Job market for pathologists

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http://www.ascp.org/PDF/Fellowship-Reports/Fellowship-Job-Market-2012.pdf

48% of neuropathology fellows got 0 job offers.
47% of pediatric pathology fellows got 0 jobs offers.

These numbers are unacceptably high. why isn't something being done to address it?

Yes This was the study presented at the Association of Pathology Chairs meeting in July. The issue with those two specialties is they are limited to academic institutions that may not be where the fellow wants to practice. They also have to be able to provide a large amount of their salary via research grant funding.

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I disagree, how do you standardize the testing? Some programs want residents to take it at home or on their own time, which opens the door for referencing books. Other programs don't even proctor the testing.

Also, there are plenty of RISE remembrances out there. These factors artificially increase a test takers scores and do not reflect their knowledge.

Cheating???say it ain't so!
 
There was a seminar on this at the Association of Pathology chairs /Program Directors meeting in July in Monterey, CA. Most residents felt their programs were very weak in this component. The finding prompted ALOT of discussion. So there is a big need for improvement.

Honestly the people running academic programs probably don't want trainees to know this stuff (I.e. how much an 88305 pays, how to negotiate with private payers for higher rates, etc). They don't want a junior attending to realize how much revenue they are generating relative to how much they get paid. Moreover, I doubt many of the academic pathologists themselves know how it works to be able to teach anyone else.
 
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Honestly the people running academic programs probably don't want trainees to know this stuff (I.e. how much an 88305 pays, how to negotiate with private payers for higher rates, etc). They don't want a junior attending to realize how much revenue they are generating relative to how much they get paid. Moreover, I doubt many of the academic pathologists themselves know how it works to be able to teach anyone else.

I doubt 5% of university docs know what cpt codes reimburse fortheir state and I doubt 1% know which insurer pays what percent of medicare for their institution.

It would be good for them to know so they could know that for every unnecessary immuno they order out of curiosity or for teaching they are costing taxpayers about 105 or more depending on the state.
 
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..snip..
Moreover, I doubt many of the academic pathologists themselves know how it works to be able to teach anyone else.

I suspect that's a sad truth. Administrators and business managers fill in to insulate many pathologists from this -- not just in academia, although managing partners in private practice certainly -should- be on top of this kind of thing. But I dare say such a disconnect between those in the trenches getting the work done and those running the numbers would not be an uncommon one, nor isolated to pathology or medicine.
 
Heres an email I just got from ASCP...They are working to increase the number of residents!!!


ASCP Advocates for Efforts to Respond to Healthcare Workforce Shortages
Supports Legislation for Training Slots for Physicians, Potential to Bolster Pool of Pathologists



ASCP maintains that the administration of health care is delivered by a spectrum of professionals trained to provide the highest level of expertise for optimal patient outcomes and that all areas of health care delivery must be adequately staffed with qualified trained professionals.

To that end, we are calling upon you to reach out to lawmakers to support (HR 6352), the Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act, designed to expand the number of Medicare-sponsored residency training slots. The legislation, introduced by Rep. Aaron Schock (R-IL) and Rep. Allyson Schwartz (D-PA), lends itself to increasing the availability of physicians in the pipeline, thereby potentially increasing the number of practicing pathologists.

The Association of American Medical Colleges is predicting that the shortage of physicians could reach 90,000 by the year 2020. Consider this, the U.S. population is living longer, requiring more medical care as they age. The passage of the Affordable Care Act provides insurance coverage for an additional 32 million Americans. They will be seeking medical treatment more proactively. In addition, there continues to be millions of Americans who rely on physician care to treat and maintain their lives with chronic illnesses. How will the ground swell of need be met with an inadequate number of physicians available to provide treatment?

By increasing the number of Medicare-sponsored training slots, HR 6352 would help train 4,000 more physicians annually, about a third of what is believed to be needed to avert a physician shortage. In addition to supporting the House bill that has been introduced, ASCP would also like to see a companion bill introduced in the Senate pushing for additional training slots in order to move toward reducing the shortage of one segment of the health care delivery team.
 
Heres an email I just got from ASCP...They are working to increase the number of residents!!!


ASCP Advocates for Efforts to Respond to Healthcare Workforce Shortages
Supports Legislation for Training Slots for Physicians, Potential to Bolster Pool of Pathologists



ASCP maintains that the administration of health care is delivered by a spectrum of professionals trained to provide the highest level of expertise for optimal patient outcomes and that all areas of health care delivery must be adequately staffed with qualified trained professionals.

To that end, we are calling upon you to reach out to lawmakers to support (HR 6352), the Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act, designed to expand the number of Medicare-sponsored residency training slots. The legislation, introduced by Rep. Aaron Schock (R-IL) and Rep. Allyson Schwartz (D-PA), lends itself to increasing the availability of physicians in the pipeline, thereby potentially increasing the number of practicing pathologists.

The Association of American Medical Colleges is predicting that the shortage of physicians could reach 90,000 by the year 2020. Consider this, the U.S. population is living longer, requiring more medical care as they age. The passage of the Affordable Care Act provides insurance coverage for an additional 32 million Americans. They will be seeking medical treatment more proactively. In addition, there continues to be millions of Americans who rely on physician care to treat and maintain their lives with chronic illnesses. How will the ground swell of need be met with an inadequate number of physicians available to provide treatment?

By increasing the number of Medicare-sponsored training slots, HR 6352 would help train 4,000 more physicians annually, about a third of what is believed to be needed to avert a physician shortage. In addition to supporting the House bill that has been introduced, ASCP would also like to see a companion bill introduced in the Senate pushing for additional training slots in order to move toward reducing the shortage of one segment of the health care delivery team.


Even the CAP Residents Forum thinks there are not enough pathologists, and they sent a letter to Congress saying so.

I just don't understand it. Even the people who would debate the existence of an oversupply would never insist that there is an undersupply! Wow. Just wow.

Our leadership is incredibly out of touch. It is doubtful that my group will ever hire another full time pathologist, yet our leadership insists that there are not enough pathologists out there.

Wow.
 
This is a recurring theme. Most of the hard data and various predictions that these decisions are evidently based on still seem weak, at least what I've seen of them. I'm not so bold as to declare it rubbish, but it seems a pretty important topic -- important enough to look at properly. I get the impression that certain folks just aren't looking at it as critically as perhaps they might were it the latest new study on the molecular pathology of some lymphoma or other, etc. It's always been famously easy to see what one wants or expects, even in more rigidly controlled research, but especially in surveys and forward projections.
 
Even the CAP Residents Forum thinks there are not enough pathologists, and they sent a letter to Congress saying so.

I just don't understand it. Even the people who would debate the existence of an oversupply would never insist that there is an undersupply! Wow. Just wow.

Our leadership is incredibly out of touch. It is doubtful that my group will ever hire another full time pathologist, yet our leadership insists that there are not enough pathologists out there.

Wow.

Is this published on the CAP page anywhere? I can't find it...
 
We need more primary care docs. Not specialists.

And if there is a dire shortage of pathologists, I am willing to double my workload if you double my pay.

And given that only like half of pathology slots fill with AMGs, expanding the number wouldn't do much to benefit the field.
 
Is this published on the CAP page anywhere? I can't find it...

Do a search on this site. I have made multiple posts about it in the appropriate thread.

Also, I found out about it through a CAP STATline publication (which was linked in my post here) and that is how I found out about it.
 
And if there is a dire shortage of pathologists, I am willing to double my workload if you double my pay.

Ditto. I would gladly double my volume for even a 50% increase. Where are all these loose specimens out there that can't find a pathologist to look at them? There is cut throat competition for even the 88304's out there. Sheesh!
 
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And given that only like half of pathology slots fill with AMGs, expanding the number wouldn't do much to benefit the field.

Is this published somewhere?

I'd say about 1/4 of the spots at my academic behemoth are filled by IMGs; barring a few accents, and perhaps relatively minor cultural differences, academically speaking one wouldn't be the wiser. The being said, we're quite picky as to who we take on, and that of course has much to do with our positive experience with IMGs.
 
Our leadership is terrible.

Indeed. The fact that they seem so out of touch is no surprise to me. What I wasn't expecting was the blurb re the CAP Residents Forum. Who the hell are these bozos? Even residents at places like MGH/BWH and Stanford are feeling the pinch.
 
Is this published somewhere?

I'd say about 1/4 of the spots at my academic behemoth are filled by IMGs; barring a few accents, and perhaps relatively minor cultural differences, academically speaking one wouldn't be the wiser. The being said, we're quite picky as to who we take on, and that of course has much to do with our positive experience with IMGs.

Yes. Search nrmp match data. You can review trends over the last 30 years.

In 2012 50.3% filed with amgs and 89% filled overall. So why push to increase spots when you can't even fill the ones you have. Especially when the talk is decreasing reimbursement to specialists and increasing reimbursement to primary care to make primary care more enticing. Our leadership needs to work on not getting our reimbursement cut more than they need to fight for more training spots that they can't even fill now.

And what do they mean shortage. All our work gets done in a timely fashion as it is. You know how some people have to wait weeks to see a doctor. Well to see me, get me your biopsy and I'll be done with you the next day.
 
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Do a search on this site. I have made multiple posts about it in the appropriate thread.

Also, I found out about it through a CAP STATline publication (which was linked in my post here) and that is how I found out about it.

Found it. Re-pasted below. I wouldn't get too hung up on this. Any sane person would fight against being de-funded. Would you rather than roll over and say "yeah, go ahead and cut GME 50%, we have too many pathologists".

Plus, if you actually read the letter, they are trying to defend GME, not just pathologists specifically. I'm sure there were cookie-cutter letters from essentially every medical society saying the same thing.

I know there are plenty of conspiracy theorists on this board that would think these folks are doing this to line their pockets, but could you argue with a straight face that they should be saying nothing at all or asking for cuts? That's crazy talk.

CAP, ASCP Residents Urge Super Committee to Protect Medicare GME Funding

The CAP Resident Forum Executive Committee and the American Society for Clinical Pathology (ASCP) Resident Council urged the Joint Committee on Deficit Reduction to protect existing Medicare financing for Graduate Medical Education (GME).

Identified as a potential target for spending cuts in December 2010 by the Bowles-Simpson Commission, GME cuts could negatively impact residency programs, thus worsening the projected pathologist shortage by decreasing the number of young pathology-trained physicians, noted both groups in a Nov. 14 letter to Joint Committee members.

The Bowles-Simpson Commission proposed two levels of cuts—funding reductions at 30% and 50%, explained Nicole Riddle, MD, Chair of the CAP Residents Forum Executive Committee, who added that these cuts are likely to hit medical specialties like pathology particularly hard. “If hospitals have to make decisions in terms of cutting residency programs, pathology is likely to suffer greater compared to other specialties,” she told Statline. “This is daunting, considering the predicted shortage of pathologists and the great need for new physicians to enter this specialty.”
 
Would you rather than roll over and say "yeah, go ahead and cut GME 50%, we have too many pathologists". .. could you argue with a straight face that they should be saying nothing at all or asking for cuts?

Yes! Absolutely. They should say exactly that. Go ahead and cut GME, because there are too many pathologists. And yes, I can say with a straight face that they should be saying nothing at all or requesting cuts to pathology residency slots. How is that "rolling over"?

Are you kidding me? Other specialties regulate their supply/demand. Why don't we?
 
Yes! Absolutely. They should say exactly that. Go ahead and cut GME, because there are too many pathologists. And yes, I can say with a straight face that they should be saying nothing at all or requesting cuts to pathology residency slots. How is that "rolling over"?

Are you kidding me? Other specialties regulate their supply/demand. Why don't we?

It seems path is the most corporatized field in medicine. I wonder if the decision makers have shares in LabCorp, Quest or Ameripath.

Radiology is concomitantly experiencing a projected overabundance of new graduates, which kind of coincides with the increasing corporatizing of that field. Again, I wonder if there is any collusion at the top.

THink about it, it behooves these companies to flood the market with pathologists/radiologists, because then they will command less bargaining power. When demand for services is high, as it is in rads and path, automation is desired and deprofessionalization is the result. The only way to prevent this is by limiting practitioners.

I found this article from the late 70s basically predicting what happened to your field.

http://www.ncbi.nlm.nih.gov/pubmed/386008?dopt=Abstract
 
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Yes! Absolutely. They should say exactly that. Go ahead and cut GME, because there are too many pathologists. And yes, I can say with a straight face that they should be saying nothing at all or requesting cuts to pathology residency slots. How is that "rolling over"?

Are you kidding me? Other specialties regulate their supply/demand. Why don't we?

FWIW- rollwithit is not a pathologist. Maybe he/she is a business type working for a corporate lab outfit.

Quote:
Originally Posted by Tissue issue
rollwithit- You have stated you are not a pathologist. What is your specialty?

This was his/her response:
Calling out bull****.
 
FWIW- rollwithit is not a pathologist. Maybe he/she is a business type working for a corporate lab outfit.

Quote:
Originally Posted by Tissue issue
rollwithit- You have stated you are not a pathologist. What is your specialty?

This was his/her response:
Calling out bull****.

That's because I'm an evil pod lab CEO...muwahahaha!!!

Seriously though - my point was that it's ridiculous if you can't see the higher purpose of that letter. It was to petition Congress not to cut GME funding after them stating there could be cuts to GME (for all of Medicine, not just path) of up to 50%. Maybe pathologists don't need as much of the pie as they get now (good luck making that argument), but this letter was something submitted in defense of medicine to preserve the total pie.

Draw an analogy to yourself. Assuming you own a home, you are deducting mortgage interest payments on your tax return. There have been more than heavy whispers of taking away this deduction from homeowners. You, as a physician and a homeowner, probably aren't rich, but probably aren't hurting either. The government thinks you can do fine without that extra deduction and they are probably right in your circumstance - in the same way that pathology could possibly do without current levels of GME funding because of a presumed current oversupply. Maybe internal medicine should get that funding instead due to an undersupply of internal medicine residents? I get that, but in reality do you, in the interest of yourself and others that receive this benefit:

A) Call your representatives and tell them to take away that deduction because you don't need it. While you are at it, tell them to take it away from everyone else. You don't need it, why should anyone else?

Or,

B) Call your representatives and raise hell that they are going to effectively raise your taxes.

Now, some of you may answer A to stubbornly make a point, but remember that pathology faces uncertainty just as much as our individual economic futures face uncertainty. Nobody lobbies to be taxed more or to have their funding taken away - especially during time of economic uncertainty and likely future healthcare-related changes.

If you want to make a case that "less funding means better path market", go for it. Just be sure to detail what makes you confident that reductions in funding would mean a proportional reduction in residency positions?

I'm pretty sure that institutions would figure out a way to maintain or increase the level of positions they train (they need the labor, remember there is a factual undersupply of physicians) even with reduced funding. You know how they will manage to do that? Resident / fellow salaries & benefits will be slashed.
 
That's because I'm an evil pod lab CEO...muwahahaha!!!

Seriously though - my point was that it's ridiculous if you can't see the higher purpose of that letter. It was to petition Congress not to cut GME funding after them stating there could be cuts to GME (for all of Medicine, not just path) of up to 50%. Maybe pathologists don't need as much of the pie as they get now (good luck making that argument), but this letter was something submitted in defense of medicine to preserve the total pie.

Draw an analogy to yourself. Assuming you own a home, you are deducting mortgage interest payments on your tax return. There have been more than heavy whispers of taking away this deduction from homeowners. You, as a physician and a homeowner, probably aren't rich, but probably aren't hurting either. The government thinks you can do fine without that extra deduction and they are probably right in your circumstance - in the same way that pathology could possibly do without current levels of GME funding because of a presumed current oversupply. Maybe internal medicine should get that funding instead due to an undersupply of internal medicine residents? I get that, but in reality do you, in the interest of yourself and others that receive this benefit:

A) Call your representatives and tell them to take away that deduction because you don't need it. While you are at it, tell them to take it away from everyone else. You don't need it, why should anyone else?

Or,

B) Call your representatives and raise hell that they are going to effectively raise your taxes.

Now, some of you may answer A to stubbornly make a point, but remember that pathology faces uncertainty just as much as our individual economic futures face uncertainty. Nobody lobbies to be taxed more or to have their funding taken away - especially during time of economic uncertainty and likely future healthcare-related changes.

If you want to make a case that "less funding means better path market", go for it. Just be sure to detail what makes you confident that reductions in funding would mean a proportional reduction in residency positions?

I'm pretty sure that institutions would figure out a way to maintain or increase the level of positions they train (they need the labor, remember there is a factual undersupply of physicians) even with reduced funding. You know how they will manage to do that? Resident / fellow salaries & benefits will be slashed.

This makes a lot of sense. Slashing GME does not equal slashing residency positions.

As I said before, the people that determine residency allocation are probably colluding with, or are direct representatives of, corporate interests that benefit from an oversupply of pathologists. The path community should really look into this. Ever since the 70s, when pathology became heavily corporatized, the oversupply was in full effect.

Radiology is witnessing a similar pattern. If the rads market is saturated, centralized radiology companies can hire them for a lower price. Not only that, those that own private imaging centers can sell them to corporations for a large chunk.

When demand for a service explodes, automation and centralization, with deprofessionalization of those that supplied the service before, are the final results.
 
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This makes a lot of sense. Slashing GME does not equal slashing residency positions.

As I said before, the people that determine residency allocation are probably colluding with, or are direct representatives of, corporate interests that benefit from an oversupply of pathologists. The path community should really look into this. Ever since the 70s, when pathology became heavily corporatized, the oversupply was in full effect.

Radiology is witnessing a similar pattern. If the rads market is saturated, centralized radiology companies can hire them for a lower price.

When demand for a service explodes, automation and centralization, with deprofessionalization of those that supplied the service before, are the final results.

Feel free to search through the SEC filings of the publicly traded companies like Quest to see if there are any conflicting relationships between their officers, directors, or major stock holders with the leaders at CAP, etc.

Collusion amongst unrelated parties is undetectable - to an extent, at least. That's not unique to pathology. I guess the only check you have on that is the risk larger labs run by decreasing salaries to the point where their employees are not motivated and/or competent causing quality decreases and lost business - or the lab gets sued to hell and back.
 
Again, it isn't about the funding or not. Its that the CAP RF stated in an official letter that there is a pathologist shortage. That is the CAP's official position - that there are not enough pathologists. It isn't that they oppose cuts in funding. It is the reason they oppose it. I suppose that everyone on the RF just sees everyone getting tons of good job offers left and right? Must be, because they think there is a shortage! Good to know things are going so well!
 
Again, it isn't about the funding or not. Its that the CAP RF stated in an official letter that there is a pathologist shortage. That is the CAP's official position - that there are not enough pathologists. It isn't that they oppose cuts in funding. It is the reason they oppose it. I suppose that everyone on the RF just sees everyone getting tons of good job offers left and right? Must be, because they think there is a shortage! Good to know things are going so well!

It's everything to do about the funding. Do you think they wrote to Congress for ****s and giggles? You should take a big step back and look at what you are arguing. I'm not saying there aren't aspects of leadership to be disappointed with, but this isn't one of them.

Also, to be fair, they reference a "projected shortage". They acknowledge no existing shortage of pathologists. If your data projects such, isn't it your duty to plan for it? What else are you supposed to do? Ignore it because the studentdoc forum said so? If they are messing up, make a valid / objective case that supports otherwise and get to emailing and phoning these folks!
 
It's everything to do about the funding. Do you think they wrote to Congress for ****s and giggles? You should take a big step back and look at what you are arguing. I'm not saying there aren't aspects of leadership to be disappointed with, but this isn't one of them.


They could have given numerous reasons not to cut funding. To save resident health insurance/benefits or to preserve educational funds or whatever. Being proactive to preserve funding is not the issue. The issue is the reason they gave in an official CAP endorsed publication - that we need more pathologists. I'd love to see this data that says there are too many specimens and not enough pathologists to diagnose them.

I am well aware of what I am am arguing. I never met anyone at any RF meeting who thought there was a shortage or looming shortage of pathologists. By contrast, everyone I ever met at those meetings was worried about the job market.
 
I don't know any resident or attending who thinks the job market is good.
 
Again, it isn't about the funding or not. Its that the CAP RF stated in an official letter that there is a pathologist shortage. That is the CAP's official position - that there are not enough pathologists. It isn't that they oppose cuts in funding. It is the reason they oppose it. I suppose that everyone on the RF just sees everyone getting tons of good job offers left and right? Must be, because they think there is a shortage! Good to know things are going so well!

I am on the rf, and I can assure you that nobody asked for my opinion before sending a letter to congress. That is what annoyed me about this. They acted like it was some consensus opinion, when it was probably just the cap leadership who just told the rf president to come up with a letter.
 
I am on the rf, and I can assure you that nobody asked for my opinion before sending a letter to congress. That is what annoyed me about this. They acted like it was some consensus opinion, when it was probably just the cap leadership who just told the rf president to come up with a letter.

Thank you for confirming this. It is worth nothing that our main advocating organization is working against us. But at the sametime it is possible that there are greater forces at work forcing the CAP to tow the line. It is possible that the cap is like the smokin man in x files and we are sculley and mulder.
 
Dear doctor
hoping you are doing good. Im really in love with Neuropathology, I would like to know once you finished the fellowship, how could you make a good profitable private pratice in the field, some told me that the best option is to find a Neuroncology group or Neurosurgery group with most of their cases in Brain surgery, Im really want to be into this specialty but Im concerned that wont be profitable. Maybe your advices of how to develop a business in Neuropath would be useful.

Thanks in advance!.
Where I work the neurosurgery group is large enough that they employ their own neurointensivists, neuro-oncologists and anesthesiologists. But they aren't biopsing enough brain tumors to make it worth their while to hire a pathologist. Moreover most of neurosurgery that produces anatomic pathology is done in hospitals where a pathology group has an exclusive contract.

If you want to do neuropathology only in a private practice setting you need to find one of those pathology supergroups which cover a dozen hospitals in a large metro area. Even then you'll have to do neuropathology and something else.
 
The health care bubble is bursting. Dot.com, sub-prime lending all over again.....

Pathologists are being laid off as well. 2 independent labs with lot of history in my area closed their doors in the last year, putting quite a few pathologists out of work. Another also just declared bankruptcy and is looking for a buyer.
 
The health care bubble is bursting. Dot.com, sub-prime lending all over again.....

Pathologists are being laid off as well. 2 independent labs with lot of history in my area closed their doors in the last year, putting quite a few pathologists out of work. Another also just declared bankruptcy and is looking for a buyer.
Yes it's bursting but there are still areas of medicine that should do well in the future. Primary care might even be a reasonable option in the coming future. Nursing and PA's seem to be in high demand. Pathology, anesthesiology, and radiology seem to be getting hit hard, but I only say that based off what I read on forums. My point is that it's not all bad. The corporatization of health care seems to be killing the specialties I listed above.
 
Come join pathology, it's a great career move:

Titanic_Trailer.jpg
 
Remember:

Buy when the news is bad....
Sell when the news is good....

FYI.

Good luck.
 
Remember:

Buy when the news is bad....
Sell when the news is good....

FYI.

Good luck.
Interesting perspective. I've wondered about this myself. Could some of these supposedly sinking specialties like radiology or pathology bounce back in the future? It seems like the lucky docs will be employed in academia, and the rest are forced to work for some major health group like Kaiser in CA or Providence health care in the Northwest as an employee. Unless you are a surgeon, GI doc, or dermatologist, it looks like this is the new trend in medicine. I just don't know if pathology is more like Border's or more like Apple.
 
Yes it's bursting but there are still areas of medicine that should do well in the future. Primary care might even be a reasonable option in the coming future. Nursing and PA's seem to be in high demand. Pathology, anesthesiology, and radiology seem to be getting hit hard, but I only say that based off what I read on forums. My point is that it's not all bad. The corporatization of health care seems to be killing the specialties I listed above.

I've told all my nieces and nephews currently in med school to give primary care a hard look. You should at least be able to find a job. NO WAY would I consider pathology, rads or gas. I thank god everyday that I was able to survive in the cesspool of pathology the last few decades.

Hey med school student, do you like doing work for BELOW medicare rates? Do you like networking your a++ off, doing multiple fellowships and brown-nosing just to find a potential employer? Do you like competing with EVERY pathologist in the country? Then pathology is for you!
 
So I guess you bought Blockbuster stock when Netflix started cutting into their business. Blockbuster went bankrupt and stock is worth zero.

So I guess you bought Borders bookstore stock when Amazon started cutting into their business. Borders went bankrupt and stock is worth zero.

Are you currently investing in equipment to do V/Q scans?

So if pathology is Blockbuster and Borders, who is Netflix and Amazon? Is there a new diagnostic service that is replacing the current?

The better way to put this is that during change (no doubt there is significant change across all of medicine) there are winners and losers. The winners generally aren't the alarmists and naysayers. The winners adapt and use it to their advantage. Medicine is a business. Business is competitive. Change or die.
 
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I've told all my nieces and nephews currently in med school to give primary care a hard look. You should at least be able to find a job. NO WAY would I consider pathology, rads or gas.

How is gas on the decline? The CRNA threat has been ongoing for decades, yet gas salaries are steadily increasing.
 
I hope this happens and 50% pathology residency positions are slashed.

Just check out what happened to dermatology in the 90s and why they are in such an excellent job market now.

They could have gone the way of pathology but they were smart enough to check the oversupply before it became a problem.

I do not understand why our organizations are so dumb. Maybe since they make money through bull**** QA/QC type stuff, they do not care about the job market.

What I find especially egregious and entirely self serving is the stance of program directors and their kin to keep on begging for more GME dollars. I do understand that since they have no other skill, there existence is tied with having a resident force.That is why I dislike almost all admin, just a bunch of talentless parasites sucking off others and wasting the time of people who actually do "real work" and not sit through hours of bull**** talking aka meetings.

Why this problem that seems a chronic one in pathology (you can find similar complaints in the 90s) and has been repeatedly stated in journals comparing the job market across different specialities, has not received the focus it deserves from our organizations is a complete mystery to me.

Oversupply brings so many problems that you have to be brain dead not to realize the hazards of it. Bad job market, decreased negotiating power , plumetting reimbursement, decreased respect, exploitative job contracts, abusive workload etc. etc. the list goes on and on and on. We are seeing all of this in pathology and the situation will only get worse if the status quo of oversupply is not checked. In the competitive market place of today, this oversupply is akin to suicide.

Most pathologists are sheeple and passive by natural selection.

If CAP were willing to release old (1980-2000) archives of CAP Today (or equivalent), you would see the same commentaries of today. Job market in 1980 was much worse than today's.
 
Pathology has the third or fourth oldest average (or median, not sure) age among medical specialties. Psychiatry is the oldest. Part of the problem was that there was a huge increase in specimens starting about 20-25 years ago with increasing use of biopsies and endoscopies, so it was assumed (incorrectly) that in increase in specimens would necessitate a concurrent increase in pathologists to cover the load. But pathologists subspecialized and/or got more efficient. And many paths work until they are older. But they are starting to retire now. What effect that will have on the job market and when it will have an effect is a difficult question to answer.

raider's description of practices is accurate for some - but to suggest that ethical practice groups are so rare is inaccurate.

I am sorry but I have never heard of this justification (statement in bold) before. It sounds to me as an ex post facto babble at the same league as the current "impending shortage" alarm.

Job market in 1980 was much worse than that of today. Early 1980 Medicare had stopped reimbursement for Part A.

Even in those days, the PDs never ever even dreamed about cutting the residency spots. Rather they used to babble the usual nonsense about the bright future and were advocating return of autopsy to resurrect the field!!

Pathology leadership is pathetic, unethical and evil.
 
Agreed. I wish the carrot of imminent pathologist retirement was never dangled again. It was used in the eighties and nineties to soften anxiety over an even worse job market than today, and the expected shortage NEVER happened.

DO NOT enter the field based even in part on the number of superannuated pathologists out there. Find something else about pathology to get excited about.


I confirm the bolded statement.
 
Interesting perspective. I've wondered about this myself. Could some of these supposedly sinking specialties like radiology or pathology bounce back in the future? It seems like the lucky docs will be employed in academia, and the rest are forced to work for some major health group like Kaiser in CA or Providence health care in the Northwest as an employee. Unless you are a surgeon, GI doc, or dermatologist, it looks like this is the new trend in medicine. I just don't know if pathology is more like Border's or more like Apple.
Borders. But I kind of liked Borders.
 
How is gas on the decline? The CRNA threat has been ongoing for decades, yet gas salaries are steadily increasing.
Probably because procedures like colonoscopy have moved from an office setting to a hospital setting and anesthesia is called in to do unnecessary sedation. Did you read the NYT article about the
Basal cell removal by Mohs that then required sedation and plastic surgery to "close" the wound?
 
getting a job may now require dating the chair of the department, baby sitting his kid, or some other quid pro quo arrangement as with mt sinai hospital in nyc! not to mention, don't be qualified to begin with prior to applying for the job! i don't know what's in the kool aid but doctors should not put with this destruction and spoliation of medicine by blatant disregard of all things ethical.
 
I knew something was missing from this forum. Now I remember what it was. It's member007 saying bad things about Mt Sinai. Remember, the best revenge is living well. Let your hate go.
 
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I knew something was missing from this forum. Now I remember what it was. It's member007 saying bad things about Mt Sinai. Remember, the best revenge is living well. Let your hate go.

what does living well have to do with revenge, you have problems, buddy. in any case, for the more advanced folks, what i am pointing out here are examples of the most untoward and outright problems with pathology residencies that potential pathology residents and current residents need to be very aware about as it could really make or ruin your career, and help you decide whether you are the type that qualifies as a rotten soulless incompetent boob that enjoys destroying people and trampling on others prior to signing up to having your life ruined or not at an organization for ex. mt sinai hospital (only one that falls in this category given my wonderful work experience with 7 other major hospitals!). let truth be free and support the whistle blowers. trust me, it helps everyone.
 
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