Share your experience of working for dermpath/gi/gu path mill

[Anfield rd]

Share your opinion about working at large labs which employ pathologists, have them read lots of cases. I am not familiar with the internal working of these companies, but I guess Ameripath, Labcorp, Caris. I am guessing Ameripath, Labcorp, Caris, Dermpath Diagnostics would fall under the category of 'path mills'.

How do you feel about being always and employee, never partner, and taking orders from MBAs types? Are the people who work these jobs looked down upon? Is that really equivalent of joining the dark side? How much do they pay? I've heard that these jobs pay well and give good vacation package, and no call. Share your thoughts, experience, gossips, and flame if you must.

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[2121115]

Share your opinion about working at large labs which employ pathologists, have them read lots of cases. I am not familiar with the internal working of these companies, but I guess Ameripath, Labcorp, Caris. How do you feel about being always and employee, never partner, and taking orders from MBAs types? Are the people who work these jobs looked down upon? Is that really equivalent of joining the dark side? How much do they pay? I've heard that these jobs pay well and give good vacation package, and no call. Share your thoughts, experience, gossips, and flame if you must.

Other pathologists do look down on those that work there, for several reasons. One is that mill pathologists are required to sign out a large number of cases everyday and that only increases the likelihood of mistakes. Two is that there are little to no multidisciplinary conferences (tumor boards, etc) and you are isolated from the general medical community and even less likely to be considered by clinicians to be a "real doctor". And three (maybe the most important reason) these mills undercut community pathologists and steal their business, particularly the easy and high reimbursing ones (GI biopsies, etc).

In multiple ways it is seen as selling out the profession. On the other hand, they offer high starting salaries (granted it never really goes up and you are still getting paid far, far less than what you earn for the company) and generous vacation time, as you mentioned. I have heard that starting salary for places like this may be 250-300K, but that it stays right there. Whereas in a traditional private practice you may start at 170-180 and then make 350-400 or more depending. With the one caveat being that in the future traditional partnership groups may not exist in the format they do now and by the time you are a partner in those groups they may be making 250-300K anyway.

Again, that is all hearsay as I do not work for one of these places. Maybe someone who does can comment. Honestly, IMO it doesn't seem like that bad of a deal as long as you can deal with other pathologists looking down on you.

 

[icpshootyz]

Well who's to say what's "real" pathology versus selling out? Is getting paid squat in an academic setting and being forced to do research to stay employed "real pathology"? Is only having 15-20 on-service weeks in academic path "real", versus 40 weeks in a lab setting? I don't know. I'm still a resident and I don't have to apply for jobs yet, but I know my happiest days are my slide previewing days. I hate research. I hate giving talks. So chances are I'm going to end up in private practice of some sort, whether it's a large lab-based practice or a small community practice. I do like derm and will be applying for a dermpath fellowship this fall, so that will likely improve my chances of ending up in a "mill" as you guys put it. But I like looking at slides. And dermpath in any setting is always high-volume. So why not work in the high-pay, high-volume setting of a large lab? From what I can see, most small practices are getting swallowed up by either large academic centers or large labs. I don't think signing up for a small private practice with the hope of a gradual increase in pay is that wise an idea - chances are you'll get bought out and end up in the same mill-job you were opposed to. Just my $.02

 

[2121115]

Well who's to say what's "real" pathology versus selling out? Is getting paid squat in an academic setting and being forced to do research to stay employed "real pathology"? Is only having 15-20 on-service weeks in academic path "real", versus 40 weeks in a lab setting? I don't know. I'm still a resident and I don't have to apply for jobs yet, but I know my happiest days are my slide previewing days. I hate research. I hate giving talks. So chances are I'm going to end up in private practice of some sort, whether it's a large lab-based practice or a small community practice. I do like derm and will be applying for a dermpath fellowship this fall, so that will likely improve my chances of ending up in a "mill" as you guys put it. But I like looking at slides. And dermpath in any setting is always high-volume. So why not work in the high-pay, high-volume setting of a large lab? From what I can see, most small practices are getting swallowed up by either large academic centers or large labs. I don't think signing up for a small private practice with the hope of a gradual increase in pay is that wise an idea - chances are you'll get bought out and end up in the same mill-job you were opposed to. Just my $.02

Not saying that I agree with all of the sentiments that I wrote in my post. I'm just saying that those sentiments are out there among pathologists. I don't currently have any job lined up so I am in no position to judge or to make assumptions about what is or is not a bad job. A mill job is better than the one I have right now, which is none.

With that said, everyone should decide for his/her self what is a good job.

 

[ScotchBonnet]

Have heard similar things as 2121115.

I am only a resident and also have no experience at a mill-type lab, but I would imagine you had better make darn sure you like your niche of path before signing onto a job like that. I would personally shoot myself if as soon as I finished a stack of prostate cores another was ready to signout with no variety in between.

 

[deleted314957]

There are many different scenarios. Mine is not unique. From 1988-1992 I was an associate in a large private practice group that had contracts at a number of hospitals. Starting in 1990 I went solo to my current hospital as medical director. I had the resources and expertise of the "group" to back me up. I still do. We had/have a large central processing histo/cyto/esoteric lab and my work was brought to me after processing. I did all the work for the hospital (approx 170 bed community hosp) and some out patient work. From 1992 to 1996 I was a partner when we "sold out" to one of the "mills". Today, I am doing EXACTLY the same thing as I was doing from 1990-1996. I am an employee and no longer an owner. I make well north of 400K with great benefits. The majority of surgeons here think I am the best thing since sliced bread. I do worry, though, about what kind of esteem or lack thereof some associate professor of rat-tail pathology at the University of Whatever has for me.

 

[Gyric]

Your situation may not be unique Mikesheree, but the flip side is also not uncommon. Practice sells out to large corporation, corporate keeps the pathologists on, but in a few years fires, increases workload, or significantly cuts pay. Sometimes the pathologists get pissed and band together to push the corporate path group out of the market (e.g. what Cellnetix did), and so perhaps your employer knows the value of keeping you happy. If your surgeons love you, then you are probably just about untouchable anyway.

I don't think that the above posters were describing your scenario working as a solo AP/CP generalist as a "mill." I think they are asking about places that focus on one subspecialty (usually the most profitable outpatient biopsy business, such as GI or derm). Some of these groups are run by pathologists, others are venture capital funded. Practicing pathologists that I have talked with consider these groups parasites for the most part. The local pathologist always has an advantage and good groups, that build long term relationships with their clinicians, are able to fend off these incursions.

I have known one pathologist to work for a GI mill and he left after 6 months, money was ok, but the work was not rewarding in any other way and good patient care was not emphasized.

Dermpath seems different, there are a few pathology owned derm only groups that I would not put in the same category as Caris, uropath, etc.

 

[2121115]

Ameripath buying out a private hospital-based practice is a totally different ballgame than working at a true mill (off site location, case load quotas, 5 minute lunch while the MBA types go out for the "power lunch", etc).

 

[Anfield rd]

Your situation may not be unique Mikesheree, but the flip side is also not uncommon. Practice sells out to large corporation, corporate keeps the pathologists on, but in a few years fires, increases workload, or significantly cuts pay. Sometimes the pathologists get pissed and band together to push the corporate path group out of the market (e.g. what Cellnetix did), and so perhaps your employer knows the value of keeping you happy. If your surgeons love you, then you are probably just about untouchable anyway.

I don't think that the above posters were describing your scenario working as a solo AP/CP generalist as a "mill." I think they are asking about places that focus on one subspecialty (usually the most profitable outpatient biopsy business, such as GI or derm). Some of these groups are run by pathologists, others are venture capital funded. Practicing pathologists that I have talked with consider these groups parasites for the most part. The local pathologist always has an advantage and good groups, that build long term relationships with their clinicians, are able to fend off these incursions.

I have known one pathologist to work for a GI mill and he left after 6 months, money was ok, but the work was not rewarding in any other way and good patient care was not emphasized.

Dermpath seems different, there are a few pathology owned derm only groups that I would not put in the same category as Caris, uropath, etc.

I was asking about the 'mill' scenario.

I would also shoot myself if I had to look at prostates all day long.

Why do you think dermpath is different?

 

[path24]

Has the CAP, ASCP, USCAP...taken any stand on these path mills? Are they trying to shut them down? Don't care/denial?

 

[lipomas]

On what basis would they be trying to shut them down? I don't like them either, but what exactly is the problem with them from a realistic standpoint? They generally provide high-quality diagnosis in a timely fashion. The fact that they pay their pathologists less than what they bill for is easily explained by the need for expansion, marketing, etc. There are also tradeoffs - less call, more incentives, strict focus on areas of your expertise.

The ASCP has taken a stand on pod labs, and they tend to get active when a major lab does things that are bad for medicine. CAP does not take a major stand against pod labs I think because they (regrettably) do not want to become anyone's enemy. But most of these large labs (Caris, Bostwick, Quest) do provide generally quality diagnosis. I personally do not care for them and there are weaknesses to the model, but there are weaknesses to the small private pathology group also. I have seen them make mistakes but they often provide better diagnosis in certain fields than many smaller general groups.

I mean good God, man. What would be your rationale for the CAP and the ASCP to attempt to "shut down" large reference labs? That doesn't even make sense. Do you even listen to what you say anymore? The fact that they may be unethical parasites is not really the point.

 

[Anfield rd]

Has the CAP, ASCP, USCAP...taken any stand on these path mills? Are they trying to shut them down? Don't care/denial?

What would be the rationale and the letter of law behind such action?

 

[Thrombus]

What would be the rationale and the letter of law behind such action?

Exploitation of the field.

Exploitation of pathologists.

Unethical practices (misuse, overuse of ancillary studies/testing).....exploitation of patients and the taxpayer.

Misleading marketing tactics.

In some cases, illegal marketing tactics (kickbacks), many of which are paid for with the aforementioned in play.

 

[pines]

Sounds like some private groups to me.

 

[Thrombus]

Sounds like some private groups to me.

The ASCP and CAP should go after them too. If we can't call out the "bad guys", CMS and Obamacare will bring us all down.

 

[pines]

You should not group all the "mills" as bad just like you shouldn't group all the private groups as bad. Right!

 

[path24]

ASCP, CAP...etc. I thought cared about ethics, professionalism, patient care...etc. Why take a stand on anything then? What good are these organizations then?Eventually we will be kissing the butt of classmates, while in med school, that are going to do GI in the hopes of them hiring us (and if we are lucky they will still call us doctor).

Lipomas...you seem think that they hurt the field of pathology (like most pathologists). Grow a pair and take a stand.

From a legal stand point it might be tough to do, but we can still try. Doesn't anyone care about this profession anymore?

How long till the "biopsy" becomes a pap smear???

 

[2121115]

ASCP, CAP...etc. I thought cared about ethics, professionalism, patient care...etc. Why take a stand on anything then? What good are these organizations then?Eventually we will be kissing the butt of classmates, while in med school, that are going to do GI in the hopes of them hiring us (and if we are lucky they will still call us doctor).

Lipomas...you seem think that they hurt the field of pathology (like most pathologists). Grow a pair and take a stand.

From a legal stand point it might be tough to do, but we can still try. Doesn't anyone care about this profession anymore?

How long till the "biopsy" becomes a pap smear???

Calm down. CAP is working on getting anatomic pathology CPT codes removed from the in office ancillary service exception to the stark law. Check out the latest edition of STATline. It looks favorable that this will happen because CMS doesn't want to pay for the overutilization that it causes. The CAP is not "doing nothing". These types of things have to be handled very delicately and with not pissing off other specialties. You need friends and you can't burn bridges. It is not as simple as "growing a pair" and cowboying up and telling the other specialties and CMS to go to hell. Life doesn't work that way.


http://www.cap.org/apps/cap.portal?_nfpb=true&cntvwrPtlt_actionOverride=%2Fportlets%2FcontentViewer%2Fshow&_windowLabel=cntvwrPtlt&cntvwrPtlt%7BactionForm.contentReference%7D=statline%2Findex.html&_state=maximized&_pageLabel=cntvwr#Story2


The corporate lab thing is a different issue though.

 

[deleted314957]

My point was/is; many people on this board lump ALL national or regional corporatized pathology companies under the catagory of "mills". The VAST majority of my colleagues/fellow pathologist employees in my organization (which is generally lumped into the aformentioned anathema) are engaged in the hospital practice of pathology. Some of the hospitals are big and even have tumor boards.

I would just suggest you be careful what you call a "mill" without some more in-depth knowledge. That should correct the misconception displayed by the original post in this thread (and many others elsewhere).

I certainly agree that a job ANYWHERE where one sits thru the day and signs out an excessive volume of prostate needle bx's to the exclusion of anything else (maybe a couple bladder bx's thrown in) is working in what we would all define as a "mill".

 

[pathstudent]

My point was/is; many people on this board lump ALL national or regional corporatized pathology companies under the catagory of "mills". The VAST majority of my colleagues/fellow pathologist employees in my organization (which is generally lumped into the aformentioned anathema) are engaged in the hospital practice of pathology. Some of the hospitals are big and even have tumor boards.

I would just suggest you be careful what you call a "mill" without some more in-depth knowledge. That should correct the misconception displayed by the original post in this thread (and many others elsewhere).

I certainly agree that a job ANYWHERE where one sits thru the day and signs out an excessive volume of prostate needle bx's to the exclusion of anything else (maybe a couple bladder bx's thrown in) is working in what we would all define as a "mill".

A mill is where you work in a cubicle at some facility and do only outpatient biopsies and when you have an MBA boss who makes twice as much as you and who is out banging your wife during his two hour lunch break while you are only half way through your thirty flats of gi biopsies which you are getting paid five cents on the dollar for each case. But hey at least you don't have to take call and don't have to deal with clinicians or give conferences and you get to where jeans and t shirts to work and listen to headphones all day long.

 

[Anfield rd]

A mill is where you work in a cubicle at some facility and do only outpatient biopsies and when you have an MBA boss who makes twice as much as you and who is out banging your wife during his two hour lunch break while you are only half way through your thirty flats of gi biopsies which you are getting paid five cents on the dollar for each case. But hey at least you don't have to take call and don't have to deal with clinicians or give conferences and you get to where jeans and t shirts to work and listen to headphones all day long.

Well... except the wife-banging part, that's sort of what I had in mind in the original post. Unless the contract stipulates otherwise, but please please let's not elaborate on that. Focus on the subject...

Why are these jobs considered anathema if they pay well and give better benfits than 'real' private practice and academia?

 

[2121115]

Why are these jobs considered anathema if they pay well and give better benfits than 'real' private practice and academia?

Who said they give better benefits than 'real' private private practice and academics?

 

[deleted314957]

Well... except the wife-banging part, that's sort of what I had in mind in the original post. Unless the contract stipulates otherwise, but please please let's not elaborate on that. Focus on the subject...

Why are these jobs considered anathema if they pay well and give better benfits than 'real' private practice and academia?

This is really simplistic but the most important parts about any job you take are that you enjoy your job and look forward to going to work. (excluding Soprano/sociopath-type stuff). Don't worry about what someone else thinks about your situation.

People often ask me when I will retire or why don't I retire. My job/work is my hobby. Why would I give that up?

 

[icpshootyz]

This is what confuses me. I love diagnosing. I don't love powerpoint. I don't love publications. Why should I be made to feel bad if I choose a job that focuses primarily (or singly) on me making diagnoses? If I end up making $300-400k/yr doing that, why would I complain? Even if the "boss" or CEO of the lab is making more, would I care if I was making that much and was happy doing what I love to do? I'm not saying there isn't room for CAP or some other agency to get involved and insure that pathologists maintain power over our field and its skillsets and reimbursements, but I'd take a "mill" job where I was happy over an academic, researchy job where I wasn't any day of the week. I wouldn't mind doing general practice in a small community, but the CP aspect might drive me insane as well, plus I think small practices are dwindling and disappearing, so it might be a lost cause.

 

[Pathwrath]

Calm down. CAP is working on getting anatomic pathology CPT codes removed from the in office ancillary service exception to the stark law. Check out the latest edition of STATline. It looks favorable that this will happen because CMS doesn't want to pay for the overutilization that it causes. The CAP is not "doing nothing". These types of things have to be handled very delicately and with not pissing off other specialties. You need friends and you can't burn bridges. It is not as simple as "growing a pair" and cowboying up and telling the other specialties and CMS to go to hell. Life doesn't work that way.


http://www.cap.org/apps/cap.portal?_nfpb=true&cntvwrPtlt_actionOverride=%2Fportlets%2FcontentViewer%2Fshow&_windowLabel=cntvwrPtlt&cntvwrPtlt%7BactionForm.contentReference%7D=statline%2Findex.html&_state=maximized&_pageLabel=cntvwr#Story2


The corporate lab thing is a different issue though.

You're right, it is a different issue and here's why:

http://www.g2reports.com/issues/advisory/advisory/joe_plandowski/227-1.html

Here's a quote from this article that I believe I also posted in an earlier discussion:

"If organized pathology is truly concerned about the capture of revenue streams from anatomic pathology services, why aren't they skewering Quest (AmeriPath), LabCorp (Dianon/Urocor/US Labs), CBL Path, GI Pathology, Caris Diagnostics, Oncodiagnostics, Oppenheimer Urologic Reference Laboratory, Bostwick Laboratories, Clarient and a host of others who are truly capturing serious monies in anatomic pathology? The lowly pod labs, primarily UroPath, have maybe a total of 50 urology practices under their control. The labs noted are just some of the commercial laboratories that, on a combined basis, have at least 50 times more urology practices for which they provide anatomic pathology testing services. And how about the gastroenterology practices receiving services from the commercial laboratories noted?"

CAP isn't "on your side", its propaganda to the contrary notwithstanding.

 

[Pathwrath]

As for the in-house pathology services, they are a growing chunk of my practice. Every year another in-service mill pops up, like a fungus. I can tell you there is nothing on the horizon but more of them.

CAP's deliberately weak "position statements" and "very delicate" imperceptible movements such as you posted are meaningless in the face of organized clinician opposition. Even radiologists--a far, far more organized and competent group than pathologists--are having a tough time, even with their purchased Congressmen:

http://www.radrounds.com/profiles/blogs/weinerbraley-self-referral

 

[yaah]

ASCP, CAP...etc. I thought cared about ethics, professionalism, patient care...etc. Why take a stand on anything then? What good are these organizations then?Eventually we will be kissing the butt of classmates, while in med school, that are going to do GI in the hopes of them hiring us (and if we are lucky they will still call us doctor).

Lipomas...you seem think that they hurt the field of pathology (like most pathologists). Grow a pair and take a stand.

From a legal stand point it might be tough to do, but we can still try. Doesn't anyone care about this profession anymore?

How long till the "biopsy" becomes a pap smear???

Personally, I think you are confusing pod labs (or in-office labs) with reference labs. There is a difference. The former is bad for medicine in general and specifically pathology. The former hires pathologists as employees for clinicians, and the practice is incentivized to squeeze as much money out of pathology as possible. Some of these groups are actually quite ethical, except in their treatment of the pathologist, and are more difficult to deal with than the typical money-grubbers who care about cost above all else.

Reference labs are a different story. Lipomas and Anfield Rd are right - what exactly are you proposing that ASCP and CAP do about reference labs? And why? Reference labs are well-established in the practice of pathology and many many physicians and even pathologists depend on them for esoteric tests as well as common specimens. The reference labs quite often do a better job with many specimens than the standard general private group. To say this is not to say I love that they are around - to say this is to give you an indication of the barrier to what you are suggesting. You mention they are bad because of "ethics, professionalism, and patient care." This is untrue. They are generally highly professional and focus on patient care. They are generally ethical except if you want to argue they are unethical in how they compensate their physician employees. Some of them use manipulative practices to gain business but in truth this is how business in america works. No one wants the government involved in health care, but you want large businesses to be legislated and stopped? That's called trying to have it both ways.

There is a huge leap to make in "taking a stand." Your position seems to be that they are bad because they lower your salary. That's not really a good argument. Very ineffective. Eliminating reference labs and returning to every hospital employing a small group of pathologists would likely harm patient care. They do not necessarily hurt the "field of pathology" as much as they hurt the entrepreneurial business practices of smaller groups of private pathologists. "Taking a stand" against reference labs means you have to make your business model superior to them. You have to cultivate relationships with local physicians and institutions.

I thought you guys were capitalists! You basically seem to be arguing that you want successful businesses to be pressured out or legislated out. That's more socialist than capitalist.

 

[yaah]

You're right, it is a different issue and here's why:

http://www.g2reports.com/issues/advisory/advisory/joe_plandowski/227-1.html

Here's a quote from this article that I believe I also posted in an earlier discussion:

"If organized pathology is truly concerned about the capture of revenue streams from anatomic pathology services, why aren't they skewering Quest (AmeriPath), LabCorp (Dianon/Urocor/US Labs), CBL Path, GI Pathology, Caris Diagnostics, Oncodiagnostics, Oppenheimer Urologic Reference Laboratory, Bostwick Laboratories, Clarient and a host of others who are truly capturing serious monies in anatomic pathology? The lowly pod labs, primarily UroPath, have maybe a total of 50 urology practices under their control. The labs noted are just some of the commercial laboratories that, on a combined basis, have at least 50 times more urology practices for which they provide anatomic pathology testing services. And how about the gastroenterology practices receiving services from the commercial laboratories noted?"

CAP isn't "on your side", its propaganda to the contrary notwithstanding.

It is true. This is a problem. But unfortunately it is a problem for practicing pathologists mostly, because clinicians and patients do not really see a problem. These labs often have better turnaround time and reports that the clinicians and patients like. Superficial, yes, but it works. But as I said, the whines of path24 are not going to get anyone anywhere.

Agree that CAP is not taking any stand on the matter, I posted that before also.

 

[Pathwrath]

Agree that CAP is not taking any stand on the matter, I posted that before also.

And they have no position on the number of trainees or the job market, either.

I'm really curious, yaah. If you are not a corporate lab owner or residency director, what is the point of paying them dues for membership? I'm not just being provocative for its own sake--what is the point?

 

[yaah]

Yeah, that's a good question actually. It depends on what your own goals are. Some people are members for CME purposes primarily. Others are for the connections it gives them opportunities for.

 

[rollwithit]

A mill is where you work in a cubicle at some facility and do only outpatient biopsies and when you have an MBA boss who makes twice as much as you and who is out banging your wife during his two hour lunch break while you are only half way through your thirty flats of gi biopsies which you are getting paid five cents on the dollar for each case. But hey at least you don't have to take call and don't have to deal with clinicians or give conferences and you get to where jeans and t shirts to work and listen to headphones all day long.

Hilarious! +1 for the MBA guy.

There is a huge leap to make in "taking a stand." Your position seems to be that they are bad because they lower your salary. That's not really a good argument. Very ineffective. Eliminating reference labs and returning to every hospital employing a small group of pathologists would likely harm patient care. They do not necessarily hurt the "field of pathology" as much as they hurt the entrepreneurial business practices of smaller groups of private pathologists. "Taking a stand" against reference labs means you have to make your business model superior to them. You have to cultivate relationships with local physicians and institutions.

I thought you guys were capitalists! You basically seem to be arguing that you want successful businesses to be pressured out or legislated out. That's more socialist than capitalist.

EXACTLY!!!!! Docs are presumably smart people, but apparently are being outsmarted left and right these days by parties wanting reap the benefits of their skill-sets (politicians, hospitals, MBAs, etc.) Why is that? Likely, it's physicians being comfortable with the status quo and the assumption that just because you put in the hard work required to become a physician, you deserve an easy path to $$$ or a practice with low-competition.

Pathologists have to realize that they don't deserve anything. Their training and education sets themselves up nicely to compete and command nice salaries or develop successful practices, but nothing is guaranteed. The value of the physician skill set will be high indefinitely. Somebody is going to reap the benefits of the value. It’s up to physicians to ensure they are the benefactor of the returns from that skill set – not just assume that it will be the case.

"Taking a stand" is going to involve coming up with better physician-run business models, or in the event of being exploited by non-physician parties, “kindly reminding” those parties who possesses the skills to do the work. Assuming that patient care isn’t being harmed, suggesting that the successful models be legislated out, or simply bitching about the fact that they exist, is just plain lazy. If you don’t like it, figure out a way to beat it - you are the physician providing the service – the MBA, hospital administrator, politician, etc. doesn’t. Otherwise, enjoy whining from the back of the pack.

 

[Whetherby]

I thought you guys were capitalists! You basically seem to be arguing that you want successful businesses to be pressured out or legislated out. That's more socialist than capitalist.

People on this board (much like 99% of the population) are capitalist when it serves them to be capitalist and socialist when it serves them to be socialist. You think people are making an argument based on an actual ideology????

 

[TinyFish]

People on this board (much like 99% of the population) are capitalist when it serves them to be capitalist and socialist when it serves them to be socialist. You think people are making an argument based on an actual ideology????

 

[KeratinPearls]

Anyone know how much Ameripath charges for reading a GI biopsy versus a private practice group. I wonder how low Ameripath is willing to go to make a buck. So, Ameripath works by charging lower prices but are abto make a profit through volume (secondary to charging less than competing groups). Is this correct?

 

[deleted314957]

Anyone know how much Ameripath charges for reading a GI biopsy versus a private practice group. I wonder how low Ameripath is willing to go to make a buck. So, Ameripath works by charging lower prices but are abto make a profit through volume (secondary to charging less than competing groups). Is this correct?

You must be from another planet. Ameripath is a wholly owned subsidiary of Quest Diagnostics. They/them are under a regulatory microscope that more resembles a colonoscope. They cannot even approach the arrangements the non-public outfits and GI offshoots like Bostwick's as re: tc/pc splits let alone the pod labs. They lose business to them all the time. Ameripath is thrilled with the medicare global 88305. I know a little about this business (over the past 33 years. 29 of them in pathology at various levels): from the military (with AFIP fellowship) to associate in large private group to partner in same(and treasurer for a couple years) to being bought by a consolidator before an IPO, to being a stock holding employee post IPO to being again aquired by a fortune 500 consolidator. You must not know much about the business end of this profession.

 

[lipomas]

Lipomas...you seem think that they hurt the field of pathology (like most pathologists). Grow a pair and take a stand.

From a legal stand point it might be tough to do, but we can still try. Doesn't anyone care about this profession anymore?

OK, I'll bite. What do you consider "taking a stand"? I bet $20 that your idea of taking a stand is posting anonymous rants on the internet, subscribing to the Dark Report, and maybe extends to sending (probably anonymous) emails to various leadership positions and organizations. And then perhaps hoping and against hope that someone else who is smarter than you does the heavy lifting and heavy thinking and does something that you can also support by signing a petition (but not giving money). Am I right?

Taking a stand against reference labs means competing with them. You out do them. You provide better service. You don't just sit back and whine because you lose your business to a more successful business. This is challenging and you will lose sometimes. Where they exhibit unethical or unprofessional behavior you call attention to this. But when they don't you can't just complain that they do.

Pathology is a business that happens to involves patient care. A lot of you seem to expect that riches will come flowing your way if you just do your job. It doesn't work that way. Complaining about successful business practices which are perfectly legal and professional isn't going to get you anywhere except to the bottom of the totem pole. What exactly do you want CAP and ASCP to do? Say that is unfair that organizations which employ hundreds of pathologists and provide quality patient care are unethical because they lower your salary? No. They might help you with in-office labs and payor arrangements which may favor specific big labs at the expense of other pathologists, but they aren't going to help you in your bitch fest. Nor should they.

 

[yaah]

People on this board (much like 99% of the population) are capitalist when it serves them to be capitalist and socialist when it serves them to be socialist. You think people are making an argument based on an actual ideology????

If you watch enough political TV, you will quickly learn how to spin anything to suit your own perspective.

 

[Freak]

If you watch enough political TV, you will quickly learn how to spin anything to suit your own perspective.

Get government out of my Medicare !!!

 

[path24]

Hmm...didn't saying anything about salary/competition...whatever. Assume away.


So here is my vision of a perfect (fantasy) pathology world:

Community pathologists following a pt's specimens (biopsy-ancillary tests-resections..etc) along with the team of other physicians (family doc, surgeon, onc...etc.). A strong healthcare team with good communication: clinical history, clinician/pt concerns, working conferences...follow the complete care of our patients just like most docs. (getting us out of the basement) Academic institutions I see as the "reference labs."

 

[KluverB]

So here is my vision of a perfect (fantasy) pathology world:

Community pathologists following a pt's specimens (biopsy-ancillary tests-resections..etc) along with the team of other physicians (family doc, surgeon, onc...etc.). A strong healthcare team with good communication: clinical history, clinician/pt concerns, working conferences...follow the complete care of our patients just like most docs. (getting us out of the basement) Academic institutions I see as the "reference labs."

?Path à la pre-Ackerman era, ie. path done by the surgeons?

Feeling nostalgic.