Pathologist Surplus - Why train too many Pathologists?

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DrP_dauterman

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Hi everybody,

One of the main reasons for the terrible Pathology Job Market has been the Pathology training programs which have continued to train about the same number of residents even though the job market has deteriorated badly. The Residency Program Directors would have known about the problem as far back as 1993, when the job market started deteriorating, but the decreases in residency positions have not kept up with the deteriorating job market.

So why train people who will never have jobs? BECAUSE OF THE TREMENDOUS AMOUNT OF MONEY INVOLVED. Keep in mind that Medicare provides Indirect Medical Education (IME) and Direct Medical Education (DME) reimbursements
to hospitals that train residents regardless of what the job market is like. This is a considerable amount of money. There is an example available on the internet at the following address:

http://hsc.virginia.edu/medicine/clinical/radiology/FinancingGME.html

In the example given the DME is US$1,280,000/yr. and the IME is US$5,250,000/yr. Reimbursements are proportional to the number of residents
so if the program substantially reduces the number of residents there is a proportionate decrease in the reimbursements. The residency program in this example is much larger than any Pathology residency program - 80
Residents and 20 Fellows in the program; but it gives you some kind of idea of the amount of money involved. Medicare is paying this program US$65,300/resident/yr. However, the residency programs only pay each resident about US$25,000-35,000/yr. yet residents sometimes work 60 hours per week doing work that otherwise would have to be done by a Pathology Assistant making around US$65,000-85,000/yr. SO THERE IS A TREMENDOUS AMOUNT OF MONEY BEING MADE IN TRAINING PEOPLE TO BE PATHOLOGISTS EVEN THOUGH THERE IS NO CHANCE THAT THEY WILL ALL FIND JOBS IN THE FIELD.

If my math is correct (correct me if I'm wrong) the residency programs are making about US$80,000-$100,000/resident/yr.

The Balanced Budget Act of 1997 reduced some of these reimbursements but did not completely eliminate them. In my opinion Pathologists will be in oversupply until these reimbursements are completely eliminated. Here are a few more links on Medicare DMEs, IMEs, etc:

http://www.aha.org/kit/GME.html

http://www.hanys.org/newsview/issues/med4.htm


Phil Dauterman, MD

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I mean, yeah. Life 101: 99% of the time anything gets done, it's because of money
 
Sometimes I forget that computers existed outside of high industry or science prior to 2000.
 
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The most pathetic part is that nothing actually changed from 18 years ago..the leaders in pathology continue to do wrong to its trainees..they destroyed one of the most cerebral fields in medicine and now spots are mostly filled with desperate IMGs, many who have no actual interest in pathology but just want to be able to practice in the US
 
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Hi everybody,

One of the main reasons for the terrible Pathology Job Market has been the Pathology training programs which have continued to train about the same number of residents even though the job market has deteriorated badly. The Residency Program Directors would have known about the problem as far back as 1993, when the job market started deteriorating, but the decreases in residency positions have not kept up with the deteriorating job market.

So why train people who will never have jobs? BECAUSE OF THE TREMENDOUS AMOUNT OF MONEY INVOLVED. Keep in mind that Medicare provides Indirect Medical Education (IME) and Direct Medical Education (DME) reimbursements
to hospitals that train residents regardless of what the job market is like. This is a considerable amount of money. There is an example available on the internet at the following address:

http://hsc.virginia.edu/medicine/clinical/radiology/FinancingGME.html

In the example given the DME is US$1,280,000/yr. and the IME is US$5,250,000/yr. Reimbursements are proportional to the number of residents
so if the program substantially reduces the number of residents there is a proportionate decrease in the reimbursements. The residency program in this example is much larger than any Pathology residency program - 80
Residents and 20 Fellows in the program; but it gives you some kind of idea of the amount of money involved. Medicare is paying this program US$65,300/resident/yr. However, the residency programs only pay each resident about US$25,000-35,000/yr. yet residents sometimes work 60 hours per week doing work that otherwise would have to be done by a Pathology Assistant making around US$65,000-85,000/yr. SO THERE IS A TREMENDOUS AMOUNT OF MONEY BEING MADE IN TRAINING PEOPLE TO BE PATHOLOGISTS EVEN THOUGH THERE IS NO CHANCE THAT THEY WILL ALL FIND JOBS IN THE FIELD.

If my math is correct (correct me if I'm wrong) the residency programs are making about US$80,000-$100,000/resident/yr.

The Balanced Budget Act of 1997 reduced some of these reimbursements but did not completely eliminate them. In my opinion Pathologists will be in oversupply until these reimbursements are completely eliminated. Here are a few more links on Medicare DMEs, IMEs, etc:

http://www.aha.org/kit/GME.html

http://www.hanys.org/newsview/issues/med4.htm


Phil Dauterman, MD

If you live past Y2K you will see the Cubs win the World Series and Donald Trump become president within 2 weeks of each other.
 
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This might be the best necrobump in history. We might be witness to internet history right now. Remember where you are and what you're doing so you can tell your children.
 
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Fortunately, apparently Dr. P was able to find a job (I assume he's busy working since he hasn't posted since 1999!)
 
And I was in my junior year of college.

Christ, I'm old.
 
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Because, they dont want vacant hospital basements. Theyre already built, so they need people to stuff in there.
 
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