Real Reimbursement For Professional Component of 88305 Drops More Than 71% Over 30 Years

[2021Doctor]

1992 88305 PC = $63 (equivalent to $131.86 today)
2021 88305 PC = $37.68

Real Reimbursement drop of 71% since 1992.
Basically means that you have to do almost quadruple the amount of work as a pathologist in 1992 to get the same income.

Even worse: current MPFS proposal is to cut to $35.94 in 2022

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[deleted314957]

And the frogs are about to boil. The government is bound and determiner to control health care costs by controlling utilization and controlling physician costs. As I have predicted for years, compensation will be your salary in a government controlled delivery system. Physician costs will no longer be a black box. y number of physicians x a set number of dollars= total physician costs. Gov’t problem solved. Get your piece of the pie by admitting lots of patients and doing lots of knee replacements! Oh, I forgot, we’re pathologists. But, not to worry. Hospital CEO’s will see to it that there is fairness to all. They’re like that.

 

[Alteran]

Don't worry. CAP has our backs.......

Edit: Is that adjusted for inflation?

 

[LADoc00]

Traditional Anatomic Pathology is basically dead, this proves it has been for some time.

 

[2021Doctor]

Don't worry. CAP has our backs.......

Edit: Is that adjusted for inflation?

$63 in 1992 (adjusted for inflation would be $131).
Instead of $131, the reimbursement now is only $37.68 and headed lower next year.

 

[octopusprime]

88305 comprises ~35-40% of our gross revenue; 88307 is about 1/3 the 88305 revenue; 88341 and 88342 combined total > 88307.
Would be interesting to know what % of gross revenue IHC comprised in 1992

 

[deleted314957]

88305 comprises ~35-40% of our gross revenue; 88307 is about 1/3 the 88305 revenue; 88341 and 88342 combined total > 88307.
Would be interesting to know what % of gross revenue IHC comprised in 1992

At least we got paid for them back then and insurers were not breathing down our necks about why and how many we could do.

 

[AZpath]

So what,
I knew ophthalmologists making millions doing Lasik in the 1980s'

 

[cmz]

Something has to give when you're creating an overabundance of "work" in the GI/GYN/URO/DERM mills

IHC, Flow Cytometry, FISH, NGS, etc is another part of the equation, too. Technology has made medicine more expensive. You have to put things in proper context. I think without question the job has become more difficult. There are higher expectations to produce a more refined AP report. Overall, were pathologists making more money 20-30 years ago than today? Yes, but that can be said for nearly every specialty (even with the outliers). We aren't alone, but it is definitely easier to corral us.

 

[gbwillner]

The physician fee schedule is a zero sum game. Any new service created diverts funds from existing services.

 

[Alteran]

There are higher expectations to produce a more refined AP report. Overall, were pathologists making more money 20-30 years ago than today? Yes, but that can be said for nearly every specialty (even with the outliers). We aren't alone, but it is definitely easier to corral us.

This is my overall issue with how our advocacy is presenting us to payors. Sure, cardiothoracic surgeons were making a mint 20 years ago and now don't do as well. But they are not being asked to provide a "higher" level of quality for less pay. A bypass is a bypass, and that's all there is to it. Its just not worth as much today as it was yesterday.

We on the other hand are being asked to provide an increasingly higher standard level of service with more inclusive reports and greater discernment of diagnostic entities for less money than before. Same procedure, increasing complexity and liability, decreasing reimbursement. This math does not add up.

The CPT coding schema for pathology should seriously be revisited and modeled after Flemish art: the more elaborate and complex the painting, the higher the commission.

 

[deleted314957]

This is my overall issue with how our advocacy is presenting us to payors. Sure, cardiothoracic surgeons were making a mint 20 years ago and now don't do as well. But they are not being asked to provide a "higher" level of quality for less pay. A bypass is a bypass, and that's all there is to it. Its just not worth as much today as it was yesterday.

We on the other hand are being asked to provide an increasingly higher standard level of service with more inclusive reports and greater discernment of diagnostic entities for less money than before. Same procedure, increasing complexity and liability, decreasing reimbursement. This math does not add up.

The CPT coding schema for pathology should seriously be revisited and modeled after Flemish art: the more elaborate and complex the painting, the higher the commission.

The problem is that there are too many pathologists and someone will always be ready to work for less than you do. You are a commodity. A chest cutter is not.

 

[WEBB PINKERTON]

They taketh and you find ways to taketh back. Nothing new. Order bunch of unnecessary/questionable testing to make up the difference. More molecular testing on toe nails please.

 

[cmz]

This is my overall issue with how our advocacy is presenting us to payors. Sure, cardiothoracic surgeons were making a mint 20 years ago and now don't do as well. But they are not being asked to provide a "higher" level of quality for less pay. A bypass is a bypass, and that's all there is to it. Its just not worth as much today as it was yesterday.

We on the other hand are being asked to provide an increasingly higher standard level of service with more inclusive reports and greater discernment of diagnostic entities for less money than before. Same procedure, increasing complexity and liability, decreasing reimbursement. This math does not add up.

The CPT coding schema for pathology should seriously be revisited and modeled after Flemish art: the more elaborate and complex the painting, the higher the commission.

I totally agree with you. However, who is going to take the time to read each and every report? The system is, by and large, not fair. The only thing the insurance carriers and MCR see are a bunch of digits and based on a certain threshold, you get paid what you think you deserve or you don't. When you don't get paid, then it's time to appeal. Most of us use some sort of third party billing company and they either take good care of you or they just collect whatever dollar amount they can get for the least amount of work. In the end, everyone gets paid, right? I wish I could be judged on the merit of my diagnoses and how well I crafted a certain comment or checked the proper boxes off in the CAP cancer summary, etc etc. The thing is, no one gives a ****. Your real reward comes from the business and repeat business your clients (e.g. ASC, Hospitals, Offices, etc) give you. In most scenarios, the client doesn't give a flying F either because they might have some sort of financial incentive to send things to a certain lab or totally don't want to confront administration demanding a better "product". Hell, one can make the argument that most of our colleagues don't even know what we do. Medicine has their fair share of *******es.

 

[Spikebd]

Pathetic. Younger generations truly got hosed. Only way out of this is by organizing walk outs of some sort, which is a utopian fantasy. Pathologists too comfy with their measly $225k +30k bonus. We’re worth so much more.

 

[deleted314957]

They taketh and you find ways to taketh back. Nothing new. Order bunch of unnecessary/questionable testing to make up the difference. More molecular testing on toe nails please.

Webb, I’m shocked. Why not just run your side gigs and quit the b.s. No need to stoop to their level.

 

[KeratinPearls]

Pathetic. Younger generations truly got hosed. Only way out of this is by organizing walk outs of some sort, which is a utopian fantasy. Pathologists too comfy with their measly $225k +30k bonus. We’re worth so much more.

When supply trumps demand, you get jobs like this. 180-200k salaries for a pathologist signing out high volume GI. These salaries are possible because the market allows it.

Is this the value we place on first year pathologists?

In my opinion pathologists deserve more, especially if they are producing much more in revenue. Oversupply is truly one of the big negatives hurting and degrading our field. It’s kinda sad if you ask me. You start to feel like a high paid factory worker. This after 5-6 years of training.

Here’s another job from Tampa where they require you to look at 150-350 cases a day. Make sure you ask if they provide a ball and chain with the position.

 

[dr.weiner]

Well, for the first time since I've been reading this forum- now demand>supply.

There are almost 700 jobs posted on pathoutlines alone, which exceeds the amount of people leaving training. Crappy jobs are starting to not get bites. Good jobs in less desirable areas are struggling to find people to interview. Same with academic jobs in big cities. Residents not doing 2 fellowships anymore. Should be an interesting couple years.

Thoughts on the Pathology Job Market

Thoughts on the Pathology Job Market

www.pathologyoutlines.com

 

[KeratinPearls]

Well, for the first time since I've been reading this forum- now demand>supply.

There are almost 700 jobs posted on pathoutlines alone, which exceeds the amount of people leaving training. Crappy jobs are starting to not get bites. Good jobs in less desirable areas are struggling to find people to interview. Same with academic jobs in big cities. Residents not doing 2 fellowships anymore. Should be an interesting couple years.

I agree there are more jobs now than I’ve ever seen on pathoutlines. I hope no one takes these abusive jobs.

Hopefully young grads have more options for jobs and thus, more negotiating leverage when it comes to contracts.

 

[deleted314957]

I agree there are more jobs now than I’ve ever seen on pathoutlines. I hope no one takes these abusive jobs.

Hopefully young grads have more options for jobs and thus, more negotiating leverage when it comes to contracts.

Well, maybe path will finally get it’s psych or PM&R moment.
I hope so for the sake of y’all.

 

[deleted314957]

So what,
I knew ophthalmologists making millions doing Lasik in the 1980s'

And I knew pathologists (in today’s dollars) making at least 1M/yr beginning with me and my partners. The government has fixed that error though.

 

[Adrian Cocot]

TBF, if you're going into path to practice clinical medicine, you're doing it wrong. The money isn't flowing to hospitals, it's flowing to biotech.

Do some research during residency/fellowship and look for an industry gig. The sting of being called a sellout wears off quickly once you realize how better life is away from clinical practice.

 

[Med Director New England]

When supply trumps demand, you get jobs like this. 180-200k salaries for a pathologist signing out high volume GI. These salaries are possible because the market allows it.

Is this the value we place on first year pathologists?

In my opinion pathologists deserve more, especially if they are producing much more in revenue. Oversupply is truly one of the big negatives hurting and degrading our field. It’s kinda sad if you ask me. You start to feel like a high paid factory worker. This after 5-6 years of training.

View attachment 344057

Here’s another job from Tampa where they require you to look at 150-350 cases a day. Make sure you ask if they provide a ball and chain with the position.

View attachment 344061

100-350 cases /day for 200k salary is really bad.

Thid is why chasing only 305 revenue is a bad idea for any pathologist. You have so do other things too. Run clinical labs,etc.

Someone scoping 300 + cases daily would be miserable and become literally crippled from neck and back injury after a few years

 

[KeratinPearls]

100-350 cases /day for 200k salary is really bad.

Thid is why chasing only 305 revenue is a bad idea for any pathologist. You have so do other things too. Run clinical labs,etc.

Someone scoping 300 + cases daily would be miserable and become literally crippled from neck and back injury after a few years

To be fair that second job for the 150-350 cases does not state a salary figure for the position but yeah I hope he or she gets paid well for all that work and gets a chance to eat during the day.

If he or she is actually getting paid 200k or in that range I would consider it a form of professional slavery.

 

[HowlPrenderghast]

I agree there are more jobs now than I’ve ever seen on pathoutlines. I hope no one takes these abusive jobs.

Hopefully young grads have more options for jobs and thus, more negotiating leverage when it comes to contracts.

Highest job postings so far since 2017. I find it interesting though and I feel like COVID had pushed some into retirement and had caused delays in hiring consequently increasing the job openings. It will soon plateau and then decline after January though if we are to follow the previous trends.

 

[WEBB PINKERTON]

Did Covid or the stock market cause the exodus? We are in bizarre times right now for sure.

Anyone else getting specimens on Afghan refuges? We have been seeing a lot.

 

[deleted314957]

Did Covid or the stock market cause the exodus? We are in bizarre times right now for sure.

Anyone else getting specimens on Afghan refuges? We have been seeing a lot.

As I alluded to before, several months ago I noticed more openings and a “ looser” feel. I think that if recent retirements have increased ( as i think they should) it is a combination of just getting tired of the ever increasing day-to-day bs and the realization that one has enough for a comfortable retirement. There is so much more to do with your leisure time today than 20 years ago and they now have the coin to take advantage of them. Folks don’t want to work till “ they die at their scope”.

 

[ScubaV]

I'm sure there's a spike in retirements, but I'm also wondering if there isn't some consolidation in where jobs are posted. Besides word of mouth, where else does anyone even look for jobs/candidates? I think the old school guys might have posted ads in journals or CAP today or something, but I doubt anyone under 50 does that now. Pathology Outlines is going to be the next Facebook/Google of the path world.

 

[WEBB PINKERTON]

When supply trumps demand, you get jobs like this. 180-200k salaries for a pathologist signing out high volume GI. These salaries are possible because the market allows it.

Is this the value we place on first year pathologists?

In my opinion pathologists deserve more, especially if they are producing much more in revenue. Oversupply is truly one of the big negatives hurting and degrading our field. It’s kinda sad if you ask me. You start to feel like a high paid factory worker. This after 5-6 years of training.

View attachment 344057

Here’s another job from Tampa where they require you to look at 150-350 cases a day. Make sure you ask if they provide a ball and chain with the position.

View attachment 344061

I definitely wouldn't look at jobs at in-office labs. How much longer till VC or hospitals come in and buy up GI practices? The first thing they will do is get rid of the strange man with microscope sitting in the converted broom closet.

 

[Med Director New England]

View attachment 344083

Highest job postings so far since 2017. I find it interesting though and I feel like COVID had pushed some into retirement and had caused delays in hiring consequently increasing the job openings. It will soon plateau and then decline after January though if we are to follow the previous trends.

Could this just reflect that an increasing % of employers are now advertising on pathology outlines ? And not necessarily any mass exodus of paths that has been predicted now for 15+ years…

I know a couple of academic places near me that circa 2010 didn’t use pathology outlines at all and now only advertise opening there.

I agree with what Wiener says above - years in fellowship will be the best indicator of jobs. If there are plenty of jobs no one will do 2nd or 3rd fellowships. Let’s see if ABP will share this data…

 

[KeratinPearls]

Could this just reflect that an increasing % of employers are now advertising on pathology outlines ? And not necessarily any mass exodus of paths that has been predicted now for 15+ years…

I know a couple of academic places near me that circa 2010 didn’t use pathology outlines at all and now only advertise opening there.

I agree with what Wiener says above - years in fellowship will be the best indicator of jobs. If there are plenty of jobs no one will do 2nd or 3rd fellowships. Let’s see if ABP will share this data…

I have a friend who I told to look for a job after his surgpath fellowship (at a great place btw). He still went on to do 2 more years of a boarded fellowship (total 7 years). Some people I think may just feel like they need to do two fellowships because:

1. Everyone they know is doing two. Most people I know have done two except for a few hemepath only people, one GI only and the forensics people.

2. They don’t feel comfortable signing out in the real world and are prolonging their training because of insecurity

3. They want to do surgpath and then become an expert in another area (like GI or derm). Most people I know did the surgpath+another fellowship combo.

4. They want to do two fellowships and get two boards (cyto, heme). This combo can be helpful for general private practice.

5. Some are just nerdy types who want to do two.

6. They did a surgpath year to fill in a year because they couldn’t get into dermpath but eventually did.


Yeah maybe some may not be able to find a job (possibly could be another reason).

 

[bauber]

5. Some are just nerdy types who want to do two.

Institution dependent of course, but academia is a really cool place to be as a trainee and you only get one chance to be there and learn.

 

[deleted314957]

Institution dependent of course, but academia is a really cool place to be as a trainee and you only get one chance to be there and learn.

You learn a hell of a lot more out on your own in practice, and a hell of a lot quicker. Academia is almost a continuation of adolescence.

 

[Drifter76]

View attachment 344083

Highest job postings so far since 2017. I find it interesting though and I feel like COVID had pushed some into retirement and had caused delays in hiring consequently increasing the job openings. It will soon plateau and then decline after January though if we are to follow the previous trends.

Mostly low quality jobs on path outlines.. but better than being unemployed I suppose. Even some of the private jobs are suspect. I just looked at the more recent postings and I saw a couple of private practices on there that I know for a fact have a track record of being dishonest about partnership tracks.

 

[Drifter76]

View attachment 343509

1992 88305 PC = $63 (equivalent to $131.86 today)
2021 88305 PC = $37.68

Real Reimbursement drop of 71% since 1992.
Basically means that you have to do almost quadruple the amount of work as a pathologist in 1992 to get the same income.

Even worse: current MPFS proposal is to cut to $35.94 in 2022

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It is unfortunate- what is being imposed on us by outside forces. What is just as unfortunate is what we do to our own.. pathologists eating their own.

During this past 20-30 year period when reimbursements have been cut drastically, a minority of pathologists have been able to maintain or even increase their income. They haven’t necessarily done it by working harder and harder. In many cases, they’ve done it by getting into the business of exploiting other pathologists, which is quite a bit more lucrative than actually practicing pathology. Look at some of the private groups out there that post positions that are “non-partner track” (or simply lie about their intentions). They hire newbies and work them to death for 220k a year.. treat their “colleagues” like factory workers, just like what the corporate labs do, and skim them. If you’re a partner in a private group and you have a high enough ratio of grunts to partners, you can more than offset the effect of declining reimbursements. You’ll never be able to work hard enough or long enough yourself to make up the difference from the declining reimbursements, but you can certainly make it up by taking from someone else. That is the scam, and that is exactly what it is: a scam. The people who benefit from this sort of scam also have a vested interest in maintaining a crap job market with supply>>demand so their grunts will be stuck. Or if some of the grunts get away from them, they’ll be easily replaced from the masses of minions begging for a job.

 

[cmz]

I can't understand how someone can work a "newbie" to death. Newbies, by definition, need their hand held and aren't worth their weight in RVUs yet. By and large, Newbies aren't quite ripe and often burden the senior pathologists for help. If anything, $220K sounds like they are being overpaid in today's climate.

 

[Drifter76]

I can't understand how someone can work a "newbie" to death. Newbies, by definition, need their hand held and aren't worth their weight in RVUs yet. By and large, Newbies aren't quite ripe and often burden the senior pathologists for help. If anything, $220K sounds like they are being overpaid in today's climate.

I had two different positions in my first couple years out of training where I routinely signed out a bigger caseload than senior partners. When they’re the ones signing the front of your paycheck, people will dump as many cases on you as they want to. They may get a 32 hour workweek with Friday off and you get a 75 hour one. If your inefficiency and inexperience from being a “newbie” adds another 20 hours for you then that is your problem. It is really quite easy to understand if you’ve ever been in one of these places. It is just as easy to create unequal workload as it is to have unequal compensation. In one of these jobs, I had a stretch where I worked 7 days a week for almost 2 months straight. There was also zero incentive/bonus pay and zero opportunity for advancement. If you never had to work in one of these places then consider yourself fortunate. I am not against working hard, but it is the combination of hard work with zero opportunity that is the problem.

 

[cmz]

I had two different positions in my first couple years out of training where I routinely signed out a bigger caseload than senior partners. When they’re the ones signing the front of your paycheck, people will dump as many cases on you as they want to. They may get a 32 hour workweek with Friday off and you get a 75 hour one. If your inefficiency and inexperience from being a “newbie” adds another 20 hours for you then that is your problem. It is really quite easy to understand if you’ve ever been in one of these places. It is just as easy to create unequal workload as it is to have unequal compensation. In one of these jobs, I had a stretch where I worked 7 days a week for almost 2 months straight. There was also zero incentive/bonus pay and zero opportunity for advancement. If you never had to work in one of these places then consider yourself fortunate. I am not against working hard, but it is the combination of hard work with zero opportunity that is the problem.

You look at the senior partner's workload and compare it to yours, but do you realize that they are possibly doing other things for their business? They own the biz and have built up the good-will to be where they are today. You are there as an employee feeding off the land they allow you to walk on.

Why stay at a job that is not aligned with your career goals and desired trajectory? I certainly would not stay at a job (let alone join a group) where I was not offered what I thought I was worth. Working hard is not 100% of the answer, either. You can be the best at what you do, but if your attitude or basic demeanor isn't in check, then I am sorry to say that you likely won't find the pot of gold at the end of the rainbow. If you had to work 7 days a week for 2 months straight, then I don't know what to tell you. You made a bad choice of employment. Check your contract. Does it offer you incentive pay? Why didn't you take some of your work and pass it back to your bosses if you felt so strongly about being used and abused? What are they going to do... fire you?

 

[Drifter76]

You look at the senior partner's workload and compare it to yours, but do you realize that they are possibly doing other things for their business? They own the biz and have built up the good-will to be where they are today. You are there as an employee feeding off the land they allow you to walk on.

Why stay at a job that is not aligned with your career goals and desired trajectory? I certainly would not stay at a job (let alone join a group) where I was not offered what I thought I was worth. Working hard is not 100% of the answer, either. You can be the best at what you do, but if your attitude or basic demeanor isn't in check, then I am sorry to say that you likely won't find the pot of gold at the end of the rainbow. If you had to work 7 days a week for 2 months straight, then I don't know what to tell you. You made a bad choice of employment. Check your contract. Does it offer you incentive pay? Why didn't you take some of your work and pass it back to your bosses if you felt so strongly about being used and abused? What are they going to do... fire you?

All of those senior partners were at one time employees who were “fending off the land they were allowed to walk on” (as you say) as well, but they actually had opportunity. They didn’t have the door slammed in their faces like what they did to the next group. Big difference… I guarantee you they weren’t treated as they chose to treat others.
I didn’t make a bad choice of employment because I didn’t have a choice. It was work there or be unemployed. There was one option.. or two I suppose if you consider being unemployed an option. The senior partners in this case weren’t the ones who built the practice. The practice was built by the prior generation that had already retired. That earlier generation had given the current partners the opportunity to work hard and have a future there, and then the current partners decided to screw the generation that came next. And I didn’t choose to stay there. I left as soon as I found something else. But the problem is, in this kind of job market, you often simply move from one bad job to another. There are too few jobs and the jobs that are out there are mostly low quality.

There’s a saying that “assume makes an ass out of u and me “. Have you ever heard that saying?

 

[Drifter76]

Why stay at a job that is not aligned with your career goals and desired trajectory? I certainly would not stay at a job (let alone join a group) where I was not offered what I thought I was worth.

Interesting that you think pathologists coming out of training actually have that luxury.. you are speaking as if pathology actually has a normal job market.

Is that you, Donald Karcher?

 

[Drifter76]

By and large, Newbies aren't quite ripe

And why would that somehow preclude an employer from dumping an avalanche of work on them on a daily basis? I know. I was there. And it isn’t just me- I know plenty of others in that kind of situation. You leave if you can, but the job market was and is a living hell.

 

[Drifter76]

You made a bad choice of employment.

I didn’t have any choice in employment, but I did make a very poor choice in specialty. I’ll give you that.

What are they going to do... fire you?

That is exactly what they would’ve done.

 

[cmz]

I didn’t have any choice in employment, but I did make a very poor choice in specialty. I’ll give you that.



That is exactly what they would’ve done.

 

[pathres9999]

Drifter76 I feel like you are always trying to release people from their chains, but I think people are still in denial as they sit in their cave amused by the shadow play that CAP and academic pathologists put on. It honestly makes me sad the way pathology is cutthroat to its own colleagues with exploitation at every stage of training and clinical practice.

I think a recurring theme in pathology I have noticed over the years, is that the people in power in pathology take pride in turning negative situations for their workers and spinning it as a positive. Reminds me of this quote by Frederick Douglass, "He [who] is whipped oftenest, who is whipped easiest."

 

[gbwillner]

Drifter76 I feel like you are always trying to release people from their chains, but I think people are still in denial as they sit in their cave amused by the shadow play that CAP and academic pathologists put on. It honestly makes me sad the way pathology is cutthroat to its own colleagues with exploitation at every stage of training and clinical practice.

I think a recurring theme in pathology I have noticed over the years, is that the people in power in pathology take pride in turning negative situations for their workers and spinning it as a positive. Reminds me of this quote by Frederick Douglass, "He [who] is whipped oftenest, who is whipped easiest."

Who are the people in "charge" in pathology? I constantly see conspiratorial thinking here. CAP is an advocacy group and accrediting body. How can they "fix" anything? Similarly wholesale blaming "academia" for pathology's ills. It's like you guys think that there is a "pentaverate" of academic paths out there, thinking about how they can steal money from your pockets.

Release people from their chains? Are you serious?

People without bias see this and laugh.

 

[deleted314957]

Who are the people in "charge" in pathology? I constantly see conspiratorial thinking here. CAP is an advocacy group and accrediting body. How can they "fix" anything? Similarly wholesale blaming "academia" for pathology's ills. It's like you guys think that there is a "pentaverate" of academic paths out there, thinking about how they can steal money from your pockets.

Release people from their chains? Are you serious?

People without bias see this and laugh.

I essentially agree with this. I think the “thing” with academia is that most career academics have a very poor understanding of private practice. I do think, that compared to many specialties the CAP does a *iss poor job of advocating for the private practice community.

 

[cmz]

I am in a position to hire pathologists at will. In fact, I am looking for an able-bodied pathologist with a little bit of experience under their belt right this very moment. I think that my group is pretty much like most private path groups out there -- most are not slave drivers with evil intent. In fact, we just voted a new partner in a few months ago after only being with us for two years. Sure, there are jobs out there that will treat you like garbage, but that goes for ANY job in ANY line of work. If you don't like who you work for, make sure it's really the job and not "you."

Would you like a change of scenery, Drifter76? Send me your CV.

 

[pathres9999]

Who are the people in "charge" in pathology? I constantly see conspiratorial thinking here. CAP is an advocacy group and accrediting body. How can they "fix" anything? Similarly wholesale blaming "academia" for pathology's ills. It's like you guys think that there is a "pentaverate" of academic paths out there, thinking about how they can steal money from your pockets.

Release people from their chains? Are you serious?

People without bias see this and laugh.

I take it you are not familiar with Plato's allegory of the cave in which the chains are a metaphor for being "chained" to a way of thought. Also people in "charge" means exactly what it means, those people who run the administration and the decision making capacity of pathology. As far as fixing things, it would be nice for anyone with even a modicum of power would acknowledge the bad deal that is the pathology career.

Everyone who claims pathology isn't that bad seems to vehemently deny the negatives of pathology but never refutes them. It is always personal attacks and outright dismissal. I'm sure this continued approach will improve resident education/decrease exploitation, medical student interest, pathology recruiting those with visa issues who can't practice, the need for multiple fellowships, lack of jobs with an appropriate location and career advancement opportunity, dropping reimbursement rates, lack of collegiate respect, ignorant professional organization, and so on.

 

[coroner]

In fact, we just voted a new partner in a few months ago after only being with us for two years.

This is one of the downsides of joining private practice. Two years to partnership should be the ceiling; not the floor. That being said, 2 yrs is actually considered "good" in pathology. The majority of groups I have interviewed with (when coming straight out of training as well as in the 5-10 year experience range) have a 3-5 five year partnership track. I have had job offers with 1-2 years to partnership, and even immediate partnership upon hire. However, the latter examples tend to come with experience, rather than being offered to rookies.

But, compared to other fields like gas or rads, 2 yrs. would be upper limit. It does not take 2 years to figure out if someone is medically competent, responsible, and has a collegial personality. Any group can easily figure that out in the first 6 months (not singling out yours cmz). And 3 yrs. to partnership in gas, rads, or pretty much any other field would be laughed at by a potential candidate as it should be unless the partners are making high six figures to 1mil+. Call it apples to oranges, but the average length of time to partnership in private practice pathology is suboptimal vs other fields in medicine and once again, it comes down to supply/demand.

Everyone who claims pathology isn't that bad seems to vehemently deny the negatives of pathology but never refutes them. It is always personal attacks and outright dismissal.

I wouldn't go quite that far as to lump everyone on here claiming pathology is a good field to never offer proof and resorting straight to personal insults. Yes, there is a segment on here that does that, but certainly not representative of the majority, let alone everyone. As we've mentioned on here time and time again, people's career experiences vary and that is also influenced by their perception/personality. When considering good vs bad jobs, "One man's trash is another man's treasure" or "Beauty is in the eye of the beholder" (you get the idea). The discordance lies because people's experiences on here are essentially anecdotal, and another person comes along with their anecdotes/experiences contradicting someone else whom they disagree with and feathers get ruffled. It's almost impossible to refute a claim based on perception/opinion. And, when speaking in generalizations about good jobs vs bad, the only thing people have to go by is their own anecdotal experience and hearsay.

Would you like a change of scenery, Drifter76? Send me your CV.

The gauntlet has been thrown...🧤

 

[cmz]

This is one of the downsides of joining private practice. Two years to partnership should be the ceiling; not the floor. That being said, 2 yrs is actually considered "good" in pathology. The majority of groups I have interviewed with (when coming straight out of training as well as in 5-10 year experience range) have a 3-5 five year partnership track. I have had job offers with 1-2 years to partnership, and even immediate partnership upon hire. However, the latter examples tend to come with experience, rather than being offered to rookies.

But, compared to other fields like gas or rads, 2 yrs. would be upper limit. It does not take 2 years to figure out if someone is medically competent, responsible, and has a collegial personality. Any group can easily figure that out in the first 6 months (not singling out yours cmz). And 3 yrs. to partnership in gas, rads, or pretty much any other field would be laughed at by a potential candidate as it should be unless the partners are making high six figures to 1mil+. Call it apples to oranges, but the average length of time to partnership in private practice pathology vs other fields in medicine is suboptimal and comes down to supply/demand again.

I agree with you that two years for the majority of private groups should be the ceiling. It is odd that it would take longer for a group to make this kind of decision. I won't elaborate as to why we decided on an arbitrary number of two years, but this was put in place mostly because we (the group) wanted to make sure that our new hire was committed to staying in the area and also wanted to participate at a higher level so to speak. I think that after six months when the honeymoon period of a new hire has worn off, both parties will sort of have a good idea if the fit is right or not. My group's goal is to entice solid pathologists who are hungry for work to help our group succeed and stand out. I cannot keep someone here for long if they do not have an attainable goal to reach.

The gauntlet has been thrown, indeed. I am 100% serious.