Need help with salary and case load expectation

[coffee46]

Hi all,

I'm thinking of making the switch from academic to either private practice at a hospital or independent laboratory setting. I have few years of experience. Live in southern California.

What are reasonable case loads for private or independent laboratory setting? I spoke to one lab, and they said 125-150 vials of biopsies per day. Is that average? And what is a reasonable salary for that type of caseload?

Would appreciate any input!

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[LADoc00]

150 cases a day?

To put that in perspective, they are getting at a minimum 6K just from professional fees.

Unless they are paying you 4K, stay the hell away.

 

[coffee46]

Thanks! I heard that they offered a new grad 200K few years ago and that sounded pretty low, but wanted to get some other perspective. Haven't really dealt with billing and payments myself so didn't really know much about it.

Thank you!

 

[HeyDalaron]

Hi all,

I'm thinking of making the switch from academic to either private practice at a hospital or independent laboratory setting. I have few years of experience. Live in southern California.

What are reasonable case loads for private or independent laboratory setting? I spoke to one lab, and they said 125-150 vials of biopsies per day. Is that average? And what is a reasonable salary for that type of caseload?

Would appreciate any input!

Depends on the pay. 125 vials a day is a lot and you should expect to be paid appropriately

 

[Spikebd]

Hi all,

I'm thinking of making the switch from academic to either private practice at a hospital or independent laboratory setting. I have few years of experience. Live in southern California.

What are reasonable case loads for private or independent laboratory setting? I spoke to one lab, and they said 125-150 vials of biopsies per day. Is that average? And what is a reasonable salary for that type of caseload?

Would appreciate any input!

Sounds like torture, I don’t think any amount of money could convince me to do 150 vials a day. If you sign up for something like this I’d tell you to ask for $4k a day at minimum, as well.

 

[KeratinPearls]

Thanks! I heard that they offered a new grad 200K few years ago and that sounded pretty low, but wanted to get some other perspective. Haven't really dealt with billing and payments myself so didn't really know much about it.

Thank you!

Yeah 200k was the starting salary few years ago. I guess that’s how much the market valued a first year pathologist. I guess it’s 300k now after hearing all this talk of first year attendings getting that much.

 

[KeratinPearls]

Sounds like torture, I don’t think any amount of money could convince me to do 150 vials a day. If you sign up for something like this I’d tell you to ask for $4k a day at minimum, as well.

4000$ a day equates to an annual salary of $960,000 working every day of the year. LOL, good luck getting paid that much. If they can find someone else to do it for less, why would they offer you that much?

 

[Spikebd]

4000$ a day equates to an annual salary of $960,000 working every day of the year. LOL, good luck getting paid that much. If they can find someone else to do it for less, why would they offer you that much?

Never said they’d get it! And I wouldn’t do that job for $960,000 when there are far better ones offering $300k+ right now.

 

[LADoc00]

What is the business arrangement i.e.
Is this a clinical practice that is referring cases internally to a POL?
Is this a commercial lab that is 3rd party billing and letting clinicians mark up the cases?
Is this a private practice pathology group with outpatient referrals?
Is this a government position?


What is the work expectations outside of signing out cases:
Is there an expectation of ROSE type service?
Is the job M-F set hours or leave when the work is done?
Can you set your own hours?
Can you sign out remotely?
Frozen section support?
Conference support?


In terms of payment:
Is this a 1099 or W-2 position?
Are any health care benefits?
What is the total value of benefits offered?

150 cases is an absolutely metric ton of cases. That is 39,000 diagnoses per year.

That is literally the work of 4-5 pathologists. With no immunos, special studies, etc just pure H+E revenue even at the lowest paying MAC in the United States is $1,646,970 in gross revenue.

I am just talking PC charges NOT Global, double that for global gross revenue.

Folks if there are pathologists willing do that for 200K or 300K or even 400K put them in touch with me NOW. I will work the deals and set up a nice six figure passive income stream for life. Even if I split the proceeds 50:50 with a group of GI/Urologists, paid my share of overhead AND paid 400K to the pathologist, Im still driving GT4 carbon fiber Porsches and partying at the W in Scottsdale every damn day.

 

[Pathprimer]

3000-4000 surgical cases a year is reasonable. Work life balance. You should get paid 300k.

 

[KeratinPearls]

Thanks! I heard that they offered a new grad 200K few years ago and that sounded pretty low, but wanted to get some other perspective. Haven't really dealt with billing and payments myself so didn't really know much about it.

Thank you!

That’s outright abuse. That’s what a surplus of young graduating pathologists will do. At least $1.6M in revenue and offering 200k to a pathologist? We all can have our own opinion of what is the value of a first year attending. Employers are able to get away with this because they CAN. Hopefully salaries are higher now and these young pathologists are paid fairly.

 

[octopusprime]

Plenty of dermpath people doing 5-10,000 cases solo, many even doing 10-15k solo (though they are unlikely compensated appropriately). Derm could be the primary exception though, followed by GI.
But $200k for that volume is criminal unless that's equivalent to a "buy-in" period, maybe a year or two depending on valuations & anticipated revenue, after which your compensation is at a minimum doubled if not tripled.

Though 125-150 'vials' could only be 50 cases...are these multipart GI or derm cases?

 

[Med Director New England]

150 vials / day is a ton of work - even if most are quickie types (outpatient GIs, easy derms).
Bound to have a few cases that bog you down.
I don’t think a new graduate can possibly push this volume.

This makes a strong case to NOT do AP only training. I really enjoy the many CP endeavors I have daily that limit my AP load.

 

[coffee46]

As clarification, they said 125-150 vials, of GI biopsies. So they are probably around 50 cases? Half of them, I am told, are lower GI, so a good number of polyps. It does sound like a lot of work. I haven't discussed compensation with them yet so I have no idea what they would offer someone with experience. But I am guessing if they offered 200K to a new grad, what they offer me won't likely exceed 300K.

I think they have their own pathology group but they are also contracted to a GI group (working as employees to the GI group's lab). Have to discuss details about how that works out.

 

[octopusprime]

Not uncommon to do 50 GI cases when covering the GI service in my group; completely doable.

 

[HeyDalaron]

Not uncommon to do 50 GI cases when covering the GI service in my group; completely doable.

Are you being appropriately compensated?

 

[octopusprime]

Are you being appropriately compensated?

well yes; we're PP so more volume = more money.

 

[drdoug]

Thanks! I heard that they offered a new grad 200K few years ago and that sounded pretty low, but wanted to get some other perspective. Haven't really dealt with billing and payments myself so didn't really know much about it.

Thank you!

New pathology residents who have recently finished residency - initial salaries can be as high as $250,000. My suggestion is to do a fellowship in a field that really appeals to you. For me it was surgical pathology followed by a fellowship in cytopathology.

 

[mike-sheree]

That equates to ~ 100K 1988 dollars which was very low then. It’s no better today especially in a metro area ( and 2 fellowships!) Still a lagging field.

 

[coffee46]

New pathology residents who have recently finished residency - initial salaries can be as high as $250,000. My suggestion is to do a fellowship in a field that really appeals to you. For me it was surgical pathology followed by a fellowship in cytopathology.

I have 2 fellowships under my belt, GI and surg path. Now with 4+ years in an academic setting. Still love the cases that I see, but the pressure to do research with the limited time they provide for research time is becoming problematic. I find myself doing my academic work in the middle of the night after putting kids to bed and still feel like I am lagging behind. Now I just want work that I can leave in the office at the end of the work day, but at the same time, dreading just signing out piles of GI biopsies.

 

[mike-sheree]

I have 2 fellowships under my belt, GI and surg path. Now with 4+ years in an academic setting. Still love the cases that I see, but the pressure to do research with the limited time they provide for research time is becoming problematic. I find myself doing my academic work in the middle of the night after putting kids to bed and still feel like I am lagging behind. Now I just want work that I can leave in the office at the end of the work day, but at the same time, dreading just signing out piles of GI biopsies.

If you demonstrate the 3 “A’s” of success you have an ideal experential background to move into a new p.p. hire. No more “rat tail“ pathology research. You will work harder( not necessarily longer) in p.p. and you will be expected to suck it up. You will do much more than gi and you will have to do things you will initially be uncomfortable about..Your pay SHOULD become far superior. Corporate is fine for general s.p. variety ( non hospital cases unless you are slated into a hospital quest, et al have contract for) for a 9-5 with bennies and an adequate salary.
It is possible this is no longer true. Things have changed.

 

[pathslides]

~6000 accessions per year consisting of surg path, cyto, smears, flow, and marrows (~8k wRVU) should have minimum salary of 425k (not including benefits) and at most 40hrs/wk. Academics is 🗑

 

[LADoc00]

I have 2 fellowships under my belt, GI and surg path. Now with 4+ years in an academic setting. Still love the cases that I see, but the pressure to do research with the limited time they provide for research time is becoming problematic. I find myself doing my academic work in the middle of the night after putting kids to bed and still feel like I am lagging behind. Now I just want work that I can leave in the office at the end of the work day, but at the same time, dreading just signing out piles of GI biopsies.

I got sad reading this.

For the record: your kids are infinitely more important than your job. I unfortunately lost sight of that several times chasing dollars, service contracts, deals etc. over the years and if I can provide any real authentic advice on SDN is never ever let anything become more important than them.

Find a job where you can go to a softball game and not sit on the phone the whole time. Find something where you can go camping on a 3 day weekend and not worry about being on call, something where you can completely disconnect from time to time to focus on the actual things that really matter and a big hint: academic publications are NOT one of the things that really matter.

 

[mike-sheree]

I got sad reading this.

For the record: your kids are infinitely more important than your job. I unfortunately lost sight of that several times chasing dollars, service contracts, deals etc. over the years and if I can provide any real authentic advice on SDN is never ever let anything become more important than them.

Find a job where you can go to a softball game and not sit on the phone the whole time. Find something where you can go camping on a 3 day weekend and not worry about being on call, something where you can completely disconnect from time to time to focus on the actual things that really matter and a big hint: academic publications are NOT one of the things that really matter.

Very, very wise advice. More physicians need to heed this. I sure should have. Too late now.

 

[drdoug]

I have 2 fellowships under my belt, GI and surg path. Now with 4+ years in an academic setting. Still love the cases that I see, but the pressure to do research with the limited time they provide for research time is becoming problematic. I find myself doing my academic work in the middle of the night after putting kids to bed and still feel like I am lagging behind. Now I just want work that I can leave in the office at the end of the work day, but at the same time, dreading just signing out piles of GI biopsies.

You are wanting a "dream job" at an institution where a pathologist signs out cases by specialty, and only that specialty. I look at Dr. John Goldblum at Cleveland Clinic. He only signs out G.I. cases and he is both fast and accurate in his diagnoses. He may have a large pile of cases to sign out, but he is able to finish them in quick order. Doing research with your work requirements is an extremely difficult situation! It is a common occurrence at major medical institutions. Most will give you 4 years or so to contribute to the scientific literature. After that, your contract is not renewed and another applicant (within a large pile of applicants!) is hired with the same nightmarish scenerio. Good luck!