Which pathologists have the best and worst lifestyles?

[Histo-Lad]

This came up on another thread talking about "academic pathologists do not have good lifestyle and can work up to 80 hours a week", but (generally speaking) which pathologists work the hardest? Which work the least?

Academics vs community vs pp?
Forensics vs surgical vs derm vs...?

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[KeratinPearls]

This came up on another thread talking about "academic pathologists do not have good lifestyle and can work up to 80 hours a week", but (generally speaking) which pathologists work the hardest? Which work the least?

Academics vs community vs pp?
Forensics vs surgical vs derm vs...?

It varies. Depends on volume and if there’s adequate staffing for the volume.

From what I’ve seen it depends on surgical volume and the group being short staffed. I’ve seen academics who have piles of trays they still have to sign out. Some are not signed out for 1-2 weeks due to being short staffed. Sometimes senior staff have to help out and it’s a matter of time before they get a stroke.

Private groups with high volume are busy too. Some hospitals can’t find a permanent pathologist and have to hire via locums. I’m sure these groups are busy because they don’t have adequate staffing. I’ve seen one hospital that has been hiring locums for 1-2 years now and the one path there can’t do it all himself so they depend on locums and if there’s no locums help that one guy has to do it all or the path service will just collapse.

One guy I know did 8-10,000 surgicals by himself. Don’t think he had much of a life though since he was coming in on weekends.

 

[octopusprime]

The only academic pathologists that have good hours are tenured / professors with several minions beneath them or section chiefs with lots of admin time off of service. They don't gross, but neither do most 5+ person PP groups.
If you're solo PP in a busy practice working +40 hrs/week you're getting abused unless they're paying you RVU or extra time...avg workload, even good work load, path groups shouldn't require weekend work (unless it's self inflicted).

 

[WEBB PINKERTON]

It varies. Depends on volume and if there’s adequate staffing for the volume.

From what I’ve seen it depends on surgical volume and the group being short staffed. I’ve seen academics who have piles of trays they still have to sign out. Some are not signed out for 1-2 weeks due to being short staffed. Sometimes senior staff have to help out and it’s a matter of time before they get a stroke.

Private groups with high volume are busy too. Some hospitals can’t find a permanent pathologist and have to hire via locums. I’m sure these groups are busy because they don’t have adequate staffing. I’ve seen one hospital that has been hiring locums for 1-2 years now and the one path there can’t do it all himself so they depend on locums and if there’s no locums help that one guy has to do it all or the path service will just collapse.

One guy I know did 8-10,000 surgicals by himself. Don’t think he had much of a life though since he was coming in on weekends.

8 to 10 thousand isn't that many. That is not a high volume.

 

[KeratinPearls]

8 to 10 thousand isn't that many. That is not a high volume.

My impression is that most paths do 5,000 surgicals a year. Sure some people do more and some do less based on experience and how the group is designed.

The pathologist I’m referring to is experienced 25 plus years) and was coming in on weekends. He was making great money and bought a bunch of properties using his earnings from path. I have never heard any pathologist doing 10,000 surgicals a year (I’m talking not just biopsies but resections as well) but again I don’t know many other paths outside my friends.

How many surgicals are you and people in your group doing? I’m sure there are some experienced paths doing 10,000 cases a year by themselves but again, I don’t know of anyone doing that much volume.

I know a two pathologist group that was getting hammered on 16,000 surgical cases a year. They were coming in every weekend.

 

[HmanPath]

FP here. I am at work about 40 hrs a week, usually 700-1500. One Saturday a month cutting. Salary will be 325K in July, plus gov benefits. Likely not as good as most PP folks, but the work continues to fascinate/entertain. That being said, this will vary significantly from office to office depending on case load/mix and staffing.

 

[shikimate]

I think the OP's question should ask what setting offers better work to reward ratio.
A fee-for-service pathologist doing 5K cases a year probably complains of not enough work(revenue).
A salaried pathologist doing 2K cases a year probably complains they're overworked.
I know one full-time, salaried pathologist, she does 1700 cases a year, and she says she's on the verge of burning out.
When I go for locums I keep asking the lab the more work but they say they have to save some for their regular pathologist lol.
It's all a matter of marginal utility and incentives.

 

[SunBakedTrash]

There is too much variation between jobs and the definition of lifestyle for this to be a meaningful discussion.

When it comes to dealing with unpredictable stuff in the middle of the night and weekends, I would say blood bank calls and neuropathology frozens are the most disruptive. I doubt most of us deal with those much in the community but it was terrible in training, even for the faculty.

 

[KeratinPearls]

This came up on another thread talking about "academic pathologists do not have good lifestyle and can work up to 80 hours a week", but (generally speaking) which pathologists work the hardest? Which work the least?

Academics vs community vs pp?
Forensics vs surgical vs derm vs...?

Who in academia works 80 hours a week? I mean I’ve seen people stay late and come in on weekends but I’m not sure they work up to 80 hours a week.

I’d prob just hang myself out of misery.

 

[HeyDalaron]

I think the OP's question should ask what setting offers better work to reward ratio.
A fee-for-service pathologist doing 5K cases a year probably complains of not enough work(revenue).
A salaried pathologist doing 2K cases a year probably complains they're overworked.
I know one full-time, salaried pathologist, she does 1700 cases a year, and she says she's on the verge of burning out.
When I go for locums I keep asking the lab the more work but they say they have to save some for their regular pathologist lol.
It's all a matter of marginal utility and incentives.

How much are you getting for locums, what regions are you doing them in, and what is the volume?

 

[coroner]

8 to 10 thousand isn't that many. That is not a high volume.

Not unless you're signing out everything as 'benign' or 'malignant'

Who in academia works 80 hours a week? I mean I’ve seen people stay late and come in on weekends but I’m not sure they work up to 80 hours a week.

The kind of people who need to open a book to sign out a gallbag and spend a half hour on urine cytologies or the new dept. head is a jerk-off causing a mass exodus of half the staff...

 

[mike-sheree]

1) private practice, full partner
2) your own community type 180 bed hospital of which you are medical director.
3) coverage from your main group(30 paths, all subspecialities)
4) own your own histo lab, couriers, billing, etc.
5) not MAJOR urban.

 

[Iceman24]

FP here. I am at work about 40 hrs a week, usually 700-1500. One Saturday a month cutting. Salary will be 325K in July, plus gov benefits. Likely not as good as most PP folks, but the work continues to fascinate/entertain. That being said, this will vary significantly from office to office depending on case load/mix and staffing.

How many cases per year and homicides %?

 

[HmanPath]

How many cases per year and homicides %?

Pathologists each under 250 A eqs. Office last year had 1127 exams, 798 autopsies. We had 69 homicides, which was 9% of autopsies.

 

[KeratinPearls]

From my observations thus far: in my career:

Best lifestyle: private community hospital paths going home at 2 pm. Getting paid 300+. Pretty much any stress free community path job or any job where you aren’t pulled from your desk for meetings, tumor boards so you can just chill and look at slides all day listening to music or podcasts.

VA paths decent pay and chill lifestyle.

Worst lifestyle: paths looking at craploads of cases for low to average pay while making the business savvy owner rich.

Piles of slide folders in their offices. Group is short staffed and members of the group are asked to cover a service when another member of the group calls in sick or has a family emergency.

Youre on vacation and the other path covering the same service as you is sick? Well, you’re getting called in to work by your overlords to cover the service because there’s no one else to do the work. You get sick? Too bad you have to come in coughing and all.

One cannot afford to get sick because there’s no one else to cover certain services. The old owner pathologist refuses to pay more to hire help whether via locums or just anyone, so the paths on staff have to carry the burden. Starting salaries are low and non negotiable.

Some pathologists in the group are doing the work of what a private practice pathologist does in a month in one week. Jobs are available for multiple subspecialties but go unfilled sometimes for over a year.

Pathologists threaten to leave. Greedy old owner has a private talk and convinces them to stay because if they leave the service would entirely collapse.

Plenty of people interview but decline offers of low pay. Old owner of group could care less as long as he collects his money (most likely in the 7 figures with net worth likely in the 8 figures or possibly 9 figures). Pathologists have been leaving the group over the past 5 years and the loyal senior paths have to step in to help out due to short staffing just because the owner is calling the shots. Greed/profits trumps everything.

Greedy old owner is on the board of directors of billion dollar companies and is an operating partner in a private equity firm owned by a well known billionaire.

Junior pathologists are doing late night frozens for transplants as well contributing to more misery. Old owner pathologist and other senior paths are at home asleep.

You work hard. You’re a team player. You teach the residents and have to deal with the residents. It’s a private group but you are paid on an academic scale. In other words, the greedy owner is making $$$ off of you while he’s keeping your salary flat. No partnership. Basically, a flat salaried employee. Total academic scam.

The group has a nice stream of residents and fellows paid for by the academic hospital. Nice stream of cheap labor. Senior pathologists try to recruit residents into their fellowship before becoming a part of the group but some residents are too smart to agree and do their fellowships elsewhere.

You work on research to get promoted all the while the owner is laughing all the way to the bank. You ask for a higher salary. The answer is no. You leave to private but it’s too late the owner has already made craploads of money off of you.

There is an element of collusion going on between the owner and the Chair of the department. Owner calls the shots and Chair just enforces it. Both are most likely making tons of money off the work of their minions. Greedy old owner brags about his 1.6 M house. The other two top senior pathologists are living in 1.5M dollar houses.

The only thing preventing this group from collapsing? Mostly from senior pathologists doing the work of two to three pathologists. Other factors include: location in a large city, hiring paths who need to relocate to the city for family reasons or who just want to be near the city, recruiting recent trainees into the group and getting pathologists on staff to hire their friends into the group. An endless supply of young grads the greedy owner has access to … to man his operation. And the cycle just goes on…more experienced pathologists leave and new young recruits come in.

Moral of the story: don’t work for scumbags. Hopefully this sheds some light on the corruption and collusion going on in our profession. We all should be advocates for one another and we should also spread the word to those unsuspecting, naive uninformed young pathologists out there. An oversupply of trainees allows groups/corporations to operate like this.

Private practices are being bought out. Academic hospitals are buying out smaller hospitals. Lab corp buying out smaller labs. If we don’t advocate for one another we will eventually become indentured professionals to corporations and greedy owners like what I described.

Unfortunately people will still join these groups because some paths are a complacent bunch of people or lack options.

Hopefully this spreads some awareness to any poor schmuck that is considering taking these jobs.

 

[mike-sheree]

Pathologists each under 250 A eqs. Office last year had 1127 exams, 798 autopsies. We had 69 homicides, which was 9% of autopsies.

I recall a weekend in Baltimore during my fellowship in 1986 when we had nine homicides and I was on call. It was me and one staff. Remind me of “the wire“.

 

[Mace1370]

I did a month at Baltimore during residency and there were usually 35-40 bodies per day. Over half were drug deaths. Pretty sad. I respect the people who do FP. It isn't for my. I'd be clinically depressed if I had to do that long term.

I think people with the best gigs from a compensation/time perspective are those who are salaried and are working 6 hour days. Think VA pathologist, government contractor or GS pathologist, etc. They aren't going to make 500k per year, but their $/hour is pretty good and they have great work/life balance.