Workload in numbers

[Patho2009]

How can you make judgement on the workload (whether heavy or light) based on the given numbers of surgicals and cytology?

Example:

A department head gave me this information. Let me know your conclusion regarding the workload (reasonable, heavy or light?):

9500 Surgicals
3500 non-Gyn and 14,000 Gyn (Pap).


I appreciate if I can hear from any practicing pathologist about the numbers that can indicate a heavy workload ?

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[yaah]

Are you talking about for residency or for pathologists in practice?

Numbers in isolation are essentially meaningless. It depends on how they are spread out. Those specimen numbers would reflect much different workloads if there were 3 pathologists versus 10 pathologists. I think the average caseload for practicing pathologists around the country is 2500 surgicals/pathologist, but that may be wrong. It depends on what type of specimen you sign out. Dermpaths can be over 10,000 each per year and that is not abnormal.

So if your group above has 5 pathologists that might be an average workload. It might be a heavy workload if they have a lot of other responsibilities like bone marrows, clinical lab coverage, things like that. It might be light if the specimens are all simple or quick.

 

[Patho2009]

Thank you Yaah so much.

My question is related to pathologists in practice, not residents.

The numbers listed above are in a lab with five pathologists and wants to hire a sixth one. When I asked for the workload, I was given these numbers.

I just wanted to check with pathologists with practicing experience -like you- what these numbers mean for you as a sixth pathologist joining the group.

Now I have understood from your answer that if I join this group, my workload would be in the "average" (or within the reasonable) range, especially if you take other work into account such as autopsies, bone marrow bx..etc.

 

[mcfaddens]

9,500 surgicals is not alot of work for 5 pathologists (Im doing around 5,000 as my cut in a general practice setting), but like yaah said it depends on the type of work you are doing. If this is a general practice 65% biopsies and 35% large complex cases 9,500 cases is not alot. But if you look at the numbers, there is alot of gyn cyto. Ask them how many cyto techs they have and what percentage of those gyn cases you will actually be reading. Also what is the frozen section load? And how many bone marrows are being done and what percentage of the flow will you be reading. Things like bone marrows and medical livers and kidney can make one case seem like ten. Congrats on getting the interview!

 

[exPCM]

Very interesting - I am apparently severely overworked. I have signed out 8500 cases in the last 12 months and this group has only 9500 cases for 5 pathologists - food for thought.

 

[Patho2009]

Great. I think there is now consensus that the load is not bad.

 

[BU Pathology]

There is a relatively recent peer-reviewed publication about this,
PMID: 16690476

The peer-reviewed literature is almost always a better source of information than postings on the internet.

 

[raider]

Anothet area where CAP should have been more active. I fail to understand why two vital areas of the practice of pathology have not been addressed by CAP:

(1) Job market analysis for pathologists.

(2) Adequate workload guidelines for pathologists.


This is in stark contrast to numerous studies from both Canada and UK addressing these very issues.

Just google "Pathologist Workload" and you will get very comprehensive articles from the aforementioned countries, but none (with the same level of detail) from the US.

Lack of this data is partly responsible for the apathy regarding these vital issues.

 

[levels x3]

http://www.svfp.se/dokument/rekommendationer/Arbetstyngdsbelastning.pdf

Interesting read. I'd quibble with valuing an autopsy only 8x more than their level 4. They are certainly way more than 8x more time consuming that a typical GI biopsy...but I'm digressing.

To add to answering the OP's question, last August I became the 5th pathologist in my group. General practice, community setting, 13,000 surgicals, 3500 non-gyn, 25,000 gyn. But...we do 180-200 autopsies each year so that increases our workload by quite a bit. The group functioned fine with 4 before I arrived and probably will stay at 4 once the first person retires (not planned, but it is an older group).

So I would want to know a few things about your prospective group (if I were you). Importantly I'd want to know about autopsies because they really add to the work. I would agree that 6 pathologists doing those numbers, assuming it's a typical community practice mix of cases, is not a lot of work. If we assume they're not doing a lot of autopsies, then it sounds pretty cush. However, I would also want to know (meaning you don't need to tell us here, but you should know) what the incomes are and where it comes from. 6 pathologists in a typical private practice type of setting with those numbers would be spreading the income kind of thin. Perhaps they've made that trade-off so they can work really short days and take a lot of vacation...just something to think about.

 

[yaah]

Very interesting - I am apparently severely overworked. I have signed out 8500 cases in the last 12 months and this group has only 9500 cases for 5 pathologists - food for thought.

Not necessarily - like I said, depending on other duties it can vary. What is your case mix? Do you do any CP? Cyto? Dermpaths routinely sign out well over 10,000 per year each. GI pathologists probably can be similar if they are doing only GI. GU and breast pathologists, a lower number is par for the course. It sounds to me as though 9500 for 5 pathologists is a little low, but depending on the practice it might not be. If 500 of those are bone marrows, that changes things. If 1000 of those are breast lumpectomies with sentinel nodes, that changes things.

Our group is somewhat subspecialized and our case numbers vary quite a bit per person. The GI people often sign out several times the number of cases I do per day, but I get lots of GU cases.

14000 paps generally means total # of accessions, not # of cases reviewed by pathologists. Pathologists sometimes only review 10% of total paps at many places.

 

[lipomas]

9500 specimens + 3500 non-gyn does not sound like a lot for a group with 5 pathologists. 6 sounds like even less work. There are groups where this works though. But you are probably not getting much dermpath or GI path. The above points are all good, in addition. 12,000 case per year for an individual might not be overwork, whereas 3,000 might be for another. This depends on the specimen variety.

However, most groups that get 9500 surgicals are unlikely to have the type of caseload that allows for someone to sign out 10,000 cases by themselves. For a group like that, 2,000 per year might be more reasonable and appropriate particularly if there are a lot of CP duties.