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Thrombus

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I see lots of complaining about the job market. You all were warned about this for years on end. The lack of jobs is only going I get worse long term. There may be a short term bump this year and next as some retire due to Obamacare, sinificant drops in reimbursements, and new confiscatory taxes. However pathologists will continue to significantly increase productivity over time.

I am sick and tired of hearing from government welfare subsidized academic pathologists who rely on cushy jobs with residents and their 200k checks attached, whining for more residents who now have to do at least 2 fellowships in many cases or settle for some RN level salary as the backlog continues to worsen.

I see many of you didn't listen as way too many matched this year. Most I know do not want you as our colleagues as we are saturated. Do not take this personally. It is a professional disdain for the exploitative cronyism in our field.

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Oh, Thrombus.... We never tire of your "crazy old man" tirades....

Thrombus post criteria:

1. "get off lawn" to prospective students: Check

2. "Damn GOVMIT" rant about too much money going to research/academic training: Check

3. "DAMN BARAK HUSSEIN OBAMA wharrggabll": Check

Success!!!
 
Pay no heed to incoherent medical students, premeds, or junior residents. Talk to private professionals in the field that are actually paying bills, running a business, and taking care of patients.

Not sure who, what or why this GB Wilmer guy is. I am reporting from the field and telling you why things are as they are. I am pretty much apathetic to politicians at this point but don't find it constructive to call the President names.
 
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I just have to chime in. Thrombus is doing a HUGE public service here for medical students considering pathology who otherwise would have no understanding of the hell they will experience on the other end of residency. Keep it up Thrombus. I only wish you had advised us before we got stuck with no pathology job.(Feel free to search all my prior postings) Thank you again.
 
Your arguments are a bit incoherent. So you're saying that pathologist productivity is going to increase, but so is the reach of the government, reference labs, etc (e.g. more regulation). Most people agree that increasing regulation and decreasing reimbursement leads to decreased productivity because there isn't as much motivation.

Or are you going to fall into the old, "people will keep fighting for the scraps that are left" argument?

I am not sure I understand your logic. To my reading, government is going to have to cut spending somewhere - cutting GME spots is going to be one of the easiest targets, with relative protection for primary care fields. So a lot of programs will likely ditch less productive fields like pathology in regards to residency training.

I think the truth is that it's extremely hard to predict the future.

Anyone planning their career would be best served by not basing their decisions mostly on their predictive abilities as to what is going to be the best paying, best job availability, etc. The country is going to continue to need good pathologists for a long time, and scaring the best candidates away is only going to make the problems you put forward worse.

And since I'm a private professional in the field for several years, with leadership and administrative roles, and a partner in my group, apparently according to your logic everyone is supposed to listen to me. You see lots of complaining about the job market. I see some complaining but most have success. Pathology as a field is far too complex to trivialize down to simple statements like "job market sucks" or "job market awesome." It's a smaller field with many many different types of practice patterns and styles. Different areas of the country also vary. Job openings can be quite cyclical and experience in one year in one area may not be similar the next year. This is unfortunate and while the job market is part of it, another part of it is simply the size and scope of the field.
 
:)
Git off my lawn!

that made me laugh.
 
I see lots of complaining about the job market. You all were warned about this for years on end. The lack of jobs is only going I get worse long term. There may be a short term bump this year and next as some retire due to Obamacare, sinificant drops in reimbursements, and new confiscatory taxes. However pathologists will continue to significantly increase productivity over time.

I am sick and tired of hearing from government welfare subsidized academic pathologists who rely on cushy jobs with residents and their 200k checks attached, whining for more residents who now have to do at least 2 fellowships in many cases or settle for some RN level salary as the backlog continues to worsen.

I see many of you didn't listen as way too many matched this year. Most I know do not want you as our colleagues as we are saturated. Do not take this personally. It is a professional disdain for the exploitative cronyism in our field.

denethor.jpg
 
If Thrombus was an older pathologist, he/she would be living large off the money he/she got from selling out. Working until he/she kills over.

This person is probably a younger generation pathologist trying to survive in the cesspool of a profession that remains.
 
Worst case scenario, if path doesn't work out, one can go back and do an IM residency. Then he can join or open up a private clinic, buy some diagnostic machinery, maybe do some biofeedback...and generally just bill, bill, bill. Also, I hear some doctors are doing e-medicine, nowadays...basically, they diagnose and bill over the internet. Still, I just can't wrap my mind around a physical exam being done over Skype.
 
I'm not sure everybody does a physical exam even in person. Isn't that what CT is for??
:rolleyes:
 
I'm not sure everybody does a physical exam even in person. Isn't that what CT is for??
:rolleyes:

Because patients love the feeling of anal penetration ....... by finger.
 
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I'm not sure everybody does a physical exam even in person. Isn't that what CT is for??
:rolleyes:

My surgery rotation preceptor in med school once made a joke about the overuse of CT scans...he said that hospitals should just have a CT scan built into the hospital doorway, so that all patients could just get a CT as they walk through the threshold.
 
Warning to medical students: Happy pathologists don't post about poor job conditions.

I'm happy, made partner in a year with no buy in, in a geographic location I want to be in with a stable pathology job.

If you want anything you have to work for it, shouldn't be a mystery by now for anyone in medicine. :thumbup:
 
The article could have been written about pathology for years. The only pathologists that are needed are residents for grossing...just like rads residents wanted for 3 am.

Hospitals/programs want the money, free labor, scutwork done, and crap call done. It doesn't matter to them what happens to you after that...job/no job.

The rads job market is apparently poor, well the path job market has been poor for decades. Maybe rads needs to watch some pathology shortage powerpoints (just substitute in rads), that seems to work.

Radiology welcome to pathology.
 
Radiology and pathology are also 'low impact' specialities in regard to overall physical demands (other than some grossing), which means that you can work a lot longer as opposed to a specialty like orthopedic surgery where you need to be in somewhat decent physical shape.

I wonder if that is a possibile contributing factor?

Although I think radiology's biggest issue is that fact that digital images can be sent anywhere to be read remotely. Prior to that, a hospital needed a radiologist on site to do a reading.
 
Radiology and pathology are also 'low impact' specialities in regard to overall physical demands (other than some grossing), which means that you can work a lot longer as opposed to a specialty like orthopedic surgery where you need to be in somewhat decent physical shape.

I wonder if that is a possibile contributing factor?

Although I think radiology's biggest issue is that fact that digital images can be sent anywhere to be read remotely. Prior to that, a hospital needed a radiologist on site to do a reading.

I think they are getting a lot more efficient - kind of similar to pathology. When I talk to radiologists they say they read far more studies than they ever used to. Kind of like pathology's increase in efficiency in the prior decade.
 
I see many of you didn't listen as way too many matched this year. Most I know do not want you as our colleagues as we are saturated. Do not take this personally. It is a professional disdain for the exploitative cronyism in our field.

Love this post Thrombus. I have to say I totally agree. Pathology is slave work nowadays. We've become so efficient at processing and examining slides that even with increased volume (current and projected), we have increased productivity. The pathologists in my group just take on the extra work. We aren't looking to hire additional staff. We are currently recruiting another pathologist to replace one who is retiring.

We recently reached out to a Hopkins fellow who interviewed for this position and they are still out of a job (we offered the position to someone else who accepted). I also got a recent call from a friend who trained at MGH and is currently in private practice. She is trying to help some of the current MGH fellows locate employment. This is completely insane guys. Point blank.
 
Love this post Thrombus. I have to say I totally agree. Pathology is slave work nowadays. We've become so efficient at processing and examining slides that even with increased volume (current and projected), we have increased productivity. The pathologists in my group just take on the extra work. We aren't looking to hire additional staff. We are currently recruiting another pathologist to replace one who is retiring.

We recently reached out to a Hopkins fellow who interviewed for this position and they are still out of a job (we offered the position to someone else who accepted). I also got a recent call from a friend who trained at MGH and is currently in private practice. She is trying to help some of the current MGH fellows locate employment. This is completely insane guys. Point blank.

It has gotten so bad in some places that clinicians are calling some groups I know trying to get people jobs.
 
It has gotten so bad in some places that clinicians are calling some groups I know trying to get people jobs.
Absurd. I have been telling my friends in medical school to think twice about pursuing pathology. It's not worth the grief given the downward spiral.
 
isn't someone supposed to chip in now to say that "everyone gets a job"
 
Warning to medical students: Happy pathologists don't post about poor job conditions.

I'm happy, made partner in a year with no buy in, in a geographic location I want to be in with a stable pathology job.

If you want anything you have to work for it, shouldn't be a mystery by now for anyone in medicine. :thumbup:

That is crazy. No buy in? Not even reduced salary for X years type of thing?? That doesnt even make sense. Perhaps you are doing something else for the founding partners outside of work?:smuggrin:

I see no reason to make someone a partner unless they bring in a sizable amount of new business and certainly I wouldnt consider making someone a partner for free in any of my practices. That is an absolute insult to the amount of work and dedication it takes to actually create a self sustaining practice and build a book of business.

Strange story. Perhaps you didnt buy in because your group are all hospital employees...
 
That is crazy. No buy in? Not even reduced salary for X years type of thing?? That doesnt even make sense. Perhaps you are doing something else for the founding partners outside of work?:smuggrin:

I see no reason to make someone a partner unless they bring in a sizable amount of new business and certainly I wouldnt consider making someone a partner for free in any of my practices. That is an absolute insult to the amount of work and dedication it takes to actually create a self sustaining practice and build a book of business.

Strange story. Perhaps you didnt buy in because your group are all hospital employees...

Maybe he means voted onto partner track after 1 year. My job does that - salaried for a certain time period, then the partners vote to keep/not keep you. If they keep you they vote you onto the partner track where you start out at x% of full partner share and it takes something like 5-6 years to work up to full partner share. I agree it would be pretty strange to make someone a full partner after 1 year. Wouldn't be the smartest business move.
 
That is crazy. No buy in? Not even reduced salary for X years type of thing?? That doesnt even make sense. Perhaps you are doing something else for the founding partners outside of work?:smuggrin:

I see no reason to make someone a partner unless they bring in a sizable amount of new business and certainly I wouldnt consider making someone a partner for free in any of my practices. That is an absolute insult to the amount of work and dedication it takes to actually create a self sustaining practice and build a book of business.

Strange story. Perhaps you didnt buy in because your group are all hospital employees...

Perhaps you simply cannot see. We (my group) are private contractors with the local for profit hospital system, thus not hospital employees. I find it amusing how greed so permeates our field that one cannot imagine no buy in. I did not bring extra clients with me either and no outside (other) service are performed though if I could be a sought after male dancer I would probably go for it. I did bring a hard work ethic and molded well with the group and the clinicans which I must say is fairly rare for many pathologists. :luck:
 
Perhaps you simply cannot see. We (my group) are private contractors with the local for profit hospital system, thus not hospital employees. I find it amusing how greed so permeates our field that one cannot imagine no buy in. I did not bring extra clients with me either and no outside (other) service are performed though if I could be a sought after male dancer I would probably go for it. I did bring a hard work ethic and molded well with the group and the clinicans which I must say is fairly rare for many pathologists. :luck:

I can simply see. This isnt greed, it has to do with basic fairness. Did you negotiate that contract with the hospital? Did you set up the S-corp for the business? Did you arrangement for payroll? Do track government filings and compliance??

I CAN see, that is the point. Your group is either full of self-deprecating fools or saints. And I never trust saints btw, never. Saints jump on swords and grenades and do things for free and at the end of day drag you with them.

I intend to die to the old fashioned way, old, drunk in a bed full of hookers...thank you.
 
I can simply see. This isnt greed, it has to do with basic fairness. Did you negotiate that contract with the hospital? Did you set up the S-corp for the business? Did you arrangement for payroll? Do track government filings and compliance??

I CAN see, that is the point. Your group is either full of self-deprecating fools or saints. And I never trust saints btw, never. Saints jump on swords and grenades and do things for free and at the end of day drag you with them.

I intend to die to the old fashioned way, old, drunk in a bed full of hookers...thank you.

This is not an uncommon arrangement..but realize that in many of these arrangements the hospital/health system controls your business/clients and marketing...which is not always the best thing. I would rather have more control over my business and clients than having to interface with a health system that has no idea of the value of my service and how to market it to clinicians. It can be a cushy arrangement for a while, but you are at the mercy of the hospital....for better or for worse.
 
That is crazy. No buy in? Not even reduced salary for X years type of thing?? That doesnt even make sense. Perhaps you are doing something else for the founding partners outside of work?:smuggrin:

I see no reason to make someone a partner unless they bring in a sizable amount of new business and certainly I wouldnt consider making someone a partner for free in any of my practices. That is an absolute insult to the amount of work and dedication it takes to actually create a self sustaining practice and build a book of business.

Strange story. Perhaps you didnt buy in because your group are all hospital employees...

It's not crazy at all. I know of lots of groups like that, and they are not making a pittance. I also know of many groups where when people retire they actually retire and don't keep sucking money out of the active partners. It's morality. People tend to think that THEY are the ones doing most of the work, doing the hard stuff, etc. If you have a good group everyone is doing this stuff. If they aren't they shouldn't be in your group.

It is perfectly reasonable to have a time to partnership, given that you just don't know when you hire someone whether they are going to be a) psycho, b) incompetent; c) dangerous, d) overconfident, e) emit a foul and unpleasant odor, and such.

What if a non-partner does lots of the actual work which allows the partner to go out and get new business, make more money, etc? Is that not valuable?
 
There are no groups where you make full partner salary from day 1. Even if there is no official "buy-in", your reduced salary for 2-3 years is the effective Buy-in.

It's not crazy at all. I know of lots of groups like that, and they are not making a pittance. I also know of many groups where when people retire they actually retire and don't keep sucking money out of the active partners. It's morality. People tend to think that THEY are the ones doing most of the work, doing the hard stuff, etc. If you have a good group everyone is doing this stuff. If they aren't they shouldn't be in your group.

It is perfectly reasonable to have a time to partnership, given that you just don't know when you hire someone whether they are going to be a) psycho, b) incompetent; c) dangerous, d) overconfident, e) emit a foul and unpleasant odor, and such.

What if a non-partner does lots of the actual work which allows the partner to go out and get new business, make more money, etc? Is that not valuable?
 
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