Shouldn't path work like this....

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

pathstudent

Sound Kapital
20+ Year Member
Joined
Mar 17, 2003
Messages
2,962
Reaction score
79
I was thinking today about how the pod labs are basically operating on a fee splitting structure, i.e. the pathologist is doing his work and only getting part of the professional component while the urologist/dermatologist/gastro is getting the rest. But isn't that what goes on in private practice groups also?? The junior pathologist works for a salary and the senior partners make money off the juniors.

Private practice surgery groups operate on a "eat what you kill" structure. That is they share the costs of operating an office but their overall pay is based on how much business they do. It's a great system because if a guy wants to work less he makes less, while if a guy wants to bust his ass he'll make a lot more cash.

Shouldn't pathology private practice groups operate in a even split system (where seniors and juniors evenly split the revenue) or operate according to an "eat what you kill" system where you collect on whatever you signed out (that is if you sign out all the flow and no one else does, you get all that money, or if you sign-out all the derm biopsies, you keep all that money instead of splitting in with the group).

We need to do away with pod labs and private practice groups where one or a few guys control the contract and pay everyone else a salary. Those systems all involve fee splitting and are fundamentally unethical.

Academics is definitely the way to go so you don't have to worry about these things.

Members don't see this ad.
 
people will always try and make money off those below them; it's the nature of a market economy. but if you want to try and establish such a business model, give it a try and see how it goes. i do agree there's less of the money issues to worry about in academia (at least based on what i've seen thus far).
 
Private practice surgery groups operate on a "eat what you kill" structure. That is they share the costs of operating an office but their overall pay is based on how much business they do. It's a great system because if a guy wants to work less he makes less, while if a guy wants to bust his ass he'll make a lot more cash.

Shouldn't pathology private practice groups operate in a even split system (where seniors and juniors evenly split the revenue) or operate according to an "eat what you kill" system where you collect on whatever you signed out (that is if you sign out all the flow and no one else does, you get all that money, or if you sign-out all the derm biopsies, you keep all that money instead of splitting in with the group).
.

So if you did an "eat what you kill structure" you wouldnt make any money to start off with, The only cases you got paid for were the contracts and business you bring in yourself. After a couple of years yes you could eventually break even. I.e. what motivation would a group have giving you their cases from their clients and not getting anything in return. That system makes no sense, anyone can bust their ass but it takes someone special to bring in more business, hence as a junior you get less because you didnt do anything to get the cases, they were handed to you. Flip the coin and if you started your own business worked very hard to get all of your clients and wanted to hire someone new, you wouldnt pay them the same you make because they did nothing to contribute to the success of your practice. At that level of the game it isnt about who can read the most slides its how you are gonna get the slides to start off with. Hope that helps.
 
Members don't see this ad :)
I understand your point. However isn't it unethical for the senior partners to pay a junior a salary that is less than what they collect on the work the junior did? That is basically fee splitting and no different than what the gastros/dermos and uros are doing to pathologists.
 
I understand your point. However isn't it unethical for the senior partners to pay a junior a salary that is less than what they collect on the work the junior did? That is basically fee splitting and no different than what the gastros/dermos and uros are doing to pathologists.

This happens in every profession - new bankers work 100 hours a week without vacations for comparatively little, new lawyers work 100 hours a week for very little. Doctors are relatively protected, actually. I agree it is somewhat unethical, the problem is that in comparison to other professions it's pretty minor and therefore is unlikely to change.

Many people also believe in compensation for experience.

Academics doesn't work much differently though - junior academics get paid much less than senior academics. Many ditch the academic life after 3-5 years for greener pastures, but in those 3-5 years they work very hard.
 
I understand your point. However isn't it unethical for the senior partners to pay a junior a salary that is less than what they collect on the work the junior did? That is basically fee splitting and no different than what the gastros/dermos and uros are doing to pathologists.

Well, I think mcfaddens has a valid point about bringing in cases. I think the other difference is that in a PP pathology group, I'd imagine you're going to have some interaction with other members of the group, maybe a consensus conference, informal "take a look at this case" type stuff, where you're directly benefiting from the elder's knowledge. This totally contrasts to fee splitting with a GI/derm doc who's putting in no input whatsoever to the pod lab that's making the diagnosis. Just a thought.

DBH
 
I understand your point. However isn't it unethical for the senior partners to pay a junior a salary that is less than what they collect on the work the junior did? That is basically fee splitting and no different than what the gastros/dermos and uros are doing to pathologists.


Mcfaddens hits this one right on the head...

If you did this in pathology the partners would say they "killed" X cases by getting them in the door...

Also senior partners don't pay a junior partner salary, "partners" get profit sharing.. pathologist employees (which is usually new junior people) get paid salary... And partnerships theoretically make people partner after a few years (and after a buy in)

Now groups that never make people partner one could argue are unethical...
 
Actually the OP is right in a sense. Surgery groups work by the principal of eating what they kill because their skill set is in high demand.

IF pathology was in same boat, it could command the same model, but it isnt.

Thus capitalism kicks in. Most if not all groups over say 4-5 people in private prac will screw over junior docs, if only for years 1-3. Still in that time, they may have made 1-2 MILLION off their labor. Many groups end up relying on this income actually and that is the reason why they cycle junior people in and out.

IMO, it is really not a red flag to see pathologists in their late 30s on job no.5 while that would raise alot of eyebrows in other fields.
 
Top