Poll: How will coronavirus affect the pathology job market?

[LADoc00]

Pathology groups, all types, small - large, academics - private - corporate, are in for a serious day of reckoning soon.

we all seen the various MD groups on Facebook what is happening to other specialists. Employed MDs in many areas are being furloughed leftand right. Imagine what will happened to an employed AP pathologist within a system that has stopped paying its employed PCPs b/c they are no longer seeing outpatients? An AP only pathologist or an AP/CP who only practices AP will be screwed soon. About 1 in 5 will be needed as basically all the usual sources of AP business are shuttered.

around me dept chairs in fields like surgery or anesthesia have told their staff -prepare to do some inpatient medicine if you want to conintue getting paid. Problem for pathologists is that most will have no role at all for a couple of months.

Yup already processed that. I think hospitals have to and will keep paying medical director fees, but if you and your group can’t make due on that alone, good luck

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[deleted314957]

Tough times. You are all really fine folks and I hope y’all hold the line. I am sure that this will be a lesson for mankind


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[Spikebd]

Serious question though... can some of these cancer surgeries wait? I still see nasty ENT resections, GI cancers, Neurosurgery cases, breast cases... all being labeled as necessary cases by the surgeons.

These 88307’s and 88309’s aren’t enough to keep the lights on for a few months?

 

[Med Director New England]

Serious question though... can some of these cancer surgeries wait? I still see nasty ENT resections, GI cancers, Neurosurgery cases, breast cases... all being labeled as necessary cases by the surgeons.

These 88307’s and 88309’s aren’t enough to keep the lights on for a few months?

Biologically yes - most human cancers can wait a month or two before treatment with no impact. The time for most to double in size is years.

 

[Spikebd]

Biologically yes - most human cancers can wait a month or two before treatment with no impact. The time for most to double in size is years.

I still don’t think surgeons will stop cutting or asking us what the biopsies show for a good chunk of cases.
i do think volume will decrease. GERD, eosinophilic esophagitis, screening colons... all can wait. I’m interested to see how it shakes out.

 

[Alteran]

around me dept chairs in fields like surgery or anesthesia have told their staff -prepare to do some inpatient medicine if you want to conintue getting paid. Problem for pathologists is that most will have no role at all for a couple of months.

They can’t possibly be serious. Never mind the credentialing nightmare that would be, but for some that would also be well outside their scope of practice. Are the institutions willing to absorb that much liability?

 

[HeyDalaron]

Accountable for what? The Democrat Hoax?

If the Communist Party of China was honest at outset about the severity of the virus and instituted swift measures, it would not have spread to the extent it did.

Instead they chose to arrest doctors and silence investigators.

This is like Chernobyl but worse. Communist hubris resulting in a global disaster.

If there is any justice, they must be held accountable for their gross negligence.

 

[CDX-2]

If the Communist Party of China was honest at outset about the severity of the virus and instituted swift measures, it would not have spread to the extent it did.

Instead they chose to arrest doctors and silence investigators.

This is like Chernobyl but worse. Communist hubris resulting in a global disaster.

If there is any justice, they must be held accountable for their gross negligence.

I'm almost certain the "official" numbers of positive COVID-19 cases and deaths within mainland China are vast underestimates.

It'd be interesting if the public anger within China towards the CCP leads to a revolution, kinda like the Arab Spring. Maybe I'm being too wishful...

 

[gbwillner]

If the Communist Party of China was honest at outset about the severity of the virus and instituted swift measures, it would not have spread to the extent it did.

Instead they chose to arrest doctors and silence investigators.

This is like Chernobyl but worse. Communist hubris resulting in a global disaster.

If there is any justice, they must be held accountable for their gross negligence.

You are right. We should send them a strongly-worded letter or congressional subpoena. That should do it.

 

[Guest8]

We've already discussed canceling our next shareholder distributions and are having our management company run numbers for various levels of revenue loss and how long that will allow us to keep the doors open at current staffing levels. We know we can keep everyone whole for a solid month, but after that things are up in the air. Certainly not going to be anywhere near the nice level of pay we received last year, that's for sure.

 

[AZpath]

Pretty much the same story as Guest8.
We just got elective surgery stop orders on Thursday.
I expect our numbers to drop 70% within 10 days.
This is likely to lasts 8-12 weeks too. Can't carry staff that long.
The Group or lab owner's biggest cash burn is a pathologist salary.
Many will have to consider letting employed pathologists go shortly.
Most contracts require 30 day notice.

The pathology job market is toast for next year at least.

 

[deleted314957]

Serious question though... can some of these cancer surgeries wait? I still see nasty ENT resections, GI cancers, Neurosurgery cases, breast cases... all being labeled as necessary cases by the surgeons.

These 88307’s and 88309’s aren’t enough to keep the lights on for a few months?

The surgeons need to be stepped on by someone with some balls.


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[LADoc00]

Anyone else get guidance from their billing company that billing has already drastically down drafted and will get much worse for the foreseeable future??

Given the small the number of states that are in both a lock down mode and elective surgery ban, seems this hit a few weeks earlier than I expected.

 

[WEBB PINKERTON]

We have an ambulatory surgery center owned by physicians that was still doing breast reductions and other elective procedures last week. Crazy.

 

[ScubaV]

I'm an employed pathologist in a multi-hospital health system. We're being told to cut our daily staffing in accordance with AP volume, probably starting next week, but hopefully not sooner. No one's being let go, but if you're off you have to use banked PTO or be unpaid. Current estimates are for a ~30% drop in volume, but it's already started and I fear it may be worse than that. Lab staff are already cycling furlough time. Rumor has it the rival network isn't (openly) exploring these measures yet, but it may only be a matter of time. Our network has been doing extremely aggressive expansion over the last year or two so I'm sure that hurts.

Our proceduralists are trying to do what they can and I'm sure they'll be super aggressive with scheduling once the situation eases, but the employment and insurance situation in the broader patient population may dictate future volumes more than anything else.

 

[WEBB PINKERTON]

Expect health insurance to be the deciding factor in the election this year. If republicans don't come up with a plan, they are toast. No one wants to hear "health savings accounts and buying insurance across state lines." They need a real plan.

 

[gbwillner]

Expect health insurance to be the deciding factor in the election this year. If republicans don't come up with a plan, they are toast. No one wants to hear "health savings accounts and buying insurance across state lines." They need a real plan.

I'm sure they will fix all that with some more tax cuts.

 

[HeyDalaron]

You are right. We should send them a strongly-worded letter or congressional subpoena. That should do it.

Alternatively we could cease trade with them until they clean up their act, literally.

 

[deleted314957]

We have an ambulatory surgery center owned by physicians that was still doing breast reductions and other elective procedures last week. Crazy.

I honest to god think the state medical boards should discipline folks who do CLEARLY elective stuff.


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[WEBB PINKERTON]

I honest to god think the state medical boards should discipline folks who do CLEARLY elective stuff.


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We needed the specimens. LOL. We have literally nothing to do. What a mess.

 

[Thr0mbus]

I honest to god think the state medical boards should discipline folks who do CLEARLY elective stuff.


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should we shut down the entire West? The virus is just going to take hold somewhere else in the world and come back in another wave.

 

[ScubaV]

US containment policy has failed miserably even with ample warning. Probably the only two short term economic solutions at this point are relax quarantine measures and let the population become immune through exposure or literally die trying; or go balls to the wall on some antiviral therapy and abbreviate the usual testing phase, hoping that the side effects don't outweigh the disease. Thanks to denial and inaction we get to choose between money and lives. I know which most politicians prefer, but even they can't be too brazen about it.

 

[Guest8]

Alternatively we could cease trade with them until they clean up their act, literally.

No, we quite literally can't cease trade with China, not right now or even in the near future. Thousands if not millions of American businesses rely on either goods from China or selling their goods to China. Many American businesses have no secondary source for goods/parts/materials other than China. It would take years to get secondary sourcing and manufacturing up and running. Ceasing all trade with China would destroy our economy as well as theirs. It's basically murder/suicide.

 

[deleted314957]

should we shut down the entire West? The virus is just going to take hold somewhere else in the world and come back in another wave.

Not at all. It is just the simple fact that PPE resources MUST now be marshaled to take care of this event. NOT elective procedures.


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[gbwillner]

I think it's time to revisit my "giant pit in the ground" healthcare policy plan. We should relax all containment procedures, then anyone who gets sick should just jump in the pit since we won't have the resources to take care of them. I will feel really bad for everyone, but hey, my portfolio is down 40% so we need to tKe some drastic measures. I'm sure you all agree.

 

[deleted314957]

I think it's time to revisit my "giant pit in the ground" healthcare policy plan. We should relax all containment procedures, then anyone who gets sick should just jump in the pit since we won't have the resources to take care of them. I will feel really bad for everyone, but hey, my portfolio is down 40% so we need to tKe some drastic measures. I'm sure you all agree.

I have lived thru this since the decade long bear of the late 70’s to date. Unless you are in a pitiable condition where you must now liquidate all your investments, or you just become wildly speculative, just don’t do s***.
I am not an authority but I hope my experience(age) and the fact I still feel quite comfortable and successful can offer comfort to those who have watched their dime go to five cents. I have seen much scarier threats.


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[LADoc00]

Everyday Im starting to rethink this whole mass panic crap...have we been had?

4 deaths in all of California as of 3/23/20, I mean sure this virus takes a bit to get going, but Im feeling very much underwhelmed folks. Meanwhile I can GUARANTEE more FAR more than 4 people have committed suicide as a result of their total financial annihilation.....

Thanks Democrats for vetoing the rescue package in order to put more crap about diversity and climate change in it.

 

[LADoc00]

Don't exaggerate; it won't be that bad.

Yah it wont be..I now feel like a TOTAL IDIOT for having posted that but that literally was my legit state of mind at the time!

When you live in a state of snowflakes that run around the supermarkets weeping about a lack of baby wipes and diapers even though they dont flipping even have a baby, it infects you like a virus! Then viola you post crazy stuff on SDN.

 

[Spikebd]

Everyday Im starting to rethink this whole mass panic crap...have we been had?

4 deaths in all of California as of 3/23/20, I mean sure this virus takes a bit to get going, but Im feeling very much underwhelmed folks. Meanwhile I can GUARANTEE more FAR more than 4 people have committed suicide as a result of their total financial annihilation.....

Thanks Democrats for vetoing the rescue package in order to put more crap about diversity and climate change in it.

Our overlords learned that we can be whipped into hysteria quite easily. Maybe we will see more bioweapon scare tactics in the future.

 

[bronx43]

Everyday Im starting to rethink this whole mass panic crap...have we been had?

4 deaths in all of California as of 3/23/20, I mean sure this virus takes a bit to get going, but Im feeling very much underwhelmed folks. Meanwhile I can GUARANTEE more FAR more than 4 people have committed suicide as a result of their total financial annihilation.....

Thanks Democrats for vetoing the rescue package in order to put more crap about diversity and climate change in it.

It's barely the second inning, you may be proven right when it's all said and done.

 

[Guest8]

Everyday Im starting to rethink this whole mass panic crap...have we been had?

4 deaths in all of California as of 3/23/20, I mean sure this virus takes a bit to get going, but Im feeling very much underwhelmed folks. Meanwhile I can GUARANTEE more FAR more than 4 people have committed suicide as a result of their total financial annihilation.....

Thanks Democrats for vetoing the rescue package in order to put more crap about diversity and climate change in it.

Not sure where you keep getting this 4 deaths in CA number, but as of yesterday there were at least 35 deaths reported in CA. Every source I can find shows 35 deaths. I'm sure it will increase today.

 

[Alteran]

Our overlords learned that we can be whipped into hysteria quite easily. Maybe we will see more bioweapon scare tactics in the future.

If you were to design bioweapons, something like COVID19 is what you'd want - high morbidity, low mortality. The goal of a successful bioweapon is to bankrupt a nation and consume its resources inward preventing it from using those same resources outward against an external opponent. During the cold war, the Soviet bioweapon stockpile was geared towards highly virulent and lethal agents. We chose to develop agents that went in the opposite direction because the designers knew that only living hysterical and panicked people are problematic....the dead are easy to deal with.

 

[LADoc00]

Not sure where you keep getting this 4 deaths in CA number, but as of yesterday there were at least 35 deaths reported in CA. Every source I can find shows 35 deaths. I'm sure it will increase today.

Yes this is another issue, there are ton of different websites tracking this thing, I cant tell which is legit...you could be right. I would still argue that suicides over the same period due to financial concerns are greatly outpacing virus related deaths all over the US.

 

[D1b()4]

Yes this is another issue, there are ton of different websites tracking this thing, I cant tell which is legit...you could be right. I would still argue that suicides over the same period due to financial concerns are greatly outpacing virus related deaths all over the US.

Here is a reliable source for you: The novel coronavirus in the U.S.

 

[D1b()4]

I'm almost certain the "official" numbers of positive COVID-19 cases and deaths within mainland China are vast underestimates.

It'd be interesting if the public anger within China towards the CCP leads to a revolution, kinda like the Arab Spring. Maybe I'm being too wishful...

Yes, you are being to wishful... Why would anyone want to have anything like Arab Spring in their country? The affected countries were much better off before the Arab Spring.

 

[D1b()4]

If the Communist Party of China was honest at outset about the severity of the virus and instituted swift measures, it would not have spread to the extent it did.

Instead they chose to arrest doctors and silence investigators.

This is like Chernobyl but worse. Communist hubris resulting in a global disaster.

If there is any justice, they must be held accountable for their gross negligence.

Since they won't respond to a strongly-worded letter or congressional subpoena, we should consider a limited nuclear strike to hold them accountable.

 

[KeratinPearls]

This country relies on waste and consuming. We are in deep trouble without some drastic measures.

It is a blood bath here at the moment. Lot of people being laid off or hours reduced and we haven't seen the worse yet. This is going to be bad for months. I have no doubt I will be laying off people at my businesses.

It is nice living rural with lots of farm animals and land.

A country boy can survive.

Pentagon says 3 months. Y’all agree?

 

[deleted314957]

Since they won't respond to a strongly-worded letter or congressional subpoena, we should consider a limited nuclear strike to hold them accountable.

Oh right, then WE get a “limited” response.


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[HeyDalaron]

Oh right, then WE get a “limited” response.


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Nuclear is a terrible option.

The entire Western world should refuse to pay any and all debts owed to China, and redistribute the supply chain to other countries. Ideally they would return to domestic soil, but as our overlords are greedy bastards, and our populace addicted to cheap garbage, moving them to more liberal countries might be preferable.

Shunning China from the global economy is the correct course of action. Should their citizens tire of the embargos, we might inspire a change in leadership.

 

[gbwillner]

Since they won't respond to a strongly-worded letter or congressional subpoena, we should consider a limited nuclear strike to hold them accountable.

That would be very counter productive as it would further delay my Amazon Prime orders that are now on 7 day delays.

 

[D1b()4]

Nuclear is a terrible option.

The entire Western world should refuse to pay any and all debts owed to China, and redistribute the supply chain to other countries. Ideally they would return to domestic soil, but as our overlords are greedy bastards, and our populace addicted to cheap garbage, moving them to more liberal countries might be preferable.

Shunning China from the global economy is the correct course of action. Should their citizens tire of the embargos, we might inspire a change in leadership.

Seriously? It was a joke. We should hold our leadership accountable.

 

[gbwillner]

Seriously? It was a joke. We should hold our leadership accountable.

Why? Trump has already stated that he takes no responsibility. It's part of his "the buck stops somewhere else" policy.

 

[bauber]

And it's just like he has said over and over, absolutely no one saw this coming!

https://www.washingtonpost.com/national-security/us-intelligence-reports-from-january-and-february-warned-about-a-likely-pandemic/2020/03/20/299d8cda-6ad5-11ea-b5f1-a5a804158597_story.html

 

[WEBB PINKERTON]

Since everyone is an expert. Tell us exactly what should have been done those months. You are better focusing on now and not worrying about how we got here.

 

[D1b()4]

Since everyone is an expert. Tell us exactly what should have been done those months.

Expanding testing capacity, increasing PPE supplies, starting screening at the airports etc.

 

[deleted915203]

Entry of Graduates of US Pathology Residency Programs Into the Workforce: Cohort Data Between 2008 and 2016 Remain Positive and Stable
Academic Pathology
First Published February 6, 2020
SAGE Journals: Your gateway to world-class research journals

The pathologist workforce in the United States is a topic of interest to the health-care community as a whole and to institutions responsible for the training of new pathologists in particular. Although a pathologist shortage has been projected, there has been a pervasive belief by medical students and their advisors that there are “no jobs in pathology.” In 2013 and again in 2017, the Program Directors Section of the Association of Pathology Chairs conducted surveys asking pathology residency directors to report the employment status of each of their residents graduating in the previous 5 years. The 2013 Program Directors Section survey indicated that 92% of those graduating in 2010 had obtained employment within 3 years, and 94% of residents graduating in 2008 obtained employment within 5 years. The 2017 survey indicated that 96% of those graduating in 2014 had obtained employment in 3 years, and 97% of residents graduating in 2012 obtained positions within 5 years. These findings are consistent with residents doing 1 or 2 years of fellowship before obtaining employment. Stratification of the data by regions of the country or by the size of the residency programs does not show large differences. The data also indicate a high percentage of employment for graduates of pathology residency programs and a stable job market over the years covered by the surveys.

 

[Guest8]

Since everyone is an expert. Tell us exactly what should have been done those months. You are better focusing on now and not worrying about how we got here.

If we don't analyze the mistakes that were made how are we to learn from them? As physicians we should most definitely be involved in root cause analysis and stark examination of what led to this crisis. Whether or not any of that blame lies in the current administration is still to be examined, but it SHOULD be examined.

 

[gbwillner]

As someone said in another related thread- those with heavy cash loads will likely scoop up a lot of business as groups struggle to survive. This will probably result in an increase of consolidation. This is not Path specific- it will hit all outpatient settings.

 

[yaah]

Huge drop in volume. I don't even know to what extent ours dropped starting about 2 weeks ago but it is at least 75%. Outpatient and inpatient. Income has to drop significantly. If yours isn't dropping, I would probably worry more because either the people paying your checks are poorly informed or they are in a holding pattern until they stop paying you. Furloughs will be the order of the day for those for whom it is applicable. I have no idea how academic departments are going to keep paying everyone. If you work for a hospital as a private group but most of the people in the lab are hospital employees, it won't affect you as much because you're not responsible for all those salaries. Save your money and be good to yourself, this too shall pass. Hospital systems have a lot of tough decisions to make though and some of them may involve you.

Personally, I worry a lot about the patients - some will be fine, just wait another month or two for their surgery. But many others will go undiagnosed or untreated for too long. And once cases start back up again volume may be much higher than normal (weekends too).

I mean, yeah, some will scoop up certain businesses but as of now there really is no business to scoop up.

 

[ScubaV]

And once cases start back up again volume may be much higher than normal (weekends too).

I've head this from some co-workers here too, but I'm worried that the larger employment situation is going to affect people's insurance and ability/willingness to pay the deductible to get elective procedures done.