Attendings. How many hours do you work? What setting? How much do you make?

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Every hospital I've been to had a Part A built into our contract. I even know some hospitals that don't pay subcontracted groups any Part A at all. If that were the case, or if the group declined to accept a Part A because they felt it was too low, could they forego accepting it and directly bill insurers for CP or would that be considered double dipping?



That's actually pretty good. Now come see the "real" America where all you've got is a Dollar General...

As I said above, part A refers to medicare. In my old practice we got part A and billed CP26 (private insurance), It would only be condidered "double dipping" if your part A was twice as high as the medicare calculation.Before negotiating a new contract, a group should do a part A time study for a few months and document all your time spent on part A activities. Hypothetically lets say you are a 7 person, two hospital practice. After months of time studies, you determine that you part A is equivalent to 2.2 fte's. Multiply that times median pathologist income, lets say 400K. That gives you 880K part A income. Multiply that times your medicare census, lets say 50%. So the number to ask for would be 440K. This would be reasonable and stand up to scrutiny.

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Good to know. I'm not the head of my group, so I don't think we bill CP26, at least not anymore. But, we do get Part A. I believe hospital administration told us we could not do so any longer. I'm guessing it was done in order to maintain amicability between themselves and insurance companies, dunno. Probably because they figure preventing these siphons from providers allows long term profitability by being approved as a health care network/provider from said private insurers. On top of that, as you said these companies may just balk at the whole notion like BCBS did in your state. I mean it's worth a shot; but, in the end it's hard to make a claim for a pathologist to collect for PC on a glucometer reading...:confused:
 
Good to know. I'm not the head of my group, so I don't think we bill CP26, at least not anymore. But, we do get Part A. I believe hospital administration told us we could not do so any longer. I'm guessing it was done in order to maintain amicability between themselves and insurance companies, dunno. Probably because they figure preventing these siphons from providers allows long term profitability by being approved as a health care network/provider from said private insurers. On top of that, as you said these companies may just balk at the whole notion like BCBS did in your state. I mean it's worth a shot; but, in the end it's hard to make a claim for a pathologist to collect for PC on a glucometer reading...:confused:

Don't sell your lab management time short. And if the hospital wont let you bill it, then they should pay for it. Meaning you don't use the medicare census correction factor. The key thing for the contract negotiation is logging your Part A hrs.
 
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I'm starting residency, but a family friend who is an attending told me this:

50-55 hours
Surgpath, big city, 2nd year in PP
220k

The hours seem kinda high but imagine the $ amount is pretty spot on. And that $ amount will continue to go down I imagine by 2% a year until it hits a floor of about 150Kish. All non-entrepreneurial types are pretty much doomed.
 
The hours seem kinda high but imagine the $ amount is pretty spot on. And that $ amount will continue to go down I imagine by 2% a year until it hits a floor of about 150Kish. All non-entrepreneurial types are pretty much doomed.

You Don't know the first thing about this practice. You have absolutely no idea how his prospects are. You spew negative BS just to make yourself feel superior.
 
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You Don't know the first thing about this practice. You have absolutely no idea how his prospects are. You spew negative BS just to make yourself feel superior.

I dont know the first thing about what exactly? Im very much fascinated by you now. You have 53 posts to your name. You joined last year....Look at my profile for a second. Look at my posting history. Look to see who I am before you spout off like some 6 year old on the playground.
 
I dont know the first thing about what exactly? Im very much fascinated by you now. You have 53 posts to your name. You joined last year....Look at my profile for a second. Look at my posting history. Look to see who I am before you spout off like some 6 year old on the playground.

You are a negative bully. You make money hand over fist (like I do) but you delight in making young pathologists/trainees feel bad about going into the profession. Knock it off. And your time on a message board and your number of posts doesn't mean sh#t and doesn't convey you wisdom or credibility same as my newness here does not indicate inexperience or ignorance. You are a jerk.
 
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You are a negative bully. You make money hand over fist (like I do) but you delight in making young pathologists/trainees feel bad about going into the profession. Knock it off. And your time on a message board and your number of posts doesn't mean sh#t and doesn't convey you wisdom or credibility same as my newness here does not indicate inexperience or ignorance. You are a jerk.

Spare us please. Pathologists of all people should be able to talk directly without the need to be snowflakes
 
Spare us please. Pathologists of all people should be able to talk directly without the need to be snowflakes

I agree, but he should actually have some facts before spewing an opinion or prognostication.
 
Knock it off boys and girls or I will tell your mommy
 
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I agree, but he should actually have some facts before spewing an opinion or prognostication.


Facts? Do you have facts to share? This is what I hate most about Pathology, the physicians who choose it. They are passive wallflowers, beta males and females who look down with shoulders slumped and sit towards the back of the room trying not make eye contact during med staff meetings. My number one inquiry when I talk to sales reps over drinks is whether I think pathologists tend to mostly be on the Autism spectrum somewhere and of course my answer is yes.

Pathology is in the rough position it is in because of the garbage leadership of generations of Autism spectrum beta pathologists.

You can now find a job easier as a NP and make more than average pathologist who has 13+ years of post secondary school education and training so forgive me Im unwilling to come onto this website and sell rainbows and unicorns to the next generation. If snowing young people is your fetish then have at it, but dont comment on my posts again.

Dave the thing is your colleagues who are orthopods or radiologists or gensurg are likely mocking you when you arent there. Its like a 98% chance. The C-suite folks probably barely know your name. That is the fate of most pathology groups. That is the practice I inherited many years ago and waged a tireless battle to fix. If you dont want honesty, dont read what I post, its that simple. Lies are everywhere out there now, just turn on the news.
 
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"Facts? Do you have facts to share? This is what I hate most about Pathology, the physicians who choose it. They are passive wallflowers, beta males and females who look down with shoulders slumped and sit towards the back of the room trying not make eye contact during med staff meetings. My number one inquiry when I talk to sales reps over drinks is whether I think pathologists tend to mostly be on the Autism spectrum somewhere and of course my answer is yes.

Pathology is in the rough position it is in because of the garbage leadership of generations of Autism spectrum beta pathologists".

LA The above is undeniably true and you described my former partners to a T. But you consistent statements that's its impossible, or at best, highly improbable that anyone going into Pathology will thrive is just wrong. In addition, telling someone not to comment on one of your posts is totally BETA
 
If the pathologists own the group low average it is around 400K the high ave is 600K revenue per path for AP alone. This about from the 40-60 percentile.
The actual range for PP is quite large with some groups netting well over a million per path. This maybe represents 5-10 of the population as does those netting near 200K.

This doe not include any part A or billed CP-26.
If your an employee or have group with a large senior hierarchy that needs to be feed, then expect your take home pay to be a lot lower.

In other words, this for sum of the practice not necessarily what the ave Joe makes.
That why a partnership or some transparency on the business is very helpful
to obtaining a good position.
 
LA The above is undeniably true and you described my former partners to a T. But you consistent statements that's its impossible, or at best, highly improbable that anyone going into Pathology will thrive is just wrong. In addition, telling someone not to comment on one of your posts is totally BETA

Hold the phone. NOWHERE have I ever said what I have accomplished or simply being successful in Pathology is impossible. If I thought it was impossible, I wouldnt waste my flipping time here.

My point is: Medicine is a business and pathology is not only a business but often much more cut throat than traditional office based medicine. If you have a passive personality, are unwilling to confront people and colleagues, if you are incapable of standing up for yourself, if your GF or BF runs roughshod over you and you end up in handcuffs face down on the bed any given Saturday night THEN maybe just maybe you would be far more successful doing something else like being a GP.

I think people that know me and know me on the site will agree that is my core message and has been for what now? 13+ years on SDN.

I hate to admit it now but back in the early days when I was single and living in LA, I pretty much just used SDN as a hook up app but I have taken the time over the years to actually spread my wisdom when I have time.
 
I hate to admit it now but back in the early days when I was single and living in LA, I pretty much just used SDN as a hook up app but I have taken the time over the years to actually spread my wisdom when I have time.

My Lord, what a great idea!
Here I've been wasting my time on those internet dating websites.
 
My Lord, what a great idea!
Here I've been wasting my time on those internet dating websites.

Internet dating originally was toxic mixture of people who were actually married and looking to cheat, women on psych meds, druggies, hookers and fat girls who excelled at photography enough to project a normal BMI pic. Also I was for a period of my single days into female pediatricians/obs specifically. Not quite fetish levels but I was turned on by ped/ob residents in scrubs so once I took a position at a cancer center with zero peds/ob, I needed to fill the void as hanging out at the UCLA med library was feeling too creepy. SDN filled that void:)
 
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Facts? Do you have facts to share? This is what I hate most about Pathology, the physicians who choose it. They are passive wallflowers, beta males and females who look down with shoulders slumped and sit towards the back of the room trying not make eye contact during med staff meetings. My number one inquiry when I talk to sales reps over drinks is whether I think pathologists tend to mostly be on the Autism spectrum somewhere and of course my answer is yes.

Pathology is in the rough position it is in because of the garbage leadership of generations of Autism spectrum beta pathologists.

You can now find a job easier as a NP and make more than average pathologist who has 13+ years of post secondary school education and training so forgive me Im unwilling to come onto this website and sell rainbows and unicorns to the next generation. If snowing young people is your fetish then have at it, but dont comment on my posts again.

Dave the thing is your colleagues who are orthopods or radiologists or gensurg are likely mocking you when you arent there. Its like a 98% chance. The C-suite folks probably barely know your name. That is the fate of most pathology groups. That is the practice I inherited many years ago and waged a tireless battle to fix. If you dont want honesty, dont read what I post, its that simple. Lies are everywhere out there now, just turn on the news.
Actually, only the insecure and immature mock others for their differences. Adult physicians should behave better than a junior high school student.

Pathologists may be less outgoing than surgeons but frankly I don't know anyone who cares about that, just that they do their job an do it well.

Let's keep the conversation on topic, professional and without insults.
 
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Did you just necro this thread from a month+ ago to make this point? Okay...and to respond:

And it actually matters alot in terms of business how outgoing pathologists are (or are not in this example).

It literally is the difference why some pathologists (and other specialists) will get nada for call while surgeons will get real money.
 
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Did you just necro this thread from a month+ ago to make this point? Okay...and to respond:

And it actually matters alot in terms of business how outgoing pathologists are (or are not in this example).

It literally is the difference why some pathologists (and other specialists) will get nada for call while surgeons will get real money.


In general, this has been my experience. Much more than most specialties, particularly those which rely on referrals from Primary Care, pathologists are
lacking in the first "A" of the "affability, availability and ability" adage for success. They are a meek lot, have disproportionately poorer communication skills and remain in the back ground in their comfort zone. Hence, they generally get hind teat. And there are far too many regardless of what AMA or CAP say.
 
This comes from 5+ decades of medical school deans seeing socially maladaptive medical students and shunting them into pathology. It creates a negative feedback loop so when even well adjusted humans enter pathology they are shellshocked by the odd behavior and undergo some career type of normalcy bias.

Im saying this because many many years ago I was there in the mix. I had to have my college roommate, an attorney, repeatedly tell me "no, normal people dont behave like this." Nothing shocks me now though with pathologists, I have seen the full spectrum of insanity (or at least I hope).
 
Actually, only the insecure and immature mock others for their differences. Adult physicians should behave better than a junior high school student.

Pathologists may be less outgoing than surgeons but frankly I don't know anyone who cares about that, just that they do their job an do it well.

Let's keep the conversation on topic, professional and without insults.

Personality deficits in big academia have been destroying leverage from our field and thus destroying the field from a macro and microeconomic standpoint. This is very on topic and relevant to our field. Thank you for your contribution, but your post itself mocked a commentator (using your own definition) by insinuating people in this thread are behaving like Jr. High schoolers.
 
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To be fair, LADoc, delivers his point in a harsh caustic manner, that it comes across as condescending and distasteful. Crossing the line into offensive territory. The substance of his argument may be true, but the tone negates the impact. So I have to back up WS on this one.

Why not just say Pathologists need to be more assertive?
 
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To be fair, LADoc, delivers his point in a harsh caustic manner, that it comes across as condescending and distasteful. Crossing the line into offensive territory. The substance of his argument may be true, but the tone negates the impact. So I have to back up WS on this one.

Why not just say Pathologists need to be more assertive?

Because its far more complex than that. Pathologists are poorly treated by admin and other physicians but real abuse occurs at the hands of other pathologists. An apt analogy would be increased rate of victims of sex abuse to become abusers themselves as a type of psychological "vampire effect". If jr. pathologists only had to deal with the fact they arent paid for call, I would even bother mentioning it but its part of such a larger deficit I comment on it. I just dont think this occurs at anywhere near the rate in any other area of medicine. More worrisome to me is that the normal folks end up being bunkered down into islands of smaller groups, making the vast swaths of landscape even worse. It was like this in late 90s and is tbh is even worse now. I dont even know if there is a floor on this anymore.
 
if your GF or BF runs roughshod over you and you end up in handcuffs face down on the bed any given Saturday night THEN maybe just maybe you would be far more successful doing something else like being a GP.

This Yaah and any other people who care to listen, this as well as demanding facts and immediately painting nearly an entire specialty of medical doctors as autistic (in a tone that CLEARLY intends to paint autism as a disqualification to success); and that this isn't even the worst of what's routinely said on this board is why this entire den of rancid vomit has become only good for one thing: whenever a candidate volunteers any sort of admiration for this board they are immediately DNR'd.

You've successfully become only a handy screening tool for sociopaths. Congratulations.
 
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This Yaah and any other people who care to listen, this as well as demanding facts and immediately painting nearly an entire specialty of medical doctors as autistic; and that this isn't even the worst of what's routinely said on this board is why this entire den of rancid vomit has become only good for one thing: whenever a candidate volunteers any sort of admiration for this board they are immediately DNR'd.

You've successfully become only a handy screening tool for sociopaths. Congratulations.

LADoc writes in Homeric simile's. A bit of a filthy mind, but nonetheless Homeric.
 
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I sometimes think of LADoc as the king of gonzo commentary: you may disagree with him or find his posts hyperbolic and inflammatory, but he's always compelling reading.
 
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I hate to admit it now but back in the early days when I was single and living in LA, I pretty much just used SDN as a hook up app...

Ha let me get this straight. You were using SDN to try to meet women while single in LA... while berating our field as too socially awkward?

Not too many attractive girls in LA to meet organically, let me try to hit on these med students via SDN private message... I think she is female based on her username... You pathologists are such dorks!
 
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My posts of course are tongue in cheek and are clearly hyperbole+ mainly because traditional conformist speech in modern medicine goes nowhere. We have this ingrained normalcy bias due to profound gravitas of what we do and a tendency to deal psychologically via a sick gallows humor. Cultural change in medicine is incredibly hard to move the needle.

The underlying issues of this field have not been addressed in over 2 decades after a number of pathologists began postings on message boards about this:
1.) Academia has overtrained pathology to absurd degree and predominantly for their own financial benefit.
2.) Residency programs are failing to train pathologists for real world skills needed for independent sign out and are feeding into the crisis created in point 1. Academia has done a wonderful job of creating professional dependency through fostering diagnostic insecurity, passivity and obedience.
3.) Medical schools are continuing to perpetuate a bigoted stereotype of pathologists as socially inept and are front and center in keeping this stereotype alive by continuing to shunt certain students into the field.
4.) The modern business model of single or small cabal of outgoing pathologists essentially enslaving the remaining population created by points 1-3 is degenerate and is driving the entire profession to the floor.

The difference between the Pathology Haves and Have Nots is insane. Insane.

Are these things prospective residents should be blind to? Should they think long and hard about what they may be doing and may be facing for at least several decades after residency is over?

What do you want to tell the next generation of pathologists? Telling young folks everything is "roses and unicorns" is literally what has happened since the 80s...
 
My posts of course are tongue in cheek and are clearly hyperbole+ mainly because traditional conformist speech in modern medicine goes nowhere. We have this ingrained normalcy bias due to profound gravitas of what we do and a tendency to deal psychologically via a sick gallows humor. Cultural change in medicine is incredibly hard to move the needle.

The underlying issues of this field have not been addressed in over 2 decades after a number of pathologists began postings on message boards about this:
1.) Academia has overtrained pathology to absurd degree and predominantly for their own financial benefit.
2.) Residency programs are failing to train pathologists for real world skills needed for independent sign out and are feeding into the crisis created in point 1. Academia has done a wonderful job of creating professional dependency through fostering diagnostic insecurity, passivity and obedience.
3.) Medical schools are continuing to perpetuate a bigoted stereotype of pathologists as socially inept and are front and center in keeping this stereotype alive by continuing to shunt certain students into the field.
4.) The modern business model of single or small cabal of outgoing pathologists essentially enslaving the remaining population created by points 1-3 is degenerate and is driving the entire profession to the floor.

The difference between the Pathology Haves and Have Nots is insane. Insane.

Are these things prospective residents should be blind to? Should they think long and hard about what they may be doing and may be facing for at least several decades after residency is over?

What do you want to tell the next generation of pathologists? Telling young folks everything is "roses and unicorns" is literally what has happened since the 80s...
I like that you say how it is...i just want to ask a few questions and this is not rhetorical or sarcastic...i really want your advice...

Foe those of us who cant escape pathology...I am a pathologist that works for a lab company....but I want to get a partner track position one day....do I tough out the lab job and get more experience (I am at a community hospital and the experience I am getting is great)?? Do I pursue more subspecialized training like GI or Derm? None of the above? How does one solve these career problems and dissatisfaction with the field???

I appreciate any real world advice you may have.
 
I like that you say how it is...i just want to ask a few questions and this is not rhetorical or sarcastic...i really want your advice...

Foe those of us who cant escape pathology...I am a pathologist that works for a lab company....but I want to get a partner track position one day....do I tough out the lab job and get more experience (I am at a community hospital and the experience I am getting is great)?? Do I pursue more subspecialized training like GI or Derm? None of the above? How does one solve these career problems and dissatisfaction with the field???

I appreciate any real world advice you may have.
 
I would stay in the community hospital situation working for Quest/et.al.
until I was known, liked and trusted by the local clinical community. If and when you want to leave for a better gig you will be far ahead of 90% of the folks seeking desirable PP positions. I say it too much but, this assumes
you have affability, availability, and ability- in that order.
 
This comes from 5+ decades of medical school deans seeing socially maladaptive medical students and shunting them into pathology. It creates a negative feedback loop so when even well adjusted humans enter pathology they are shellshocked by the odd behavior and undergo some career type of normalcy bias.

Im saying this because many many years ago I was there in the mix. I had to have my college roommate, an attorney, repeatedly tell me "no, normal people dont behave like this." Nothing shocks me now though with pathologists, I have seen the full spectrum of insanity (or at least I hope).

This is so true.

I have also found that pathologists are a bit like North Korean citizens. A few top cats are making off like bandits, while the rest of the populace is squalid and powerless. Even worse, one-in-three of your comrades would be eager to stab you in the back at the first chance to curry favor with their so-called superiors, be it admins, surgeons or other top-dog pathologists.
 
This is so true.

I have also found that pathologists are a bit like North Korean citizens. A few top cats are making off like bandits, while the rest of the populace is squalid and powerless. Even worse, one-in-three of your comrades would be eager to stab you in the back at the first chance to curry favor with their so-called superiors, be it admins, surgeons or other top-dog pathologists.
Where is that loudmouth LADoc to respond to my inquiry? Usually he doesn't shut up...
 
I like that you say how it is...i just want to ask a few questions and this is not rhetorical or sarcastic...i really want your advice...

Foe those of us who cant escape pathology...I am a pathologist that works for a lab company....but I want to get a partner track position one day....do I tough out the lab job and get more experience (I am at a community hospital and the experience I am getting is great)?? Do I pursue more subspecialized training like GI or Derm? None of the above? How does one solve these career problems and dissatisfaction with the field???

I appreciate any real world advice you may have.
Honestly buddy if you seriously want serious advice on something like that there's no hope for you. God almighty.
Do you keep your job or quit or go back to residency or look elsewhere or just post on SDN hoping to have some salvation delivered by an insightful anonymous dude with a pithy username who presumable knows more of what's best for you than you do....
 
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Honestly buddy if you seriously want serious advice on something like that there's no hope for you. God almighty.
Do you keep your job or quit or go back to residency or look elsewhere or just post on SDN hoping to have some salvation delivered by an insightful anonymous dude with a pithy username who presumable knows more of what's best for you than you do....
I wasn' asking you ..you obviously don't know s@*t
 
Seriously dude, no one knows you, your life, the details of your situation, where you practice, where you want to practice, where you trained, what your skill level is...all we know is you're unhappy and don't know what to do...and you want serious advice from this crowd? Talk to your colleagues; contact your alma mater; contact friends; sit down with a glass of Oban 18 and have some serious introspection.
 
Seriously dude, no one knows you, your life, the details of your situation, where you practice, where you want to practice, where you trained, what your skill level is...all we know is you're unhappy and don't know what to do...and you want serious advice from this crowd? Talk to your colleagues; contact your alma mater; contact friends; sit down with a glass of Oban 18 and have some serious introspection.
Thank you....you def have a point....maybe not scotch though....
 
I wasn' asking you ..you obviously don't know s@*t

You come here, ask a valid question and then start to trash the folks
who have been around here for ages? That is poor form. I’m not surprised you are having a difficult professional life. And I DO know s*** about
this business.
 
I like that you say how it is...i just want to ask a few questions and this is not rhetorical or sarcastic...i really want your advice...

Foe those of us who cant escape pathology...I am a pathologist that works for a lab company....but I want to get a partner track position one day....do I tough out the lab job and get more experience (I am at a community hospital and the experience I am getting is great)?? Do I pursue more subspecialized training like GI or Derm? None of the above? How does one solve these career problems and dissatisfaction with the field???

I appreciate any real world advice you may have.

This is a phenomenally challenging question to seriously answer via internet posting. Its akin to someone posting "I want a be a Navy SEAL diver"...I dont know you, your risk tolerance, your family dependency situation, your financial books etc. Geographic restrictions, adaptability, independence level etc.

One thing is absolutely certain: IF you wait to make change, real change in your situation until you are married with 2 kids you are hosed, forever. Your risk tolerance will be too low, your familial geofence will be too narrow, you will be weakened too significantly by an inability to leave your gilded prison cage.

As DeNiro said in Heat: Don't let yourself get attached to anything you are not willing to walk out on in 30 seconds flat if you feel the heat around the corner.

Your kids will grow up knowing only a slave dad and not a man. They may have their material needs taken care of, but will be internally repelled by the moral compromises you made by laying prostate before idiot middle managers after you spent 12+ years in college, med school and residency.
 
This comes from 5+ decades of medical school deans seeing socially maladaptive medical students and shunting them into pathology. It creates a negative feedback loop so when even well adjusted humans enter pathology they are shellshocked by the odd behavior and undergo some career type of normalcy bias.

Im saying this because many many years ago I was there in the mix. I had to have my college roommate, an attorney, repeatedly tell me "no, normal people dont behave like this." Nothing shocks me now though with pathologists, I have seen the full spectrum of insanity (or at least I hope).

This is so true. I was an NCAA athlete in a major sport in college...very social, enjoy shooting the **** and networking with people, confident enough to speak up and be assertive (but respectful) in times of disagreement/conflict. When I started pathology residency I QUICKLY learned that most of my classmates were not like that. Good people (actually a great group of smart people) and mostly not weird, but very passive/self-deprecating. Attempts to be assertive or apply leadership skills were often seen as too aggressive or alpha. I decided to purposely tone it down a bit to keep my reputation positive. It has worked out well, but sometimes it's painful. Much easier to have a candid conversation with my clinicians than other pathologists, and when you stand up for yourself/pathology they actually seem to respect you more for it (especially surgeons).
 
I wish this thread yielded more pathologists sharing their hours/setting/salary. Since the conversation has deeply digressed, if you do not feel comfortable sharing this info publicly, please pm me your experiences!
 
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I wish this thread yielded more pathologists sharing their hours/setting/salary. Since the conversation has deeply digressed, if you do not feel comfortable sharing this info publicly, please pm me your experiences!

1st year out of training, 1 SP fellowship. $230K, partner track, hours are roughly 30/week, inclusive of internet shopping and lunch time. Virtually no call or weekends. Schedule is nice, but current employed and (rumored) partner salaries for group are on the low side.. Definitely would be willing to work more in exchange for paying off loans faster.
 
50-60 hrs a week, call weeks about 4 times a year, partner after less than 5 years, just over 7 figures after partnership low 200's to start.
 
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