Non-dermpath boarded dermatologists practicing dermpath

[torero]

---

Members don't see this ad.

Found this interesting post in a dermatology board:

"It is exceptionally common for non-DP to read their own slides. The private practice world is very different from the academic world. It is just like there are many docs who perform Mohs in private practice without doing an additional year of training. I actually did a dermpath followship, partly because I found it interesting and was thinking about academics, but if you have a solid exposure to dermpath in residency you do not need additional training. Alot of derm docs attempt to read and then send out questionable pigmented lesion or unusual inflammatory stuff. That is where I generally get my consult cases. I predict an uptick in interest in reading slides as the new Medicare fee schedule for derm is not looking favorable--45% reduction in the code for AK destruction and a nearly 75% reduction in the code to destroy ISK and warts. The revenue has to be replaced from somewhere and I think dermpath is an easy pick up."

 

[LADoc00]

Found this interesting post in a dermatology board:

"It is exceptionally common for non-DP to read their own slides. The private practice world is very different from the academic world. It is just like there are many docs who perform Mohs in private practice without doing an additional year of training. I actually did a dermpath followship, partly because I found it interesting and was thinking about academics, but if you have a solid exposure to dermpath in residency you do not need additional training. Alot of derm docs attempt to read and then send out questionable pigmented lesion or unusual inflammatory stuff. That is where I generally get my consult cases. I predict an uptick in interest in reading slides as the new Medicare fee schedule for derm is not looking favorable--45% reduction in the code for AK destruction and a nearly 75% reduction in the code to destroy ISK and warts. The revenue has to be replaced from somewhere and I think dermpath is an easy pick up."

I have always said the year you spend in a dermpath fellowship as a pathologist should almost solely be devoted to learning clinical dermatology. Im not a fan of the current model of path--->dermpath practice, it is WAY to dependent on referrals, dangerously so. You could be making 25K a month one day, and near nothing the next, and your costs are fixed. A far better plan would be to have your own biopsy clinic during the morning, read during the afternoon and ensure your own financial survivability through self-referral.

Given the number of non-dermatologists including people who never did a residency I know that bill insurance for clinical derm, a dermatopathologist could EASILY do it. the start up costs are minimal especially since commericial property in many areas is getting dirt cheap (outside of big cities that is). Write a business plan and go to a local bank and get a loan if needed.

Journeying into the treacherous world of outpatient Pathology can be profitable if done right, but it is risky..far more than simply working hospital contracts. In the untrained hand, it could be a big financial disaster. Thats what I see for some groups in the future.

DERMSLAYER:

 

[juddson]

Does this mean that reimbursements for derm are finally going to bring derm incomes into line with the level of work and expertise the pratice seems to require?

[ducking]

Judd

 

[yaah]

" but if you have a solid exposure to dermpath in residency you do not need additional training. Alot of derm docs attempt to read and then send out questionable pigmented lesion or unusual inflammatory stuff.

This does happen a lot - the question is though, do they actually know when they are missing something? A lot of the time it probably doesn't matter, but they do make errors and miss subtle things. We see things here that come in as "re-excisions" of lesions (often nevi) where the derm read the original biopsy and then re-excised. They are wrong quite frequently, and not always in a way that isn't potentially harmful.