Torn between rads and path--$ considerations

[Shredder]

---

Members do not see this ad.

Money aside I would choose path...but that is money aside. Are there opportunities in path to make as much as rads? Some rads can go very high like beyond 500k-1M even, I believe. Do any paths do this? How can I research this on my own? I want to make a well-informed decision come ranking time. I doubt I will rank anything besides these two.

Path residency and lifestyle seem comparable to rads but easier on both counts. From what I read, path residency and lifestyle seem to be among the lightest of all fields. I'm not lazy but I have outside interests I want to pursue in business and investing so light+predictable hours are a big plus.

One more thing--will it make a difference which program I enter? I don't plan on doing anything academic/research at any point, just practicing and making $ with spare time on the side. Sry if my tone's flippant, I wrote this post quickly and am basically just wondering about the comparison between the two specialties. And I am wondering about income potential in both and how to achieve it. Thanks guys

*I'm going to check the FAQs again, it's been a while

 

[djmd]

Money aside I would choose path...but that is money aside. Are there opportunities in path to make as much as rads? Some rads can go very high like beyond 500k-1M even, I believe. Do any paths do this? How can I research this on my own? I want to make a well-informed decision come ranking time. I doubt I will rank anything besides these two.

Path residency and lifestyle seem comparable to rads but easier on both counts. From what I read, path residency and lifestyle seem to be among the lightest of all fields. I'm not lazy but I have outside interests I want to pursue in business and investing so light+predictable hours are a big plus.

One more thing--will it make a difference which program I enter? I don't plan on doing anything academic/research at any point, just practicing and making $ with spare time on the side. Sry if my tone's flippant, I wrote this post quickly and am basically just wondering about the comparison between the two specialties. And I am wondering about income potential in both and how to achieve it. Thanks guys

*I'm going to check the FAQs again, it's been a while

Check the FAQ, do a search, then go into business.

 

[LADoc00]

I was at the same branch point in my decision making although I thought about this well prior to attending medical school. Rads and path are similar.

As for compensation, there are poor radiologists and well off pathologists and vice versa. If you are looking for some odds ratio for this, Im not sure who can help you.

I will give you this cherry piece of advice and not even charge you for it:
Medicine like all of business can be very profitable at the fringe. The fringe is an area where the margins are high because the consumer doesnt understand the cost of doing business well. Fringes can be achieved through one of two ways: either you can be in fringe industry that is poorly understand, small and doesnt attract scrutiny or be in a fringe location where your costs are low and your competition is absent.

If you really follow that advice you will be successful regardless of the speciality you choose.

 

[yaah]

Path residency and lifestyle seem comparable to rads but easier on both counts. From what I read, path residency and lifestyle seem to be among the lightest of all fields. I'm not lazy but I have outside interests I want to pursue in business and investing so light+predictable hours are a big plus.

Any residency can be light if you don't work at it. Path residency is just as grueling as others if you are interested in being an excellent pathologist. Perhaps there are fewer requirements.

You may not be lazy but you sound like you're willing to compromise your education (and your residency duties) as well as your career beyond that for your own side needs. This is going to make things more difficult. It is also going to make it more difficult to actually be the success you think is so attainable.

There is no real easy path to big money, if there was, the big money would decrease (because everyone would want to do it). You make big money by some combination of being lucky, being smart, having great timing, or often by being a prick and taking advantage of others (sad to say).

Income potential also depends to a great extent on the future (much of which is unknown). If you can predict the future this well you don't even need to be in medicine.

 

[schrute]

I'm glad to see my competition for residency takes a genuine interest in the field rather than selecting the field with the highest life$tyle/work ratio.

I'm not trying to be flippant either, but is there anyone entering path nowadays that has a sincere interest for the science & biology behind this field?

Everyone always says how path is getting more competitive...undoubtedly because the people that would normally enter other specialties take advantage of the lifestyle of pathologists.

I'm not a trench coat-wearing nerdo (quite the opposite), but path to me seemed one of the fields with the most intellectual capital and honest-to-goodness love of science. Guess I should buck up and drop the nostalgia...I suppose 21st century healthcare is to blame.

 

[LADoc00]

Gee whiz, I wish you had been around before I got my MBA and I wouldn't have wasted all that time and money! I never knew it was all so simple!

See how much $ you couldve saved by reading my posts on SDN earlier!!!

 

[mlw03]

don't let the comments of one person influence your opinion of all of us going into pathology. any specialty requires effort to be good - period. nothing is easy in medicine. plenty of us are still going into path because we find it interesting. if the OP really wants to make lots of money without a lot of work, medicine ain't the place to do it.

I'm glad to see my competition for residency takes a genuine interest in the field rather than selecting the field with the highest life$tyle/work ratio.

I'm not trying to be flippant either, but is there anyone entering path nowadays that has a sincere interest for the science & biology behind this field?

Everyone always says how path is getting more competitive...undoubtedly because the people that would normally enter other specialties take advantage of the lifestyle of pathologists.

I'm not a trench coat-wearing nerdo (quite the opposite), but path to me seemed one of the fields with the most intellectual capital and honest-to-goodness love of science. Guess I should buck up and drop the nostalgia...I suppose 21st century healthcare is to blame.

 

[1Path]

I think I'm gonna be sick!

 

[trent05]

I also had difficulty in choosing between the two fields. I think path has a better lifestyle on average than rads. I think the average community pathologist works less hours than the average community radiologist and I think the pathologist has a lighter workload. That being said, with Rads it is easier to find a job and the average salary is significantly higher. If your goal is to make 500+K then Rads is definitely your best option. You will have to work for that kind of money, even in Rads. So if your goal is the highest possible salary Path would be a poor choice IMHO.

 

[DarksideAllstar]

I would echo trent05's sentiments-- in private rads you will be working very hard to earn the type of income that you are quoting. Most rads who earn this are interventional radiologists working at a very busy community hospital taking a fair amount of call. Diagnostic radiologists earning lots of $$ are probably also doing a lot of call-- at my med school the private rads people (some of whom had been out >10 years) were still doing overnights. I would look for the average salary of radiologists to drop, as there have been some changes to the way that they bill patients when they use MRI/CT at their own outpatient centers. Not sure of the specifics, but many people have told me that this will negatively impact salaries.

I was also deciding between Rads and Path-- I enjoy aspects of both fields, but ultimately I just enjoyed my path experience more than I did my rads experience.

 

[Playmakur42]

Pick the area of medicine you enjoy the most for the sake of your patients and your own sanity.

There are always ways to supplement your income if you so desire.

 

[Louisville04]

Diagnostic radiologists earning lots of $$ are probably also doing a lot of call-- at my med school the private rads people (some of whom had been out >10 years) were still doing overnights.

At the hospital I am at the radiologists have a program called nighthawk? where overnight films are read in Hawaii (or some other distant location)

 

[dermpathlover]

if you like both about the same then definitely do rads. Under the current system rads make twice as much as paths on average when comparing docs working at the same hospital.

BOth fields are under attack, but rads are always figuring out new things to do and technology moves so rapidly that they are always moving forward. In path technology is always perceived as a threat that will make the H&E slide (which is going on 200 years old) history.

 

[CameronFrye]

At the hospital I am at the radiologists have a program called nighthawk? where overnight films are read in Hawaii (or some other distant location)

I believe Nighthawk is based in Australia, but I'm not 100% sure on that.

 

[DarksideAllstar]

BOth fields are under attack, but rads are always figuring out new things to do and technology moves so rapidly that they are always moving forward. In path technology is always perceived as a threat that will make the H&E slide (which is going on 200 years old) history.

While true, one of the major cash cows for rads is having their own scanners. Based on some new billing rules, their salaries will decrease unless they up their volumes to compensate. IR will be lucrative, but be prepared to live like a general surgeon.

At the hospital I am at the radiologists have a program called nighthawk? where overnight films are read in Hawaii (or some other distant location)

They are based out of Australia and Switzerland. They are also accredited by JCAHO, which I don't think most people realize. Here's some more info: http://www.nighthawkrad.net/ . Keep in mind that your group probably has to pay a premium to obtain these services, and not all groups subscribe, as it costs you money in the end.

 

[Tiki]

I'm going through the same decision right now, rads vs. path but I don't really care about the difference in salary. I'm currently on a radiology elective and I like it more than I thought I would. I'm still leaning more towards path (80% Path, 20%Rads) but I'm holding off my decision until I do a more formal Path elective.

Anyway, I agree with everyone else in that you shouldn't choose something based on money. This is what you are going to be spending your life doing, you should make sure you like it.

 

[LADoc00]

While true, one of the major cash cows for rads is having their own scanners. Based on some new billing rules, their salaries will decrease unless they up their volumes to compensate. IR will be lucrative, but be prepared to live like a general surgeon.



They are based out of Australia and Switzerland. They are also accredited by JCAHO, which I don't think most people realize. Here's some more info: http://www.nighthawkrad.net/ . Keep in mind that your group probably has to pay a premium to obtain these services, and not all groups subscribe, as it costs you money in the end.

why would it neccessarily cost you money? Why couldnt Nighthawk just get the billing info and bill for their professional fees directly to payors???

 

[pathstudent]

why would it neccessarily cost you money? Why couldnt Nighthawk just get the billing info and bill for their professional fees directly to payors???

Moreover, you might even be able to make some money. Just like in path there might be some MBAs who have gotten some unfortunate radiologists to work for them. The radiologists working for the MBAs are on salary and then the MBAs and the private group of radiologists can split the professioinal fee.

 

[Shredder]

Where do you guys find the $ numbers that you are citing? I would like to find these--and beyond the simple means and medians that most sites list. Since few people actually sit right at the median, what factors cause people to go above or below that on the bell curve? What would be really helpful are distributions for the various specialties rather than a few discrete numbers. I'd like to see path and rads superimposed. If I liked the two equally I'd do rads, but I prefer path thus the dilemma.

Why is technology perceived as a threat in path rather than an opportunity? Even if it hurts many, if will greatly benefit the few innovators. Not to mention patients and healthcare overall. And if you cant beat em join em

Thanks all

 

[Meatwad]

Doesn't dermatopath pay real well? Sure you've got to do a fellowship, but that will give you the two things you want most: path + money.

 

[path19]

Good luck getting that dermpath fellowship. I'm sure if you explain your reason for wanting it ($$$) they may consider your application more seriously. Even better, you could expalin it to the residency programs that also have dermpath fellowships and they just might offer you a combined residency-dermpath spot, kind of like AP-NP. 🙂

 

[DarksideAllstar]

why would it neccessarily cost you money? Why couldnt Nighthawk just get the billing info and bill for their professional fees directly to payors???

It is essentially lost revenue (ie costs the group money). I've talked with rads in a couple of private groups who prefer to take their call and keep the $$--not ship it off to NightHawk.

 

[dwil75]

I'm not trying to be flippant either, but is there anyone entering path nowadays that has a sincere interest for the science & biology behind this field?

I think some people do... and I do. I just started a path residency, having switched from a clinical residency. It's fascinating and learning this sort of material is why I was drawn to medical school, not to do endless social work, messages, and paperwork. (I'm glad there are people who do this... but just saying, it was never my thing.)

I think even though the hours are technically much shorter than what I was doing, I spend much more time at home reading for work than I ever used to do. It's not easy material and I'm realizing how much basic science I need to relearn to get good at this job. I go in early and stay late many days... because I want to. When I was a clinical intern, the highlight of every day used to be crossing that day off on a calender when it was through, but these first two weeks have flown by.

I don't know about other people, but thanks to path, I love medicine again 😛

 

[djmd]

Where do you guys find the $ numbers that you are citing? I would like to find these--and beyond the simple means and medians that most sites list. Since few people actually sit right at the median, what factors cause people to go above or below that on the bell curve?

The people who don't have this attitude

residency .... light+predictable hours ...

and the lucky.

 

[yaah]

I'm not trying to be flippant either, but is there anyone entering path nowadays that has a sincere interest for the science & biology behind this field?

I think some people do... and I do.

Don't worry, there are lots of people who really do like the field - generally they often become the successful ones also. It is true, a lot of financial success in life comes from luck and chance and related issues, but job satisfaction comes from liking what you do.

 

[docbiohazard]

Don't worry, there are lots of people who really do like the field - generally they often become the successful ones also.

I am interested in Pathology because of the field, the science behind it, the related research opportunities and the interaction with my fellow physicians. I think if you choose a speciality based upon percieved future compensation you're running a high risk of being miserable, unless you're the kind of person who's comfortable doing just about anything it it means making more cash at the end of the day...

BH

 

[Tiki]

I am interested in Pathology because of the field, the science behind it, the related research opportunities and the interaction with my fellow physicians. I think if you choose a speciality based upon percieved future compensation you're running a high risk of being miserable, unless you're the kind of person who's comfortable doing just about anything it it means making more cash at the end of the day...

BH

I agree. I'm sure this sounds totally naive, but I don't really care about the money. Well, that's not totally true. I care that I make enough in my future career to pay back my loans and live comfortably, maybe take a vacation once a year. But I feel like any of the specialties (including Peds and Psych) would give me enough money to do that.

What I really care about is being able to wake up in the morning and not dread going into work. I've worked a lot of crappy jobs before medical school, and it sucks to hate your job.

I love Path because I find it to be intellectually stimulating, I love that it actually utilizes science, and it allows me to do research and teach if I so choose.

 

[LADoc00]

Im not interested in the exact amount of the compensation as long as it somewhere north of "Baller" territory.

 

[yaah]

What I really care about is being able to wake up in the morning and not dread going into work. I've worked a lot of crappy jobs before medical school, and it sucks to hate your job.

Interestingly, I still wake up in the morning and actually look forward to going into work a lot of the time. There are times when I would rather stay home, of course, and a lot of the time I could do with a bit less workload, but I really like what I do. Kind of insane, I guess, but whatever. Guess I found the right job for me.

Now, I really HATED third year of med school, and most of fourth year also. When it was time to go home I actually got excited.

 

[KeratinPearls]

Im not interested in the exact amount of the compensation as long as it somewhere north of "Baller" territory.

I've always wondered what type of salary is considered "north of Baller territory?"

>500K/year? 1 mil/year? >1 mil/year?

 

[LADoc00]

I've always wondered what type of salary is considered "north of Baller territory?"

>500K/year? 1 mil/year? >1 mil/year?

Depends really. Your basic West Coast baller is looking at being a minimum of 500, maybe more depending on location (SF, LA being more). Your NYC baller is a much higher bar, min. of 7 digits there. Rarely does a MD outside of a dermpath, neurosurgeon or plastics guy with their own corp. reach that layer cake. Boston you are also screwed as I believe the last baller convention in Orlando in 2006 established the AMA guidelines near 7 dig's in the greater Boston and DC areas.

Texas baller is different. There you have a basic and advanced baller. Usually 350 and 600 are the cutoffs.

 

[DarksideAllstar]

Depends really. Your basic West Coast baller is looking at being a minimum of 500, maybe more depending on location (SF, LA being more). Your NYC baller is a much higher bar, min. of 7 digits there. Rarely does a MD outside of a dermpath, neurosurgeon or plastics guy with their own corp. reach that layer cake. Boston you are also screwed as I believe the last baller convention in Orlando in 2006 established the AMA guidelines near 7 dig's in the greater Boston and DC areas.

Texas baller is different. There you have a basic and advanced baller. Usually 350 and 600 are the cutoffs.

Ortho Spine does very well, probably better than most plastics. We had a baller Ortho Spine guy at my med school roll up to the county hospital parking garage in his Aston Martin-- now that is ballin' at its best (ala Paul Wall).

 

[b&ierstiefel]

Interestingly, I still wake up in the morning and actually look forward to going into work a lot of the time. There are times when I would rather stay home, of course, and a lot of the time I could do with a bit less workload, but I really like what I do. Kind of insane, I guess, but whatever. Guess I found the right job for me.

Now, I really HATED third year of med school, and most of fourth year also. When it was time to go home I actually got excited.

I do too. I find the diagnostic work to be challenging and quite fun.

As for medical school, I hate the clinical clerkship phase more and more now that I am more removed from it. The memories aren't pleasant and I'm glad those times are behind me. The first two years of med school where we actually studied pathophysiology were much more rewarding. I symphathize with what the poor MS3's and MS4's have to deal with when I meet them during their pathology rotations.

Back to the original topic...Shredder, if you want to make money, go into Rads. With pathology, the money can be good but you may have to settle and get a high paying job in some middle-of-nowhere town. I don't know how Rads is but in pathology, I hear this complaint all the time.

 

[KeratinPearls]

Ortho Spine does very well, probably better than most plastics. We had a baller Ortho Spine guy at my med school roll up to the county hospital parking garage in his Aston Martin-- now that is ballin' at its best (ala Paul Wall).

Isn't the malpractice for ortho spine high? By baller, I mean someone who can make a great living with minimal work-related stress. Neurosurgery doesn't cut it. Nor, does ortho spine. Ppl in the OR are miserable in general.

I would include derms, radiologists, plastic surgeons in the baller category for sure. With good business sense, these guys can rake it in nasty style.

http://www.icedoutgear.com/media/Pimp%20Gobleet.jpg

I wonder what's the most amount of $$$ you've ever heard a physician make? Let's hear it.

 

[LADoc00]

Prem Reddy is the no. 1 earning physician in the Western US and I would guess top 3 in the US in general. He makes Bernie Ackerman look like a down and out hobo on skidrow. (There is one other guy in his ballpark but he is an Ortho guy whos income comes almost solely from patents, others including MD-CEOs of big insurance and biopharma are excluded for purposes of this comparison)

Reddy has a net worth in excess of 300 million USD. Do an internet search if you are interested.

I would include Ortho spine/Neuro in 1 group. Both are around 800K-1.5M depending on payor mix and set up. Much more if you have ownership in a surgery center (would guess that might double you to a ~3M).

The numbers I quote are after expenses, so malprac is already calculated.

This is merely mental masturbation tho because it would near impossible for anyone coming out of training now to get anything near this. That window has completely closed...

Lifestyle between path and rads are nearly identical IMO with the advent of Nighthawking. I would say the AVERAGE Rads person makes MUCH MORE than path (almost 2x) due to the huge amount of path overtraining and corresponding rads undertraining. If you are a hedge the bets type, I would go rads.

 

[schrute]

LA, I wonder if the ortho guy you're referring to is from MI...my friend went to a birthday party at this ortho doc's house...apparently he has several patents, most notable the one for the major TKR hardware used by most orthos.

he said it was just sick...the guy didn't have 'a' bentley, he had a collection of them. he gave a grand tour to show off his decorating skills. the furtniture was genuine 17th century French royalty...like Louis the 14th or someting.

he's like p. combs...money hangin out the anus...and got a benz that he aint even drove yet.

 

[docbiohazard]

Hey, no matter what field you go into, you can always come up with some sort of weight loss or male anatomy enlargement "herbal" remedy and market it on QVC, HSN, and late night cable infomercials... then sit back and watch the money roll in... I think, if current TV advertisements are any proof, you don't even have to be done with residency yet...

Its all about the side businesses - get on the board of a biotech startup, write a self-help/diet book, sling some herbs...

BH

 

[TheCritic]

Money aside I would choose path...but that is money aside. Are there opportunities in path to make as much as rads? Some rads can go very high like beyond 500k-1M even, I believe. Do any paths do this? How can I research this on my own? I want to make a well-informed decision come ranking time. I doubt I will rank anything besides these two.

Path residency and lifestyle seem comparable to rads but easier on both counts. From what I read, path residency and lifestyle seem to be among the lightest of all fields. I'm not lazy but I have outside interests I want to pursue in business and investing so light+predictable hours are a big plus.

One more thing--will it make a difference which program I enter? I don't plan on doing anything academic/research at any point, just practicing and making $ with spare time on the side. Sry if my tone's flippant, I wrote this post quickly and am basically just wondering about the comparison between the two specialties. And I am wondering about income potential in both and how to achieve it. Thanks guys

*I'm going to check the FAQs again, it's been a while

I hate to encourage the original poster, but I heard a quote from a recent hemepath fellow citing 250k to start and a 75k a year raise for up to five years--maxing her out at 725k. No BS. Obviously not common place though.

 

[LADoc00]

I hate to encourage the original poster, but I heard a quote from a recent hemepath fellow citing 250k to start and a 75k a year raise for up to five years--maxing her out at 725k. No BS. Obviously not common place though.

There is NO F_CKING WAY you can make 725K year doing hemepath. Hate to burst bubbles but Medicare allowable for >18 antibodies by flow is a mere 127 dollars. The highest non-dermpath salary I have ever heard of....EVER...is in the mid 600s and that is with THE top groups on the West Coast and require huge buyins, like HUGE buyins.

Can you make 725K?? Yes, absolutely yes. But why would I as an employer pay a hemepath fellow 725K a year when I can hire someone for 250K EASILY and have like 200+ applicants??

I know pathology billing, I live, eat and sleep it. I know what a good payor mix is. You can make big bucks but really only if you are majority owner or at least a sizable shareholder in a solid pathology S-corp.

Think about it, there is no one on EARTH I would hire to do hemepath for 725K, there is no one even remotely that good. With those terms, you could EASILY hire away the most well known hematopathologists at BWH, JHU, Cornell or Stanford, why would you get a trainee?? Is she is isanely hot? Is she Jessical Biel, Elisha Cuthbert and Kate Beckinsale rolled into one? There must be more to this story....

who is this fellow?

http://www.hecklerspray.com/wp-content/uploads/2006/09/kate%20beckinsale.jpg



350K is reasonable, 750K is a pipedream unless you really have your shiat together.

 

[TheCritic]

Texas baller is different. There you have a basic and advanced baller. Usually 350 and 600 are the cutoffs.

Texas baller is probably more like:

Beginner: 250K
Intermediate: 350-500K
Advanced: >500K

 

[TheCritic]

There is NO F_CKING WAY you can make 725K year doing hemepath. Hate to burst bubbles but Medicare allowable for >18 antibodies by flow is a mere 127 dollars. The highest non-dermpath salary I have ever heard of....EVER...is in the mid 600s and that is with THE top groups on the West Coast and require huge buyins, like HUGE buyins.

Can you make 725K?? Yes, absolutely yes. But why would I as an employer pay a hemepath fellow 725K a year when I can hire someone for 250K EASILY and have like 200+ applicants??

I know pathology billing, I live, eat and sleep it. I know what a good payor mix is. You can make big bucks but really only if you are majority owner or at least a sizable shareholder in a solid pathology S-corp.

Think about it, there is no one on EARTH I would hire to do hemepath for 725K, there is no one even remotely that good. With those terms, you could EASILY hire away the most well known hematopathologists at BWH, JHU, Cornell or Stanford, why would you get a trainee.

350K is reasonable, 750K is a pipedream unless you really have your shiat together.

Fair enough. I'm just saying what I heard. Maybe it's bullsh*t. 250k to start with some sort of yearly raise seems very reasonable though. I'm pretty sure she wasn't just going to be doing hemepath.

 

[LADoc00]

I will add that once every 10 or so years a super resident/fellow comes along and because of his superior connections/social skills lands what I would consider the dream gig. It is rare. Does happen. Im not calling total BS on your story but Im skeptical.

Breaking into the 700s is really reserved for a select few. I would doubt during an interview they would just flop that. Something akin to Ben Affleck throwing the keys to his Ferrari on the table when he is interviewing new brokers in "Boiler Room"...makes for a theatrical story amongst trainees but almost never happens.

You Want details? Fine. I drive a Ferrari, 355 Cabriolet, What's up? I have a ridiculous house in the South Fork. I have every toy you could possibly imagine. And best of all kids, I am liquid.

 

[106174]

if bruiser is from utsw or has connections to our program, then i think i know who s/he is talking about.

2 of our recent graduates landed jobs within the dallas-fort worth metroplex and they each signed very similar contracts. start at 250-275K, yearly increase of 50-75K, then partner in 3-4 years, during which time they will make anywhere from 700-800K. practice involves general surg path plus hemepath.

if one takes LADoc's arguments, then i guess both of our graduates are either delusional or big time liars.

 

[Meatwad]

Isn't the malpractice for ortho spine high? By baller, I mean someone who can make a great living with minimal work-related stress. Neurosurgery doesn't cut it. Nor, does ortho spine. Ppl in the OR are miserable in general.

I would include derms, radiologists, plastic surgeons in the baller category for sure. With good business sense, these guys can rake it in nasty style.

I wonder what's the most amount of $$$ you've ever heard a physician make? Let's hear it.

Hmm, a baller is money AND lifestyle? Easy; they are called orthodontists.

 

[CameronFrye]

I've heard of starting salaries for heme in the 200's. However, I've never heard of the pay accelerating so quickly. 700k four years out of training? Something sounds fishy. People just don't give away money for nothing. Are these jobs 70+ hours per week? Or perhaps there is an obscene buy-in. The finances don't make sense.

 

[LADoc00]

Someone flopping 700-800K nuts to fellows at UTSW is a serious RED FLAG.(or to fellows at ANY program)

There are many ways to make illegal gains in the Pathology, most of which involve Medicare/Medicaid fraud on very large scales. Im not specifically claiming anything and I dont know who/what this entity that is paying 35-year old docs 725K in salary... Read that last sentence again. This reeks of a 'Boiler Room' operation.

My guess is anytime you are 4-5 times the average salary of a Pathologist in the Dallas metro area, you HAVE to ask how they produce those sorts of margins.

I have interviewed for 20+ jobs in 4 different states in my time AND even the "gems" never flopped digits that big.

[The 90th percentile for the Dallas Metro area is about 300K in Pathology for salary.com and about 350-400K for last CAP survey.]

 

[Shredder]

I've been keeping up with the thread btw, thanks all. I'm still torn--I'll have to assess the outlook once I see how I do on the USMLE next year. I'll also have to look at the job market going into third or fourth year. I like path more but not enough more to overlook potentially 2x more remuneration in rads, if I have the good fortune of being able to match in either. 2x more remuneration is enough to offset the prelim year and whatever other considerations I cited. True, nighthawking is a huge lifestyle perk.

Of course this is also the path forum so there will be more of a tilt in that direction, but since I like path more I decided to post it here.

 

[pathstudent]

It is essentially lost revenue (ie costs the group money). I've talked with rads in a couple of private groups who prefer to take their call and keep the $$--not ship it off to NightHawk.

How many emergency radiology reads need to be done in the middle of the night? I know they are common, expecially at places with trauma, but my guess is that it is a small percentage compared to the number of imaging studies done over a period of a day.

 

[pathstudent]

i think there was a time, maybe before 5-10 years ago when hospital pathology practice could be very lucrative and very interesting. You had a nice mix of stuff out of the o.r. mixed in with a healthy supply of g.i. biopsies, prostate biopsies and skin biopsies. But now the people that produce those biopsies (which are technically easy to gross and process and have the highest reimbursement/time spent on case) have realized that they can not give that stuff to their colleagues in pathology and can make a little cash themselves. It has forced pathologists to survive on what comes out of the o.r.

The only thing we can hope for is if the federal gov't cuts the technical component considerably (so you get paid $x for the first container in the case and a nominal fee for each one after that). Then the outside entities won't have the same motivation to keep those biopsies for themselves. Pathologists in the future will never know what it is like to own a histo lab, but we have lost that already and at least we might get the professional component back.

I used to think that our best hope was if the federal gov't outlawed POD labs (out of ethical reasons), but that isn't going to happen because the federal gov't is all about for profit medicine and even if it did happen, they would probably grandfather in currently operating pod labs.

So, now I think our best hope is to have the technical component slashed so that it becomes almost impossible to make a buck off it.

 

[trent05]

Maybe it is something about Texas. I heard from a friend of mine at Baylor that they had two cytopath fellows that got jobs with solid starting salaries and partnerships at 600K+. I think they were located in more rural areas of Texas, but still.