subspecialty signout

[sleeping beauty]

i have a very simple question. can an attending without dermpath, hemepath, cytopath...board certified sign out derm, heme, cyto....speciemens respectively? (i am not a resident yet). thanks.

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[dermpathlover]

i have a very simple question. can an attending without dermpath, hemepath, cytopath...board certified sign out derm, heme, cyto....speciemens respectively? (i am not a resident yet). thanks.

absolutely

 

[mlw03]

from what i've seen, yes. at the local VA their bread and butter is tons of GI and prostate and i know that a lot of the signout is by pathologists without those fellowships.

 

[yaah]

Yes, most people who sign out things around the country are not fellowship trained in that area. So many people seem to have cytopath fellowships and no one else wants to do it (it seems) that a lot of cytopath is signed out by boarded cytopaths though. The practice model seems to be moving ever more towards subspecialization, but most private practices don't have someone for every area, and even if they did people still have to cross cover.

 

[Thaitanium]

So, why is there a need to do a fellowship? Someone educate me. I mean if general paths can sign out a majority of the bread and butter cases in GI, derm, etc, I don't see why there would be a need to hire a subspecialty-trained pathologist in private practice?

I guess what I have a question about pertains to private practice only. I have read here, in this forum, that 90% of derm can be read by someone without a fellowship. The other 10% consists of those cases which you need subspecialty training to accurately diagnose. I am sure the same goes for GI or any other field, where a majority of cases can be signed out by any pathologist. So, having said this, why dont PP groups just hire general pathologists for their groups if most of the cases can be read by any pathologist and send the other 10% to subspecialty-boarded pathologists or experts in the field. I mean is it really profitable for a group to hire a GI, derm, GU path fellowship trained pathologist, if they are really only there for those 10% of cases where the diagnosis is questionable? On top of that, is one year of fellowship training sufficient to make a diagnosis for those ambiguous cases?

So, it seems to me, as if fellowships are there for you to learn how to diagnose those 10% of cases any Joe Shmoe MD pathologist cannot diagnose.

 

[CameronFrye]

So, why is there a need to do a fellowship? Someone educate me. I mean if general paths can sign out a majority of the bread and butter cases in GI, derm, etc, I don't see why there would be a need to hire a subspecialty-trained pathologist in private practice?

I guess what I have a question about pertains to private practice only. I have read here, in this forum, that 90% of derm can be read by someone without a fellowship. The other 10% consists of those cases which you need subspecialty training to accurately diagnose. I am sure the same goes for GI or any other field, where a majority of cases can be signed out by any pathologist. So, having said this, why dont PP groups just hire general pathologists for their groups if most of the cases can be read by any pathologist and send the other 10% to subspecialty-boarded pathologists or experts in the field. I mean is it really profitable for a group to hire a GI, derm, GU path fellowship trained pathologist, if they are really only there for those 10% of cases where the diagnosis is questionable? On top of that, is one year of fellowship training sufficient to make a diagnosis for those ambiguous cases?

So, it seems to me, as if fellowships are there for you to learn how to diagnose those 10% of cases any Joe Shmoe MD pathologist cannot diagnose.

In private practice, a lot of it's about marketing. Also, a lot of groups are going to have people who are "experts" in certain fields (although these people aren't necessarily fellowship trained) to show difficult cases to.

 

[Circumflex]

So, why is there a need to do a fellowship? Someone educate me. I mean if general paths can sign out a majority of the bread and butter cases in GI, derm, etc, I don't see why there would be a need to hire a subspecialty-trained pathologist in private practice?

I guess what I have a question about pertains to private practice only. I have read here, in this forum, that 90% of derm can be read by someone without a fellowship. The other 10% consists of those cases which you need subspecialty training to accurately diagnose. I am sure the same goes for GI or any other field, where a majority of cases can be signed out by any pathologist. So, having said this, why dont PP groups just hire general pathologists for their groups if most of the cases can be read by any pathologist and send the other 10% to subspecialty-boarded pathologists or experts in the field. I mean is it really profitable for a group to hire a GI, derm, GU path fellowship trained pathologist, if they are really only there for those 10% of cases where the diagnosis is questionable? On top of that, is one year of fellowship training sufficient to make a diagnosis for those ambiguous cases?

So, it seems to me, as if fellowships are there for you to learn how to diagnose those 10% of cases any Joe Shmoe MD pathologist cannot diagnose.

In most private practice settings, pathologists with fellowship training in a certain area will also sign out general surg path cases. So, they don't just do the 10% (or whatever) of cases that need a specialist.

 

[DrBloodmoney]

Yep. I'm only doing general surg path and I'm fully planning on signing out anything that is accessioned as a surg path specimen (lymph nodes, liver, lung, kidney, brain, etc). The key is knowing when/why consult specimens out.