Why pathology could downdraft ANOTHER 50% in total manpower and still be crazy overstaffed.

[LADoc00]

Look at this ad from CAP: We are looking for a Board certified or Board eligible pathologist to join our group of six private hospital based practice pathologists in [REDACTED]. The job can either be a partnership or non-partnership track position. We provide coverage for three area community hospitals that have a combined capacity of 672 beds. The hospitals have a combined surgical pathology workload of 17247 cases, 11113 gynecologic smears and 1923 non-gynecologic cytology cases. AP/CP experience is preferred, as is subspecialty training.

Those numbers make no sense. 17K surgicals across 6 FTEs is 2800 per FTE. 2800. That is like 2 months of work. What are they are doing for the other 10 months per year?? Knocking down 1800 pap smears per guy/gal? Wow. Stop the presses at CAP, they are massively short staffed at the moment...

This is absurd. At that volume they need 3 guys. THREE. Dump the paps to Quest if they are dragging your admin time into the sewer. They are the lowest margin of all possible work aside from ROSE when you account for the cost of the cytotech etc.

Currently, I think most groups are in pseudo retirement mode or something.

At 7 guys, they are looking at 12, TWELVE cases per day*. Assuming 5 cases are GI biopsies, 3 are routine surgicals like gallbladders, appendix etc, 2 routine derm and 2 are subspec/oncology cases that is MAYBE MAYBE 30 minutes of work. What are they are gonna do for the other 6-7 hours?? Sip coffee? Attend meetings? Read SDN? Comment on cat videos on youtube???

Current manning in Pathology is bonkers. So feel free to ignore all this nonsense about a huge pathology shortage, we have MILES to go folks.

*17000 cases/200 workdays per year/7 FTEs = 12.14285 cases per day per FTE. If you make the assumption one FTE is always on vacation (6-7 weeks of vacation per year), then its a whopping 14.16666 cases per day per FTE.

7 weeks of vacation and 30 minutes of work a day when you do put on pants and show up? Seriously??

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[WEBB PINKERTON]

Most fill out their day dealing with the drama in THEIR lives. Seems like everyone I know has troubled kids/young adults that cause them to leave regularly so they can drive them to court, job, appointments etc.

Jobs with that kind of productivity won't last too much longer. What a waste.

 

[deleted314957]

Most fill out their day dealing with the drama in THEIR lives. Seems like everyone I know has troubled kids/young adults that cause them to leave regularly so they can drive them to court, job, appointments etc.

Jobs with that kind of productivity won't last too much longer. What a waste.

I’ve been saying this for years. I think it must be a requirement that all groups have 4 more paths than one would reasonably expect. This is so they can always get a foursome together for an all-day bridge marathon.

 

[LADoc00]

I met a sales rep last month who told me a neighboring hospital has 5, FIVE PATHOLOGISTS doing less work than just me. I couldnt believe it. She said they only each work 1-2 days per week because that is all the stress their snowflake CNS can process. Then they recharge for 5 days and rinse repeat.

This entire country maybe to going straight into some Idiocracy-type of apocalypse. Are any other SDNers worried about this but me??

 

[stickyshift]

How in the hell do these people make a living?

 

[Alteran]

I met a sales rep last month who told me a neighboring hospital has 5, FIVE PATHOLOGISTS doing less work than just me. I couldnt believe it. She said they only each work 1-2 days per week because that is all the stress their snowflake CNS can process. Then they recharge for 5 days and rinse repeat.

This entire country maybe to going straight into some Idiocracy-type of apocalypse. Are any other SDNers worried about this but me??

12 cases a day

On a slow day I do 30 and on my busier days I can do over double that thanks to efficiencies we built into our practice. We do more cases than the local regional university hospital with one third the staffing....and have better turn around time.

But to your point as I've already said this in another forum, the quality of the pathologists I've seen come through my practice and from what I've heard of is diminishing. The only thing that isn't diminishing is the number of these pathologists, unfortunately.

 

[y2k_free_radical]

Look at this ad from CAP: We are looking for a Board certified or Board eligible pathologist to join our group of six private hospital based practice pathologists in [REDACTED]. The job can either be a partnership or non-partnership track position. We provide coverage for three area community hospitals that have a combined capacity of 672 beds. The hospitals have a combined surgical pathology workload of 17247 cases, 11113 gynecologic smears and 1923 non-gynecologic cytology cases. AP/CP experience is preferred, as is subspecialty training.

Those numbers make no sense. 17K surgicals across 6 FTEs is 2800 per FTE. 2800. That is like 2 months of work. What are they are doing for the other 10 months per year?? Knocking down 1800 pap smears per guy/gal? Wow. Stop the presses at CAP, they are massively short staffed at the moment...

This is absurd. At that volume they need 3 guys. THREE. Dump the paps to Quest if they are dragging your admin time into the sewer. They are the lowest margin of all possible work aside from ROSE when you account for the cost of the cytotech etc.

Currently, I think most groups are in pseudo retirement mode or something.

At 7 guys, they are looking at 12, TWELVE cases per day*. Assuming 5 cases are GI biopsies, 3 are routine surgicals like gallbladders, appendix etc, 2 routine derm and 2 are subspec/oncology cases that is MAYBE MAYBE 30 minutes of work. What are they are gonna do for the other 6-7 hours?? Sip coffee? Attend meetings? Read SDN? Comment on cat videos on youtube???

Current manning in Pathology is bonkers. So feel free to ignore all this nonsense about a huge pathology shortage, we have MILES to go folks.

*17000 cases/200 workdays per year/7 FTEs = 12.14285 cases per day per FTE. If you make the assumption one FTE is always on vacation (6-7 weeks of vacation per year), then its a whopping 14.16666 cases per day per FTE.

7 weeks of vacation and 30 minutes of work a day when you do put on pants and show up? Seriously??

Perhaps all of their cases are large complex multi specimen cases

 

[rirriri]

the # of cases is a basic characteristic of workflow. The type and complexity of the cases is more important, IMO.

If you are getting 1 block biopsies all day long then sure you can sign out loads of them. If you’re getting mastectomies,thyroids, sarcomas, and whipples everything changes in regards to numbers of cases one can sign out.

 

[deleted314957]

the # of cases is a basic characteristic of workflow. The type and complexity of the cases is more important, IMO.

If you are getting 1 block biopsies all day long then sure you can sign out loads of them. If you’re getting mastectomies,thyroids, sarcomas, and whipples everything changes in regards to numbers of cases one can sign out.

In general, if you are doing lots of whipples, mastectomies, thyroids and sarcomas, you are at an academic place ( at least a place with residents) and you are in a whole ‘nother
world from p.p.

 

[LADoc00]

the # of cases is a basic characteristic of workflow. The type and complexity of the cases is more important, IMO.

If you are getting 1 block biopsies all day long then sure you can sign out loads of them. If you’re getting mastectomies,thyroids, sarcomas, and whipples everything changes in regards to numbers of cases one can sign out.

Okay no one is signing out whipples and sarcomas everyday in PP.

No one.

Its all the same, GI-GU and trash bread and butter cases and then a few subspec cases. It doesnt matter where you all, that is breakdown of simple human disease.

Unless you live perhaps next to Pripyat Ukraine and have waiting rooms of festering radiation induced sarcomas or something. Do you??

 

[rirriri]

In general, if you are doing lots of whipples, mastectomies, thyroids and sarcomas, you are at an academic place ( at least a place with residents) and you are in a whole ‘nother
world from p.p.

Okay no one is signing out whipples and sarcomas everyday in PP.

No one.

Its all the same, GI-GU and trash bread and butter cases and then a few subspec cases. It doesnt matter where you all, that is breakdown of simple human disease.

Unless you live perhaps next to Pripyat Ukraine and have waiting rooms of festering radiation induced sarcomas or something. Do you??

You CAN be in PP and sign out those things; if there is a private practice that is operating or contracted within a group of medical centers and/or hospitals. I’ve seen it before.

But otherwise you are right the majority of those cases are happening at academic centers.

 

[Deucedano]

In general, if you are doing lots of whipples, mastectomies, thyroids and sarcomas, you are at an academic place ( at least a place with residents) and you are in a whole ‘nother
world from p.p.

Except for the fact that many hospital systems have been consolidating over the last 10 years and these situations are a lot more common. If you have a practice like mine in a state of client billing where all the easy GI, GU and Derm specimens are sent off to quest or Lab Corp you are signing out the remainder of the more complex specimens.

Okay no one is signing out whipples and sarcomas everyday in PP.

No one.

Its all the same, GI-GU and trash bread and butter cases and then a few subspec cases. It doesnt matter where you all, that is breakdown of simple human disease.

Unless you live perhaps next to Pripyat Ukraine and have waiting rooms of festering radiation induced sarcomas or something. Do you??

Your practice sounds like the palo alto VA. I could easily do 60+ cases a day at that place. I had a few weeks of 60+ cases a day at my practice and my days were 14+ hours long with each day having multiple lumpectomies, prostatectomies, lung resections, complex gyn resections and bone marrows (my hospital does allogenic BMT) in addition to the "bread and butter" stuff. Some practices are like yours with a lot of easy stuff but an increasing number are not. Case number does not equal workload.

 

[y2k_free_radical]

Except for the fact that many hospital systems have been consolidating over the last 10 years and these situations are a lot more common. If you have a practice like mine in a state of client billing where all the easy GI, GU and Derm specimens are sent off to quest or Lab Corp you are signing out the remainder of the more complex specimens.



Your practice sounds like the palo alto VA. I could easily do 60+ cases a day at that place. I had a few weeks of 60+ cases a day at my practice and my days were 14+ hours long with each day having multiple lumpectomies, prostatectomies, lung resections, complex gyn resections and bone marrows (my hospital does allogenic BMT) in addition to the "bread and butter" stuff. Some fare like yours with a lot of easy stuff but an increasing number are not. Case number does not equal workload.

I didn't appreciate how fortunate i was.But surely you have several PAs to assist.

 

[gschl1234]

In general, if you are doing lots of whipples, mastectomies, thyroids and sarcomas, you are at an academic place ( at least a place with residents) and you are in a whole ‘nother
world from p.p.

I am at a PP with no residents and the bulk of our work is multi-part 88307/88309 cancer resections mostly consisting of breast and gyn-onc, but GI, ENT, and GU resections too; hardly any BX work other than the rare in patient GI BX. A few rad outpatient centers send their breast BX to us but that is just a few cases. No derm. A good chunk of my day spent on frozen and ROSE. So yeah, there are days I only get 12 cases but 6 or 7 are multipart cancer resections. And that doesn't count all the cytology.

 

[Torsed]

I miss Pap smears, but its silly to not boot them off to Quest. No money and big litigation.

I honestly wish we had more work, I don't know what people in academics do unless they are writing books. Where I am the clinical lab needs constant baby sitting, big tech turn over and newbies.

 

[Denmark]

, I don't know what people in academics do unless they are writing books.

I am a European pathologist. I have often wondered how many books and how many talks around the world some of these high society US pathologist do! Do they not at all read garden variety glass/cases more.

 

[cmz]

I am not a fan of reading paps (it's been years since I read one), but I still think that the pap business is lucrative if you're set up to grab the molecular. With paps also come a huge random assortment of other gyn biopsies, etc.

 

[y2k_free_radical]

, I don't know what people in academics do unless they are writing books.

I am a European pathologist. I have often wondered how many books and how many talks around the world some of these high society US pathologist do! Do they not all read garden variety glass/cases more.

Some are busy informing the Government about the impending shortage of pathologists from surgical volume increases and the ever impending massive retirement wave while writing in Pathology magazines and posting here about the strong job market.

 

[WEBB PINKERTON]

I am not a fan of reading paps (it's been years since I read one), but I still think that the pap business is lucrative if you're set up to grab the molecular. With paps also come a huge random assortment of other gyn biopsies, etc.

Exactly, the money is in the ancillary tests you run. HPV, different strains of candida, BV, Trich and on and on. The actual screening for cervical dysplasia is low on the list of priorities anymore.

Would be nice if CAP would lower their proficiency testing costs. Talk about a rip off.

Pap/Tissue correlation is too important for us to outsource the Paps. It is better to control the specimen if possible.

 

[FourCandles]

I met a sales rep last month who told me a neighboring hospital has 5, FIVE PATHOLOGISTS doing less work than just me. I couldnt believe it. She said they only each work 1-2 days per week because that is all the stress their snowflake CNS can process. Then they recharge for 5 days and rinse repeat.

This entire country maybe to going straight into some Idiocracy-type of apocalypse. Are any other SDNers worried about this but me??

Yeah worried so what?

 

[FourCandles]

How in the hell do these people make a living?

flipping burgers

 

[Vicinal]

It’s a scam

 

[y2k_free_radical]

It’s a scam
[May be they have an old contract from 1960s giving them a percentage of clinical laboratary income--those were the days

 

[Med Director New England]

Block count might be a better proxy than cases....after 100 slides my eyes are pretty tired if they care from 50 accessions or 12

 

[yaah]

I don't get it either. A hospital near us has 1/2 the number of general pathologists as us but about 15% of the case load. And they are looking for someone else.