Let's talk salary...

[EC3]

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So I really like histology and think a career in path would really suit me. The problem I'm running into, though, is that I'm not sure if the salary is competitive with the other fields of medicine I'm considering.

I've seen varying quotes from the high 100Ks to the low 300Ks. Can someone give me some honest salary information for private practice, let's say 3+ years out of residency. And as far as subspecialty training, what about fellowships in GI, Heme, or Derm (would be a long shot but curious).

And if anyone posts that money shouldn't be a deciding factor, I'll PM you my address and you can send me 10% of your yearly salary

 

[TheCritic]

So I really like histology and think a career in path would really suit me. The problem I'm running into, though, is that I'm not sure if the salary is competitive with the other fields of medicine I'm considering.

I've seen varying quotes from the high 100Ks to the low 300Ks. Can someone give me some honest salary information for private practice, let's say 3+ years out of residency. And as far as subspecialty training, what about fellowships in GI, Heme, or Derm (would be a long shot but curious).

And if anyone posts that money shouldn't be a deciding factor, I'll PM you my address and you can send me 10% of your yearly salary

Okay I'll bite. Once you realize the wide range of possibilities you will probably stop asking this question and start really pondering whether or not you like path enough to devote your life to it. You probably won't get rich, but will live comfortably--hopefully enjoying what you do. That being said, I will tell you the numbers getting thrown around near me by residents.

In general, with no fellowship or a less desirable one, starting is 170-220k.

3 years out:
GI 250-500K
Heme 200-350k
Derm not really sure but my guess is 250-500k

There are still people out of these ranges on both ends though.

What you actually make depends on so many things. I don't know what you mean by an honest answer.

 

[EC3]

Okay I'll bite. Once you realize the wide range of possibilities you will probably stop asking this question and start really pondering whether or not you like path enough to devote your life to it. You probably won't get rich, but will live comfortably--hopefully enjoying what you do. That being said, I will tell you the numbers getting thrown around near me by residents.

In general, with no fellowship or a less desirable one, starting is 170-220k.

3 years out:
GI 250-500K
Heme 200-350k
Derm not really sure but my guess is 250-500k

There are still people out of these ranges on both ends though.

What you actually make depends on so many things. I don't know what you mean by an honest answer.

Awesome post; this is exactly the kind of stuff i'm looking for. I'm just trying to get more taylored numbers rather than just "pathologists make X much" because there are many different areas of pathology and many different types of practices.

I've also heard that many path jobs have some great benefits packages (i.e. 6 weeks vacation, etc.). Any word on this?

 

[Tiki]

Okay I'll bite. Once you realize the wide range of possibilities you will probably stop asking this question and start really pondering whether or not you like path enough to devote your life to it. You probably won't get rich, but will live comfortably--hopefully enjoying what you do. That being said, I will tell you the numbers getting thrown around near me by residents.

In general, with no fellowship or a less desirable one, starting is 170-220k.

3 years out:
GI 250-500K
Heme 200-350k
Derm not really sure but my guess is 250-500k

There are still people out of these ranges on both ends though.

What you actually make depends on so many things. I don't know what you mean by an honest answer.

Those numbers seems a little high to me. I don't know, but from what I've heard, how much you make is going to depend on where you live. I'm a northeastern girl (and plan to stay in the northeast after residency) and from what I've heard from residents, they aren't starting anywhere near 170.

 

[trent05]

My understanding is that partners usually make the same salary regardless of fellowship training. There are plenty with only AP/CP and no fellowship.

 

[TheCritic]

Those numbers seems a little high to me. I don't know, but from what I've heard, how much you make is going to depend on where you live. I'm a northeastern girl (and plan to stay in the northeast after residency) and from what I've heard from residents, they aren't starting anywhere near 170.

Absolutely true. In other regions these numbers could be way different.

 

[mlw03]

One GI fellow joined a PP group, his deal was 400/yr as a partner, however his first two years he gets only 200 and the remaining 200 goes toward his "buy in". This was a medium sized Midwest city. Another GI fellow got at least 300 (including productivity bonus) starting in a new england path mill signing out only GI. I also know of someone with only a 5th year/surgpath fellowship who started at an HMO type practice at 170 in new england.

these are pretty good salaries - very encouraging stuff. i know LA may chide me for this, but i bet you can live extremely well on $200K/year in a medium midwestern city, let alone $400K. i know i certainly could have all the material stuff i could ever want on that amount. i think the poster who said you'll live comfortably as a pathologist is right on the money. i've never met a pathologist who said they're struggling financially while here in the tampa bay area.

 

[drhoffmann]

So the salaries are generally higher in the southeast?

 

[Patholog]

Salaries vary almost too much to be able to discuss succinctly. They vary according to region, state, subspecialty vs. general, whether the group is a hospital-employed group, independent and contracts with hospital(s) but does not own a lab, and independent with ownership of a lab.

You need to look at Medicare reimbursement on a state-by-state basis (I think LA has very good reimbursement and maybe FL as well). Generally speaking, the better the reimburse, the better your salary. I interviewed for a job in a very small midwestern city last week with up to 5 partners, 2 years to partner, independent but no lab ownership: I was quoted 280K starting (including benes-205K salary), 255K salary the next year and then around 500-550K as a partner with no buy in. I know of 4 other jobs within a 4 hour radius of my training program where one will make ~750K in college towns or smaller working ~40 hours per week and performing general pathology duties. I think jobs in the midwest pay more (very generally speaking and controlling for lucrative subspecialties) than other locales. I may be wrong, but that's what I've heard. I am only looking for jobs in the midwest, so that's all I know. But when you take into account cost of living, 750K in a small midwest town goes a hell of a lot further than in San Fran or NYC. But you have to go and do what you like.

 

[Thaitanium]

Salaries vary almost too much to be able to discuss succinctly. They vary according to region, state, subspecialty vs. general, whether the group is a hospital-employed group, independent and contracts with hospital(s) but does not own a lab, and independent with ownership of a lab.

You need to look at Medicare reimbursement on a state-by-state basis (I think LA has very good reimbursement and maybe FL as well). Generally speaking, the better the reimburse, the better your salary. I interviewed for a job in a very small midwestern city last week with up to 5 partners, 2 years to partner, independent but no lab ownership: I was quoted 280K starting (including benes-205K salary), 255K salary the next year and then around 500-550K as a partner with no buy in. I know of 4 other jobs within a 4 hour radius of my training program where one will make ~750K in college towns or smaller working ~40 hours per week and performing general pathology duties. I think jobs in the midwest pay more (very generally speaking and controlling for lucrative subspecialties) than other locales. I may be wrong, but that's what I've heard. I am only looking for jobs in the midwest, so that's all I know. But when you take into account cost of living, 750K in a small midwest town goes a hell of a lot further than in San Fran or NYC. But you have to go and do what you like.

750K for general pathology and working 40 hours a week?!? I have a hard time believing that. It seems as if everyone here is saying you will make in the 200Ks as a gen path. If you own the practice and have a good referral base/you are the only pathologist in town, then I would believe you.

 

[Patholog]

750K for general pathology and working 40 hours a week?!? I have a hard time believing that. It seems as if everyone here is saying you will make in the 200Ks as a gen path. If you own the practice and have a good referral base/you are the only pathologist in town, then I would believe you.

I think that is somewhat artifactual, in that many people who post here are not from the midwest. Indeed, the groups to which I refer own their own reference labs. They also contract with multiple hospitals in a hundred mile or so radius. None of these groups are solo practitioners; they are all > or = 5partners. Some have no buy in, others have >1 million. One group is a half hour away from my training program and makes 650K before benes, with a reference lab and partner in a year. I told you about the one at which I interviewed. Another makes 650K salary before benes, has a 2K buy in after 2years, I think. Another makes >650K, owns a reference lab, has a huge buy in and you have to wait at least 4 years to partner. There are lots of options in the midwest, where the market is not more saturated with people. I think (just a theory) that salaries get somewhat diluted on the coasts because there are more practitioners there and because the places are so attractive to live that people will potentially settle for less. Just my opinion, I don't know for sure.

 

[trent05]

I interviewed for a job in a very small midwestern city last week with up to 5 partners, 2 years to partner, independent but no lab ownership: I was quoted 280K starting (including benes-205K salary), 255K salary the next year and then around 500-550K as a partner with no buy in. I know of 4 other jobs within a 4 hour radius of my training program where one will make ~750K in college towns or smaller working ~40 hours per week and performing general pathology duties. I think jobs in the midwest pay more

Looks like I'm headed to the midwest.

 

[LADoc00]

750K is a stretch, let me tell you why. If someone had a gig where they set it up and made 750K, which is possible (not probable though), they would likely be working 60+ hours a week in a solo slot, or what I call a solo+0.5 position (basically a 1.5FTE pathologist billet).

No one would really offer that to some right out of training. The reality is you dont need to. There is no fellow in the world worth that, or even half that.

Think about, I can buy the best fellows in the country on the spot market for 250K and Im going to pay 750?! Does this group also shop for $100K Honda Civics too? If so I can sell them one.

Midwest is NOT the goldmine people have made it out to be. Yes it much better than NYC (hell Mexico is better than NYC) but it is not Willy Wonka's Chocolate Factory either.

I have interviewed in the midwest in very low cost of living areas with massive oil revenues and frankly was disappointed. Yes I can get a job for 400-500K in Iowa, big deal I can make more living on the beach in California. Yes I can get a very sweet deal in a college town in Oklahoma, but I can swing almost as good of deal in San Deigo or Newport or Miami.

I personally think the Midwest is the place to be for some other reasons, mainly for the culture respect for medicine that doesnt exist in Palo Alto or Manhattan. Also, there is prospect of incredible amounts of beautiful property, good schools for kids etc. BUT if you absolutely cant stand Tulsa, then no amount of $$ will make you happy really.

Good rule of thumb: if someone is offering you X, then they are making at least 2X. That is the nature of a capitalist economy. So in your example, you would assume the managing partners are making at least 1.5m, which is a hard pill for me to swallow because even in the best reimbursement areas represents around 12K+ surgicals/year.

find me a fellow that can knock back 12k/year and I will crown him king. Ive been at jobs where we had 8 pathologists signing out that much (and running the CP areas etc).

 

[Patholog]

750K is a stretch, let me tell you why. If someone had a gig where they set it up and made 750K, which is possible (not probable though), they would likely be working 60+ hours a week in a solo slot, or what I call a solo+0.5 position (basically a 1.5FTE pathologist billet).

No one would really offer that to some right out of training. The reality is you dont need to. There is no fellow in the world worth that, or even half that.

Think about, I can buy the best fellows in the country on the spot market for 250K and Im going to pay 750?! Does this group also shop for $100K Honda Civics too? If so I can sell them one.

Midwest is NOT the goldmine people have made it out to be. Yes it much better than NYC (hell Mexico is better than NYC) but it is not Willy Wonka's Chocolate Factory either.

I have interviewed in the midwest in very low cost of living areas with massive oil revenues and frankly was disappointed. Yes I can get a job for 400-500K in Iowa, big deal I can make more living on the beach in California. Yes I can get a very sweet deal in a college town in Oklahoma, but I can swing almost as good of deal in San Deigo or Newport or Miami.

I personally think the Midwest is the place to be for some other reasons, mainly for the culture respect for medicine that doesnt exist in Palo Alto or Manhattan. Also, there is prospect of incredible amounts of beautiful property, good schools for kids etc. BUT if you absolutely cant stand Tulsa, then no amount of $$ will make you happy really.

Good rule of thumb: if someone is offering you X, then they are making at least 2X. That is the nature of a capitalist economy. So in your example, you would assume the managing partners are making at least 1.5m, which is a hard pill for me to swallow because even in the best reimbursement areas represents around 12K+ surgicals/year.

find me a fellow that can knock back 12k/year and I will crown him king. Ive been at jobs where we had 8 pathologists signing out that much (and running the CP areas etc).

Let's be clear. 750K is not the starting salary, so it is misleading to say you are paying "fellows" that much...you are paying partners that much. Also, a residency colleague just signed a contract for what I quoted you in one of the groups, so unless they breach contract, that is what he will make. I don't know how many hours he will work and I don't know what the old-timers make, though, so I'll grant you that. But I'm pretty sure he said it is an equal share practice. Based on this and other posts from LADoc, I presume he doesn't believe that such a thing exists, that all people are out to screw each other, and that may be true, but not in every situation.

A senior partner in another of the groups to which I was referring told me what they made years ago before I was even a consideration by that group...and he is a friend, so I have no reason to believe he was lying. We can all be cynical that there is no deal better than the one we are currently in or that we have heard of but the truth is, there are great jobs in the midwest, and I'm sure in other areas as well. I was born and raised in the midwest and have no intention of leaving, as I have family close by, so that is the biggest draw in and of itself. Give me >650K on top and that just sweetens the deal.

I'm being purposely vague about these jobs with regard to location, salary, etc so as to not put myself in an awkward situation, and I realize that that invites criticism and disbelief, but I don't care. I'm in the process of finalizing a contract with one of the above-mentioned groups and I'm thrilled, as it is the best choice for myself and my family. The money just makes it better.

 

[LADoc00]

Let's be clear. 750K is not the starting salary, so it is misleading to say you are paying "fellows" that much...you are paying partners that much. Also, a residency colleague just signed a contract for what I quoted you in one of the groups, so unless they breach contract, that is what he will make. I don't know how many hours he will work and I don't know what the old-timers make, though, so I'll grant you that. But I'm pretty sure he said it is an equal share practice. Based on this and other posts from LADoc, I presume he doesn't believe that such a thing exists, that all people are out to screw each other, and that may be true, but not in every situation.

A senior partner in another of the groups to which I was referring told me what they made years ago before I was even a consideration by that group...and he is a friend, so I have no reason to believe he was lying. We can all be cynical that there is no deal better than the one we are currently in or that we have heard of but the truth is, there are great jobs in the midwest, and I'm sure in other areas as well. I was born and raised in the midwest and have no intention of leaving, as I have family close by, so that is the biggest draw in and of itself. Give me >650K on top and that just sweetens the deal.

I'm being purposely vague about these jobs with regard to location, salary, etc so as to not put myself in an awkward situation, and I realize that that invites criticism and disbelief, but I don't care. I'm in the process of finalizing a contract with one of the above-mentioned groups and I'm thrilled, as it is the best choice for myself and my family. The money just makes it better.

No one, NO ONE signs a contract for what their partnership salary will be. Lets be crystal clear here on how this works. First off, medicine is a business, how could you sign a contract for future partnership date when you have no clue in the slightest what your income will be at time X?? I run a pathology group, my income can vary by a 100K between 2 back to back months.

What groups do is elude, not state, not put in writing (maybe rough numbers only) to what managing partners make when they interview someone. The contract you sign is for year 1 salary, maybe MAYBE with a clause for a 10-20% increase year 2. You wont even see the partnership agreement until they vote on you. You have clue how much is deemed founder bonus, how much is senority compensation or if the group has silent retired partners (this is a HUGE one to watch out for).

Im trying to 100% honest with peeps here, what senior founding partners make, you likely wont and that assumes you even make partner. I was in a group where the senior core went through 26 (!!!) junior associates and made none of them partner.

Realize groups have little to no incentive to treat you fairly and pay you outrageous sums when the supply of pathologists is so plentiful. Hell I could pick up a phone RIGHT NOW and staff 2 150 bed hospitals with pathologists just from people I know around me looking for work.

 

[mellowmarshall]

LADoc, you paint a bleak portrait. Is the path market really that crowded?

 

[yaah]

LADoc, you paint a bleak portrait. Is the path market really that crowded?

My impression is that there are a lot of less qualified and desirable candidates out there, but if you are a good candidate your prospects improve quite a bit.

 

[mlw03]

LADoc, you paint a bleak portrait. Is the path market really that crowded?

remember that LADoc is just that... in LA. we all know the coasts are crowded because people wanna live there. i certainly don't know the job market the way LADoc does, but i am betting my career that there will be job opportunities for me when i finish training around 2013 - and every pathologist i've talked to in person has told me that's a safe bet to make. i don't expect to make massive gobs of money though - but i do expect to make enough to live quite comfortably. all the pathologists i know in the tampa bay area are able to do at least that, sometimes more.

 

[DarksideAllstar]

remember that LADoc is just that... in LA. we all know the coasts are crowded because people wanna live there. i certainly don't know the job market the way LADoc does, but i am betting my career that there will be job opportunities for me when i finish training around 2013 - and every pathologist i've talked to in person has told me that's a safe bet to make. i don't expect to make massive gobs of money though - but i do expect to make enough to live quite comfortably. all the pathologists i know in the tampa bay area are able to do at least that, sometimes more.

LADoc00 is not in LA anymore. I do believe that the jobs in path will never be as "plentiful" as they are in other specialties. The mass "retirement" has been predicted for a number of years now, but alas, there are still 65+ year olds signing out...

 

[mlw03]

LADoc00 is not in LA anymore. I do believe that the jobs in path will never be as "plentiful" as they are in other specialties. The mass "retirement" has been predicted for a number of years now, but alas, there are still 65+ year olds signing out...

my apologies - i didn't know that. you are still in cali though, yes?

 

[docbiohazard]

My impression is that there are a lot of less qualified and desirable candidates out there, but if you are a good candidate your prospects improve quite a bit.

I think Yaah raises an excellent point... there are a certain number of "less than fantastic" candidates out there - perhaps more than just a few. I like to think that if one is industrious, works harder in their training, passes their boards with flying colors and strives to be adept at evaluating the job market, then pursuing their individual happiness (be it location, money, status, whatever) with vigor will lead to success over time.

I also tend to think the mass retirement is coming, at the hands of the reaper if nothing else...

BH

 

[pathdawg]

I am going to state this as someone who is a subspecialist with over 7 years post-fellowship experience as an attending. What LADoc posted about new recruits and (potential) partnership money is 100% correct. What happens is that a group will be very general with a new recruit. They will tell you that some senior partner makes (insert unrealistic sum here) dollars a year with the veiled implication that you can expect that in a few short years. In my experience, you (as the new recruit) will never see that kind of partnership money, either because either partnership will never be offered (a very common occurance), or because the offered buy-in is (intentionally) far too expensive, or they'll be giving you far less as a junior partner. Recent grads are very easily impressed with "partnership money" and groups know this and use it to their advantage. Its a tough world out there, kids. Believe that.

Also, I can say that, as far as the east coast (at least in metropolitan areas such as Philly, NYC, and Boston), the numbers being quoted here are very high. Obviously, in other parts of the country, ymmv.

This much I have learned in seven years: medicine is a very tough business to make money in. It just is. As tough as path is, be thankful you're not in primary care.

 

[DarksideAllstar]

my apologies - i didn't know that. you are still in cali though, yes?

no biggie-- I was posting more for clarification than anything else. I am in SF-- you are correct sir! /edmcmahon voice

 

[ZZPath]

If you are flexible in choice of location and partnership is important in the long run.............
Some advice before taking that first job:

Go on lots of interviews if you can.
Find a group with a good track record of admitting juniors into the fold.
Contact the group's former associates and ask about their reasons for leaving.
Ask your potential employer why, if anyone, left the practice. Compare answers.
Get a lawyer to go over your contract with a fine tooth comb.
Don't take the first offer.

It will save you mucho dinero over a career if you pick the right group at the start. Just think of all that compound interest.....

Letting juniors with vague expectations of partnership hang around for years is a very common business model in pathology. The partners know a junior is trapped after several years of employment by things like home ownership, spouse's job, kids' schooling and tail coverage expense. And the owners know its a buyer's market for fellowship-trained newbies (except for derm and GI).

Good luck to everyone looking for their first job. May you find peace, happiness and gobs of money.....

 

[docbiohazard]

I never quite understand where this mass retirement idea comes from.

Most recently, there was an article in New Physician about Pathology, which stated that of the ~14k practicing pathologists in the US today, ~6k were over 55yo according to the AAMC. The article can be found here:

http://www.amsa.org/tnp/articles/article.cfx?id=361

Also talks about lifestyle, variety of practice, and salaries... not sure where the salary data comes from... incidentally, you can always hit up Salary.com to get regional salary ranges, but again, hard to correlate to what sort of position is actually earning that amount...

You are correct about the dramatic increase in the number of training spots. It should be interesting to see how things play out in the next 5-10-20 years...

BH

 

[pathdawg]

I just wanted to add that to assume that mass pathologist retirement would correlate with new jobs opening up would be incorrect. Very often, when a pathologist retires, the other members of a group simply work harder and envelop the added workload. They'd rather work harder (and earn more) than hire a newbie.

And for the record, they have been talking about this "mass retirement" expectation for about 20 years now. Hasn't happened.

 

[djmd]

Most recently, there was an article in New Physician about Pathology, which stated that of the ~14k practicing pathologists in the US today, ~6k were over 55yo according to the AAMC. The article can be found here:

http://www.amsa.org/tnp/articles/article.cfx?id=361

Also talks about lifestyle, variety of practice, and salaries... not sure where the salary data comes from... incidentally, you can always hit up Salary.com to get regional salary ranges, but again, hard to correlate to what sort of position is actually earning that amount...

You are correct about the dramatic increase in the number of training spots. It should be interesting to see how things play out in the next 5-10-20 years...

BH

It doesn't say how active they are so it could be ~3k full time and ~3k part time. So over the next decade 4.5k will retire, and 1.5k full timers will go part time... (more likely even less will full retire)
And from that same article, only 500 pathologist are trained every year...
so over the next decade, 5k pathologist will enter a job market being vacated by >5k full time pathologists...

Oh wait that doesn't sound that good...Besides how many pathologist retire at 65? Maybe they go part time, or maybe the keep working till they are 70.

Call me when 6k plus pathologist are over 65 and pathology is putting out less than 400 new residents per year... maybe then the job market will favor the new hire...

 

[LADoc00]

I just wanted to add that to assume that mass pathologist retirement would correlate with new jobs opening up would be incorrect. Very often, when a pathologist retires, the other members of a group simply work harder and envelop the added workload. They'd rather work harder (and earn more) than hire a newbie.

And for the record, they have been talking about this "mass retirement" expectation for about 20 years now. Hasn't happened.

Yep. In my area there are less pathologist FTEs now than there were in 1973...and the population/number of hospital beds has more than doubled.

Retirements will not translate into jobs at anywhere close to a 1:1 ratio.

IMO, there was a spin doctoring in the 90s when academia witnessed a huge drop off in applicants to Path, I think somewhere around 1988-1991, post CLIA. The consultants they hired created the 'retirement myth', which received official CAP blessing in the mid to late 90s. Sadly, it actually worked on med students and instead of 50% of programs closing (what should have happened post 1987) we saw only a smattering of community hospitals lose ACGME credentials in that time period.

There is no single entity in the US save for this rogue band of guys on the East Coast (I think) and the Dark Report, that kept a close eye on all these shenanigans that unfolded the last 2 decades. Millions of dollars (hundreds of millions to be more precise) were made on this by lots of players at cost of hundreds maybe even thousands of careers in path were trashed.

Honestly this is a simple tale of greed and not much more.

 

[deschutes]

Contact the group's former associates and ask about their reasons for leaving.
Ask your potential employer why, if anyone, left the practice. Compare answers.

How do you find these people anyway? I don't imagine either party would be terribly forthcoming with information of this nature, but maybe I imagine wrong.

 

[djmd]

How do you find these people anyway? I don't imagine either party would be terribly forthcoming with information of this nature, but maybe I imagine wrong.

You ask. If your potential employer doesn't at least have a last know address and contact information, they should be able to point you in the right direction. Failure to provide something like that is a major red flag.


On the other hand expecting the two stories to jive exactly is foolish...
🙄

 

[ZZPath]

Beyond asking your interviewers, find former associates through the hospital medical staff services, or by contacting others you met during the interview process - like the lab manager or the pathology assistant. Some of the junior staff are likely goldmines of info; some may want to warn you. Get their contact info away from work and (if possible) take them out for a beer. Alcohol and informal surroundings may make useful info flow more freely. It is worth an extra night's stay at the hotel or another trip back to town to get the inside scoop on your next employer. With a little intel, much pain and suffering can potentially be avoided. Be especially diligent in your efforts when interviewing for widely advertised private practice jobs (i.e. internet postings). Unable to escape their local reputation, the group may be trying to cast a wide net outside of the regional network of their colleagues, both private practice and academic.

 

[pathdawg]

Yep. In my area there are less pathologist FTEs now than there were in 1973...and the population/number of hospital beds has more than doubled.

Retirements will not translate into jobs at anywhere close to a 1:1 ratio.

IMO, there was a spin doctoring in the 90s when academia witnessed a huge drop off in applicants to Path, I think somewhere around 1988-1991, post CLIA. The consultants they hired created the 'retirement myth', which received official CAP blessing in the mid to late 90s. Sadly, it actually worked on med students and instead of 50% of programs closing (what should have happened post 1987) we saw only a smattering of community hospitals lose ACGME credentials in that time period.

There is no single entity in the US save for this rogue band of guys on the East Coast (I think) and the Dark Report, that kept a close eye on all these shenanigans that unfolded the last 2 decades. Millions of dollars (hundreds of millions to be more precise) were made on this by lots of players at cost of hundreds maybe even thousands of careers in path were trashed.

Honestly this is a simple tale of greed and not much more.

Truth.

 

[LADoc00]

Beyond asking your interviewers, find former associates through the hospital medical staff services, or by contacting others you met during the interview process - like the lab manager or the pathology assistant. Some of the junior staff are likely goldmines of info; some may want to warn you. Get their contact info away from work and (if possible) take them out for a beer. Alcohol and informal surroundings may make useful info flow more freely. It is worth an extra night's stay at the hotel or another trip back to town to get the inside scoop on your next employer. With a little intel, much pain and suffering can potentially be avoided. Be especially diligent in your efforts when interviewing for widely advertised private practice jobs (i.e. internet postings). Unable to escape their local reputation, the group may be trying to cast a wide net outside of the regional network of their colleagues, both private practice and academic.

You would be shocked and utterly floored by the warnings you get from people. And when you get a warning about a job take it VERY seriously considering the person who gave it to you may have been risking their job to bring you that information.

I have had junior staff I went to grad school with give me outright red flag warnings. I have had associates send me very omnious emails, one I vividly remember as simply being "Run, Forest, Run..."

I would get a listings of prior associates in your area from the medical staff office (which is neutral in every hospital), google that list and contact them. I cant stress that enough.

 

[Neddy]

Yep. In my area there are less pathologist FTEs now than there were in 1973...and the population/number of hospital beds has more than doubled.

LA, I'm just curious about how this is possible. I'd think the number of biopsies and surgeries would have risen much faster than the number of hospital beds, given the rise of endoscopy, minimally invasive surgery, etc (and HMO cost cutting on inpatient stays). So who is handling this huge rise in specimen volume if the number of fully employed pathologists has gone down? Part-time associates? (but they would still count toward FTE's). Are pathologists just more productive now than they were in the past due to more PAs, techs, automation, longer hours etc?

 

[Potomania]

I have a relative who has been in PP for 20+ years and when I quoted some of these numbers to him, he about fell out of his chair laughing and basically says anyone who thinks they are going to make 400-700K in Pathology is living in a fairyland, no matter how many years out they are from fellowship. He basically said the only way this was possible is if you are either running a ref lab or a getting a huge cut at the expense of everyone else in a moderate to large sized group with good volume. He has a job in a group of 6 and makes around 300-350, has expertise in both heme and GU, and works 10-12 hour days. So, forget the "I'll make partner working for complete strangers" route and just start up your own practice or reference lab if you want to make this kind of money. Otherwise, expect 150-350, depending on the area, the volume, and the practice.

 

[djmd]

I have a relative who has been in PP for 20+ years and when I quoted some of these numbers to him, he about fell out of his chair laughing and basically says anyone who thinks they are going to make 400-700K in Pathology is living in a fairyland, no matter how many years out they are from fellowship. He basically said the only way this was possible is if you are either running a ref lab or a getting a huge cut at the expense of everyone else in a moderate to large sized group with good volume. He has a job in a group of 6 and makes around 300-350, has expertise in both heme and GU, and works 10-12 hour days. So, forget the "I'll make partner working for complete strangers" route and just start up your own practice or reference lab if you want to make this kind of money. Otherwise, expect 150-350, depending on the area, the volume, and the practice.

No offense to your relative, but the range goes over 350...
Not a lot of jobs do, but they exist...
I mean for starters, your relative is in a group of 6 and making 300-350. If they had a little more volume, a slightly better payee mix, or did the work with say 5 or 5.5 pathologists, then he would be making more... And odds are that your relative is not specifically the top of possible earnings...
Not to mention that neither GU nor Heme are the 'money' specialties...
Derm path definitely can break the 350k mark...

 

[trent05]

Not to mention that neither GU nor Heme are the 'money' specialties... Derm path definitely can break the 350k mark...

So if GU and Heme are not 'money' specialties then what besides derm would you consider 'money'?

 

[ZZPath]

Pathology is one of the theoretically more lucrative specialties - just don't tell the pathologists. OK, as a thought experiment, how much revenue, before expenses, would you say an average pathologist pulls in for AmeriPath/Quest/Caris, etc. every day, assuming 60 patients a day, 2 biopsies (88305 x 2) per patient, a special stain every ten biopsies (88312) and an immunostain every ten biopsies (88342)? Assume global reimbursement Medicare rates. Anyone want to guess? Now what percentage of this pathologist's professional fee (forget the technical component) does this poor soul recoup if he/she is making 250 K/yr?
And, below what percentage of your technical fee would you consider unfair? Criminal?😡
The right answer to the first question will give you an idea of the upper range of possibilities for path reimbursement. No right answer for the last question, but personally would be insulted at anything less than 20% of the total (even with the no call/no weekends/9-5/free coffee and donuts lifestyle).😉

 

[ZZPath]

Should have asked "below what percentage of your professional fee would you consider unfair?" on my last post...
😴

 

[djmd]

So if GU and Heme are not 'money' specialties then what besides derm would you consider 'money'?

I guess GI, based off of the logic ZZtop was using above there...

I actually don't tend to think about stuff like that, but the poster who's relative said "350 is top, and oh I make 350" just bugged me. My point was simply that if he is general pathology, and strong in GU and heme, there had to be people who could make more money. A person doing mostly Derm or GI bx, could clear more....

It is a stupid point, but so was the "350 is max" thing...

 

[djmd]

And, below what percentage of your technical fee would you consider unfair? Criminal?😡
The right answer to the first question will give you an idea of the upper range of possibilities for path reimbursement. No right answer for the last question, but personally would be insulted at anything less than 20% of the total (even with the no call/no weekends/9-5/free coffee and donuts lifestyle).😉

Ironically, the corporation are not remoted interested in unfair, and 'criminal' doesn't really bother them either as it a criminally unfair, not illegally criminal... (and no that is not really irony)

How much money does a Mastectomy or LAR make? How do I bill for tumor boards? What is my pay out for autopsies?

That is why both pathologist don't make 'a lot of money', and why the whole concept of Biopsy only referral labs (and pod labs) is criminal.
Biopsies make money, and pretty much everything else does not (or the return for time spend is way off).

Sure, someone can make more money off just biopsies, but who is going to deal with the mastectomy after the breast BX?

 

[pathdawg]

LA, I'm just curious about how this is possible. I'd think the number of biopsies and surgeries would have risen much faster than the number of hospital beds, given the rise of endoscopy, minimally invasive surgery, etc (and HMO cost cutting on inpatient stays). So who is handling this huge rise in specimen volume if the number of fully employed pathologists has gone down? Part-time associates? (but they would still count toward FTE's). Are pathologists (are) just more productive now than they were in the past due to more PAs, techs, automation, longer hours etc?

I highlighted the correct answer to your question.

 

[Potomania]

I never said "350 was the max" at all. All I quoted was that this range is what one can expect in general...I specifically said if you are running a reference/referral lab or taking a big cut it is possible to exceed this...sorry if I was "too stupid" to be more clear. Of course it is a gaussian curve and there are extremes, but I believe he was referring to 2 SD's on either side. He knows of people who make more than this, he even worked for one in a reference lab several years ago, but they are few and far between according to him and don't just walk into these setups on easily like some people on this board describe. In general, most of his buddies in the southeast make around 200-350...this is in general pathology. Of course labs which focus on subspecialties such as derm can expect to pull in more, but this is not the majority of people who are in practice. I think each person in his group has their own "specialty" they do in addition to general signout and CP call, and the profits are devied out among them in some fashion.

The bottom line is, you certainly have an outside chance to make the kind of numbers people sling around this board, but your going to have to be in the right setup with a certain amount of luck and alot of hard work and saavy. This just doesn't happen for most people in the field....like 95% of them. This was his point I believe, not what you can theoretically make in a perfect world with X number of biopsies with great returns with big volume or assuming you'll be like some guy you heard of thru the grapevine who got 700K for a heme job in Texas.