THE POD LAB Ascendancy!

[LADoc00]

These ads are flying around in multiple East Coast cities now:

Urology Group Practice Seeks Experienced Anatomic Pathologist. Fee for Service Opportunity – Independent Contractor. Compensation: $350K - $400K Plus Range. Unlimited Benefits – Maximize Your Retirement Savings. No Call or Autopsies: 8 to 5 / M – F. No Travel. Vacation – You Decide!

Read between the lines: I (non-medical person) will bill for your services, take a big cut and send some of that as a kickback to the Urologists and pay you a reasonably sounding salary.

On the condition you wear a latex gimp suit....

but seriously 400K/year is REAL money. This whole POD thing is getting interesting.

You could do this from home between breaks in your computer games and net surfing..mortgage due? ching ching, 10 sets of prostate needles
new car? ching ching...20 sets
A lapdance from a drunk Britney Spears....you get the picture.

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Members don't see this ad.

 

[anencephalic]

ASCP is supposed to be working with legislators to close the loopholes which allow the pod labs to get reimbursed in the current manner, but damn...maybe I'd sell my soul for 400K

As for the Brit lapdance...is this with or without hair?

 

[djmd]

Compensation: $350K - $400K Plus Range.

I don't buy those numbers.
It is literally a numbers game. They will pay you X per prostate case.
While they might be willing to pay you $400K, I imagine personal ability to SO# cases per day, and "oh you would could have made $400k, but we only had enough cases for you to make $300k." would make those numbers unlikely.

I have seen slides from these Uro-pod labs.
three separate cores (inked, red, green, and blue) in one cassette-> one slide with 6 levels.
Just to save paraffin and glass... They are shaving cents.
Not that trying to save to make money is a crime, but they are not doling out cash to pathologists.

 

[yaah]

Part of it I think is that some people are just attracted to the idea of being an employee. They will take their salary and let others worry about billing, adminstration, other relationships, etc. In truth, making $300k + without having any of these responsibilities is pretty good, and you aren't going to find it many other places. I imagine that $300k is full of incentive clauses though. Probably get docked for each immunostain you order.

 

[djmd]

Probably get docked for each immunostain you order.

You probably get docked every time the Hospital that reviews your Bx disagree with your Gleasons. or anything else.. anything take the money out of your pocket back into the urologist.

 

[Byronsgoat]

Fee for Service Opportunity – Independent Contractor. Compensation: $350K - $400K Plus Range. Unlimited Benefits – Maximize Your Retirement Savings. No Call or Autopsies: 8 to 5 / M – F. No Travel. Vacation – You Decide!

Sounds like a pyramid scheme. "unlimited benefits" ?? What does that mean, exactly?

It's likely that the real situation is a bit more complex, that the money is not that easy and that the sacrifices for the "independent contractor" are much greater than it appears. And, don't forget, independent contractors are not full-time employees (e.g. 1099 for tax purposes) and will be responsible for the full social security tax liability, may not be covered under workman's comp; and, perhaps, won't be covered under company health insurance plans, etc.

That ad is a marketing gimmic; not to say that it isn't worth it, just be careful.

 

[yaah]

I would also suggest that any job that paid $350-400k with those other fringe benefits shouldn't have to advertise everywhere if it was really a legitimate good job. Send a few emails to urologic pathologists. I think they are looking for someone they can dump on. Could be wrong, but it doesn't really make a lot of sense.

 

[pathdoc68]

I have seen slides from these Uro-pod labs.
three separate cores (inked, red, green, and blue) in one cassette-> one slide with 6 levels.
Just to save paraffin and glass... They are shaving cents.

I have also seen the same kind of biopsy - from a NY based Uro-Pod lab, the histo and report was a crying shame. In my lab we do six cores, each seperately embedded.

 

[djmd]

I have also seen the same kind of biopsy - from a NY based Uro-Pod lab, the histo and report was a crying shame. In my lab we do six cores, each seperately embedded.

One BX site= one block. the way it should be.

I wonder if it is the same group.. The one I am thinking of is NY based.
I almost hope so, just because then that would mean there wouldn't be TWO groups doing the same thing just to save literally $0.02.

 

[pathstudent]

I imagine that $300k is full of incentive clauses though. Probably get docked for each immunostain you order.

Not true.

The urologists own the lab and make money performing immunostains and can bill for your professional interpretation of them. So it is just the opposite. They would like you to order as many immunos as possible.

 

[djmd]

Not true.

The urologists own the lab and make money performing immunostains and can bill for your professional interpretation of them. So it is just the opposite. They would like you to order as many immunos as possible.

But what immuno stains would they have? The PIN cocktail? Mostlikely these labs aren't set up to do ANY immunos. Why pay for the extra cost...?

Besides allowing the pathologist to bill for techinical interpretation is going to make them upity. Next they will want rights, and coffee breaks.....

 

[pathstudent]

But what immuno stains would they have? The PIN cocktail? Mostlikely these labs aren't set up to do ANY immunos. Why pay for the extra cost...?

Besides allowing the pathologist to bill for techinical interpretation is going to make them upity. Next they will want rights, and coffee breaks.....

They pay for the extra cost because they can get reimbursed far more than it costs them to do the stains and they can also bill for the pathologists interpretation of the stains (there is a CPT code for that). The pathologist's income is the same whether he orders them or not, so they would prefer him to order as many immunos as possible because it would be more money in their pockets.

It is true that a group of urologists wouldn't need much more than PSA, HMWK, racemase and maybe P63. If they needed anything else they could just send the block out, forgo the technical reimbursement, but still make a little cash of the pathologist's interpretation. It is money for nothing to them. As pod labs continue to proliferate, someone will come up with a little machine that does just those immunos, kind of like the little biomarker machines for breast by Vantana. Maybe they exist already.

 

[dermpathdoc]

Part of it I think is that some people are just attracted to the idea of being an employee. They will take their salary and let others worry about billing, adminstration, other relationships, etc. In truth, making $300k + without having any of these responsibilities is pretty good, and you aren't going to find it many other places. I imagine that $300k is full of incentive clauses though. Probably get docked for each immunostain you order.

Yes...and the reality is most of these pod labs require you to provide your own malpractice and helath care..that rapidly eats up your 400K..so your take home is more like 150 to 200K. as an aside..beware working for Labcorp in some areas....they have the same situation....you have to provide your own malpractice and health care..and in order to make that break even you better be able to sit down and read a good 150 or more cases a day

 

[DarksideAllstar]

....

 

[b&ierstiefel]

Edit: I got rid of your quote. Just for your edification, I was laughing solely at your response and not the target of that response.

Oh yeah, it wasn't beer.

 

[DarksideAllstar]

Thanks for making me spit my drink all over my keyboard.

I hope it was a beer-- then my job is done.

Edited: for my pleasure.

 

[djmd]

Maybe I talk to pathologists who are only into making peanuts, but of the 5 or 6 I have talked to, not one of them signs out 150 cases/day.

Wow talk about missing the point...

Darkside go back and read DermpathDOC's post you quoted. (note it is NOT DPL you're quoting)

AT uropods to make 350k you will have to be SO 150 cases /day.
and yes that is not something most people do/ or even can do?

 

[b&ierstiefel]

So let's take dermpath. Really simple scenario...150 cases...let's assume that we have 150 small skin ellipses...tips go in one cassette and the remainder of the serial sections go into a second cassette...and you get levels x3 on the second block. So that's 4 slides per case x 150 cases = 600 slides. 20 slides go into one tray...that's 30 trays.

OK...well, give or take but I've been to dermpath signouts where we had 47 trays total, and that's not including consults. Now, I dunno if that was 150 cases or not...not that we were really counting.

 

[djmd]

Can people do 150 cases per day. Yes. No question (it is still alot.)
150 /day x 5days/week * 45 weeks/year = 33750 cases per year?

150 Prostate 6-12 packs? per day?
Just be sure to keep your grey matter off the slides when you blow your brains out after 500th prostate core of the day.

DPD (and this thread is) talking about URO-PODs.

 

[DarksideAllstar]

Wow talk about missing the point...

Darkside go back and read DermpathDOC's post you quoted. (note it is NOT DPL you're quoting)

AT uropods to make 350k you will have to be SO 150 cases /day.
and yes that is not something most people do/ or even can do?

Dammit! No offense DPDOC. I think in the future you should preface all your posts in big flashing lights that you aren't DPL. I naturally assumed since the conversation involved making mucho dinero that he was the one posting. Carry on.

 

[b&ierstiefel]

Can people do 150 cases per day. Yes. No question (it is still alot.)
150 /day x 5days/week * 45 weeks/year = 33750 cases per year?

150 Prostate 6-12 packs? per day?
Just be sure to keep your grey matter off the slides when you blow your brains out after 500th prostate core of the day.

DPD (and this thread is) talking about URO-PODs.

Fine...so 150 prostates...one block for each side x 3 levels per block = 6 slides per case. 600 slides. 30 trays. Not horrible...prostate bx slides can be read pretty quickly but yeah, I wouldn't be able to keep concentration to do all 30 trays in one sitting. I'd have to take multiple breaks throughout the day.

 

[djmd]

Fine...so 150 prostates...one block for each side x 3 levels per block = 6 slides per case. 600 slides. 30 trays. Not horrible...prostate bx slides can be read pretty quickly but yeah, I wouldn't be able to keep concentration to do all 30 trays in one sitting. I'd have to take multiple breaks throughout the day.

150 prostates...one block for each side x 3 levels per block = 6 slides per case. 600 slides. 30 trays???

150 prostates x 6-10 bx per prostate/3 bx sites per block (different inks), 6 levels (ribbon) per slide. That's only 300-500 slides per day.
But is also 900+ bx sites, with 6 levels each. (see earlier discussion regarding uro-pods money saving by putting 3 cores all in one block)

Don't equate it to other stuff you have done. After 20+ prostate cases with 6-10 Bx sites per prostate, you will have a a hard time looking at new cases. Yes you can eventually read a lot of prostate bxs. But it is easy to get sloppy and miss things. For the same reason they have limits on the number of Gyn cyto screened per day. It starts to run together.

Next thing you know, you are ignoring nerve invasion or miss scoring Gleason grades.

It is a brutal number of prostates to see in a day. 150 prostate Bx SITES do-able. 150 prostates, each with 6 pack + bxs. insane.

 

[b&ierstiefel]

150 prostates x 6-10 bx per prostate/3 bx sites per block (different inks), 6 levels (ribbon) per slide. That's only 300-500 slides per day.
But is also 900+ bx sites, with 6 levels each. (see earlier discussion regarding uro-pods money saving by putting 3 cores all in one block)

Wow...I'm not accustomed to things being done that way. We just put all the cores (usually anywhere from 4-7) in one block...hence my calculation. We don't ink them either. But I haven't seen GU consult cases so I don't know how other outside insitutions process these bx's. And plus, I'm not even talking about cases where different bx's on the same side are designated differently (e.g., right apex, right base, right lateral, etc) in my simplistic calculation. And most of our cases don't even go into that much detail...we just receive 2 containers, one labeled R and one labeled L.

 

[djmd]

And most of our cases don't even go into that much detail...we just receive 2 containers, one labeled R and one labeled L.

They do more localized bx, partly because they can bill for Each Bx.(most hospitals and groups do 6-pack+ Bx)
And then the multiple bx ink, is just a stupid way to save a small ammount of money, as these Uro groups are trying to make as much money from doing the pathology internally.

 

[yaah]

Standard practice here is 12-14 sites, each with one core. Two slides with 2-3 levels each, plus two blanks on each for impox. Yes, that's about 25 slides per patient, double that because we also get two blanks per patient, although obviously we don't look at those. Most outside cases we review here are the sextant type of biopsy - six specimens total, apex, mid, base on each side. Variable number of cores though. Some places still just do "right" and "left" and have multiple cores and fragments.

I'm weird, I really like prostate cores. The guy who performs them here is on vacation this week so I missed out on the day where we get 5-10 patients, each with 12-14 cores. I'm actually disappointed.

Many institutions will refuse to put more than two cores in one block (you increase your chances of missing parts of the core if you do).