CAP Pathologist Leadership Conference

[cmz]

I think they are fine at what they do but needles just don't have great yield on a fair number of lung nodules. It's not their fault. They nail it with the forceps virtually every time. Forceps outperforms needle consistently. I have 10s of thousands of cases that help me come to this conclusion.

Guardant 360 will be replacing the need for ROSE I would think at some point. Our oncologists order this regardless if there is enough tissue or not. 10 years from now we will look back and say "remember standing around doing all that useless ROSE procedures that we didn't get paid for?" I could have cut down a tree for 2 grand in that time.

I am on board with this 100%. I would rather stay away from ROSE but we just find it difficult to divorce ourselves from this necessary evil right now. And yes, the possibility of getting a limited sample exists (and happens more often than you would like even if you try your hardest to get more tissue) and our only real option is NGS or some derivative of that... the amount of ancillary testing being requested is outrageous.

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[Alteran]

As discussed ad nauseum, there really is no good data to suggest oversupply OR shortage. only anecdotes.

I agree there is no standard way to measure. But I will offer to the forum here that my group posted a couple of pathologist positions on Pathology Outlines and we got about a dozen or so applicants, per position, in under 72 hours. And we kept getting them right up until the posts were taken down. Keep in mind my city is off the beaten path and no where near as desirable as the bigger metro areas in my state. For comparison, it takes the local radiology group about a decade on average to hire an interventional radiologist.

Edit: Forgot to mention that all the applicants were unique (i.e. the same applicant was not applying for multiple positions with our group).

 

[cmz]

The notion that a "shortage" or "oversupply" can be simply calculated with tabulation of numbers and projections is a farce.

These are the facts:
1.) Academic centers WANT current or increased numbers of residents because it:
a.) reinforces the idea that respective institutions are competitive, relevant and important;
b.) it is cheaper to increase pathology training positions than hire PAs;
c.) decreasing resident spots is a sign to institutional GME offices that said pathology department is losing volume and hence revenue.
2.) Corporate labs WANT current or increased numbers of residents because it creates a cheaper labor force. This is purely economics; they care about the bottom line not the profession of pathologist physicians.
3.) The ability to find non-academic and non-corporate positions is increasingly hard for graduating residents, who in turn extend their training by increasing periods of time to make themselves more competitive.
4.) There is a MASSIVE disconnect regarding practice expectations, attitudes and perceptions when comparing academic to private pathology.
5.) Given the choice between an academic center paying "X" dollars, a corporate lab paying "X - 1.5X" dollars, or a private gig paying "2X - 3X" dollars, the overwhelming majority of applicants would choose the third option were it not for intense geographic restriction, underlying interest in academic pathology, or family/social reasons.
6.) The idea that retiring pathologists and new pathologists equals a 1:1 job ratio is a farce. Not all retiring pathologists occupy a full-time position, and the loss in revenue from decreasing reimbursements and corporate competition necessitates that not all positions would be filled in the first place.
7.) CMS rates go down every year; sometimes private rates go up, but overall revenue streams are tied to volume not value, and it is a constant battle to maintain revenue streams.

I don't see how a massive shortage can be foreseen unless being delusional, dishonest or both.

Agree with all points stated. However, private rates usually going up may be a myth, too. Most private carrier rates are tied into as a percentage of MCR. So if MCR dips 10%, so will your private carrier rates.

At least in my geographic locale, we are an underserved area. I am not sure on the current trends for pathologist distribution per 100,000 population, but it seems to be somewhere in the neighborhood of 3.5-5 pathologists/100K population. My area has a whopping 1.5/100K and that's because I'm being generous. Texas, in general, is at the bottom 1/3rd according to JAMA (Trends in the US and Canadian Pathologist Workforces From 2007 to 2017).

 

[path24]

Any pathologist that has been out of training and practiced for a few years knows there is an oversupply. You see it with getting a job, contracts, insurance, locums...etc. I don't know what to tell you if you think you need a paper or data. The real world of pathology provides tons of evidence.

As always med students stay away from this field. You will end up in a corporate or academic mill. (maybe all physicians will end up there, but pathologists will always be the doctor on the bottom)

 

[deleted314957]

so how the hell does this stupid myth keep perpetuating? who uncovered that the AMA data supplied to the CAP was a 40% undercount? were there retractions or corrections in the myriad of publications that bemoan the looming shortage?
what a load of garbage.

Of course there were retractions

 

[Allegri]

This idea it is only academics perpetuating the pathologist shortage is questionable. Of the five pathologists on the panel discussion of the workforce, cited in the OP, only one (Mills) is an academic. Assuming the panelists were all in some form of agreement (I don't know, wasn't there), you have a good number of private practice pathologists there apparently agreeing with the shortage.

 

[deleted314957]

The 1st paragraph of Path24’s post says it all. The most casual observer of this field knows there’s too many paths. Just look at the comically low number of cases most paths( particularly in academia) sign out. But, I guess if I was on a 300k salary with things going the direction they have for the last 35 years, I’d be real slow and bitch about having to do 5k/yr and scream for more help( aka residents in academia) too.

 

[Doormat]

This idea it is only academics perpetuating the pathologist shortage is questionable. Of the five pathologists on the panel discussion of the workforce, cited in the OP, only one (Mills) is an academic. Assuming the panelists were all in some form of agreement (I don't know, wasn't there), you have a good number of private practice pathologists there apparently agreeing with the shortage.

You are correct about this - but I believe that there is a mix of pathologists within these subgroups who are incentivized to maintain a pathologist oversupply. Private practice pathologists who have pulled up the ladders behind themselves and employ minions want an oversupply. Academic pathologists who are salaried and need cheap labor want an oversupply. The MBA VPs at LabCorp, Quest, Sonic, and other corporate labs want an oversupply. These diverse groups are aligned in their support for maintaining a glut of pathologists.

An earlier thread mentioned a CAP Today article that quoted a private practice pathologist-lab owner who was lamenting the good old days when they could offer a crappy salaried position to a pathologist fresh out of training and they would take just it.

I am one of those who believe supply and demand matters. Slashing pathology training positions will benefit future and current pathologists.

 

[KeratinPearls]

Any pathologist that has been out of training and practiced for a few years knows there is an oversupply. You see it with getting a job, contracts, insurance, locums...etc. I don't know what to tell you if you think you need a paper or data. The real world of pathology provides tons of evidence.

As always med students stay away from this field. You will end up in a corporate or academic mill. (maybe all physicians will end up there, but pathologists will always be the doctor on the bottom)

Just use COMMON SENSE observations. You don’t need data.

 

[PATHDOCNYCNJ]

Cutting the number of residency spots sure is a great start. Do we really need to train more residents at HCA or other no name community hospitals. No I don’t think so.

Cut the number of spots which will make the field more competitive to get into and you won’t get crappy applicants applying and getting in every year. Or even worse applicants whose hearts aren’t set on actually becoming a pathologist.

At the very least, put trainees in high volume academic places so they don’t graduate without knowing how to read a Pap smear.

Emulate dermatology. Their field has flourished over the years because they limit the numbers who match. What’s so special about Derm that makes it so competitive to get in. There’s nothing special about Derm. They just manage their field well.

I graduated from a high volume academic place. And the role of a resident was that of a glorified secretary and meat cutter. A typical day would be organizing the slides to match the paperwork all morning. There were a dozen sub specialists plus some who would do the Medicaid cases. You had to know which case went to which specialist. Then when you find missing slides missing paperwork etc, you were running to the lab and the secretaries. Then you had to make appointments with the pediatric pathologist, the breast pathologist the ent pathologist, the GI pathologist etc etc etc and run all through five floors to where each one had the office. The department chairman loved acquiring accounts which would all go in aqua cassettes and you had to show these only to the pathologist who had a contract with said account. Each pathologist would dictate the diagnosis while you transcribed his or her verbiage onto the paper you then had to walk over to the secretarial pool. Perhaps while being his/her secretary you would be shot a few path pearls or get pimped. Very passive learning. If you did not finish all of this and start grossing by 1 pm, you would likely be grossing well into the evening. For hepatic pathology, you grossed their specimens then the fellow took it over and read with the liver team. You never got a chance to learn liver pathology in action, but they made senior residents evaluate transplant livers that came in after midnight on FS. Derm and neuro rotations were combined. They needed your body at the grossing station. I learned how become an excellent PA. One year the boss tried to train the PAs (who were only putting biopsies in cassettes) to do the junk cases like hernia sacs, gallbladders etc but they became bitter and vocally griped that they’re getting this because the residents don’t want to do work.

There was a pediatric path rotation, but you only did placentas, POCs and autopsies.

Cytology rotation: only 2 months out of the 4 years. You just sat with a cytopath attending who just reviewed the slides and spoke mainly with the cyto fellow while you zoned out watching cells speed by your field of vision. Then the fellow would give you a cyto didactic Kodachrome set from 1970 for you to learn PAP smear reading.

After all that I graduated with no job lined up. No one was hiring pathologists just out of residency. When I joined the residency, I was told how the boss knows tons of people and jobs would be easy to come by. He didn’t even care after the 4 years. You were on your own. I was lucky to get a job in a Medicaid slide mill for $4.00 per slide a few months later.

 

[KeratinPearls]

I graduated from a high volume academic place. And the role of a resident was that of a glorified secretary and meat cutter. A typical day would be organizing the slides to match the paperwork all morning. There were a dozen sub specialists plus some who would do the Medicaid cases. You had to know which case went to which specialist. Then when you find missing slides missing paperwork etc, you were running to the lab and the secretaries. Then you had to make appointments with the pediatric pathologist, the breast pathologist the ent pathologist, the GI pathologist etc etc etc and run all through five floors to where each one had the office. The department chairman loved acquiring accounts which would all go in aqua cassettes and you had to show these only to the pathologist who had a contract with said account. Each pathologist would dictate the diagnosis while you transcribed his or her verbiage onto the paper you then had to walk over to the secretarial pool. Perhaps while being his/her secretary you would be shot a few path pearls or get pimped. Very passive learning. If you did not finish all of this and start grossing by 1 pm, you would likely be grossing well into the evening. For hepatic pathology, you grossed their specimens then the fellow took it over and read with the liver team. You never got a chance to learn liver pathology in action, but they made senior residents evaluate transplant livers that came in after midnight on FS. Derm and neuro rotations were combined. They needed your body at the grossing station. I learned how become an excellent PA. One year the boss tried to train the PAs (who were only putting biopsies in cassettes) to do the junk cases like hernia sacs, gallbladders etc but they became bitter and vocally griped that they’re getting this because the residents don’t want to do work.

There was a pediatric path rotation, but you only did placentas, POCs and autopsies.

Cytology rotation: only 2 months out of the 4 years. You just sat with a cytopath attending who just reviewed the slides and spoke mainly with the cyto fellow while you zoned out watching cells speed by your field of vision. Then the fellow would give you a cyto didactic Kodachrome set from 1970 for you to learn PAP smear reading.

After all that I graduated with no job lined up. No one was hiring pathologists just out of residency. When I joined the residency, I was told how the boss knows tons of people and jobs would be easy to come by. He didn’t even care after the 4 years. You were on your own. I was lucky to get a job in a Medicaid slide mill for $4.00 per slide a few months later.

Residency is basically a master slave type of scenario. We’ve all been through that. Every field. I did most of what you had to do as well. Not getting to review the cases you gross is a big NO NO. Any resident should report this in their ACGME survey during residency.

But the thing in Pathology is that you do all this work for 6 years and come out into a job market with limited jobs with 5 years to partnership and 180-200k starting salary!

BTW, did you know there is a shortage of residents in Pathology!!! LMAO!

 

[Alteran]

I graduated from a high volume academic place. And the role of a resident was that of a glorified secretary and meat cutter. A typical day would be organizing the slides to match the paperwork all morning. There were a dozen sub specialists plus some who would do the Medicaid cases. You had to know which case went to which specialist. Then when you find missing slides missing paperwork etc, you were running to the lab and the secretaries. Then you had to make appointments with the pediatric pathologist, the breast pathologist the ent pathologist, the GI pathologist etc etc etc and run all through five floors to where each one had the office. The department chairman loved acquiring accounts which would all go in aqua cassettes and you had to show these only to the pathologist who had a contract with said account. Each pathologist would dictate the diagnosis while you transcribed his or her verbiage onto the paper you then had to walk over to the secretarial pool. Perhaps while being his/her secretary you would be shot a few path pearls or get pimped. Very passive learning. If you did not finish all of this and start grossing by 1 pm, you would likely be grossing well into the evening. For hepatic pathology, you grossed their specimens then the fellow took it over and read with the liver team. You never got a chance to learn liver pathology in action, but they made senior residents evaluate transplant livers that came in after midnight on FS. Derm and neuro rotations were combined. They needed your body at the grossing station. I learned how become an excellent PA. One year the boss tried to train the PAs (who were only putting biopsies in cassettes) to do the junk cases like hernia sacs, gallbladders etc but they became bitter and vocally griped that they’re getting this because the residents don’t want to do work.

There was a pediatric path rotation, but you only did placentas, POCs and autopsies.

Cytology rotation: only 2 months out of the 4 years. You just sat with a cytopath attending who just reviewed the slides and spoke mainly with the cyto fellow while you zoned out watching cells speed by your field of vision. Then the fellow would give you a cyto didactic Kodachrome set from 1970 for you to learn PAP smear reading.

After all that I graduated with no job lined up. No one was hiring pathologists just out of residency. When I joined the residency, I was told how the boss knows tons of people and jobs would be easy to come by. He didn’t even care after the 4 years. You were on your own. I was lucky to get a job in a Medicaid slide mill for $4.00 per slide a few months later.

This is why as a med student you have to ask the right questions when both screening a program and when you're interviewing:

1. How many PAs does the department have? If the answer is zero or "we're planning on hiring one", move on. Scratch it off the list and don't look back.
2. How much previewing do you afford your residents? If the answer sounds hinky or in your mind isn't realistic (as in an hour or two to look over 50 cases every morning or at random intervals throughout the week), move on.
3. What is a surgical pathology rotation like? If it even sounds remotely similar to what is described above, the program should be classified as malignant and I wouldn't bother even ranking them.

There is no quality control for pathology residency programs, which is so ironic because pathologists bill themselves as quality assurance experts in all we do...except for the quality of the pathologists we're training. My latest shower thought on the matter is that if we as a profession have to undergo inspections for all that we do, residency programs should also be inspected by CAP in collaboration with ACGME by practicing pathologists to include those in private practice. There really should be a mandatory checklist for residency programs to maintain an accredited pathology program. I'm thinking of stuff like:
- Absolute minimum amount of surgical pathology volume/resident.
- Absolute minimum amount of a variety of specimens.
- Absolute minimum amounts of preview time per certain units of volume.
- Dedicated sign-out time with the attendings which is protected.
- Being able as an inspector to sit down with senior (PGY-3/4) residents, of your choosing, at the scope and see how they're able to function.
- An absolute minimum number of PAs/quantity of surgical volumes.

These inspections should be totally random and unannounced every year with rare blackout date exceptions. If CAP were actually to do the above in collaboration with ACGME, and it were a serious effort, it would go a long way to get rid of the pathology training mills and produce a better colleague.

 

[KeratinPearls]

This is why as a med student you have to ask the right questions when both screening a program and when you're interviewing:

1. How many PAs does the department have? If the answer is zero or "we're planning on hiring one", move on. Scratch it off the list and don't look back.
2. How much previewing do you afford your residents? If the answer sounds hinky or in your mind isn't realistic (as in an hour or two to look over 50 cases every morning or at random intervals throughout the week), move on.
3. What is a surgical pathology rotation like? If it even sounds remotely similar to what is described above, the program should be classified as malignant and I wouldn't bother even ranking them.

There is no quality control for pathology residency programs, which is so ironic because pathologists bill themselves as quality assurance experts in all we do...except for the quality of the pathologists we're training. My latest shower thought on the matter is that if we as a profession have to undergo inspections for all that we do, residency programs should also be inspected by CAP in collaboration with ACGME by practicing pathologists to include those in private practice. There really should be a mandatory checklist for residency programs to maintain an accredited pathology program. I'm thinking of stuff like:
- Absolute minimum amount of surgical pathology volume/resident.
- Absolute minimum amount of a variety of specimens.
- Absolute minimum amounts of preview time per certain units of volume.
- Dedicated sign-out time with the attendings which is protected.
- Being able as an inspector to sit down with senior (PGY-3/4) residents, of your choosing, at the scope and see how they're able to function.
- An absolute minimum number of PAs/quantity of surgical volumes.

These inspections should be totally random and unannounced every year with rare blackout date exceptions. If CAP were actually to do the above in collaboration with ACGME, and it were a serious effort, it would go a long way to get rid of the pathology training mills and produce a better colleague.

Well said.

Practical exams to see how diagnostically competent graduating residents are. Give senior residents 10-20 gyn and nongyn cytology cases, 20+ surgpath, 20+hemepath cases and see if they can work them up. Show them frozens. See if they are able to make an accurate diagnosis. Make these subpar residency programs sweat. Consistent failures leads to probation and closure of programs.

Programs need to be held accountable for graduating diagnostically competent graduates.

There are programs where you can slip through the cracks and can’t even diagnose a pap to save your life or can’t even call a cancer on a frozen.

 

[deleted314957]

I graduated from a high volume academic place. And the role of a resident was that of a glorified secretary and meat cutter. A typical day would be organizing the slides to match the paperwork all morning. There were a dozen sub specialists plus some who would do the Medicaid cases. You had to know which case went to which specialist. Then when you find missing slides missing paperwork etc, you were running to the lab and the secretaries. Then you had to make appointments with the pediatric pathologist, the breast pathologist the ent pathologist, the GI pathologist etc etc etc and run all through five floors to where each one had the office. The department chairman loved acquiring accounts which would all go in aqua cassettes and you had to show these only to the pathologist who had a contract with said account. Each pathologist would dictate the diagnosis while you transcribed his or her verbiage onto the paper you then had to walk over to the secretarial pool. Perhaps while being his/her secretary you would be shot a few path pearls or get pimped. Very passive learning. If you did not finish all of this and start grossing by 1 pm, you would likely be grossing well into the evening. For hepatic pathology, you grossed their specimens then the fellow took it over and read with the liver team. You never got a chance to learn liver pathology in action, but they made senior residents evaluate transplant livers that came in after midnight on FS. Derm and neuro rotations were combined. They needed your body at the grossing station. I learned how become an excellent PA. One year the boss tried to train the PAs (who were only putting biopsies in cassettes) to do the junk cases like hernia sacs, gallbladders etc but they became bitter and vocally griped that they’re getting this because the residents don’t want to do work.

There was a pediatric path rotation, but you only did placentas, POCs and autopsies.

Cytology rotation: only 2 months out of the 4 years. You just sat with a cytopath attending who just reviewed the slides and spoke mainly with the cyto fellow while you zoned out watching cells speed by your field of vision. Then the fellow would give you a cyto didactic Kodachrome set from 1970 for you to learn PAP smear reading.

After all that I graduated with no job lined up. No one was hiring pathologists just out of residency. When I joined the residency, I was told how the boss knows tons of people and jobs would be easy to come by. He didn’t even care after the 4 years. You were on your own. I was lucky to get a job in a Medicaid slide mill for $4.00 per slide a few months later.

HOLY S***! You have really described HELL as a resident! WHY, WHY, WHY did you put up with that? Really. I’m curious, though it’s no one’s business.

 

[PATHDOCNYCNJ]

Residency is basically a master slave type of scenario. We’ve all been through that. Every field. I did most of what you had to do as well. Not getting to review the cases you gross is a big NO NO. Any resident should report this in their ACGME survey during residency.

But the thing in Pathology is that you do all this work for 6 years and come out into a job market with limited jobs with 5 years to partnership and 180-200k starting salary!

BTW, did you know there is a shortage of residents in Pathology!!!

Well said.

Practical exams to see how diagnostically competent graduating residents are. Give senior residents 10-20 gyn and nongyn cytology cases, 20+ surgpath, 20+hemepath cases and see if they can work them up. Show them frozens. See if they are able to make an accurate diagnosis. Make these subpar residency programs sweat. Consistent failures leads to probation and closure of programs.

Programs need to be held accountable for graduating diagnostically competent graduates.

There are programs where you can slip through the cracks and can’t even diagnose a pap to save your life or can’t even call a cancer on a frozen.

I like this idea, but it has to be so that the program director can’t deflect and blame the resident. If you can last four years at a program, you should not be the fall guy for their lack of teaching. The lack of cyto pathology teaching at my program was criminal, and does no good to say “we have a superb liver pathology group” if the resident only cuts their meat and the fellow gets all the benefit of medical liver disease pathology training. Of course there are residents that decide path is not for them, but I have never seen such a resident last longer than 1 year.

 

[PATHDOCNYCNJ]

HOLY S***! You have really described HELL as a resident! WHY, WHY, WHY did you put up with that? Really. I’m curious, though it’s no one’s business.

In a major city like NYC you can’t just quit and go to another program, especially if due to family concerns you cannot leave the area. The department chair can also bad mouth you to other residency programs. It is easier to just switch out of path altogether rather than go to another path program. If I had the ability and no family there I would have moved to another state, but the expense of moving is too much when you are paid subsistence salary while having a loan the size of a mortgage hanging over your head.

 

[Med Director New England]

This is why as a med student you have to ask the right questions when both screening a program and when you're interviewing:

1. How many PAs does the department have? If the answer is zero or "we're planning on hiring one", move on. Scratch it off the list and don't look back.
2. How much previewing do you afford your residents? If the answer sounds hinky or in your mind isn't realistic (as in an hour or two to look over 50 cases every morning or at random intervals throughout the week), move on.
3. What is a surgical pathology rotation like? If it even sounds remotely similar to what is described above, the program should be classified as malignant and I wouldn't bother even ranking them.

There is no quality control for pathology residency programs, which is so ironic because pathologists bill themselves as quality assurance experts in all we do...except for the quality of the pathologists we're training. My latest shower thought on the matter is that if we as a profession have to undergo inspections for all that we do, residency programs should also be inspected by CAP in collaboration with ACGME by practicing pathologists to include those in private practice. There really should be a mandatory checklist for residency programs to maintain an accredited pathology program. I'm thinking of stuff like:
- Absolute minimum amount of surgical pathology volume/resident.
- Absolute minimum amount of a variety of specimens.
- Absolute minimum amounts of preview time per certain units of volume.
- Dedicated sign-out time with the attendings which is protected.
- Being able as an inspector to sit down with senior (PGY-3/4) residents, of your choosing, at the scope and see how they're able to function.
- An absolute minimum number of PAs/quantity of surgical volumes.

These inspections should be totally random and unannounced every year with rare blackout date exceptions. If CAP were actually to do the above in collaboration with ACGME, and it were a serious effort, it would go a long way to get rid of the pathology training mills and produce a better colleague.

Great idea ^^
CAP being part of the acgme accreditation and inspection process of residency programs would give a voice to non academics….academia would fight anything like this.

 

[TrojanRaggy]

Well said.

Practical exams to see how diagnostically competent graduating residents are. Give senior residents 10-20 gyn and nongyn cytology cases, 20+ surgpath, 20+hemepath cases and see if they can work them up. Show them frozens. See if they are able to make an accurate diagnosis. Make these subpar residency programs sweat. Consistent failures leads to probation and closure of programs.

Programs need to be held accountable for graduating diagnostically competent graduates.

There are programs where you can slip through the cracks and can’t even diagnose a pap to save your life or can’t even call a cancer on a frozen.

Probably only 10-20% of US residents will be able to pass the kind of exam described (Royal college pattern). Less if you let them do a "fellowship of the left elbow" first

 

[path24]

Academics, path mills, path organizations will not be changing anything. They like the oversupply and exploitation. The best thing this forum can do is to inform med students about how bad of a decision it is to go into pathology. It is the worst pick a med student can make. The field will not change, but we can make sure young people are aware of the poor choice they may make or at least understand the consequences that come with the decision. The future GI doc will always own the future path doc. I don't care about your scores, letters, schools...etc. That is the market and it isn't going to change (for decades pathology leadership has made sure it won't).

 

[WEBB PINKERTON]

Academics, path mills, path organizations will not be changing anything. They like the oversupply and exploitation. The best thing this forum can do is to inform med students about how bad of a decision it is to go into pathology. It is the worst pick a med student can make. The field will not change, but we can make sure young people are aware of the poor choice they may make or at least understand the consequences that come with the decision. The future GI doc will always own the future path doc. I don't care about your scores, letters, schools...etc. That is the market and it isn't going to change (for decades pathology leadership has made sure it won't).

The future GI doc will be owned as well.

There are a few worse choices than pathology. Are rad onc, EM, gas really in better shape?

 

[KeratinPearls]

Academics, path mills, path organizations will not be changing anything. They like the oversupply and exploitation. The best thing this forum can do is to inform med students about how bad of a decision it is to go into pathology. It is the worst pick a med student can make. The field will not change, but we can make sure young people are aware of the poor choice they may make or at least understand the consequences that come with the decision. The future GI doc will always own the future path doc. I don't care about your scores, letters, schools...etc. That is the market and it isn't going to change (for decades pathology leadership has made sure it won't).

Academics, path mills, path organizations to all young trainees and pathologists:

WE OWN YOU.

 

[KeratinPearls]

The future GI doc will be owned as well.

There are a few worse choices than pathology. Are rad onc, EM, gas really in better shape?

Do other physicians take a 50% cut out of their (EM, radon’s, gas) pay? Serious question.

 

[path24]

The future GI doc will be owned as well.

There are a few worse choices than pathology. Are rad onc, EM, gas really in better shape?

When both docs are employed the 88305 PC will still be on the table. It will be negotiated by the GI doc and the employer. The path will be happy just to have a job. Path won't be at the table, easily replaced. Still owned by a GI doc that knows what's up.

 

[HeyDalaron]

I like the idea of CAP inspections of residency programs. Unfortunately, I think that CAP would game it so that most would pass, seeing as how they appear to be just fine with the surplus of subpar programs causing a glut. An external inspecting organization would be a better choice.

 

[cmz]

Do other physicians take a 50% cut out of their (EM, radon’s, gas) pay? Serious question.

GI groups monetize pathology. They also certainly monetize gas. They employ a bunch of CRNAs with possible oversight by an MD/DO (I am not sure of the requirements here). At least path isn't 100% getting boned. It's tough to say who is getting paid more, on average, but you should have an easier time pushing volume as a pathologist to earn more $$$.

 

[WEBB PINKERTON]

Do other physicians take a 50% cut out of their (EM, radon’s, gas) pay? Serious question.

They just employ more mid-levels.

Pathology mid-levels will be computers or pigeons someday.

 

[KeratinPearls]

CAP research states there’s going to be a 200 pathologist shortage per year?!? I see few jobs in my area despite the uptick in jobs. Where are all the jobs then?

What’s going on? 100K increase in starting salaries and now 200 pathologists retiring/dying off per year? Are more and more people getting cancer so we need more pathologists to diagnose more biopsies?

 

[HeyDalaron]

How can anyone trust CAP's data given that, by their own admission, they have been using inaccurate data for the last decade or more?

 

[deleted314957]

As someone who was actively involved in hiring new pathologists in a large P.P. group I would anticipate that the currently employed paths would be “encouraged “ to do more( than the average path is signing out) work before I jumped on the hiring bandwagon.

 

[LADoc00]

I heard that several Russian generals attended the CAP leadership conference shortly before the invasion of the Ukraine...

I think one dead Russian general was even spotted still clutching his CAP certificate by a CNN crew recently.