mikesheree

Lifetime Donor
Gold Donor
7+ Year Member
Feb 27, 2010
1,180
304
NOT behind a scope.
Status
Attending Physician
If you trust the math, the monetary benefits that CAP provides each member simply in the increased reimbursements and representing the profession in DC are much greater than the cost of the membership. I have spent time on committees at CAP and every single meeting starts with the affirmation that the organization exists to benefit the members. If something seems skewed or fishy, like a program seemingly designed purely for the purposes of furthering the business aspect of CAP, the members who sit on the directing committees quickly take note and make sure the program is re-evaluated and that the revenue is directed as it should be. I think it is run fairly, with extensive input from the general membership, and smartly (the staff are second to none). Because it brings in a large amount of money from PT and accreditation, etc. some view it as "corrupt" but this is because 1) they don't understand how businesses run, and 2) they don't understand where the money goes (back into education, professional development, advocacy, the annual meeting, etc.).

If you don't appreciate the benefits CAP provides the profession, you can keep your money. Unfortunately, this makes you a free-rider because you still get the benefits!
Your last paragraph is a gem. Sounds just like the bitching by the
government employee unions who are gonna get nailed by SCOTUS
in a couple weeks.
 

Thrombus

Member
Removed
Removed
Account on Hold
10+ Year Member
Sep 27, 2004
749
95
If you trust the math, the monetary benefits that CAP provides each member simply in the increased reimbursements and representing the profession in DC are much greater than the cost of the membership. I have spent time on committees at CAP and every single meeting starts with the affirmation that the organization exists to benefit the members. If something seems skewed or fishy, like a program seemingly designed purely for the purposes of furthering the business aspect of CAP, the members who sit on the directing committees quickly take note and make sure the program is re-evaluated and that the revenue is directed as it should be. I think it is run fairly, with extensive input from the general membership, and smartly (the staff are second to none). Because it brings in a large amount of money from PT and accreditation, etc. some view it as "corrupt" but this is because 1) they don't understand how businesses run, and 2) they don't understand where the money goes (back into education, professional development, advocacy, the annual meeting, etc.).

If you don't appreciate the benefits CAP provides the profession, you can keep your money. Unfortunately, this makes you a free-rider because you still get the benefits!
I apologize for your naivety. If the CAP and academia were to allow the number pathologists to decrease so that we had a stable market, one without big corporate labs exploiting us, there would be no need for them to "increase our reimbursements" as the market would take care of that itself. As a matter of fact, they have been at the helm of the ship while we have had MASSIVE DECREASES in reimbursements. Where does that factor in their EXTREME NEGATIVE VALUE to the profession?

Their accreditation and PT schemes are nothing more than a MOB SCHEME with NEGATIVE PATIENT VALUE and nearly ZERO high level evidence of patient benefit. There is ever increasing MINDLESS red tape and harassment on their end.

SCREW THE CAP!
 

WEBB PINKERTON

7+ Year Member
Dec 16, 2010
1,462
347
Status
Non-Student
CAP used your money and came up with the "Pathologists are Groovy" campaign.

I don't see CAP putting much money back into the PT. I just took a cytology PT test with slides that looked 10 or more years old with faded stain.

CAP used to lobby against the cytology PT until they got in on the act and now have a national duopoly with ASCP. We are paying nearly 2000 dollars a year for a proficiency test in the dying field of GYN cytopath. It is like a tax on newspapers or bookstores.
 

jupiterianvibe

2+ Year Member
Mar 3, 2016
217
128
Status
Post Doc
If you trust the math, the monetary benefits that CAP provides each member simply in the increased reimbursements and representing the profession in DC are much greater than the cost of the membership. I have spent time on committees at CAP and every single meeting starts with the affirmation that the organization exists to benefit the members. If something seems skewed or fishy, like a program seemingly designed purely for the purposes of furthering the business aspect of CAP, the members who sit on the directing committees quickly take note and make sure the program is re-evaluated and that the revenue is directed as it should be. I think it is run fairly, with extensive input from the general membership, and smartly (the staff are second to none). Because it brings in a large amount of money from PT and accreditation, etc. some view it as "corrupt" but this is because 1) they don't understand how businesses run, and 2) they don't understand where the money goes (back into education, professional development, advocacy, the annual meeting, etc.).

If you don't appreciate the benefits CAP provides the profession, you can keep your money. Unfortunately, this makes you a free-rider because you still get the benefits!
Please provide your math.

It would also help if you could reveal the nature of your relationship with CAP.

This is the math I'm familiar with:

My current understanding is that the PT business comprises the vast majority of the CAPs funds, at an almost 50 to 1 revenue ratio. This makes the PT business the primary focus of the CAP, with its membership being a secondary consideration. I base that claim on pathPAC, our voice in Washington, being funded approximately 250,000 dollars a year. This is a woefully small sum for lobbying efforts for an organization that nets tens of millions of dollars yearly, and would partially explain our dismal situation in comparison to our peers, particularly those in radiology.

The CAP would best separate the PT business out entirely, as the profits it brings dwarfs the contributions, and thus interests, of its members.

As I believe our professional organization is not representing our interests at all, it reminds me of a book I read about the specialty of Emergency Medicine called "The Rape of Emergency Medicine"; I recommend reading it, as it is easy to find online, and is provided free by the authors. Not too long ago, the EM specialty society was working against the best interests of its members, so a large number of them split off and started a professional society that better represented their field. Years later, in the current day, emergency medicine is enjoying a favorable professional environment. Pathologists should follow their lead.
 
Last edited:

Morichka

7+ Year Member
Oct 26, 2009
21
14
Status
Resident [Any Field]
Please provide your math.

It would also help if you could reveal the nature of your relationship with CAP.

This is the math I'm familiar with:

My current understanding is that the PT business comprises the vast majority of the CAPs funds, at an almost 50 to 1 revenue ratio. This makes the PT business the primary focus of the CAP, with its membership being a secondary consideration. I base that claim on pathPAC, our voice in Washington, being funded approximately 250,000 dollars a year. This is a woefully small sum for lobbying efforts for an organization that nets tens of millions of dollars yearly, and would partially explain our dismal situation in comparison to our peers, particularly those in radiology.

The CAP would best separate the PT business out entirely, as the profits it brings dwarfs the contributions, and thus interests, of its members.

As I believe our professional organization is not representing our interests at all, it reminds me of a book I read about the specialty of Emergency Medicine called "The Rape of Emergency Medicine"; I recommend reading it, as it is easy to find online, and is provided free by the authors. Not too long ago, the EM specialty society was working against the best interests of its members, so a large number of them split off and started a professional society that better represented their field. Years later, in the current day, emergency medicine is enjoying a favorable professional environment. Pathologists should follow their lead.
Ok, here's some math.

CAP cannot contribute to PathPAC. The PAC is funded solely through voluntary individual contributions from PathPAC members. As you so carefully note, pathologists are not exactly the most energetic contributors (see below). Also, you are correct that the vast majority of CAP operating revenue comes in from PT (70%). Next is Accreditation (20%). Membership dues comprise only 2% of revenue, or 3.8 million. If you'd like to check the numbers, go look at the Annual Report, which I found online. The CAP invests $8 million every year in advocacy efforts. That alone is twice what we pay in dues. And that doesn't count the other benefits, including the heavily subsidized annual meeting (they definitely don't make money on that!), educational offerings (CAP offers more CME for pathologists than any other organization), the work that goes into the CAP cancer templates, which are provided free to members and nonmembers, etc.

A little math goes a long way. Over half of the current pathologists in the US are members of CAP (18,000), and CAP is the only voice in Washington that exclusively represents pathologists. There are so many people I have met who put in a lot of time to the CAP, none are compensated, except for travel reimbursement. We are lucky to have the extraordinary staff at the CAP who are compensated and who can put together the materials, meetings, trainings, surveys, policy briefs, etc. to optimize the efforts of any who decide to participate and give back, to try to make pathology more visible.

upload_2018-6-13_16-42-25.png
 

AZpath

5+ Year Member
Nov 1, 2012
449
118
Status
Attending Physician
CAP and Pathologists would be far worse off without PT money.
The dues are nothing.
 

Path or bust

I like meat
10+ Year Member
Jan 16, 2008
413
20
www.
Status
Attending Physician
In my experience, the most valuable "fellowship" in pathology is the ability to be someone that people want to work with. That, and the ability to do multiple things. A lot of graduates don't want to do or think they can't do any CP, despite being CP trained. They don't want to sign out anything outside of their fellowship(s).

We get lots of applications for our jobs. Very few are people who would be good fits for our group. But most of them are not good fits because they disqualify themselves by one of the following ways:
1) Can't communicate
2) Make demands before they even get the job
3) Have bad references
4) Don't want to do something that everyone else in the group does (like be a medical director)
5) Are overconfident or outright obnoxious
6) Are so timid they would hesitate to diagnose almost anything.
7) Don't get along with others.

I am totally serious here. We have interviewed less than 20% of the people who on paper look like they would be good fits for our group. And why is that? Because they take themselves out of the game during a phone interview or email or whatever by one of the above. I have no idea who is hiring all these people or where they are working. This doesn't even include the people with very weak CVs (like 5 jobs in 6 years, multiple gaps in their employment record, very weak training record).

If you meet all these criteria, and you want to be in a private group, more general fellowships like heme or cyto or surg path are most helpful. But it also otherwise depends on timing. Like right now, we need breast path, but not GI path. 6 years ago we needed GI path.
Well said, I agree and it should be 'stickied' at the top. Emotional intelligence, communication and being available to your peers and clinicians is invaluable. Nobody is born with these skills and they aren't innate either.

I'm the medical director for a large group of higher level of care hospitals and 50% of the stuff I do on a day to day basis I never learned or would have learned in a residency or fellowship. I never thought I would be doing so much clinical pathology (ie creating blood utilization programs, anticoagulation reversal guidelines, MTPs, interpret thromboelastography, heparin therapeutic curves -moving to anti-Xa assays). Most of this stuff I never even heard of before I finished residency, but I learned along the way because people looked to me for the answers. While a baseline knowledge is needed, I am constantly humbled by what I don't know, by the questions I get or by what I knew at some point but forgot. But you don't have to know everything to be successful.

Being good to those around you is a requirement. Be willing to learn something new and go teach your clinicians and get their buy in. Share something new you learned, without being arrogant about it. Participate in conferences that have nothing to do with pathology, such as Morbidity and mortality or department conferences. Create value for your institution in areas such as medical staff and system performance improvement. Its not surgical pathology that will make you stand out or your unique fellowship, its clinical pathology, communication and attitude.
 

mikesheree

Lifetime Donor
Gold Donor
7+ Year Member
Feb 27, 2010
1,180
304
NOT behind a scope.
Status
Attending Physician
Well said, I agree and it should be 'stickied' at the top. Emotional intelligence, communication and being available to your peers and clinicians is invaluable. Nobody is born with these skills and they aren't innate either.

I'm the medical director for a large group of higher level of care hospitals and 50% of the stuff I do on a day to day basis I never learned or would have learned in a residency or fellowship. I never thought I would be doing so much clinical pathology (ie creating blood utilization programs, anticoagulation reversal guidelines, MTPs, interpret thromboelastography, heparin therapeutic curves -moving to anti-Xa assays). Most of this stuff I never even heard of before I finished residency, but I learned along the way because people looked to me for the answers. While a baseline knowledge is needed, I am constantly humbled by what I don't know, by the questions I get or by what I knew at some point but forgot. But you don't have to know everything to be successful.

Being good to those around you is a requirement. Be willing to learn something new and go teach your clinicians and get their buy in. Share something new you learned, without being arrogant about it. Participate in conferences that have nothing to do with pathology, such as Morbidity and mortality or department conferences. Create value for your institution in areas such as medical staff and system performance improvement. Its not surgical pathology that will make you stand out or your unique fellowship, its clinical pathology, communication and attitude.
Amen! Very, very well said. This falls well into the old adage “ affability,
availability and ability (in that order)”.
 
  • Like
Reactions: Spikebd
Nov 17, 2017
21
11
Status
Medical Student
My advice for all, as a path fellow having done fellowships in ivy leagues and still finding no jobs is DO NOT GO into pathologist. My co-fellows are suffering as well.
Market is absolutely terrible.
Im about to apply to pathology - what the ****. If there are no jobs why do they let so many foreign graduates go into pathology? This is bull****.
 
Aug 10, 2018
134
96
Status
Medical Student
Im about to apply to pathology - what the ****. If there are no jobs why do they let so many foreign graduates go into pathology? This is bull****.
Ya don't apply then. Its August 24th. Apps are due very soon. And you JUST NOW explore pathology and decide to take for face value random internet postings? Troll
 

AZpath

5+ Year Member
Nov 1, 2012
449
118
Status
Attending Physician
Im about to apply to pathology - what the ****. If there are no jobs why do they let so many foreign graduates go into pathology? This is bull****.
Other specialty spot are ranked higher by AMGs, they fill quickly.
FMGs want a chance to immigrate.
The open spots in pathology represent their best shot.
 
  • Like
Reactions: y2k_free_radical