Medscape salary survey results 2012

[gbwillner]

Sorry to break up the doom and gloom barrage (temporarily of course), but the results of a medscape survey result have come in and Pathology seems to be doing pretty well in this respect (NOTE- I am not claiming pathology will give you a job in Hawaii starting at 500K, merely that salaries compared to other specialties are holding steady vs. dropping).

link: http://www.medscape.com/features/slideshow/compensation/2013/pathology?src=wnl_edit_specol

In case you can't see it, here are some highlights:

1. More pathologists make more than 400K than less than 100K
2. 30% of pathologists say they are making more than last year, 20% say less (everyone else about the same)
3. Mean compensation: $247K
4. The south-central makes the least as a region ($219K), the Northwest the most ($311K).
5. Academic mean is $191K, multispecialty practice is $324. Everyone else in the middle.
6. 94% are board certified
7. a full 12% are older than 65 years

Compared to other specialties-
8.Path is one of the few non-primary fields who did not see a drop in compensation. About half of pathologists feel adequately compensated- same as across all specialties.
9. 15% consider themselves "rich", tops the survey by specialty.
10. pathologists would go into their specialty if they had to do it all over again- more than physicians across the board (49% vs. 41%)

Survey was comprised of > 24,000 responders

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[Kilgoretrout 65]

Path is one of the few non-primary fields who did not see a drop in compensation.
- Probably because they are all working harder and not hiring an extra person for their group

15% consider themselves "rich", tops the survey by specialty.
- Ha! Knowing pathologists, they think they are rich when they can use a new tea bag in the morning or when they can pay to wash the Saturn...

 

[dr.weiner]

Pretty fitting that the optimistic survey with n=24000 gets a lot less attention than the pessimistic survey with n=26.

Observations from both surveys:
- Avoid NYC job market if possible
- Get a private practice job

 

[Enkidu]

Pretty fitting that the optimistic survey with n=24000 gets a lot less attention than the pessimistic survey with n=26.

Observations from both surveys:
- Avoid NYC job market if possible
- Get a private practice job

Are there even 24,000 pathologists in practice?

As for that "pessimistic" survey - it was a survey of the *perceptions of residents*. It wasn't an actual study of the job market or of pathologist salary. I doubt that any of those pathology residents were even looking for a job - I'm sure they were all preparing for fellowships.

 

[dr.weiner]

Are there even 24,000 pathologists in practice?

As for that "pessimistic" survey - it was a survey of the *perceptions of residents*. It wasn't an actual study of the job market or of pathologist salary. I doubt that any of those pathology residents were even looking for a job - I'm sure they were all preparing for fellowships.

The 24,000 probably represents the total number of people who took the survey. Not sure how many pathologists. I don't have access.

 

[Euchromatin]

The 24,000 probably represents the total number of people who took the survey. Not sure how many pathologists. I don't have access.

If you just Google "Medscape salary survey 2012" you can get to it without medscape access.

There were 24,216 respondents total and 3% of them were pathologists (about the same percentage responded from ortho, ophthy, rads, neurology, etc.) = 727

 

[Thrombus]

GB Willner if this is how you interpret data, do not go into pathology please.

 

[Enkidu]

GB Willner if this is how you interpret data, do not go into pathology please.

How do you interpret the medscape data?

 

[malchik]

GB Willner if this is how you interpret data, do not go into pathology please.

...because your mission has always been to encourage only the best and brightest to enter pathology.

 

[gbwillner]

GB Willner if this is how you interpret data, do not go into pathology please.

As a board certified pathologist is is too late for me. I guess I should have been more like you, and instead of rationally interpreting the data that are available, I should just have screamed from the top of my lungs irrational and baseless things (like we should cut off all NIH funding, and scare away the most competent prospective residents).

If only I had the great "real world" experience that you have- where everyone is out to get you, and new trainees are either cannon fodder for "academia" (i.e., liberal commie pinkos) or competition that must be eliminated at all costs (since simply being a competent pathologist is never enough), I would see how wrong about everything I truly was.

You are right though- we work hard for peanuts. And by hard I mean never having to take in-house call or deal with needy patients at 2 AM, and by peanuts I mean a mean salary of $250K/year, which is more than all those fields you keep telling people to go into.

I'll just have to cry myself to sleep every night since there are no jobs available (except for all those jobs that are available and filled by myself and everyone I know). I know there are a few unlucky, highly qualified people who have had trouble (or so I've seen on this forum), but that's the price we pay for having an independent specialty.

 

[2121115]

As a board certified pathologist is is too late for me. I guess I should have been more like you, and instead of rationally interpreting the data that are available, I should just have screamed from the top of my lungs irrational and baseless things (like we should cut off all NIH funding, and scare away the most competent prospective residents).

If only I had the great "real world" experience that you have- where everyone is out to get you, and new trainees are either cannon fodder for "academia" (i.e., liberal commie pinkos) or competition that must be eliminated at all costs (since simply being a competent pathologist is never enough), I would see how wrong about everything I truly was.

You are right though- we work hard for peanuts. And by hard I mean never having to take in-house call or deal with needy patients at 2 AM, and by peanuts I mean a mean salary of $250K/year, which is more than all those fields you keep telling people to go into.

I'll just have to cry myself to sleep every night since there are no jobs available (except for all those jobs that are available and filled by myself and everyone I know). I know there are a few unlucky, highly qualified people who have had trouble (or so I've seen on this forum), but that's the price we pay for having an independent specialty.

pwned.

 

[Thrombus]

Do you people have any idea what pathologists would be making if there was not such a large glut?

The ignorance here is overwhelming.

 

[gbwillner]

Do you people have any idea what pathologists would be making if there was not such a large glut?

The ignorance here is overwhelming.

Are you a birther or a truther? I'm going to guess birther.

 

[Substance]

Are you a birther or a truther? I'm going to guess birther.

He's got a point. Your oversupply is causing you to be lowballed. Same thing is happening in imaging right now (though that'll probably reverse, given imaging's reputation for being shrewd)

 

[gbwillner]

He's got a point. Your oversupply is causing you to be lowballed. Same thing is happening in imaging right now (though that'll probably reverse, given imaging's reputation for being shrewd)

Is there a point to those that say there are too many pathologists being produced, and that number should be reduced to fit market conditions? YES. Could the job market improve by reducing residency positions? PROBABLY.

Is there a point to what Thrombus says, that includes (but is not limited to):
1. We would all get compensated MORE if there was a shortage of pathologists. (doubtful).
2. close 85% of residency programs (Derp).
3. shut down the NIH, since they either supply resident funding or give academia money (depending on which side of the bed Thrombus wakes up that day), which somehow means [black box] bad for market!!! (Derpa-derp)
4. Pathology is filled with *****s who couldn't hack it in "real" specialties... and the top residents who want to go into pathology are "warned" that there is no place for them or jobs and they should go elsewhere (Hurp-a-derpa-derp).

... Not really, no.

 

[Substance]

Is there a point to those that say there are too many pathologists being produced, and that number should be reduced to fit market conditions? YES. Could the job market improve by reducing residency positions? PROBABLY.

Is there a point to what Thrombus says, that includes (but is not limited to):
1. We would all get compensated MORE if there was a shortage of pathologists. (doubtful).
2. close 85% of residency programs (Derp).
3. shut down the NIH, since they either supply resident funding or give academia money (depending on which side of the bed Thrombus wakes up that day), which somehow means [black box] bad for market!!! (Derpa-derp)
4. Pathology is filled with *****s who couldn't hack it in "real" specialties... and the top residents who want to go into pathology are "warned" that there is no place for them or jobs and they should go elsewhere (Hurp-a-derpa-derp).

... Not really, no.

Let's be realistic though. Thrombus does put a bit of a jingoistic slant on things, but he does make some good points.

Your field has had tremendous difficulty in recruiting competent doctors since the 80s, according to various man-power studies and papers which you can look up. If bright young AMGs are avoiding the specialty, it might be because there's something wrong with it. Your leadership hasn't done a very good job in figuring out what this is.

Programs are given too much incentive to recruit residents; namely, subsidized PAs. In doing so, the market is flooded.

Your field has done a poor job in defining what it actually does. Perception is oftentimes thought to be reality, even if its inaccurate, which is why though your field is the one that conveys the most important prognostic information, everyone thinks you just do worthless autopsies. This is probably a big reason why the field isn't funded very well, and why good students avoid it.

I mean, I understand why you're skeptical and critical of all of the doom-and-gloom posts around here since they're fairly ineffective and amount to nothing more than a gripe-fest, but much of what is said is accurate. Now, how to fix things is the more challenging part, and I haven't seen much in the way of suggestions about how to go about doing just that.

If pathologists actually got together and changed what they did, and made plans to improve your field for everyone, then maybe it'd work out better. But just sitting here bitching about it doesn't do a thing. Run for positions on CAP and USCAP, get involved in hospital committees, blackball graduates from garbage programs, hire people without fellowships, refuse to work for POD labs, things like that.

 

[Path or bust]

Good post, completely agree.

Let's be realistic though. Thrombus does put a bit of a jingoistic slant on things, but he does make some good points.

Your field has had tremendous difficulty in recruiting competent doctors since the 80s, according to various man-power studies and papers which you can look up. If bright young AMGs are avoiding the specialty, it might be because there's something wrong with it. Your leadership hasn't done a very good job in figuring out what this is.

Programs are given too much incentive to recruit residents; namely, subsidized PAs. In doing so, the market is flooded.

Your field has done a poor job in defining what it actually does. Perception is oftentimes thought to be reality, even if its inaccurate, which is why though your field is the one that conveys the most important prognostic information, everyone thinks you just do worthless autopsies. This is probably a big reason why the field isn't funded very well, and why good students avoid it.

I mean, I understand why you're skeptical and critical of all of the doom-and-gloom posts around here since they're fairly ineffective and amount to nothing more than a gripe-fest, but much of what is said is accurate. Now, how to fix things is the more challenging part, and I haven't seen much in the way of suggestions about how to go about doing just that.

If pathologists actually got together and changed what they did, and made plans to improve your field for everyone, then maybe it'd work out better. But just sitting here bitching about it doesn't do a thing. Run for positions on CAP and USCAP, get involved in hospital committees, blackball graduates from garbage programs, hire people without fellowships, refuse to work for POD labs, things like that.

 

[Path_to_Endo]

Solid argument. Maybe its program dependent, but there doesn't seem to be much of leadership on the issue of training residents to adapt to the future of the field, whatever form it may take. There are a lot of great things about the field, but there is an overwhelming lack of willingness to innovate and to confront the challenges to the field in a united way.

 

[yaah]

Could the job market improve by reducing residency positions? PROBABLY.

There are so many variables to that question. I agree it is much easier to just say DERP DERP CUT POSITIONS PROFIT but the real world is so complicated.

Cutting residency spots, unless you are going to fire currently active residents, means that it will have zero effect for at least 4 years. Here's a problem though - theoretically a shortage of pathologists may actually encourage the move towards reference labs and consolidation (and thus will do little for salaries). I mean, you can SAY that it won't, but the point is it MIGHT and you don't really know. Hospitals won't be able to hire pathologists so they will send out their work even more. It might raise the lower end salaries because they will have to pay more to retain paths, and it will help the .1% at the top who own everything (most of which probably wouldn't be pathologists anyway). But the middle probably won't change. Reimbursement is going to continue to go down, and labs are going to continue to compete for business by lowering prices EVEN IF there are fewer pathologists.

But yeah, it's easier to just DERP DERP DERP.

The truth as always is somewhere in the middle. Note of course this is not to say that nothing can and nothing should be done to address current problems.

 

[InterimChair]

There are so many variables to that question. I agree it is much easier to just say DERP DERP CUT POSITIONS PROFIT but the real world is so complicated.

Cutting residency spots, unless you are going to fire currently active residents, means that it will have zero effect for at least 4 years. Here's a problem though - theoretically a shortage of pathologists may actually encourage the move towards reference labs and consolidation (and thus will do little for salaries). I mean, you can SAY that it won't, but the point is it MIGHT and you don't really know. Hospitals won't be able to hire pathologists so they will send out their work even more. It might raise the lower end salaries because they will have to pay more to retain paths, and it will help the .1% at the top who own everything (most of which probably wouldn't be pathologists anyway). But the middle probably won't change. Reimbursement is going to continue to go down, and labs are going to continue to compete for business by lowering prices EVEN IF there are fewer pathologists.

But yeah, it's easier to just DERP DERP DERP.

The truth as always is somewhere in the middle. Note of course this is not to say that nothing can and nothing should be done to address current problems.

whatever. it's only complicated when you are not realizing your value in a system that utilizes you to drive supply and demand but doesn't pay accordingly. the truth is never in the middle.

 

[Substance]

whatever. it's only complicated when you are not realizing your value in a system that utilizes you to drive supply and demand but doesn't pay accordingly. the truth is never in the middle.

Yet here you are, still bitching about it online, like that does anything.

Why aren't you all putting a stop to your own exploitation? Is what people say about pathology true, that you're all a bunch of antisocial cowards? Piss people off, go out there and do something about it! You need to say your names, and get out there and support each other.

Thrombus isn't a name, nor is pathstudent. But the chairs all have names, and they are all very comfortable. If you care enough about your own job, your pay, and your clinical duties, you'll have no problem putting yourselves out there. Otherwise, you're as responsible for the downfall of your field as the CAP and the corps and the urologists. Pathetic.

 

[InterimChair]

Yet here you are, still bitching about it online, like that does anything.

Why aren't you all putting a stop to your own exploitation? Is what people say about pathology true, that you're all a bunch of antisocial cowards? Piss people off, go out there and do something about it! You need to say your names, and get out there and support each other.

Thrombus isn't a name, nor is pathstudent. But the chairs all have names, and they are all very comfortable. If you care enough about your own job, your pay, and your clinical duties, you'll have no problem putting yourselves out there. Otherwise, you're as responsible for the downfall of your field as the CAP and the corps and the urologists. Pathetic.

don't try me, you hypocrite!

 

[path24]

Decades of overproducing pathologists is apparently not enough data, to try cutting slots to see what happens...for the nonbelievers. Start cutting spots and see how it plays out. We might just end up with options for employment, a valued collegue instead of a GI/Uros employee, and actually not being so underemployed also.

 

[Substance]

don't try me, you hypocrite!

It wasn't a challenge, just a suggestion. But why are all of you so afraid?

 

[WEBB PINKERTON]

I can't imagine someone choosing to work at a reference lab over a hospital, so if there is a shortage it seems like it would hurt the reference labs.

I trust that study that says there will be a 4000 pathologist shortage in 2020. Everything will be great in 7 years. Just hang in there!

 

[Substance]

Sounds as if the shortage is measured against whether reference labs can be appropriately staffed at affordable rtes.

 

[pathstudent]

Hospitals won't be able to hire pathologists so they will send out their work even more. It might raise the lower end salaries because they will have to pay more to retain paths, and it will help the .1% at the top who own everything (most of which probably wouldn't be pathologists anyway). But the middle probably won't change. Reimbursement is going to continue to go down, and labs are going to continue to compete for business by lowering prices EVEN IF there are fewer pathologists.

But yeah, it's easier to just DERP DERP DERP.

The truth as always is somewhere in the middle. Note of course this is not to say that nothing can and nothing should be done to address current problems.

How many hospitals hire pathologists? Most I know contract with pathology groups. I can't imagine a hospital sending out work. Who would do the frozens? Who would present at tumor boards. I can't imagine any reasonable sized hospital functioning without onsite pathologists.

 

[KluverB]

Yawn.

If the U.S. has such a pathologist oversupply, why isn't anyone clamoring for path jobs elsewhere?

Oh yeah, because despite huge shortages pretty much everywhere else around the world, you won't get paid as much as you will here; not to mention, you get to work in the cushy conditions that you do. So, STFU. Where is your supply-demand argument now?

 

[Substance]

Yawn.

If the U.S. has such a pathologist oversupply, why isn't anyone clamoring for path jobs elsewhere?

Oh yeah, because despite huge shortages pretty much everywhere else around the world, you won't get paid as much as you will here; not to mention, you get to work in the cushy conditions that you do. So, STFU. Where is your supply-demand argument now?

It's all relative. Compared to working in Uzbekistan, being a pod lab shill is paradise. But compared to being a rad, heme onc, or basically anything that isn't primary care, it's a raw deal.

 

[gbwillner]

There are so many variables to that question. I agree it is much easier to just say DERP DERP CUT POSITIONS PROFIT but the real world is so complicated.

Cutting residency spots, unless you are going to fire currently active residents, means that it will have zero effect for at least 4 years. Here's a problem though - theoretically a shortage of pathologists may actually encourage the move towards reference labs and consolidation (and thus will do little for salaries). I mean, you can SAY that it won't, but the point is it MIGHT and you don't really know. Hospitals won't be able to hire pathologists so they will send out their work even more. It might raise the lower end salaries because they will have to pay more to retain paths, and it will help the .1% at the top who own everything (most of which probably wouldn't be pathologists anyway). But the middle probably won't change. Reimbursement is going to continue to go down, and labs are going to continue to compete for business by lowering prices EVEN IF there are fewer pathologists.

But yeah, it's easier to just DERP DERP DERP.

The truth as always is somewhere in the middle. Note of course this is not to say that nothing can and nothing should be done to address current problems.

Thanks for bringing a reasonable discussion to the table.

I think adjusting the # of residency positions for market conditions is a REASONABLE approach when there is a tight market (which there may be- although this is still not clear until there is actual data and not just anecdotal reports). Yes, there would definitely be a lag in any effect.

However, it is not "everything or nothing" here. Maybe consolidation happens as you say if there are not enough pathologists available- maybe if we reduce spots by 80% or some crazy Thrombus-like number. But if we adjust by 5%? 10%? Would that create such a dearth of staff that hospitals would be forced to send everything out? I really doubt it.

Yes, hospitals (unless they are academic centers) do not actually hire pathologists (in general), they contract out to private groups. This is why we don't get jobs as second year residents like the medicine guys. They need warm bodies to fill the wards. If you suck they will fire you. Private groups will hire what, 1 new guy every 5 years? They will be careful in that selection. They are not going to be represented in job fairs. But the upside is they own their own business, and aren't limited to whatever the hospital pays their staff.

IMHO, if you own your own practice and are pulling in less than $200K per year, you should go into academics. You will make the same money, work half as hard, and not have to deal with all the paperwork or solicitations. But I'm getting off topic...

I think reducing the number of spots (by 5-10%) would be good for the field. I also think there WILL be a relative "mass" retirement soon. This is just my speculation, based on the fact that many retirement-ready pathologists lost their savings in the market crash of 2008, and decided to keep working. Now that the market has recovered to pre-2008 levels (unless they made really poor decisions), they probably have enough to retire on again. That, plus time has gone by, and they've just gotten older. The Medcape survey showed that 12% of practicing pathologists are over 65, with 6% being over 70. That's nuts.

I would predict that a small change in the number of residents would give competent 4th years a reasonable chance at practicing in small communities without subspecialty training. It may also help prevent some abusive practices. But I'm not sure it will really change salaries all that much, since a majority of that is decided by what medicare pays.

 

[KluverB]

But compared to being a rad, heme onc, or basically anything that isn't primary care, it's a raw deal.

A raw deal? Seriously?

I can't imagine doing anything other than path. Not even if any of the other fields paid 10x as much, or more. Perhaps ours is not a problem of oversupply, but one of people who simply don't belong in our field? You don't like path, GTFO.

 

[Enkidu]

But compared to being a rad, heme onc, or basically anything that isn't primary care, it's a raw deal.

I'm not sure about this - my impression from the radiology forum and from the NY resident survey here is that radiology has just as bad a job market as pathology, better pay, but worse lifestyle. That may be a wash.

As for heme/onc - that's a weird comparison. But that NY survey indicates that their job market is not much better than pathology, and I don't believe that they are earning much (if any) more than pathologists do.

What do you do again?

 

[gbwillner]

What do you do again?

Troll pathology forums, apparently.

 

[Pingu]

I think there is a real need to cut a moderate percentage of residency spots from an economic standpoint. The reality is that a group will not hire someone unless they have the specimen volume and subsequent reimbursement to cover that new hire. Keep in mind that an employee is more than just the cost of the salary. You have the employer side of SS/Medicare as well as benefits, all of which are costs that have drastically increased in the past few years. So a new hire at a 200k salary will wind up costing anywhere from 250 to 300k depending on benefits/retirement, etc. In order to justify that expense, you would need 250 to 300k in reimbursement.

Meanwhile, reimbursement has decreased over the years and payors are taking longer to pay and denying things for essentially no reason or just not paying. The technical component of the 88305 just got drastically cut as well.

So to even consider hiring a new pathologist, you would need approximately 4300 additional global 88305 charges per year based on the 2013 Medicare reimbursement rates. Based on the 2012 rates, you would have needed 2833 88305 global. While I realize that this is an extreme generalization that doesn't account for case mix, immunos, billing charges, or administrative costs, the reimbursement realities are that a significant volume increase in specimens would be needed to justify a hiring increase. Most groups would likely just work a little harder and absorb the extra volume rather than even considering a hire.

I think a lot of the projections of shortages/overages are based on the idea that once a group hits a magical cut off number of specimens, an additional pathologist is automatically necessary. You typically hear 3000 touted as this number, which is low in my opinion. It's not like a group says "3001 specimens! We must hire immediately" which is where I think projections tend to go wrong.

Essentially, based on the declining reimbursement, we will likely need BOTH mass retirement AND more specimens just to maintain status quo.

 

[yaah]

I can't imagine someone choosing to work at a reference lab over a hospital, so if there is a shortage it seems like it would hurt the reference labs.

This is illogical. Of course there are people who would choose a reference lab over a hospital. Many reference labs actually pay better than many hospital based jobs. Seriously. The best compensated jobs are typically private, autonomous and entrepreneurial groups at successful hospitals, but that isn't everything. Other reasons someone might pick a reference lab job include:

-No call
-Fewer administrative duties
-Less travel to outlying hospitals/labs
-Chance to specialize and not have to cover everything
-More stable workhours and work day

I actually know people who left academia and private practice jobs for reference lab jobs. They are not all the same.

I get the sense that a lot of people on these forums presume that all reference lab jobs are essentially indentured servitude. While I am sure there are some of these, there are plenty of hospital-based jobs that are little different in that aspect. Reference lab jobs can often pay better because the pathologist can do reimburseable work with all of their time, as opposed to the hospital pathologist who has to spend half of every day going to meetings and overseeing QC and such.

I can't imagine anyone who has ever worked in the real world of pathology and talked to lots of others who would think like you do, to be honest. Sure, if you pick out the worst 25% of reference lab jobs and the best 25% of private hospital-based jobs the reference lab jobs are going to suffer by comparison.

 

[yaah]

However, it is not "everything or nothing" here. Maybe consolidation happens as you say if there are not enough pathologists available- maybe if we reduce spots by 80% or some crazy Thrombus-like number. But if we adjust by 5%? 10%? Would that create such a dearth of staff that hospitals would be forced to send everything out? I really doubt it.

I have no idea what the numbers are. I certainly agree that there is room to cut residency training spots in pathology. Pathologists keep getting more efficient also, as others keep pointing out. I don't know what the limit to that is either. I know, personally, that I could probably handle more work in my job. But I also know that this is in part because I work with people who are good at lots of different things. Other groups are different. I also think that smaller hospitals are going to continue consolidating. They may not move to "send out" all their specimens, but they may essentially start merging labs with local partners which saves money in many ways. This is already happening.

Yes, hospitals (unless they are academic centers) do not actually hire pathologists (in general), they contract out to private groups. This is why we don't get jobs as second year residents like the medicine guys. They need warm bodies to fill the wards. If you suck they will fire you. Private groups will hire what, 1 new guy every 5 years? They will be careful in that selection. They are not going to be represented in job fairs. But the upside is they own their own business, and aren't limited to whatever the hospital pays their staff.

Actually you would be surprised at how many hospitals hire their own pathologists. I am sure this varies greatly by region but it definitely happens. Another trend is towards the existence of multispecialty groups which are hospital-owned. If ACOs take off this will continue, if they don't it might still continue but the impetus will not be as strong.

I think reducing the number of spots (by 5-10%) would be good for the field. I also think there WILL be a relative "mass" retirement soon. This is just my speculation, based on the fact that many retirement-ready pathologists lost their savings in the market crash of 2008, and decided to keep working. Now that the market has recovered to pre-2008 levels (unless they made really poor decisions), they probably have enough to retire on again. That, plus time has gone by, and they've just gotten older. The Medcape survey showed that 12% of practicing pathologists are over 65, with 6% being over 70. That's nuts.

More than half of my group is over 50, with most of those over 55. No one is over 65 but no one is planning to work much past 65. We expect to have about 30-40% turnover from our group in the next 10 years. I don't know if this is true elsewhere but for lots of pathologists in this age group the impetus to keep working keeps shrinking as reimbursement declines and administrative stuff gets more onerous. Personally, I don't think there will be such a thing as a "mass" retirement. It will just be kind of gradual. And a lot of this will be accompanied by further lab consolidation if not outright sales (to hospitals, larger groups, or even continued reference lab sales). So it is very hard to say how much impact this is going to have on the job market, but I would say that future residency graduates would be advised to be nimble, well-balanced, good at communicating, and educated in the business aspect of medicine. Administrators are going to keep taking away more of this but it benefits everyone if doctors continue to be involved.

 

[yaah]

How many hospitals hire pathologists? Most I know contract with pathology groups. I can't imagine a hospital sending out work. Who would do the frozens? Who would present at tumor boards. I can't imagine any reasonable sized hospital functioning without onsite pathologists.

Shoot man go visit the midwest sometimes. Define reasonably sized. 30 inpatient beds? 50? There are lots of smaller hospitals who do not have pathologists physically present all the time. These are hospitals that may not do much cardiac surgery but are essentially full service hospitals with 24 hour ERs, multiple ORs, and CCUs. Oftentimes the arrangement is that a large group at a neighboring affiliated hospital (because hospitals keep consolidating and merging too) run the lab and visit when necessary for these tasks.

I know of plenty of hospitals who actually employ their pathologists and are not academic centers. There aren't too many I know of personally that send out their pathology but there are quite a few who send out certain types of specimens (lots of times it's heme stuff). And of course outpatient specimens are fully up for grabs at many places and smaller pathology labs can't really offer the same stuff that reference labs do.

Healthcare is a changing field. Physicians and administrators are traveling more than ever to cover multiple sites.

 

[pathstudent]

Shoot man go visit the midwest sometimes. Define reasonably sized. 30 inpatient beds? 50? There are lots of smaller hospitals who do not have pathologists physically present all the time. These are hospitals that may not do much cardiac surgery but are essentially full service hospitals with 24 hour ERs, multiple ORs, and CCUs. Oftentimes the arrangement is that a large group at a neighboring affiliated hospital (because hospitals keep consolidating and merging too) run the lab and visit when necessary for

Healthcare is a changing field. Physicians and administrators are traveling more than ever to cover multiple sites.

If a place does not need pathologist on site now and only needs one to drop by once a month to sign qc data and protocols, then a shortage of pathologists wouldn't matter to them anyway.

I don't believe there is a massive over supply of pathologists or think there is some conspiracy to train more so universities can have cheap labor.

Buy your conjecture that an shortage will damage community based pathologists is a reach

 

[2121115]

Hospitals hiring pathologists directly is essentially the norm in certain geographic regions, like the NE.

And yes, groups are going to (already are) absorb volume rather than hire new pathologists. For instance my group isn't going to hire anyone to replace our senior partner who is retiring this year. Just reorganize the work flow.

 

[WEBB PINKERTON]

I am in the midwest and the majority of small hospitals in my area just rent a pathologist from Ameripath.

 

[Thrombus]

I am in the midwest and the majority of small hospitals in my area just rent a pathologist from Ameripath.

Perfect. The hospital AND ameripath scrape off their pathologists' profit.

Can anyone find a surgeon that this is done to?

 

[WEBB PINKERTON]

An entrepreneur pathologist should just underbid Ameripath at those small hospitals maybe. That was my piece of advice to a locum we hired awhile back who was complaining about the job market. The locums we have used are all having trouble but they are geographically limited due to spouse. Next piece of advice: Marry a woman who is happy staying at home raising the children and can relocate easily.

 

[InterimChair]

Sounds as if the shortage is measured against whether reference labs can be appropriately staffed at affordable rtes.

reference laboratories? does these include labs at large teaching hospitals that does everything/?

 

[Pathwrath]

whatever. it's only complicated when you are not realizing your value in a system that utilizes you to drive supply and demand but doesn't pay accordingly. the truth is never in the middle.

Well, to be fair, I think it is complicated. Pathology employment and compensation are the result of many factors. The problem with "It's so complicated" as a rhetorical device, however, is that it is an excuse to do nothing.

Who the hell has ever rallied behind a "reasonable" solution that one concedes is not really necessary and actually won't really do anything to address a "complicated" problem? Especially when there are entrenched interests who are very aware what that solution will do and and don't want any of it? How does that work in the real world, exactly?

One may as well just defend the status quo, full stop, no apologies. That would be more intellectually honest.

 

[Thrombus]

An entrepreneur pathologist should just underbid Ameripath at those small hospitals maybe. That was my piece of advice to a locum we hired awhile back who was complaining about the job market.

This sounds like a great plan until you find out that the Ameripath pathologist comes with the full army of Quest driving his sleigh.

No matter how incompetent, the admin in the hospital will hire the cheap foreign Ameripath pathologist as he/she views our profession as a commodity rather than a profession.

You can thank academia for taking welfare money from Medicare in exchange for the glut of pathologists and the businessman/woman in corporate pathology for the decades long fables they have been spinning about a looming crisis in retiring pathologists. Never let a crisis go to waste!

 

[WEBB PINKERTON]

This sounds like a great plan until you find out that the Ameripath pathologist comes with the full army of Quest driving his sleigh.

No matter how incompetent, the admin in the hospital will hire the cheap foreign Ameripath pathologist as he/she views our profession as a commodity rather than a profession.

You can thank academia for taking welfare money from Medicare in exchange for the glut of pathologists and the businessman/woman in corporate pathology for the decades long fables they have been spinning about a looming crisis in retiring pathologists. Never let a crisis go to waste!

I have always wondered what some of the local hospitals pay Ameripath for these people. I bet it isnt peanuts. Seems like the hospital could save money not using them. Why not just underbid?

But then again Hospitals hire parking companies to employ people to park cars and concierge companies for those services. Those seem like a waste also.

 

[Thrombus]

I have always wondered what some of the local hospitals pay Ameripath for these people. I bet it isnt peanuts. Seems like the hospital could save money not using them. Why not just underbid?

But then again Hospitals hire parking companies to employ people to park cars and concierge companies for those services. Those seem like a waste also.

How are you supposed to underbid when the Ameripath pathologist comes with the full array of quest diagnostics?

 

[turtle1966]

I have always wondered what some of the local hospitals pay Ameripath for these people. I bet it isnt peanuts. Seems like the hospital could save money not using them. Why not just underbid?

But then again Hospitals hire parking companies to employ people to park cars and concierge companies for those services. Those seem like a waste also.

Ameripath/Quest has several advantages
1- they can view this as a "door" to get into hospital lab business, therefore, willing to take a present loss.
2-they have breadth of services.
3-they have a pool of low cost pathologists, who are mostly "flexible".
4-they can work with excess "capacity" at the margin. Truly, Ameripath would not mind collecting only "a dollar" per hour for their excess pathologist's time.
5-they have marketers and managers experienced in negotiating with hospital CEOs.

Once I heard a Quest executive expound their plan to break into hospital lab business. It appears the winds are blowing to their favor. For a very long time, AP used to be a "loss-leader" for commercial labs as Quest and Labcorp. If commercial lab are successful in making inroad to hospital, it will be a game-changer in my opinion.

Folks, please see the big picture: for decades, academic dons over-trained pathologists for their immediate gain. The rest is a sequel. Albeit all protestations, presently, no other field is like ours.

 

[WEBB PINKERTON]

Ameripath/Quest has several advantages
1- they can view this as a "door" to get into hospital lab business, therefore, willing to take a present loss.
2-they have breadth of services.
3-they have a pool of low cost pathologists, who are mostly "flexible".
4-they can work with excess "capacity" at the margin. Truly, Ameripath would not mind collecting only "a dollar" per hour for their excess pathologist's time.
5-they have marketers and managers experienced in negotiating with hospital CEOs.

Once I heard a Quest executive expound their plan to break into hospital lab business. It appears the winds are blowing to their favor. For a very long time, AP used to be a "loss-leader" for commercial labs as Quest and Labcorp. If commercial lab are successful in making inroad to hospital, it will be a game-changer in my opinion.

Folks, please see the big picture: for decades, academic dons over-trained pathologists for their immediate gain. The rest is a sequel. Albeit all protestations, presently, no other field is like ours.

I have seen the large national labs lose a lot of business due to the hospital buying spree that has been going on. The lab that is growing the fastest in my area is a large hospital due to all the physician offices/small hospitals they have acquired.

I hope hospitals dont sell off their labs to quest and labcorp. It is looking very likely that each state is going to have one to three major hospitals that own virtually everything (surgery centers, physician offices etc). Quest and labcorp will really dominate the market if they are able to buy up the labs at these health care systems.

 

[pathstudent]

I have always wondered what some of the local hospitals pay Ameripath for these people. I bet it isnt peanuts. Seems like the hospital could save money not using them. Why not just underbid?

But then again Hospitals hire parking companies to employ people to park cars and concierge companies for those services. Those seem like a waste also.

Why would the hospital pay ameripath anything. Ameripath can just sign the contract for coverage, bill for the pathologists services and take their 50% cut. It is much cleaner. I don't see why the hospital would agree to pay anything unless there is actually a shortage of pathologists!