The best thing to do for anyone who wants to try and decrease the overtraining that occurs in pathology is to publish articles which repudiate the fallacy that the job market in pathology is OK or that a shortage is imminent.
As an example, it would be relatively easy to collate the number of pathology job advertisements per year on the CAP website and compare this with the number of graduating pathology residents each year. Why not begin by presenting the data in a poster at the next CAP meeting.
Once there is published data in the literature the argument is no longer based on anecdotal evidence and will not be as easily dismissed.
Although I do not think you can assume you know the answers about market questions
a priori, I agree with your point- real data is the only way to move the needle with the leadership. True, Rads and other fields responded to their market pressures by reducing residency spots, leading to betterment of their fields, but what kind of data did they have to make these decisions? Anecdotal ravings by anonymous internet posters? BTW, Rads now has the same problems we have. Are they going to reduce residency positions even further?
What kinds of studies would give credence to the notion of market saturation in pathology?
Why don't we use this thread/forum for something positive for once? What study would help prove your point, Older Pathologist? What data will convince CAP to support your claim?
Here are some suggestions from me....
1. Survey many/all graduating pathologists from a fixed time point and measure their actual annual case load broken down by CPT code. Compare to prior years. This, in theory would lend evidence that productivity is not static but increasing. If previous such data are not available, poll for estimated volumes 5, 10 years ago. If productivity IS increasing, this would strike at the heart of the argument that a pathologist shortage is coming, assuming the assessment was made upon the assumption that pathology productivity is stagnant, and volumes will increase. Given that reimbursement has already been affected, these data should already be available.
2. Survey Surgeons about their likely behaviour with specimen submission to pathology services in the event of bundled payments. If surgeons state that they would submit 25% fewer specimens, for example, that would need to be incorporated into pathology work models in the event these policies are put into effect.
3. Track both total pathologist compensation (adjusted by PGY) and their compensation relative to their case load. This may again support the productivity argument- I assume total compensation is fairly consistent over the last 5-10 years, but compared to case load it may be dramatically reduced.
4. Accurately track graduating residents/fellows for jobs data. The ABP puts out annual job data, but it is at best very misleading. They poll residents/fellows in the spring, when most have not yet found work, and it is very difficult to make sense of the data because there is no follow-up. A better plan would be to contact
every single ABP PGY 4-8 in December (6 months after the end of the academic cycle), and ask:
A- Did you complete you final year of training in the past 12 months? If no, survey ends. If yes:
B- Did you secure employment?
C- How many jobs did you apply for?
D- how many interviews were granted?
E- Did you secure full-time employment?
F- What is your estimated case volume (by CPT code)
G- How many fellowships did you complete?
H- Did you intend to enter the marketplace, but were forced to do additional fellowships because you could not secure employment?
I- How many job offers did you receive?
J- What subspecialty fellowships did you complete, if any?
K- Is your subspecialty training a major part of your job?
L- Are you AMG or FMG?
M- Do you think your resident training was satisfactory to prepare you to practice your specialty?
N- What is your estimated salary (in $50K increments) - this will only identify starting salaries.
O- did you take an academic position, private practice, or industry?
P- If an academic position was taken, were you offered a professorship or Instructorship?
Thoughts?
