Pathologist inducement

[Doormat]

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Check out the following E-mail I got from a salesperson from a Calfornia lab that does FISH and other molecular tests. I redacted the identifying info.

I had to pinch myself to make sure I wasn't a GI, derm, or uro doc getting called on by yet again by another shady lab offering unethical inducements.

What do you think? Now pathologists have the opportunities to be greedy D-bags just like the specialist phyisician groups we sometimes serve.....


Hi Dr. ________,



My name is ______ and I work for ________ Laboratories.



I have a personalized plan for you and the group that could help you conservatively generate up to $10,000 per month in revenue by reading out the professional component of FISH (88367-26) on Hematopathology and Solid Tumor cases.



Are you available to meet this Friday in ______ to discuss this opportunity?



Thank you,



_______ Laboratories

Territory Business Manager

_________.com

 

[Pingu]

I don't know if I would consider that an inducement. To me, an inducement is getting something for nothing and screwing over the person actually doing the work.

It just sounds like they need someone to read out their FISH for them. Most likely they don't want to pay for an onsite pathologist and want to contract out interpretation. It could be a legitimate business opportunity.

I would research the reimbursement rate for 88367-26 (especially with the changes to molecular reimbursement) and get an idea of the potential volume to make sure you aren't being screwed.

At the very least, make them take you out for a nice seafood dinner and hear them out. You never know what will come from it. Some of my most lucrative opportunities came from a random call or email.

 

[2121115]

Lab reps come around here all the time with TC/PC split programs for reading FISH. It is true that your practice can generate significant revenue doing this. FISH billing is per probe and pays well. Just make sure it is legit and don't get caught like Bostwick and his urologists did. Make sure they are not essentially doing it for you and then you push a few buttons and bill PC, or you will wind up in court for fraud. For the lab, they get the FISH TC and they get all of your cytogenetics and other referral business, so there is incentive for them to attract you by getting the PC for FISH.

Just be very careful.

 

[pathstudent]

Lab reps come around here all the time with TC/PC split programs for reading FISH. It is true that your practice can generate significant revenue doing this. FISH billing is per probe and pays well. Just make sure it is legit and don't get caught like Bostwick and his urologists did. Make sure they are not essentially doing it for you and then you push a few buttons and bill PC, or you will wind up in court for fraud. For the lab, they get the FISH TC and they get all of your cytogenetics and other referral business, so there is incentive for them to attract you by getting the PC for FISH.

Just be very careful.

I disagree. If you review it and then just push a few buttons, you should bill for the PC. Techs don't understand everything.

 

[WEBB PINKERTON]

Did Clarient visit your area?

 

[2121115]

I disagree. If you review it and then just push a few buttons, you should bill for the PC. Techs don't understand everything.

This is exactly what Bostwick is in trouble for right now. You don't see everything in these types of systems. With some of these companies, they set the entire thing up, select the appropriate cells, and give you a few representative images. There is no way for you to tell if they selected the appropriate cells. Moreover, the pathologist didn't select them. There is much debate about whether this constitutes enough work to ethically bill the PC. In fact, one of the companies who offers this type of program has to have their sales rep bring a legal statement with them on sales calls. That just screams shady, IMO.

 

[pathstudent]

This is exactly what Bostwick is in trouble for right now. You don't see everything in these types of systems. With some of these companies, they set the entire thing up, select the appropriate cells, and give you a few representative images. There is no way for you to tell if they selected the appropriate cells. Moreover, the pathologist didn't select them. There is much debate about whether this constitutes enough work to ethically bill the PC. In fact, one of the companies who offers this type of program has to have their sales rep bring a legal statement with them on sales calls. That just screams shady, IMO.

The person I saw doing it once was using Neogenomics and he would review each of the 200 cells counted. It seemed legit to me. And this was heme fish. How do you select cells anyway?

So should there ever be PC for FISH? Should a pathologist only get to bill it if he sits at the scope and does all the tech work? That seems ridiculous. When I was in residency, It was even easier for the attendings. The tech produced the report and the attending would sign it out in the computer without ever reviewing anything. Surely they were billing global.

And I thought the accusation against Bostwick was for doing testing that was not requested by a physician.

 

[WEBB PINKERTON]

The person I saw doing it once was using Neogenomics and he would review each of the 200 cells counted. It seemed legit to me. And this was heme fish. How do you select cells anyway?

So should there ever be PC for FISH? Should a pathologist only get to bill it if he sits at the scope and does all the tech work? That seems ridiculous. When I was in residency, It was even easier for the attendings. The tech produced the report and the attending would sign it out in the computer without ever reviewing anything. Surely they were billing global.

And I thought the accusation against Bostwick was for doing testing that was not requested by a physician.

Maybe pathologist should not allow techs to screen pap tests. By the time you get the paps on your desk, cells are marked and a preliminary diagnosis is in the computer. All we do is look at the dots, click verify and pocket the full PC. When all physicians are hospital employees, TC/PC should be gone.

 

[scienceguy19]

Can someone explain to me something. Do you need a MD to interpret FISH studies for the PC billing or can a PHD do it too? What determines if a PHD is qualified to do so?