 path, pp, not sure about PA or his schedule. He was making a killing doing solo path (~$800K) and was able to do this briefly; but, guess what...he got burnt out after a couple of years and eventually hired a part-time pathologist to help.

There are many others, but they all fall within the above range. On average, for hospital-based pathology these places were doing anywhere from 3K to 5K surgicals/yr per pathologist i.e. not anywhere close to the 7500/yr. I've never seen a hospital (not POD lab) with 15K surgicals/yr covered long term by 2 pathologists. It just ain't happenin' folks, unless you're signing out everything as 'benign' or 'malignant'...

160 bed hospital with biopsies coming from smaller 25 bed hospitals and surgical centers in an undesirable location. They have a PA.

 

[mike-sheree]

I don't know how fast you guys sign out, but this is not sustainable long term for 2 pathologists. That's 7500 surgicals per year for each pathologist. Plus, as New England said, ROSE, frozens, tumor conferences, other admin/CP meetings.

There are 3 big X-factors:
1. If there's a PA. Even with [a PA] it's still unsustainable long term. If there is no PA, forget about it...
2. Case mix. If it's just GI bx's or derm at a POD lab, then it can be done with a PA. I don't know the case mix at this place, but from my estimate, even a medium-sized community-based hospital with 15K surgicals is going to have its fair share of big cases/cancer resections.
3. Vacation: Assuming you and your other partner take 6+ weeks off, you're going to sign out the equivalent of 15K surgicals for those six weeks (or more). Sure, all this is possible if you wanna work 60+ hrs a week and make 800K, but that kind of lifestyle is a recipe for burnout...

From my experience of either working at or interviewing at several small to mid-sized community hospitals (Midwest & mid-Atlantic region), here's a small sample size of volume and coverage to give a breakdown:
1) Hospital A: 9500 surgicals/yr, 2 pathologists, no PA, tech grossing smalls, private practice (pp) (moderately busy, worked about 8:00 - 4:30)
2) Hospital B: 6K, 2 paths, pp, no PA (these guys worked from about 9-4:30, part of an 8 person group covering other hospitals)
3) Hospital C: 16K, 4 paths, PA, pp (average schedule i.e. 9-5)
4) Hospital D: 6K, 2 paths, PA, pp (this was cush)
5) Hospital E: 13-16K, 4 paths, PA, hospital employed (I think they started around 7:30 to 8 until 4-5)
6) Hospital F: 9K, 2 paths, tech grosses smalls, pp (8:30-5)
7) Hospital G: 10K, 2 paths, hospital employed. No PA initially, after they got one, the pathologist literally told me it was a "godsend"
8) Hospital H: 7-7.5K, 1 path, pp, not sure about PA or his schedule. He was making a killing doing solo path (~$800K) and was able to do this briefly; but, guess what...he got burnt out after a couple of years and eventually hired a part-time pathologist to help.

There are many others, but they all fall within the above range. On average, for hospital-based pathology these places were doing anywhere from 3K to 5K surgicals/yr per pathologist i.e. not anywhere close to the 7500/yr. I've never seen a hospital (not POD lab) with 15K surgicals/yr covered long term by 2 pathologists. It just ain't happenin' folks, unless you're signing out everything as 'benign' or 'malignant'...

These examples, in general, don’t (didn’t ?) represent much work. HOWEVER, I will be the first to admit that there are FAR more nuances and hoops to jump thru in today's surgical pathology environment. 10-12k was no problem for me. I was solo med director at ~185 bed community hospital BUT I was, admittedly, GI heavy. But, that had an over-representation of medical liver. Different time and place (and, no, I never got sued or questioned in any seriousness) and things have changed to the point I am no longer in a position to assess as a peer in the field.

 

[Sawback3]

I did a little over 2200 surgicals over a 3 month stretch a couple years ago. Mix of Big Resections, lumpectomies, lung biopsies, 2-6 part GI biopsies, junkos, prostate cores, etc. It was a tough stretch and probably not doable in the long term these days if it’s that sort of mix. Especially with frozens, occasional ROSE, and tumor boards on top of that. Was looking at 10-hour days, 5 days a week.

 

[shikimate]

You guys work very hard in the USA. Here are some # from Canada for comparison:

Hospital A: teaching center, 55-60K surgical including heme, cyto extra, ROSE, frozen, academic activity etc. 32 pathologists (including NP and forensics), lots of PA, salary 373K
Hospital B: teaching center, 50K surgical including heme, cyto extra, ROSE, frozen, academic activity etc. 26 pathologists (including NP but excluding forensics), lots of PA, salary 377K
Hospital C: community hospital, 18K, heme and cyto extra, no ROSE, rare frozen, no academic activity, some forensics. 9 pathologists, 1 PA, self incorporated 400+K
Hospital D: community hospital, 11K, including heme, cyto extra, no ROSE, rare frozen, no academic activity, some forensics, 2.5 pathologists, 1 PA, self incorporated 373K.
Hospital E: community hospital, 6K surgicals only, no heme, no cyto, no ROSE, rare frozen, no academic activity, no forensics, 2 pathologists, 1 PA, salary 373K

 

[mike-sheree]

You guys work very hard in the USA. Here are some # from Canada for comparison:

Hospital A: teaching center, 55-60K surgical including heme, cyto extra, ROSE, frozen, academic activity etc. 32 pathologists (including NP and forensics), lots of PA, salary 373K
Hospital B: teaching center, 50K surgical including heme, cyto extra, ROSE, frozen, academic activity etc. 26 pathologists (including NP but excluding forensics), lots of PA, salary 377K
Hospital C: community hospital, 18K, heme and cyto extra, no ROSE, rare frozen, no academic activity, some forensics. 9 pathologists, 1 PA, self incorporated 400+K
Hospital D: community hospital, 11K, including heme, cyto extra, no ROSE, rare frozen, no academic activity, some forensics, 2.5 pathologists, 1 PA, self incorporated 373K.
Hospital E: community hospital, 6K surgicals only, no heme, no cyto, no ROSE, rare frozen, no academic activity, no forensics, 2 pathologists, 1 PA, salary 373K

Hospital “E” sounds great but between yourself, the other path and the P.A., you’re going to have to find a “fourth “ for bridge for about 6 hours a day.

 

[shikimate]

Hospital “E” sounds great but between yourself, the other path and the P.A., you’re going to have to find a “fourth “ for bridge for about 6 hours a day.

I do sincerely hope hospital E's practice doesn't get absorbed into the nearby university affiliated academic center. I'm hoping to move to hospital E in the next few years. The question is will the guy there retire at 65 or 85 lol.

 

[mike-sheree]

At their pace. he is already pretty much “retired”!

 

[coroner]

These examples, in general, don’t (didn’t ?) represent much work. HOWEVER, I will be the first to admit that there are FAR more nuances and hoops to jump thru in today's surgical pathology environment. 10-12k was no problem for me... BUT I was, admittedly, GI heavy.

I did a little over 2200 surgicals over a 3 month stretch a couple years ago. Mix of Big Resections, lumpectomies, lung biopsies, 2-6 part GI biopsies, junkos, prostate cores, etc. It was a tough stretch and probably not doable in the long term these days if it’s that sort of mix. Especially with frozens, occasional ROSE, and tumor boards on top of that. Was looking at 10-hour days, 5 days a week.

You guys work very hard in the USA. Here are some # from Canada for comparison:

So, from this small sample size:

- 3-5K surgicals/yr per pathologist, across 8 different small to medium sized community hospitals, manageable long term.
- 10-12K/yr, GI bx heavy, 1 hospital, manageable long term.
- Equivalent to 8,800 surgicals/yr, burning the person out and non-sustainable long term.
- In Canada, an average of ~2,600 surgicals/yr per pathologist, across 5 hospitals, manageable long term.

The spectrum of what makes up a lot or a little work is certainly relative compounded with the X-factors as mentioned earlier i.e. nuances/hoops: +/- PA, case mix, and time sucks away from sign-out e.g. frozens, ROSE, teaching, meetings. Another factor is setting: academic, community, private practice vs non-private practice.