We are the 99%!

[scienceguy19]

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We are the 99%! We are the 99% of pathologists.
Stop corporations from taking over the practice of pathology.
Stop mega-labs from reaping big profits from pathologists and patients.
Don't allow pathologists with special interests in corporations to represent us in any pathology organization or lobby group.
If we don't act now, they will become the wall street of pathology...
Let's not allow big business and rich CEOs to hijack healthcare.

 

[mlw03]

Care to explain further?

 

[WEBB PINKERTON]

It's too late pretty much. Notice the news lately? PSA, Breast and Cervical cancer screening under fire=a lot less path specimens. My bet is that Thyroid will be debated next. Been keeping track of MedPac cuts? It those go through, it will be the final death nail for many.

If you are practicing, make your money and GTFO. Of course there is gonna be some academic say how great pathology is but he/she isnt in the real world.

 

[scienceguy19]

I guess there's always autopsies for pathologists to do.

It's too late pretty much. Notice the news lately? PSA, Breast and Cervical cancer screening under fire=a lot less path specimens. My bet is that Thyroid will be debated next. Been keeping track of MedPac cuts? It those go through, it will be the final death nail for many.

If you are practicing, make your money and GTFO. Of course there is gonna be some academic say how great pathology is but he/she isnt in the real world.

 

[mlw03]

I guess there's always autopsies for pathologists to do.

that's what i'm counting on.

 

[yaah]

We are the 99%! We are the 99% of pathologists.
Stop corporations from taking over the practice of pathology.
Stop mega-labs from reaping big profits from pathologists and patients.
Don't allow pathologists with special interests in corporations to represent us in any pathology organization or lobby group.
If we don't act now, they will become the wall street of pathology...
Let's not allow big business and rich CEOs to hijack healthcare.

What are your proposals?

It is difficult to have it both ways. Do you want regulations that allow corporations to make profit out of the practice of pathology? Because most private partnership groups are corporations. Or is it just corporations that are "too large" that are not allowed to make a profit? Where do you draw the line? How do you prevent large labs from making profits but not prevent smaller but still very large labs from making profits? How do you increase regulations on large labs without making them just as onerous on smaller labs?

And how do you square the fact that a great many pathologists are perfectly happy working for someone else, be it an academic center, a large hospital, a large reference lab, or even a multispecialty group? Do they not have a say or do we discount their opinions?

I am not saying the proliferation of reference labs, etc, is a good thing for pathology, but it is a natural offshoot of the business of medicine, the push for efficiency, and the regulatory process that allowed for the "golden years" to even exist.

Or are you pushing for more socialized-type medicine where such profit is not allowed? You can't have less government involvement AND less big corporation involvement. Well, I suppose you can if you drastically cut reimbursement so that no one can make any profit. But I doubt you are proposing that. So what are you proposing?

 

[scienceguy19]

I think that ideally, the pathologists should be able to bill directly for their services in the form of a professional component. The entire professional fee component should be mandated to be paid only to the physician. Other individuals and shareholders should not be able to 'profit' from receiving this professional fee payment. This professional component should comprise the majority of the physician income. The technical component reimbursement should be kept to a minimum, enough to cover operating costs. This will require government intervention to work, of course. The government should get involved because it would lead to an overall lower cost of healthcare in addition to happier pathologists who don't feel exploited.

My understanding of the current situation is that the professional component is low relative to the technical component. Corporations are currently allowed to profit from both the professional and the technical component, taking money away from the physician. Of the bill that patients receive for their biopsies, a large portion goes to paying corporations, CEOs, and shareholders rather than pathologists, pathology assistants, and histotechs. Hopefully we may rectify this situation.

What are your proposals?

It is difficult to have it both ways. Do you want regulations that allow corporations to make profit out of the practice of pathology? Because most private partnership groups are corporations. Or is it just corporations that are "too large" that are not allowed to make a profit? Where do you draw the line? How do you prevent large labs from making profits but not prevent smaller but still very large labs from making profits? How do you increase regulations on large labs without making them just as onerous on smaller labs?

And how do you square the fact that a great many pathologists are perfectly happy working for someone else, be it an academic center, a large hospital, a large reference lab, or even a multispecialty group? Do they not have a say or do we discount their opinions?

I am not saying the proliferation of reference labs, etc, is a good thing for pathology, but it is a natural offshoot of the business of medicine, the push for efficiency, and the regulatory process that allowed for the "golden years" to even exist.

Or are you pushing for more socialized-type medicine where such profit is not allowed? You can't have less government involvement AND less big corporation involvement. Well, I suppose you can if you drastically cut reimbursement so that no one can make any profit. But I doubt you are proposing that. So what are you proposing?

 

[pathstudent]

While I agree the world of private practice pathology is very corrupt and what is essence fee splitting is ubiquitous for the lucrative derm, gi and prostate cases, but how can you propose that the pc component be mandated to the pathologist that made the diagnosis. That doesn't exist anywhere except in the instance where you have a solo practioner. Junior academics don't get 100% of their pc. New hires in private practice don't get anywhere near 100% of their pc. If you mandate that you are destroying private practice and academics as it has been done for decades.

 

[lipomas]

Yeah it's hard to write these rules. Too many "legitimate" practices take advantage of the same things. The "self referral" thing needs to be addressed though. For some reason no one can really do a great study that proves these yahoos overutilize labs (or radiology if they own that).

There are only so many things you can do without moving to socialized medicine. I see a lot of complaints on here about "OBAMACARE" and "SOCIALIZED MEDICINE" and all that. But a lot of the real world complaints seem to be mostly directed at the free market and not the socialized aspects. Sure, medicare reimbursement has issues that warrant complaint. But those aren't the major gripes on here! I am sensing hypocrisy.

What is interesting is that most practicing pathologists are not truly part of the occupy wall street folks' 99%. 😉 So you are not going to get a lot of sympathy from anyone outside the field. Sorry but that's the way it is.

 

[scienceguy19]

Yeah unfortunately, the unemployed artists and english majors protesting on wall street could care less about the situation of pathologists.

Yeah it's hard to write these rules. Too many "legitimate" practices take advantage of the same things. The "self referral" thing needs to be addressed though. For some reason no one can really do a great study that proves these yahoos overutilize labs (or radiology if they own that).

There are only so many things you can do without moving to socialized medicine. I see a lot of complaints on here about "OBAMACARE" and "SOCIALIZED MEDICINE" and all that. But a lot of the real world complaints seem to be mostly directed at the free market and not the socialized aspects. Sure, medicare reimbursement has issues that warrant complaint. But those aren't the major gripes on here! I am sensing hypocrisy.

What is interesting is that most practicing pathologists are not truly part of the occupy wall street folks' 99%. 😉 So you are not going to get a lot of sympathy from anyone outside the field. Sorry but that's the way it is.