Pathology Small Corporate lab offers

[KeratinPearls]

I received a corporate lab offer of $210,000 and 11 days of vacation, 5 days CME. One friend received 265k (not including bonus) and a similar vacation time of 2 weeks and 1 week CME. Both small outpatient labs (biopsy mostly and paps thyroid FNA). You guys consider these Low ball offers? How about the 2 weeks vacation? Never heard of any medical specialty where they get only 2 WEEKS of vacation PER year.

My concern is if I work in an outpatient lab like this will it hurt my chances of getting a hospital based job in a few years?

This may be the only option I have in a tight job market.

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[Med Director New England]

if these are bigger labs they are likely in a position to have these offers benchmarked and are probably in line with the local market (based on supply / demand).

A truly ****ty / lowball offer or continually doing this will penalize any employer by making it more difficult to recruit and retain. This dynamic will keep the temptation to low ball in check. Has this group had a lot of turnover

2 weeks vaca sounds low to me. I know for a fact Q/AP and LC typically offer 4 + 1 CME week even for new hires and more with yrs experience.

if you have no offers locally sounds like 210 is not out of line. Do you have any sense for what you could expect in salary in 3-5yrs? Also thevolume of work should be considered.

GL

 

[Alteran]

I don't know if you're geographically restricting yourself or not. But if you aren't and this is all you have in the bag, I would take it and immediately start to parlay the sign-out experience for a better position. Those positions sound astoundingly awful and predatory in my opinion - as in biopsy mill sweatshop style practices paying 20% of what the pathologist is billing professionally.

 

[CDX-2]

I received a corporate lab offer of $210,000 and 11 days of vacation, 5 days CME. One friend received 265k (not including bonus) and a similar vacation time of 2 weeks and 1 week CME. Both small outpatient labs (biopsy mostly and paps thyroid FNA). You guys consider these Low ball offers? How about the 2 weeks vacation? Never heard of any medical specialty where they get only 2 WEEKS of vacation PER year.

My concern is if I work in an outpatient lab like this will it hurt my chances of getting a hospital based job in a few years?

This may be the only option I have in a tight job market.

Did the corporate lab offering $210K provide an approximate figure as to how many cases / slides you're expected to report / day?

 

[bauber]

You can always counteroffer. 11 days of vacation is low, I would ask for 5 more. The salary isn't bad but you can certainly ask for more. I only had one offer at the time so I was conservative with my salary counter (7.5% increase) and they said no problem.

 

[pathslides]

That is a low offer, especially vacation. Who the heck gets less vacation than a resident.

 

[moosepatrol77]

That's a low ball salary and you're getting shafted on vacation. I wouldn't accept less than 4 weeks vacation. You're being served a poop sandwich.

 

[canadapath]

Horrible salary and vacation... extremely low volume such that you can leave at noon every day is probably the only way this can be justified

 

[WEBB PINKERTON]

That is way too low IF the place is a slide mill. 2 weeks vacation is horrible as well.

 

[Unty]

Only in pathology. 2 weeks vacation. Name one other field where doctors get two weeks of vacation?! Modern day slavery. Some people feel like they have to take a job like this because they don’t have any other offers in a tight (more regional) job market.

Academics who promote this oversupply are clueless because they sit in the ivory tower, in their leather chairs, while supposedly doing “research“ (or have their fellows aka cheap labor do it for them). They sign out 1-3 specialties.


Academics are insulated from the world of private practice.

This happens in pathology because of the oversupply. Employers will see who is willing to bite on such a crappy deal. Maybe an IMG will? Lowball offers like this will put more money into the owners Pocket.

Do you see dermatologists getting offered low 200s and 2 weeks of vacation? Hahaha

 

[Med Director New England]

A lot of comments ^^^ decrying the salaries of 210 and 250 as absurdly low for someone just starting out.

you guys should talk to someone in training looking in really congested markets(like most of New England). Recent grads here basically have no chance of landing a good job, pvt practice job / corp job / hosp employed, etc until they have 3-5 yrs exp. Really the best a newbie can do in these areas is an entry level academic job at instructor or assistant prof level -annual salary well below 210. I agree 2 weeks off is thin, but still those salaries for recent grads are not awful depending on the area of the country your talking about.

 

[Guest8]

A lot of comments ^^^ decrying the salaries of 210 and 250 as absurdly low for someone just starting out.

you guys should talk to someone in training looking in really congested markets(like most of New England). Recent grads here basically have no chance of landing a good job, pvt practice job / corp job / hosp employed, etc until they have 3-5 yrs exp. Really the best a newbie can do in these areas is an entry level academic job at instructor or assistant prof level -annual salary well below 210. I agree 2 weeks off is thin, but still those salaries for recent grads are not awful depending on the area of the country your talking about.

Agreed, those starting salaries for an in-demand area are not low. We start new hires right out of training between those two salaries. Although it's just for a short employed period of <2yrs, then they get on partner track. Over the years only one hire has not made partner track, and that was for serious personality issues. And the pay improves significantly on partner track.

 

[Unty]

Agreed, those starting salaries for an in-demand area are not low. We start new hires right out of training between those two salaries. Although it's just for a short employed period of <2yrs, then they get on partner track. Over the years only one hire has not made partner track, and that was for serious personality issues. And the pay improves significantly on partner track.

So after 2 years the person is on a partner track for how many more years in your group until they become partner?

 

[WEBB PINKERTON]

For god's sake GO RURAL. Don't settle for a pathetic salary of 210 to 250. Plus you have to deal with higher cost of living on top of that.

Move to where you are wanted.

 

[DoctorCancer]

A lot of comments ^^^ decrying the salaries of 210 and 250 as absurdly low for someone just starting out.

you guys should talk to someone in training looking in really congested markets(like most of New England). Recent grads here basically have no chance of landing a good job, pvt practice job / corp job / hosp employed, etc until they have 3-5 yrs exp. Really the best a newbie can do in these areas is an entry level academic job at instructor or assistant prof level -annual salary well below 210. I agree 2 weeks off is thin, but still those salaries for recent grads are not awful depending on the area of the country your talking about.

I agree! I wonder what is a "good salary" according to people who think this range is absurdly low!

 

[SunBakedTrash]

I agree! I wonder what is a "good salary" according to people who think this range is absurdly low!

good question. according to ascp surveys based on RISE scores, the majority start out far below 250k. I’m not sure what people think is reasonable to start out with, because 180-230 is most of what I have seen, with occasional outliers.

 

[KeratinPearls]

For god's sake GO RURAL. Don't settle for a pathetic salary of 210 to 250. Plus you have to deal with higher cost of living on top of that.

Move to where you are wanted.

Webb sorry but some Jobs in rural/ semirural places pay that muchin Pathology.

 

[deleted314957]

I received a corporate lab offer of $210,000 and 11 days of vacation, 5 days CME. One friend received 265k (not including bonus) and a similar vacation time of 2 weeks and 1 week CME. Both small outpatient labs (biopsy mostly and paps thyroid FNA). You guys consider these Low ball offers? How about the 2 weeks vacation? Never heard of any medical specialty where they get only 2 WEEKS of vacation PER year.

My concern is if I work in an outpatient lab like this will it hurt my chances of getting a hospital based job in a few years?

This may be the only option I have in a tight job market.

RIGHT NOW, if this what you have AND YOU ARE FRESH OUT OF RESIDENCY, you jump on that like a bum on a ham sandwich and use it to get a better job after time.


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[Alteran]

good question. according to ascp surveys based on RISE scores, the majority start out far below 250k. I’m not sure what people think is reasonable to start out with, because 180-230 is most of what I have seen, with occasional outliers.

That salary range is not out of the norm for recent graduates. What makes the OPs post scary is that no job that I have ever heard of prior to this post has only 11 days of vacation - period. For reference, my first job was as an employee at $275k/year with 20 days of vacation + 5 days CME which was all expense paid. So that salary at the top is way out of line with the amount of time off.

 

[KeratinPearls]

Some smaller corporate or even outpatient lab groups do this. Like I said I had a friend who was offered a job at an outpatient lab with 2 weeks vacation. He just told me today he tried to get more vacation time and they said “no”.

 

[Med Director New England]

Supply vs. demand.
That’s all it is, nothing too complex here folks

ask your friends in FP who are just finishing training what they are getting offered in terms of salary, vaca, loan repayments and sign on bonuses.

 

[D1b()4]

That's horrible vacation and salary. I interviewed at some outpatient labs/biopsy mills, and they offered 4-5 weeks of vacation with salary right around 300k plus bonuses depending on productivity with total salary around 400k (if you are average in terms of productivity). Starting salary in low 200s would be acceptable for a partnership-track position with a potential for good salary bump in the future but not for a dead-end position that will probably limit your employment options in the future.

Accept this position if you have to and keep searching for a better one.

 

[CDX-2]

Horrible salary and vacation... extremely low volume such that you can leave at noon every day is probably the only way this can be justified

What is considered extremely low volume?

To me, $210K sounds absolutely wonderful if OP is expected to report 20 biopsy cases / day (with no big specimens).

On the other hand, $210K would be absolutely terrible if OP has to report 100 biopsy cases / day.

It isn't clear how many cases are meant to be reported, so in theory we can't pass full judgment re: the offered salary.

 

[KeratinPearls]

That's horrible vacation and salary. I interviewed at some outpatient labs/biopsy mills, and they offered 4-5 weeks of vacation with salary right around 300k plus bonuses depending on productivity with total salary around 400k (if you are average in terms of productivity). Starting salary in low 200s would be acceptable for a partnership-track position with a potential for good salary bump in the future but not for a dead-end position that will probably limit your employment options in the future.

Accept this position if you have to and keep searching for a better one.

thanks for the response. I think it depends on volume for each lab as well. I know that I’ll be signing out a lot of paps, 10-15 prostates a week, handful of thyroid fnas a week, some GI and nails, Gyn biopsies and breast biopsies. I “think” it will be a 8-5 job. I don’t know exactly how many 88305s but I’ll get back to you in regards to that.

Quest doesn’t even pay that much (250-300) for looking at 100 88305s so depends on the lab I guess.

 

[Guest8]

So after 2 years the person is on a partner track for how many more years in your group until they become partner?

A ladder track of 3 years. In the 4th year you're at 100% share. No other buy-in, the ladder is the buy-in.

 

[KeratinPearls]

A ladder track of 3 years. In the 4th year you're at 100% share. No other buy-in, the ladder is the buy-in.

So 6 years until 100% partner?

 

[Guest8]

So 6 years until 100% partner?

4.5-5 years depending on when you start. Partner track changes only happen in January each year. For new grads it would be 4.5 yrs - 1.5 employment years, 3 years before 100%.

 

[hurrycane]

Can someone who is running a PP or working for a corporate lab answer one question? Does it really pay to lowball and to get a crappy pathologist in your group? I just cannot get it. It seems like a disaster to me to hire a mediocre fresh grad every two years, if you talk long term. Isn’t it better to hire a decent person and to retain him/her?
I mean, the offer he is getting is decent for a fresh-out-of-fellowship path. I would have taken it for the reason mikesheree mentioned above. But I’d probably start looking around after a year, if not earlier. Two weeks of vacation? Do they think people go through the hell of med school and residency to die at work?

 

[Med Director New England]

Can someone who is running a PP or working for a corporate lab answer one question? Does it really pay to lowball and to get a crappy pathologist in your group? I just cannot get it. It seems like a disaster to me to hire a mediocre fresh grad every two years, if you talk long term. Isn’t it better to hire a decent person and to retain him/her?
I mean, the offer he is getting is decent for a fresh-out-of-fellowship path. I would have taken it for the reason mikesheree mentioned above. But I’d probably start looking around after a year, if not earlier. Two weeks of vacation? Do they think people go through the hell of med school and residency to die at work?

No it does not. But if a practice is very near a swath of large programs pumping out tons of well trained pathologists every year looking for local jobs (I.e Boston) it certainly is a lot easier to get away with lowballing b/c folks have few or no alternatives.

But then again isn’t that just paying the market value for the commodity?

 

[Thr0mbus]

KNOW YOUR ROLE AND SHUT YOUR MOUTH.

BIG ACADEMIA HAS SCREWED YOU AND YOUR PROFESSION.

 

[KeratinPearls]

No it does not. But if a practice is very near a swath of large programs pumping out tons of well trained pathologists every year looking for local jobs (I.e Boston) it certainly is a lot easier to get away with lowballing b/c folks have few or no alternatives.

But then again isn’t that just paying the market value for the commodity?

agree low ball offers like this occur because they are fishing to see who is willing to take it. Can only occur in an oversupplied market.

 

[Autopsy101]

I think you need to have some vague idea where the job is located to make any kind of determination if it is a low salary offer. For someone right out of training in my area, that is a reasonable, middle of the road offer for salary. The vacation would be a deal breaker for me. I have never seen a physician job with less than 3 weeks vacation - even at the VA and the medical examiner's they get that much time off.

 

[deleted314957]

agree low ball offers like this occur because they are fishing to see who is willing to take it. Can only occur in an oversupplied market.

I was low balled, knew it and took the job because I was certain I would make partner and kick ass. I did. The lowball was more than recompensed. Don’t forget, you usually start at the bottom.


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[KeratinPearls]

Can someone who is running a PP or working for a corporate lab answer one question? Does it really pay to lowball and to get a crappy pathologist in your group? I just cannot get it. It seems like a disaster to me to hire a mediocre fresh grad every two years, if you talk long term. Isn’t it better to hire a decent person and to retain him/her?
I mean, the offer he is getting is decent for a fresh-out-of-fellowship path. I would have taken it for the reason mikesheree mentioned above. But I’d probably start looking around after a year, if not earlier. Two weeks of vacation? Do they think people go through the hell of med school and residency to die at work?

most people graduating fellowship with no signout experience are mediocre. There are mediocre grads joining good groups as well. I don’t think all grads joining groups are all great. You develop your skills over time.

 

[Sawback3]

210K would be a common starting salary in the Northeast (I've heard of lower). I would get details on the volume. Unlikely that they would negotiate on vacation, but that is really crappy. I agree with some other posters, though. If this is what you have then I would take it for a couple years and get the experience.

 

[deleted314957]

most people graduating fellowship with no signout experience are mediocre. There are mediocre grads joining good groups as well. I don’t think all grads joining groups are all great. You develop your skills over time.

This is a no sh***er. As rep. If you had 2 years post residency(not fellowship) real s/o experience in a diverse general pathology setting, community, urban, rural or academic and the appropriate references,etc., I would hire you in a heartbeat over someone fresh out of a fellowship at MSK. I have been in hiring positions before.


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[path_spouse]

The vacation would be a deal breaker for me. I have never seen a physician job with less than 3 weeks vacation - even at the VA and the medical examiner's they get that much time off.

To add more detail, most federal employees, including physicians, start at four hours of leave per pay period, which comes to 13 days a year. That leave accrual rate goes up after three years.

10 days is rather low.

 

[Alteran]

Its truly amazing isn't it. Here we are debating awful jobs and benefits on a sliding scale of crappiness while other forums are arguing the quickest way to get rid of their massive debt in under a year:

2018-2019 Compensation Report for Emergency Physicians - ACEP Now

ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.

www.acepnow.com

6 Attending Paychecks later - 195k student loans wiped out

Not that I'm above derailing threads. But if we want to talk about Chinese virus creation, or anything else really, let's not take away from the utility in this thread. So, only talk about FIRE/FatFIRE/loan repayments. Otherwise, it's getting locked.

forums.studentdoctor.net

Granted, I would't want to do ER myself, but this still is annoying. And just poking my head into other forums, no other forum is asking questions like the OP.

 

[deleted941485]

Its truly amazing isn't it. Here we are debating awful jobs and benefits on a sliding scale of crappiness while other forums are arguing the quickest way to get rid of their massive debt in under a year:

2018-2019 Compensation Report for Emergency Physicians - ACEP Now

ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.

www.acepnow.com

6 Attending Paychecks later - 195k student loans wiped out

Not that I'm above derailing threads. But if we want to talk about Chinese virus creation, or anything else really, let's not take away from the utility in this thread. So, only talk about FIRE/FatFIRE/loan repayments. Otherwise, it's getting locked.

forums.studentdoctor.net

Granted, I would't want to do ER myself, but this still is annoying. And just poking my head into other forums, no other forum is asking questions like the OP.

Palliative care?

 

[LADoc00]

211K would be acceptable if you only did 100 or less cases per week.

Everyone should always try to negotiate a base pay with bonuses for ANY productivity over a certain threshold. You cant simply accept salary X vs. an unknown volume, unless X is a like 1.2 million a year or something..

Can they telepath the cases to your house? That might be interesting, live in Mexico on the beach or something.

I second the comments on folks with no solo sign out experience, they are almost useless tbh.

 

[KeratinPearls]

Question about malpractice insurance.

Malpractice covered with 31 days of tail coverage is considered good?

 

[Med Director New England]

Question about malpractice insurance.

Malpractice covered with 31 days of tail coverage is considered good?

No
that is effectively no tail at all. If something comes up on day 32 you’re on the hook.

tails really need to be unlimited / perpetual totruly function to protect if you move on. I have heard of limited tails but still 5 or 10 yrs. 10 yrs is reasonable - this is the point at which most labs dispose of archived AP material. So in essence no evidence if a mistake was made for a case > 10 yrs old.

 

[KeratinPearls]

No
that is effectively no tail at all. If something comes up on day 32 you’re on the hook.

tails really need to be unlimited / perpetual totruly function to protect if you move on. I have heard of limited tails but still 5 or 10 yrs. 10 yrs is reasonable - this is the point at which most labs dispose of archived AP material. So in essence no evidence if a mistake was made for a case > 10 yrs old.

Thanks for the reply. The company will provide malpractice during my employment and then up to 31 days after I leave the job

I was told in that instance, my new employer would have to cover after 31 days (beginning day 32) which I believe is called nose coverage.

My state has a 2 year statute of limitations

 

[Alteran]

Thanks for the reply. The company will provide malpractice during my employment and then up to 31 days after I leave the job

I was told in that instance, my new employer would have to cover after 31 days (beginning day 32) which I believe is called nose coverage.

My state has a 2 year statute of limitations

Be careful how that statue of limitation is written. Is it 2 years from date of service or 2 years from when the error was discovered? For example, say a nevus was read 5 years ago, but they discovered it was actually melanoma today on re-review of the slide in a patient with widely metastatic melanoma. Does the patient still have the right to sue within 2 years of today or are they SOL because 2 years have elapsed since the nevus was excised. I think most state laws are written such that the statue of limitations timer starts when reasonable discovery of the error came to light. So just be sure that's the case for you.

 

[Med Director New England]

Agree with ^^
I don’t believe any place in the US has a statute of limitations that short.

Also current policies typically won’t function as tail for non-current policies. Just about the only way to not need a tail for a prior claims made type of policy is to retire, many insurors waive liability on retirement. I guess you could always die too...

 

[D1b()4]

Question about malpractice insurance.

Malpractice covered with 31 days of tail coverage is considered good?

Realistically they don't provide tail coverage at all. 31 days is not enough to discover most diagnostic errors in pathology; you need at least 5 years or so. Most solid places provide indefinite tail coverage. Is it the same job offering 11 days of vacation and low pay?

 

[KeratinPearls]

Realistically they don't provide tail coverage at all. 31 days is not enough to discover most diagnostic errors in pathology; you need at least 5 years or so. Most solid places provide indefinite tail coverage. Is it the same job offering 11 days of vacation and low pay?

Thanks for the reply. I’ll see if I can get 4-5 months malpractice tail. I heard it is expensive.

I was told that any new employer can provide “nose” coverage if I quit this job one day. Can a new malpractice insurance at a new employer cover claims made for cases signed out at your old job?

Yes it is the same job but I was told the 2 weeks vacation 1 week of CME is up until the end of the year and my vacation time resets to the “second year” of my job where I will be given 16 days vacation and 1 week CME my second year.

I will have to make sure that’s in the contract in writing.

 

[KeratinPearls]

211K would be acceptable if you only did 100 or less cases per week.

Everyone should always try to negotiate a base pay with bonuses for ANY productivity over a certain threshold. You cant simply accept salary X vs. an unknown volume, unless X is a like 1.2 million a year or something..

Can they telepath the cases to your house? That might be interesting, live in Mexico on the beach or something.

I second the comments on folks with no solo sign out experience, they are almost useless tbh.

The job is 30-35 cases (mostly biopsies) a day. Sounds pretty cush compared to my friends at Quest. Out by 430-5 pm.

 

[D1b()4]

I was told that any new employer can provide “nose” coverage if I quit this job one day. Can a new malpractice insurance at a new employer cover claims made for cases signed out at your old job?

Of course they can, but will they? You should tell these people that most employers provide at least 5 years of tail coverage.

I am sure you can get tail or nose coverage on your own, but you will have to pay for it. I got two offers, and both contracts stated unambiguously that it was my responsibility to arrange tail coverage for my previous work.

 

[yaah]

Old thread that is becoming less relevant to everyone with every passing day, but I think that's a low ball offer. The caveat is if it's a low-volume job that isn't that busy, it might be an appropriate salary unless you're required to staff some place full time 10 hours a day even with the minimal work.