Yup, its bad.

[LADoc00]

CompHealth called me so I chatted em up for a bit to get some numbers.

Pathology per diem pay is $800 or roughly what a per diem experienced nurse makes and what a 19 year old exotic dancer will pull down in 2x 4 hr shifts.

The same arm doing this is also doing Dermatology, which pays $1600 day! TWICE. TWICE THE AMOUNT. And that is for basic office based derm.

For Mohs surgery derm, the rate is up to $4000, 500% more.

Let that sink in.

When pushed CHealth admitted the predominant reason for being offered what is otherwise the single lowest per diem rate of ALL physicians (aside from office based family med)is the fact that there is a ton of FMGs who are willing accept that or even lower.

And I thought for some reason the situation was turning a corner, which it is not.

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[Merely]

Wow

 

[Spikebd]

CompHealth called me so I chatted em up for a bit to get some numbers.

Pathology per diem pay is $800 or roughly what a per diem experienced nurse makes and what a 19 year old exotic dancer will pull down in 2x 4 hr shifts.

The same arm doing this is also doing Dermatology, which pays $1600 day! TWICE. TWICE THE AMOUNT. And that is for basic office based derm.

For Mohs surgery derm, the rate is up to $4000, 500% more.

Let that sink in.

When pushed CHealth admitted the predominant reason for being offered what is otherwise the single lowest per diem rate of ALL physicians (aside from office based family med)is the fact that there is a ton of FMGs who are willing accept that or even lower.

And I thought for some reason the situation was turning a corner, which it is not.

=(

 

[Unty]

Sad.....

 

[bronx43]

Wow... even hospitalists make only average 1500-1800 per day.

 

[Vicinal]

Leaders..... shut this abuse down. If you saw the crap going on in academics. Some programs have as many as 16 residents for 30K accessions. Should be a maximum of 1 per 15K. How do they get away with this. It’s so much money and wasted time.

 

[Unty]

Yup know of a program with 12 residents for 26k accessions and 3, I repeat 3, surgpath fellows. Cheap labor!!!

 

[turtle1966]

I have been saying that the issue is not only finding the initial job, rather (a) quality, (b) short and long term stability, (c) comparative pay and (d) the distance from the desired geographic region.

Under the calm of many of those with job, there is an unstated dissatisfaction and longing, that pride would not allow expression, prompting them to seek for and apply to "any" job that may, on the surface, appear better, until they tire themselves out.

I think still there is quite a bit of fat and efficiency to be squeezed out of the system. Many pathologists may not see them, however, quite a few administrators do.

 

[Alteran]

CompHealth called me so I chatted em up for a bit to get some numbers.

Pathology per diem pay is $800 or roughly what a per diem experienced nurse makes and what a 19 year old exotic dancer will pull down in 2x 4 hr shifts.

The same arm doing this is also doing Dermatology, which pays $1600 day! TWICE. TWICE THE AMOUNT. And that is for basic office based derm.

For Mohs surgery derm, the rate is up to $4000, 500% more.

Let that sink in.

When pushed CHealth admitted the predominant reason for being offered what is otherwise the single lowest per diem rate of ALL physicians (aside from office based family med)is the fact that there is a ton of FMGs who are willing accept that or even lower.

And I thought for some reason the situation was turning a corner, which it is not.

This is the price we pay as a profession for generations of professional neglect. Trying to correct this is not impossible, just highly improbable.

At this point, if we wanted sane control of the profession again we'd have to buy out all the academic practices and install leadership there that is more attuned to the realities of practice. And before the idea gets poopooed, whole academic departments have been ousted for financial reasons and rolled into new leadership in my recent memory. Evidently, university and academic hospital administrators can indeed be convinced that they don't have to bankroll doctor's lifestyles - especially those whose RVUs are grossly mismatched with their salaries. It just hasn't happened often enough and on a scale big enough to merit a response.

 

[medgator]

Rad onc isn't quite there yet, but the powers that be are placing our specialty on that trajectory with the current number of residents being pumped out. I know for a fact some retired ROs will take $1200/day. Going rate is $1500

 

[path24]

Don't even remotely consider this field. Pathology just gets worse and worse and worse. Its embarrassing to be in this field.

 

[LADoc00]

Rad onc isn't quite there yet, but the powers that be are placing our specialty on that trajectory with the current number of residents being pumped out. I know for a fact some retired ROs will take $1200/day. Going rate is $1500

You realize at the “going rate” rad onc is still almost twice path.

Stop trolling us. There are many pathologists apparently that would not only cover the work but also perform degrading sexual favors for 1200 a day haul....

This is absolutely a disaster

 

[y2k_free_radical]

This is the price we pay as a profession for generations of professional neglect. Trying to correct this is not impossible, just highly improbable.

At this point, if we wanted sane control of the profession again we'd have to buy out all the academic practices and install leadership there that is more attuned to the realities of practice. And before the idea gets poopooed, whole academic departments have been ousted for financial reasons and rolled into new leadership in my recent memory. Evidently, university and academic hospital administrators can indeed be convinced that they don't have to bankroll doctor's lifestyles - especially those whose RVUs are grossly mismatched with their salaries. It just hasn't happened often enough and on a scale big enough to merit a response.

As another exercise in futility i would like the ACADEMICIANS on this board ,especially DR. REMICK, and the CAP to address the financial or business side of pathology.

 

[Unty]

Dr Remick disappeared a while back but occasionally comes on to read.

 

[deleted314957]

As another exercise in futility i would like the ACADEMICIANS on this board ,especially DR. REMICK, and the CAP to address the financial or business side of pathology.

As dedicated and academically impressive as (some) of the folks in academia are, the ones who have been there all of their professional lives do not understand what is going on out where y’all are.
Metaphorically, they have an available, caste-like tier of cheap labor which is dependent on a phony largess and I’m not sure they even know it.

 

[caffeinegirl]

These rates have been true for a long while - Labcorp would offer $12.50/88305; locums jobs for $80/hour - and these are not in rural areas but urban coasts. They wouldn't have these rates unless there were people who would take them. Race to the bottom.

 

[Dave CX]

Caffeinegirl if you can crank, 12.50$ per 88305 can mean serious bucks.

 

[Vicinal]

Open the books.... audit programs....
How is ACGME complicit in all this? Do they have any metric for just agreeing to allow programs to have too many residents?

 

[jupiterianvibe]

Open the books.... audit programs....
How is ACGME complicit in all this? Do they have any metric for just agreeing to allow programs to have too many residents?

I called and asked. Acgme takes the word of pathology pds because they literally have no idea what a pathology residency requires.

 

[caffeinegirl]

Caffeinegirl if you can crank, 12.50$ per 88305 can mean serious bucks.

Yes, if the volume is there (and if you are efficient). I agree that you can hustle, as you have, in multiple locations to make $$. But in this case with Labcorp, you don't have control over volume, quality of slides, turnaround and QC of stains, etc. And, in the end, it's your malpractice insurance on the line if they mess up the specimens.

 

[LADoc00]

I think the core of the issue is we have a ton of practicing pathologists with little to no self respect. Physicians with self respect would simply not put with up this. Pathologists are VASTLY more essential to the healthcare ecosystem than Dermatologists, yet the hard truth is readily apparent.

I think this is a very complex issue to lay at the feet of any one cause but what can most easily done is the reduction of the pathology training slots by 1/2. I dont think this will happen for a moment though as large multinationals have a vested interested in keeping the slaves looking at 88305s for 12 bucks and change.

As long as there are pathologists willing to accept these rates, nothing will change.

 

[Dave CX]

The patients don't originate with us. This is the number one problem. Built in total lack of control.

 

[time to move on]

My hospital just hired a Pathologist. I told this Pathologist that he/she would get a low offer ($250k) but that they would go up to $350k at least (rural area). The pathologist was "too scared to negotiate" and accepted $250k.

NO WORDS.....

 

[time to move on]

I have no respect for Pathologists that don't even attempt to negotiate. That is exactly why hospitals have zero respect for Pathology. They know that if one leaves, there are 100 waiting in line to work for crumbs.

 

[time to move on]

done venting

 

[jupiterianvibe]

My hospital just hired a Pathologist. I told this Pathologist that he/she would get a low offer ($250k) but that they would go up to $350k at least (rural area). The pathologist was "too scared to negotiate" and accepted $250k.

NO WORDS.....

Fmg?

 

[time to move on]

Fmg?

yes... but I know plenty of non FMGs that are too scared to negotiate

 

[jupiterianvibe]

yes... but I know plenty of non FMGs that are too scared to negotiate

Pathetic

 

[LADoc00]

I will have started my career journey on SDN and leave one day when I retire saying the same thing: Respect. It all begins with respect.

Your family, your coworkers, your community and yourself.

 

[time to move on]

The problem is many hospitals and groups want scared, insecure pathologists. They care about the bottom line.... extra cash taken off salaries. FMGs in general have no educational debt so they can take the lower paying jobs.

Very true. They also need visas so the hospital has the power to low ball and stay low because they know they need the visa

 

[Unty]

Very true. They also need visas so the hospital has the power to low ball and stay low because they know they need the visa

True that. FMGs talk about their visa issues in residency and finding a job after training.

 

[jupiterianvibe]

True that. FMGs talk about their visa issues in residency and finding a job after training.

All fmg residency positions should be closed

 

[octopusprime]

I feel a Trump rally brewing...

 

[WEBB PINKERTON]

I am reminded of that episode of south park where people from the future are taking jobs in the present so they all form that "pile". If we all become gay, there will be no future pathologists and job market will improve.

 

[time to move on]

I feel a Trump rally brewing...

all in today! All time high again soon

 

[Dave CX]

Here's what happened in my city.. The local HCA system announced that their pathologists (12 or so, 3 hospitals), are losing their contract this fall. They offered employment contracts to all of them. 300K for the system chairman, 280 for individual directors and 250 for everyone else. Obviously that was a a massive pay cut, so the group got together to compel a higher salary. Administration shrewdly picked off the weak link, a young female with kids in school and told her she would have to move if she didn't accept. She accepted 250 and massively undermine the rest who capitulated to the original offer.

 

[path or no path]

CompHealth called me so I chatted em up for a bit to get some numbers.

Pathology per diem pay is $800 or roughly what a per diem experienced nurse makes and what a 19 year old exotic dancer will pull down in 2x 4 hr shifts.

The same arm doing this is also doing Dermatology, which pays $1600 day! TWICE. TWICE THE AMOUNT. And that is for basic office based derm.

For Mohs surgery derm, the rate is up to $4000, 500% more.

Let that sink in.

When pushed CHealth admitted the predominant reason for being offered what is otherwise the single lowest per diem rate of ALL physicians (aside from office based family med)is the fact that there is a ton of FMGs who are willing accept that or even lower.

And I thought for some reason the situation was turning a corner, which it is not.

IS that per day/shift?

 

[LADoc00]

Per diem means per day..I guess they dont teach Latin anymore. Must be the impact of SJWs on pedagogy.

 

[LADoc00]

Here's what happened in my city.. The local HCA system announced that their pathologists (12 or so, 3 hospitals), are losing their contract this fall. They offered employment contracts to all of them. 300K for the system chairman, 280 for individual directors and 250 for everyone else. Obviously that was a a massive pay cut, so the group got together to compel a higher salary. Administration shrewdly picked off the weak link, a young female with kids in school and told her she would have to move if she didn't accept. She accepted 250 and massively undermine the rest who capitulated to the original offer.

When you square off vs. a syndicate acting like this, you must be absolutely ruthless and compel tribal loyalty at all costs.

I have waited my entire career/life to encounter this situation. Spending a lifetime acquiring a specific set of skills and never actually use them is quite depressing.

There are million different ways to approach this sticky situation but I would say some of the more "creative" approaches were pioneered by the KGB...I'll leave it at that.

 

[CDX-2]

Yup know of a program with 12 residents for 26k accessions and 3, I repeat 3, surgpath fellows. Cheap labor!!!

12 residents for 26K accessions???

The lab I'm in right now (in Australia) has 2 registrars (residents, including me) and it averages ~21K accessions / year.
As you can imagine, I'm grossing 5 days / week...

The larger labs in Melbourne and Sydney have >40K accessions, and they don't have any more than 5 registrars / residents each...

 

[bronx43]

When you square off vs. a syndicate acting like this, you must be absolutely ruthless and compel tribal loyalty at all costs.

I have waited my entire career/life to encounter this situation. Spending a lifetime acquiring a specific set of skills and never actually use them is quite depressing.

There are million different ways to approach this sticky situation but I would say some of the more "creative" approaches were pioneered by the KGB...I'll leave it at that.

You mind sharing some of these tactics? Genuinely curious.

 

[Nilf]

You mind sharing some of these tactics? Genuinely curious.

There you go:



Cheka is a predecessor of Комите́т Госуда́рственной Безопа́сности (KGB).

BTW I would not invoke the name of either organization in a jokingly casual way out of the respect for its victims.

 

[y2k_free_radical]

I think the core of the issue is we have a ton of practicing pathologists with little to no self respect. Physicians with self respect would simply not put with up this. Pathologists are VASTLY more essential to the healthcare ecosystem than Dermatologists, yet the hard truth is readily apparent.

I think this is a very complex issue to lay at the feet of any one cause but what can most easily done is the reduction of the pathology training slots by 1/2. I dont think this will happen for a moment though as large multinationals have a vested interested in keeping the slaves looking at 88305s for 12 bucks and change.

As long as there are pathologists willing to accept these rates, nothing will change.

Don't forget academia and the CAP

 

[jupiterianvibe]

Dont pay for cap pt and stop doing inspections for them

 

[path or no path]

That's very unfortunate. A highly trained professional accepting such low rate. I too considered path at one point. I ended up going with IM. Hospitalist locums gigs pay easily double that rate.

 

[Bobbbyyyy]

That's very unfortunate. A highly trained professional accepting such low rate. I too considered path at one point. I ended up going with IM. Hospitalist locums gigs pay easily double that rate.

staying true to your name I see

 

[Torsed]

I did a week of locums recently, basically because I'm jaded of it all and wanted to travel a tad, it was 900 a day, they paid for flight and rental car and hotel. Job was absolute cake, smashed out the work in like 3 hours and surfed internet and payed bills the rest of the time. Lab was run like a complete circus, but I didn't have to care at all. Got off at 3 or 4 usually and explored the area which was coastal. Lotta good breweries etc. It's not like pathologists walk in with a 40 person census to round timelessly until their shift is over like IM hospitalists. I'll say this further, but pay does depend on location, this was a nice coastal area that was desirable, the locums company did have other assignments that went up to 1300 for a day, but think waaaaay rural.

Nice thing was I didn't have to care about the dumpster fire of lab that wasn't mine own. Made me feel good there was the same stupid admin b.s. thinking the lab isn't necessary for a hospital.

I must add the slides that were produced were about a micron above uninterpretable if you ask me. :/ Locums certainly has a Jason Bourne feel, you just show up, get paid, jet. No admin / QC/QA, billing, drama, crying or what else from the lab or others. I told the lab director (freshly there for a week) frankly, not my circus not my monkeys.

Honest to Jehovah I've never heard of a locums derm person. What wonders we hear about! Must be like seeing a unicorn in the in a rainbow meadow or they are trying to recover from jail time or board action.

 

[Torsed]

Here's what happened in my city.. The local HCA system announced that their pathologists (12 or so, 3 hospitals), are losing their contract this fall. They offered employment contracts to all of them. 300K for the system chairman, 280 for individual directors and 250 for everyone else. Obviously that was a a massive pay cut, so the group got together to compel a higher salary. Administration shrewdly picked off the weak link, a young female with kids in school and told her she would have to move if she didn't accept. She accepted 250 and massively undermine the rest who capitulated to the original offer.

How are they gonna make her move?

 

[rirriri]

So much negativity here; primarily by private practice Pathologists from what I see.

The Path world isn’t going to run like a private practice; hate to break it to you. No we are not going to adhere to just a profit-making philosophy over the fine details of practicing Pathology. First and foremost you should care about patient care. The majority of Pathologists in this country are in hospital-based jobs and private practice factories are only a fraction of Path jobs. Private practice worry about every little financial change because the biggest part of that type of practice is the finances. Those of us who are focused on hospital or academic practice have different modes of funding. We aren’t solely concerned with policy or financial dynamics. Perhaps that’s why we’re not so negative.

Oversupply? Possibly. In big trouble? Nope. If you read SDN from 2012 you’ll find the same type of fear mongering and no those changes didn’t happen so instead of discouraging young Pathologists with fear; how about you contribute to solutions over time as well as offer constructive ideas rather than just point fingers and do nothing.

I am more excited than ever about Pathology and think we are at the epicenter of disease understanding just like Path was 50 years ago or more.

Worry about the science more than the RVUs. Worry about integrity more than $.

To med student hopefuls, trainees, or young attendings just KNOW there is a population of Pathologists who see things positively.

This place is called “STUDENT” Doctor Pathology not Angry Older Peeps Vent Room. Lol. Set a good example for young Doctors don’t fill up their minds with one sided negativity.

 

[Torsed]

Can’t tell you how many emails I get from young un’s looking for jobs and there are none. Unless one enjoys South Dakota. Another issue is many have done 2 plus fellowships. I try to guide them the best I can.

It’s not negativity but the harsh reality of the march toward single payor ririrri. Academics may be fine for some, but this discussion Since 2012 is about business survival in a failing system.

When the newbies are coming out with 400k in loans plus cost of living for jobs that pay less than 150k, they need to know the struggle is real.

Wish I shared your optimism.