I am only seeing this driving more lab consolidation…many of the dying labs don’t have any business being in operation anyways.
Just hastening efficiencies that need to happen imo
I will be honest because I have spent several hours thinking about due to my own situation: There is no role for lab "consolidation" to make any difference whatsoever. Small "in town" regional efforts in histology might be possible, but unless there is widespread adoption of virtual microscopy combined with remote directorships, I dont need how this football moves forward.
3 elements need to become near universal for what will be the next phase of the disruptive pathology transformation:
1.) Virtual microscopy where cases are grossed by low level staff at facilities, move to a core lab and are read at banks of cubicles by staff pathologists. This would have to include frozen sections. Eventually this moves completely to a cloud environment where pathologists are at home, can remotely see specimens grossed on video feeds, read and order follow on testing via computer terminals in their residence & massively reducing overhead.
2.) Remote directorships where clinical labs as well as tumor boards, staff meetings and conferences are 100% video calls. Here you have 20 "at home" pathologists you could pay maybe minimally due to flexibility and cover 100 hospitals.
3.) The staff to power this model.
I think the above is actually inevitable now due to the sea change in the gender distribution of pathology, the fact that women much prefer at home work options and greater flexibility and the acceptance that at the end of the day pathologists who dont have procedures as part of their practice (vast majority of us now), do not need to ever step foot in a hospital or clinic as we have COVID mini outbreak after outbreak. The above model is completely resistant to lockdowns, emerging infectious disease and local labor shortages. Its actually even resistant to national-level issues like taxes as I could employ licensed staff living abroad very easily.
You build this model to be 100% vertically integrated from having your own residency and fellowship (remote of course), to training your own pathology assistants for the hospital component up to the IT cloud management of the massive data storage needed. Eventually you produce your own formalin/fixation chemicals, histology equipment, stains, antibodies etc. You lock the market completely down and make the ghost of John D. Rockefeller proud.
Once you can give people true 100% remote work, companies can hire pathologists for 150K fairly easily. At some point soon, if it hasnt already occurred, venture capital will see this opportunity and move in to completely crush established large practices (or offer to buy them? who knows) on scale we have never seen (even beyond the Ameripath emergence).
I think the above is a no brainer for a disruptive Silicon Valley-type start up given the notoriously dumb ideas like Cerebral they have put forward and got billions in VC money for already in the last 10 years.
Ive been toying with the idea of creating a pitch deck presentation and selling this to Sand Hill with the
Codename: Tiamat so no one steal my idea!!!! I will hunt you
🙂
Tiamat, the Dragon of Chaos, will first eat the dying carcass of pathology groups, then feed on the Leicas, Ventanas, Thermo-fishers, etc. Then you eat all the molecular testing companies that currently beg groups and histology labs for blocks. All the blocks will be Tiamat's blocks. All the testing will be Tiamat's property. It will be corporate version of opening a black hole and the gravitational pull drags in a 1000 companies crushing them into the singularity.
