I am always curious what causes people to come out of the woodwork and start blasting the forum with "THERE ARE NO JOBS" posts (I suppose it's still better than the anesthesia forum "THEY TOOK RR JOBS!!" posts). I swear to all that is holy that perceptions of the job market in path are so vastly different among otherwise sane and competent people that it strains credibility. And everyone thinks those on the "other side" are a) delusional or b) incompetent. Here we have another new poster stating that the vast majority of existing practices are either terrible assembly line jobs or are ruled by corrupt oligarchs who want to treat you like dirt and discard you. There is just no in between anymore.
Here's a tip: It strains your credibility when one goes to such extremes. I mean, I know of numerous practices in my area alone that are not only ethical, but stable. I do know some where the pathologists want out, of course. The biggest problem I seem to hear about is a boss (or practice manager) who is just a giant douche and doesn't respect his/her colleague pathologists (who he/she likely refers to as employees). And I know other path mill-type jobs that I wouldn't want to work for. But there are also some good places! Imagine that!
Please understand I do not mean to malign our new poster - I always appreciate (as do others) any time we get a veteran practicing pathologist (if that is what you are, I am assuming) who is willing to post here and provide advice. I just wish sometimes we would get a little more practical advice or realistic appraisals instead of the sturm und drang that we seem to mostly get.
Having been in the field for many years, rest assured that you are getting solid advice and also the absence of overly optimistic forecasts that have plagued manpower analyses for decades. The reason so many dour voices emerge is because they are expressing the truth and want to ensure that young people do not suffer as most who enter pathology do; It has always been bad in pathology; the "good" years ended in the 1970's. I do love the field so and only wish that another medical field offered as much intellectual satisfaction as looking at beautiful images and arriving at vitally important conclusions.
I have heard of so-called stable practices before and always found out they turn people over when you look hard enough. A "stable" practice once interviewed me and selected another; moaning and groaning occurred until one of their layoffs came looking for a job in our area. A "super" practice that at least permitted about half its hires to stay on did so as long as partnership was not requested; even then, the chances of staying on were, as stated, only about 50%. Kaiser is sort of reasonable that way; someone told me they do not get rid of people, but I kind of doubt it. The fellow who used to be in charge never did; he told me a few years ago that it is a knife fight for jobs in general. The VA is the best place for a pathologist to work in the US, for it truly does offer a form of stable employment. You will increase your pay significantly by going to Canada, so it is important to find out about what you need to do to obtain employment there. Looking back on my career, the biggest mistake was failing to emigrate before my parents became old.
The best chance of getting a stable job lies in going where no one wants to live. Look far and wide. Go to the most rural and desolate location possible. Generally, spouses hate this, but it really is a way to get to be able to sleep at night. The pay may be less (usually more than compensated by the decreased housing costs), but the security is an absolute dream. Plus, consider this: if your wife really moans about it, you can get divorced at a much lower cost than generally accrues.
Two other things will cause you to be able to stay. At contract time, see if there is any way of trading off the IRA for some sort of trivial sum, such as $10,000. In this way, the $40,000 economic excuse for eliminating you at 1.5 years is eliminated. Another item to try to negotiate away is tail coverage, the cost that must be paid to the insurer when you leave the practice to cover your actions. This can be as high as $50,000, some have told me. So what you do is to ask them to cover the tail. They will then say they do not do this. Then you ask why not. Keep them talking until they give some stupid figure ("What are you so concerned about? It's only $15,000.") At that point, you say to them: "I will pay you $16,000 if you will take care of the tail coverage." This is a masterwork for you because it then costs them over $30,000 to get rid of you!
Usually you will be able to find fraud if you look carefully; this is quite useful because when the ax comes you can then threaten them with being turned over to the Office of the Inspector General if they bother you. 1) Fnd out about the corporate structure of the partnership. This is doable by calling the an office in the state that registers corporations. There you will find a listing of who is in the partnership. Then check to see what other entities these partners are involved in. You will be amazed at what you find out from this simple, usually free call; sometimes you can even access the information on the web. 2) see if they are component billing and also billing individual charges for evaluations: first, you will see them ask you to put a charge code for evaluating a blood smear; if you see this, then go get some blood work on a neighbor and check out the bill; you will then usually see some sort of charge rendered for the pathologist service. If they have a contract with the hospital to manage the laboratory, then component billing and also billing for individual charges is also defrauding the patient. 3) Find out if they are giving money somehow to those who send them cases; this counts as fee splitting, which is illegal. 4) Look carefully for any evidence of fake names (so-called fictitious names); originally such names were intended to allow a foreign company to adopt a name in America, such that Royal Dutch Shell could be considered Shell oil. In practice, they are almost invariably used as means to deceive customers and employees. 5) Stark violations are kind of neat if you can nail them on it, but very tough to prosecute. All you need to do on this one is find out where they are sending their special stains to and where they are garnering their supplies. If there is a financial connection, a potential Stark violation looms.
Be wary of high paying job offers in ads. Look here:
http://www.merritthawkins.com/job-s...ian&specialtyId=50®ionId=-1#jobGridResults
Those seem like amazing jobs, do they not? Amazing starting salaries and eye popping income possibilities. It is possible that they are actually what they say they are, but think carefully about this point: Merrit Hawkins is one of the best job search firms in the country; of the thousands and thousands of physician job offerings they have, only two, these two, are in pathology.