Physician shortage data: Where are the pathologists

[raider]

<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD vAlign=top width="70%">I hate reports like this. Never includes specific data per speciality. Just gives more ammo to the "selfish academic departments" in pathology to "beg" for more governmental funding. Yes, there will be a shortage in general, but what about pathologists in specific???



AAMC Releases New Physician Shortage Estimates Post-Reform

Sept. 30, 2010

</TD><TD vAlign=top align=right width="30%">


News Alert
</TD></TR></TBODY></TABLE>
The AAMC (Association of American Medical Colleges) has released new physician shortage estimates based on projections by the Center for Workforce Studies that, beginning in 2015, are 50 percent worse than originally anticipated prior to health care reform.
The United States already was struggling with a critical physician shortage and the problem will only be exacerbated as 32 million Americans acquire health care coverage, and an additional 36 million people enter Medicare.
Some key findings include:
• Between now and 2015, the year after health care reforms are scheduled to take effect, the shortage of doctors across all specialties will quadruple. While previous projections showed a baseline shortage of 39,600 doctors in 2015, current estimates bring that number closer to 63,000, with a worsening of shortages through 2025.
• There also will be a substantial shortage of non-primary care specialists. In 2015, the United States will face a shortage of 33,100 physicians in specialties such as cardiology, oncology, and emergency medicine.
• With the U.S. Census Bureau projecting a 36 percent growth in the number of Americans over age 65, and nearly one-third of all physicians expected to retire in the next decade, the need for timely access to high-quality care will be greater than ever.
• The number of medical school students continues to increase, adding 7,000 graduates every year over the next decade. However, unless Congress supports at least a 15 percent increase in residency training slots (adding another 4,000 physicians a year to the pipeline), access to health care will be out of reach for many Americans.

For more information, contact:
Retha Sherrod
202-828-0975
[email protected]

---

Members don't see this ad.

 

[lipomas]

They should change that last line to "unless Congress supports a pay raise for these specialties..." Revenue keeps dropping for cardiology and oncology. Oncology is a crazy lifestyle - they always have to cover hospitalized patients + outpatient procedural stuff and chemo + all the office visits many of which are chronic patients.

 

[KCShaw]

Looking at the asterisk at the bottom of that linked "report," the projections include only primary care, surgical, and medical specialties (so, presumably excludes at least radiology & pathology).

Have to remember this also comes from the Association of American Medical Colleges which, again presumably, would like to encourage funneling of money/students their way by finding or projecting shortages and then finding ways for their potential applicants and immediate graduates to have a residency position. They would probably love for there to be less competition for residency slots. Doesn't mean any of it isn't true, just seems like a biased source.

 

[Enkidu]

So is there a sense that the pathology job market will improve due to health care reform?

 

[Thrombus]

Getting a job is only 1% of the battle.

At that job, you will be constantly defending your turf against big megalabs promising the moon to administrators and other docs with nice kickbacks and lowball offers (with hidden costs of course) and you will find yourself up against a nice colorful brochure.

All because we are easily exploited. Why are we easily exploited? How is any group exploited? When in high supply my friend....high supply.

 

[path24]

Look for this info to be used in a powerpoint to discuss all of the new jobs coming to pathology, followed by the classic...a large group of pathologists are about to retire, creating even more opens. Hopefully they will serve cookies with the koolaid.

 

[raider]

Compared to other specialities we have the worst job market (Yes the report from NEJM came out in 1998, and as far as I am concerned that is the only valid data until some similar recent study comes out and I will continue to believe it rather than some "lame" report from CAP's resident council or the BS that ASCP publishes... what a freaking joke). What is really surprising is that since 1998 when the report came out, the situation has only gotten worse with Megalabs and other specialities reducing pathologists to mere employees. Our organizations (CAP,ASCP) need to be ashamed of themselves for letting us all down and just talking nonsense instead of addressing this issue that has become a festering wound.
Where is a report comparing pathology job market to other specialities?
What concrete steps were ever taken after the 1998 NEJM report which showed pathology had the second worst job market?
And the losers talk about transformation. What a bunch of BS. The only transformation that should be taking place is slashing the surplus residency positions.

 

[icpshootyz]

I agree with cutting residency positions. At my program we graduate 8-10 residents a year, and many struggle to find jobs. The only reason we have so many residents is because we have no PA's. Not a single one. We have a couple path techs that do small bx's, but that's it. So we need residents, and many of them, to cover all the services. We could easily cut resident spots by at least 1/3, but that would require the department/hospital hiring PA's, who obviously cost far more than residents. But yet, if anything, programs seem to continue adding resident slots as if that's the answer. Ah well. I guess resident spots are like government jobs - once they exist they're almost impossible to get rid of.

 

[raider]

It is the greed of certain pathology residency programs and program directors. They will always "beg" for more governmental funds by "cooking up" data (falsely presenting data on tech shortage and making it seem as a shortage of pathologists or else getting data from hell holes where no sane person wants to work or harping on about the impending retirement of pathologists or other such chicanery) so that they can keep up their supply of dollars and cheap resident labor (in the case of pathology many losers who could not match in any other field due to low scores or many years post grad).

There is another angle. In most residency programs, the program director is probably the worst diagnostician. The only justification for their salary is a residency program. The more slots they have the more they can justify "lazing around" (aka being program director) and not signing out (which will expose their incompetence and weak diagnostic skills). So whenever, these fools meet or publish anything you can bet your money on their presenting data and arguing for increasing residency positions.

 

[2121115]

I agree with cutting residency positions as well. All I ever hear in my department is how we need residents to cover all the services and the department wouldn't be able to function with any fewer residents.

Bull crap.

Private practice pathologists function every day with no residents AT ALL.

0.

 

[Thrombus]

I agree with cutting residency positions as well. All I ever hear in my department is how we need residents to cover all the services and the department wouldn't be able to function with any fewer residents.

Bull crap.

Private practice pathologists function every day with no residents AT ALL.

0.

Tell these "attending" pathologists to get off their ***** and do some real pathology.

 

[deleted314957]

lots of them really must not do s***. I will see ads, particularly at universities for "help wanted" and there are 15 staff md's and phd's and 10 residents and they do 28000 or 32000 surgicals a year. i do about 12-13k myself ( although weighted toward gi) as a solo hospital lab medical director. those other places must get together a couple staff foursomes of bridge every day!

 

[2121115]

lots of them really must not do s***. I will see ads, particularly at universities for "help wanted" and there are 15 staff md's and phd's and 10 residents and they do 28000 or 32000 surgicals a year. i do about 12-13k myself ( although weighted toward gi) as a solo hospital lab medical director. those other places must get together a couple staff foursomes of bridge every day!

They need all that extra time to write up the next ground breaking case report of some random thing. That stuff doesn't just write itself you know.

 

[zao275]

Compared to other specialities we have the worst job market (Yes the report from NEJM came out in 1998, and as far as I am concerned that is the only valid data until some similar recent study comes out and I will continue to believe it rather than some "lame" report from CAP's resident council or the BS that ASCP publishes... what a freaking joke). What is really surprising is that since 1998 when the report came out, the situation has only gotten worse with Megalabs and other specialities reducing pathologists to mere employees. Our organizations (CAP,ASCP) need to be ashamed of themselves for letting us all down and just talking nonsense instead of addressing this issue that has become a festering wound.
Where is a report comparing pathology job market to other specialities?
What concrete steps were ever taken after the 1998 NEJM report which showed pathology had the second worst job market?
And the losers talk about transformation. What a bunch of BS. The only transformation that should be taking place is slashing the surplus residency positions.

raider, I appreciate your reference of the literature. Do you happen to have the citation for that paper so I can look it up? I would like to read it.

While I am disappointed that you think residents who are trying to do something (even if it is "lame") are just a joke, I certainly agree with you that published peer-reviewed articles are an excellent source of info. You may dislike the organizations or disagree with the opinions or reports they make and you may absolutely cast doubt upon the veracity of the claims that they make (I appreciate when you make concrete arguments against individual facts, point out weakness in survey design, or call out potential bias in a stake holder.). However, I really do take it personally when you blatantly insult those of us (especially residents and fellows) who are actually trying to figure things out and find ways to do something about it. Maybe we are not brilliant statisticians, powerful politicians, or private practice pathologists. But do we deserve scorn for being involved, putting in time and effort to at least attempt to do something good? I don't have a really good reason to just throw out some BS survey results. I have a vested interest in knowing what kind of job market I will face in a couple of years when I am out in the real world. And I don't get paid for the results of "lame" reports or surveys. I actually want to know what is going on in the market beyond what anecdotes I read from nameless people on SDN. Is that so wrong? You obviously have much more experience and wisdom about the real situation than I do, and I respect that you probably have a valid reason to be frustrated at the market and to want to take it out on someone. I mean that honestly and with no disrespect. May I humbly and politely request that you vent your frustrations in a constructive way (suggesting solutions perhaps?) rather than tearing down the hard (and maybe even lame) work of others who are trying to help?

 

[2121115]

I think that the CAP resident's arm is valiant in trying to do something and to get this issue noticed by the CAP membership. I have seen numerous times when residents have tried to bring up this issue with CAP leadership. However, few are listening. The short of it is that most CAP members either don't believe you or don't care or both. Also, there are competing interests in CAP - there is more academic vs private practice conflict than you might think (everyone is not on the same page, particularly on this issue).


Those whom I have spoken with on this issue agree that the job market is not ideal but they have a "I had to put up with it so you should too" mentality. Basically, that finding a job is part of "paying your dues".


There is also an almost universal opinion that new graduates suck and they are lazy and if you are looking for a job then you are fighting this preconception constantly.

 

[raider]

The reference is JAMA, 280(9):777-83 1998 Sep 2. The unemployment rates for recent graduates during the survey period were:

Specialty Unemployed Comment
Orthopedic Surgery 1.0 Best
Pulmonary Disease&Crit Care 1.3 Second Best
Emergency Medicine 1.5
Ob/Gyn 2.1
Otolaryngology 2.1
Urology 3.8
Dermatology 4.7
Family practice 4.9
Psychiarty 5.2Cardiovascular disease 5.7
Hematology/oncology 6.0Pulmonary disease 6.1
General Surgery 6.2
Gastroenterology 6.4
Neurology 6.5Diagnostic radiology 6.7Endocrinology 6.7
Rheumatology 6.8
Anesthesiology 7.3
Physical Med and Rehab 7.5
Nephrology 7.9
Critical Care Medicine 8.0Plastic Surgery 9.2
Pediatrics 9.3
Infectious Disease 10.3Internal Medicine 11.1Ophthalmology 11.6Oncology 12.5Geriatric Medicine 14.3
Pathology - Anatomic&Clinical 14.7 Second Worst
Hematology 19.0 Worst


</PRE>

 

[2121115]

To support a statement I made a few posts up in this thread, I offer the following from the above cited article in JAMA:


"... the percentage of resident physicians reporting significant difficulty securing practice positions was almost 4 times higher than the percentage reported by program directors. Although the overall degree of difficulty reported by program directors and residents was quite different, both groups of respondents indicated that graduates in the specialties of pathology, plastic surgery, ophthalmology, gastroenterology, and radiology experienced the most difficulty. Only the 1996 graduates reported difficulty finding employment in anesthesiology and the internal medicine subspecialties. The percentage of residents who reported being unemployed also was much higher than the rate reported by program directors (7.1% vs 1.2%). Even if all the nonresponding resident physicians were employed and did not experience difficulty finding a practice position, the percentage of unemployment and difficulty experienced by resident physicians (approximately 3.3% and 10.1%) would still be higher than the percentages reported by program directors (1.2% and 6.0%)."

 

[2121115]

The JAMA article also concluded the following:


"Based on previous research, we now believe program directors generally do not systematically collect complete information from their graduates about their experiences in seeking practice opportunities; therefore, the usefulness of the program directors' responses is open to question."

 

[deleted314957]

The JAMA article also concluded the following:


"Based on previous research, we now believe program directors generally do not systematically collect complete information from their graduates about their experiences in seeking practice opportunities; therefore, the usefulness of the program directors' responses is open to question."

You cannot believe a program directors response regarding employment of their residents anymore than you can believe a physicians response regarding income surveys.

 

[Enkidu]

Hematology/oncology 6.0

Pathology - Anatomic&Clinical 14.7 Second Worst
Hematology 19.0 Worst

Why are there two numbers for hematology?

 

[2121115]

Why are there two numbers for hematology?

One is for people seeking work as a hematologist only; the other is looking for more broad specialization. Also, I think there used to be a way to train in hematology only but few ever did because of the very reason you bring up. It was sort of analogous to AP and CP.

 

[lipomas]

There is also an almost universal opinion that new graduates suck and they are lazy and if you are looking for a job then you are fighting this preconception constantly.

That is far from a universal opinion. Our group has hired several "right out of fellowship" graduates in the past few years and had great experiences. You have to check references and evaluate carefully but while many recent graduates may have an initial period of caution and uncertainty (as well as near total lack of knowledge about lab management) laziness is rarely an unexpected finding.

There are also many practicing, experienced pathologists who have a reputation of sucking and being lazy (or in it only for the money). Their reputations tend to precede them though and are easier to sniff out.

 

[LADoc00]

going out on a limb here....

If bubba gubberment can FLOOD the market with tons of MDs (including some who have a tendency to go bonkers and shoot up Army bases), then wont they have supreme leverage in any sort of healthcare overhaul??

I mean with all the desperate starving numbers of MDs, universal HC might be a good idea.

I think we are witnessing bubba gubberments cunning plan in action...

muhahahhaha.

 

[Lokhtar]

Err, what? I am not aware of any plan by the Obama administration to increase residency spots?

 

[yaah]

Err, what? I am not aware of any plan by the Obama administration to increase residency spots?

If you spend too much time on the internet you will quickly learn that the Obama administration is both trying to increase residency spots (to flood the market and lower salaries) and trying to decrease or eliminate residency spots (so that nurses can take over and thus lower salaries). How these can both be true, I am not sure. But the internet says it so it must be true.