Starting salary 180-190K Low?

[D1b()4]

Advertisement - Members don't see this ad

that was an easy example. if you read 5000 x88305-26 surgical biopsies a year, I would lose money on paying you anything more than 40.75 x 5000 = 203K gross - expense end would be roughly 120-135K.

If someone is paying you more than twice that coming out of fellowship, they are either total suckers or really really bad at basic math...


Given how utterly useless even most experienced pathologists are to me, your name would have to be Juan Rosai, Jr. for this to make any sense.

The point being is someone right out of training isnt worth even $120,000 to most groups. People are overpaying to get really expensive vacation coverage.

The reality is I can call CompHealth and get someone to cover for 800 bucks flat a day or $160,000 for entire 200-day work year..so yah you arent worth 400K buddy, nothing even remotely close to that.

If fellows are worth 400K out of training, then I would be underpaid by the tune of like 11 million+ a year! hahaha.

Your estimates have one big flaw. I said 5000 cases, not 88305s.

Anyway, I have not come here to boast or prove my worth to you. I just wanted to confirm that decent-paying jobs do exist for people straight out of fellowship.

OP, if someone is offering you less than 200k in private practice for a full-time position, ask them for more or let them use the services of someone from CompHealth.

 

[Unty]

Your estimates have one big flaw. I said 5000 cases, not 88305s.

Anyway, I have not come here to boast or prove my worth to you. I just wanted to confirm that decent-paying jobs do exist for people straight out of fellowship.

OP, if someone is offering you less than 200k in private practice for a full-time position, ask them for more or let them use the services of someone from CompHealth.

Sadly someone will take a job less than 200.

 

[D1b()4]

Sadly someone will take a job less than 200.

Yes, because there are too many graduates, especially IMGs with no student debt.

 

[Unty]

I have a friend who worked hard for an outpatient lab who started at 190k. Worked HARD for them. Made the owner (one a mba type) lots of money obviously. They pushed up her pay 50k as time went on. They were going to pay her 300k by the time she said she was going to leave.

She told me one of the co-owners was upset when she left.

I told her of course he is....you made a lot of money for them. Some people don’t know how much money they are making for their “masters” and think “working hard” is the only way to go. Some people have no clue how much they are being taken advantage of.

 

[LADoc00]

If someone wants to pay you right out of fellowship near 400K for general surgpath volume and maybe some call YOU TAKE IT. That is what Im saying. You guaranteed arent financially worth that (at least not at this stage in your career) so if someone is willing to eat six figures in loses while you potentially grow into the position you should spend literally every week there thanking them and proving the risky bet will pay off.

But I would strongly advise other SDN folks not to roll into interviews claiming their "good buddy from the internet just got 400" and that is somehow the new normal.

Realize since I started most CPT codes have gone DOWN not up, meaning technically in a free market you would be getting paid LESS than circa 2000 to start now in 2020.

 

[LADoc00]

I have a friend who worked hard for an outpatient lab who started at 190k. Worked HARD for them. Made the owner (one a mba type) lots of money obviously. They pushed up her pay 50k as time went on. They were going to pay her 300k by the time she said she was going to leave.

She told me one of the co-owners was upset when she left.

I told her of course he is....you made a lot of money for them. Some people don’t know how much money they are making for their “masters” and think “working hard” is the only way to go. Some people have no clue how much they are being taken advantage of.

Im gonna play the devil's advocate and say your friend's situation is far far more opaque than you are making it out to be. Did they make money off her? Maybe, but they also did all the business, took on all the headache of taxes, accounting, revenue cycle management, compliance and capital expenditure. That is ALOT, I cannot emphasize how minimal my daily workload actually pertains to signing out cases and how much time and emotional energy I sink into all the other crap.

Just be careful going out there and triggering folks like myself with the Millennial attitude that somehow you are worth 5x because that is how Google got started or some nonsense.

1.) Just educate yourself on the fact you add up all the gross revenue based on 100%CMS fee schedule of your work for a group.
2.) factor in your employer has overhead that includes insurance, fixed and variable costs any small business would incur, your health benefits if they provide them and payroll taxes as well as billing.
3.) figure you need to make 1.5 dollars roughly in 100%medicare fee schedule to be worth 1.0 dollars of pay as no one manages people let alone pathologists for free.

I will also add this because unfortunately I have ALOT of damn experience with this myself: often when pathologists complain about how hard work is and all they are doing is signing out 88305s from a GI scope clinic or something, it is because they SUCK. They are poor time managers, they are poor decision makers and they were poorly trained by their residency to deal with stressful cases that arise all the time in medicine. Not throwing salt on your friend because frankly I dont know her at all, but adding a different perspective.

 

[Unty]

Im gonna play the devil's advocate and say your friend's situation is far far more opaque than you are making it out to be. Did they make money off her? Maybe, but they also did all the business, took on all the headache of taxes, accounting, revenue cycle management, compliance and capital expenditure. That is ALOT, I cannot emphasize how minimal my daily workload actually pertains to signing out cases and how much time and emotional energy I sink into all the other crap.

Just be careful going out there and triggering folks like myself with the Millennial attitude that somehow you are worth 5x because that is how Google got started or some nonsense.

1.) Just educate yourself on the fact you add up all the gross revenue based on 100%CMS fee schedule of your work for a group.
2.) factor in your employer has overhead that includes insurance, fixed and variable costs any small business would incur, your health benefits if they provide them and payroll taxes as well as billing.
3.) figure you need to make 1.5 dollars roughly in 100%medicare fee schedule to be worth 1.0 dollars of pay as no one manages people let alone pathologists for free.

I will also add this because unfortunately I have ALOT of damn experience with this myself: often when pathologists complain about how hard work is and all they are doing is signing out 88305s from a GI scope clinic or something, it is because they SUCK. They are poor time managers, they are poor decision makers and they were poorly trained by their residency to deal with stressful cases that arise all the time in medicine. Not throwing salt on your friend because frankly I dont know her at all, but adding a different perspective.

Not saying that the work from the owners of the group is minimal because it is not.

Just saying she can be better compensated for her work working for someone else or someplace else whether that be a different city or employer.

 

[LADoc00]

Everyone who is employed should always be looking for the BBD, bigger better deal. No question at all. I have zero problem with that.

Im just personally grappling with the fact that the new grads somehow want more money than folks with 20 years of sign out experience and although I absolutely want to give the next gen a hand UP, I highly disdain the attitude Im seeing.

Grats to the guy who landed 400K though, I dont want to be hater at all, I just smelled a somewhat cavalier initial post about it that triggered me.

Its like we have gone from "there are no jobs, the sky is falling!" to "400K starting with the potential of 400M with stock options!" in mere months..

 

[D1b()4]

Everyone who is employed should always be looking for the BBD, bigger better deal. No question at all. I have zero problem with that.

Im just personally grappling with the fact that the new grads somehow want more money than folks with 20 years of sign out experience and although I absolutely want to give the next gen a hand UP, I highly disdain the attitude Im seeing.

Grats to the guy who landed 400K though, I dont want to be hater at all, I just smelled a somewhat cavalier initial post about it that triggered me.

Its like we have gone from "there are no jobs, the sky is falling!" to "400K starting with the potential of 400M with stock options!" in mere months..

I was not trying to be cavalier at all; I am very grateful for the job offers I got.

The job market is tight but not hopeless. There are jobs, but you have very little control over the location, and many private practice jobs pay in 200s to fresh graduates. I would rather go into academics or VA than make low 200s in private practice.

 

[Med Director New England]

What are you trying to say?

that I doubt this is true

400k for a fresh grad, hospital employed, not doing derm, not doing a billable CP task, no cyto, modest AP volume to put it nicely stretches the limit of believability....
looks like I am not the only one thinking this.
Again you are in the midst of experienced pathologists spread out all over the country.

 

[octopusprime]

had a similar offer right out of training: high 300s first year, loan repayment; incremental increases over 3 yrs or so, maxed out high 400s. Again, undesirable (for most) location.
turned it down for a lower starting but higher partner max out.

 

[Med Director New England]

had a similar offer right out of training: high 300s first year, loan repayment; incremental increases over 3 yrs or so, maxed out high 400s. Again, undesirable (for most) location.
turned it down for a lower starting but higher partner max out.

And I believe you - you’ve been here awhile. Also clear from your posts you are credible.

I don’t put the same faith in someone who joined a week ago, with an extraordinary claim in an initial post...perhaps entirely truthful But I still have doubt.

 

[octopusprime]

And I believe you - you’ve been here awhile. Also clear from your posts you are credible.

I don’t put the same faith in someone who joined a week ago, with an extraordinary claim in an initial post...perhaps entirely truthful But I still have doubt.

even if he's telling the truth, such scenarios are quite rare...i agree...every other offer i had was 200ish with a 3 yr partner track that maxed 400 +/-
i'm sure it was an employed position in a big system that adhered closely to MGMA and rural enough so as to have difficulty bringing in applicants.

 

[deleted314957]

I believe it. I know of peeps getting jobs like this. Will you be doing everything, ie: general AP, flow, smears,SP

 

[deleted314957]

I retired in 2013. I don’t know if this offers any perspective but the most money I ever made as a non owner employee was as a medical director (solo, but part of a large group) of a ~170 bed hospital that I had been at for 23 years (all as director). My group hade been purchased by Ameripath before they were a going concern (pre ipo) and i was then an employee. Quest bought Ameripath in ~2004 and all this time i was in the same job at the same hospital. I signed out about 12000 surgical a year, 20-25 derm frozen a week and did the regular medical staff and director crap. At the time I retired from Quest I had a salary of ~450,000 and fantastic benefits.

AND, this was AFTER things started to go to s***. Good luck starting at 450,000 doing 5000 surgical s a year, even if you are “heavy” on 307’s and 309’s.

 

[cmz]

I retired in 2013. I don’t know if this offers any perspective but the most money I ever made as a non owner employee was as a medical director (solo, but part of a large group) of a ~170 bed hospital that I had been at for 23 years (all as director). My group hade been purchased by Ameripath before they were a going concern (pre ipo) and i was then an employee. Quest bought Ameripath in ~2004 and all this time i was in the same job at the same hospital. I signed out about 12000 surgical a year, 20-25 derm frozen a week and did the regular medical staff and director crap. At the time I retired from Quest I had a salary of ~450,000 and fantastic benefits.

AND, this was AFTER things started to go to s***. Good luck starting at 450,000 doing 5000 surgical s a year, even if you are “heavy” on 307’s and 309’s.

You did 12K accessions by yourself?

 

[deleted314957]

You did 12K accessions by yourself?

Yes indeed. For years. Admittedly, I was GI heavy.

 

[cmz]

Yes indeed. For years. Admittedly, I was GI heavy.

Makes more sense now. I was also going to comment about the 170 bed hospital you were at too. You must have had a lot of outpatient work. The times have changed a lot...

 

[LADoc00]

At my peak I was a little over 1K shy of 12K accessions in a year. I dont think I can get back to that volume now in my twilight years.

 

[Vicinal]

Some poorly run groups and academic centers pay by RVU not actual reimbursement. They quickly realize that this is untenable after a few years. It is obviously not possible to pay a 450K salary if the group is not being reimbursed for services rendered. I am not aware of any exceptions to this unless there is some magical place where you get paid simply for being magically awesome. Maybe there are some extra hookups like reading slides for biotech or managing clinical trials.

 

[cmz]

Some poorly run groups and academic centers pay by RVU not actual reimbursement. They quickly realize that this is untenable after a few years. It is obviously not possible to pay a 450K salary if the group is not being reimbursed for services rendered. I am not aware of any exceptions to this unless there is some magical place where you get paid simply for being magically awesome. Maybe there are some extra hookups like reading slides for biotech or managing clinical trials.

I am not sure what most academic centers are paying their pathologists. When I left UTSW, most pathologists were in the ballpark of 160K-220K (assistant to associate professor). They still had quite a few in the 130-140K range because they were under long term contracts. I know that the avg salary has increased to around 200K ballpark for most pathologists with incentives based on publication/research track record. Department heads are making between 250-300K.

Search | Texas Tribune Government Salaries Explorer

The Texas Tribune's Government Salaries Explorer lists compensation for Texas state employees.

salaries.texastribune.org

I interviewed an out of state applicant last weekend and they mentioned they were earning around 300K at an academic center with an RVU bonus compensation of up to 50K. $350K plus benefits is not too shabby. The same applicant also mentioned that they were being asked to increase their research time to 25%, which would obviously cut down time at the scope and perhaps directly affect their ability to reach certain MGMA RVU benchmarks for bonuses. Does academia really pay this much?

 

[Unty]

350k + benefits is good especially if you are doing more research. Get paid to do research? If you like research then sounds like a good gig.

 

[Guest8]

Crazy. My wife makes >$150K as a pharmacist at an academic medical center. NOOOOOOO reason any MD should be making less than her considering she's been making decent money since age 24, not 34.

 

[Alteran]

I interviewed an out of state applicant last weekend and they mentioned they were earning around 300K at an academic center with an RVU bonus compensation of up to 50K. $350K plus benefits is not too shabby. The same applicant also mentioned that they were being asked to increase their research time to 25%, which would obviously cut down time at the scope and perhaps directly affect their ability to reach certain MGMA RVU benchmarks for bonuses. Does academia really pay this much?

As stated many times, salaries are all over the place. Academia can pay a lot, but it depends on your pedigree and what you bring to the table. Some salaries are entirely derived from service work (clinical track) and some entirely from their research grants (tenure track). While salaries in private practice are entirely derived from billable services, non-partner/employee pathologist jobs such as private practice multidisciplinary groups or academia can supplement the salaries beyond what that pathologist is billing through other sources. So yes, academia can pay that much but it won't be for someone right out of fellowship. From what I've seen, that's the kind of salary a full professor would command or an associate professor who properly negotiated the value of his/her consult expertise to the academic department. Keep also in mind that some "academic" departments are really private practices that operate under the auspices of an educational umbrella, so they're free to doll out the dollars as they see fit.