I think NIH funding should be slashed and pathology residency positions should be slashed. Academia is out of touch with what is going on in the non-academic pathology world where we are viewed as a commodity and not as professionals. Academics have for too long lived high on the hog with government money and free resident labor. This corruption needs to be stopped!
Petition to increase NIH funding
- Thread starter Thrombus
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Who would advance medical science? Community hospital pathologists?
When academia becomes more about "advancing medical science" instead of "advancing one's career by putting out meaningless papers" I will listen.
Right now there are far too many sitting high off the hog using government funded resident labor that is putting the screws to non-academic pathologists as we have ZERO leverage in negotiations. Hospitals are now refusing to pay us for our work. And academics say we have no oversupply. Not only are they not recognizing the problem, they ARE the problem.
I personally am sick of it and will call them out when they post things like this crying for more money for this scheme from a broke (15 trillion and counting) federal government.
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I hate to bite on that, but who do you have zero leverage with? And what do you mean that hospitals are refusing to pay you for your work? If you are an employee of that hospital, that would be so totally illegal. If you are simply contracted to provide pathology services, do you not bill patients?
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Are you serious?
Residents are paid from Medicare funds, not the NIH.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495035/
NIH funds basically all the science in this country (and others as well) in the form of extramural (and intramural) grants.
/Damn Govmint! get yer hands off my medicare!
(and the taxpayer pays for both of them) shhhhhh!
Academic pathologists have their heads in the sand if they don't realize that hospitals are leveraging themselves to not have to pay for many of pathologist's services despite time, effort, stress, work, education, and liability....and there are lackeys out there that will take it forcing us all into the race to the bottom. (but there is no oversupply)
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So are you still advocating slashing the NIH budget or not?
Interestingly, the white house and economists are talking about the proposal for the "Buffett rule", which loosely means those in the top 1% of all income earners should pay a 30% tax rate regardless of the origins of their income (also known as the Romney rule, since his current tax rate is ~13% since he earns no wages). Detractors claim this would be a waste of time since the $40-45 Billion it would generate in taxes is insignificant and wouldn't make a dent in the deficit and thus a waste of time (although if the Bush tax cuts for the top 1% expire that will also generate roughly $125-150 Billion). But it's roughly TWICE the NIH budget, just to put it in perspective.
Also to put it in perspective, we spent $159 Billion in the war in Iraq/Afghanistan last year. Does anyone think that is as good a use of our resources?
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I would actually like to see the NIH budget increased. I think there must be some confusion here about exactly what the NIH funds.
I feel the"Buffett rule" is wrong because that money has already been earned and dividends should not be taxed the same as earned income. The feds have a spending problem, not a taxing problem. Yes I think nearly all the money is a waste personally. I find politicians to be corrupt and the government inept. Most academic research is a waste. We have all been there, lets not kid ourselves. If our leaders were honorable, government efficient, and academic research mostly of value I would feel differently and would be the first to sign up for socialized medicine and more research money.
Lets not get sidetracked. Academics are propped up by cheap/free labor and federal grants off the backs of residents and taxpayers. This leads to pathologist oversupply which is killing us.
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OK, let's not get sidetracked. The NIH is not at fault for the pathology supply problem you rant about (constantly). You should apologize to the NIH for your silly internet accusation.
The rest of your grumpy old man rant I have no trouble with. I think the point of the Buffett rule is wealth re-distribution, and to maintain a semblance of a middle-class (which is shrinking and may soon otherwise dissapear, IMHO).
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academia knows what's up. each year program director's watch fellows freak out trying to find jobs- sometimes failing and doing a second fellowship. the oversupply doesn't get acknowledged by programs because residents are the cheapest labor in the department..
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This is why people should name crap programs in the thread I started a few weeks ago. The more obviously bad their reputations, the less likely they'll be able to get people working there.
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Could I ask your opinion- why do you think residents signed off on that letter to Congress about the looming pathologist shortage (see the shortage of pathologists thread if you haven't already). Thanks in advance for your reply.
How many residents have negotiated anything. Most have no clue how a pathologist even gets reimbursed. Let's leave the conversation for adults...
More NIH funding the more academics will say we need more pathologists to do research. No thanks.
The oversupply is already out of control, why add to it.
Academics won't address the lack of jobs, so I am against anything that guts their cash flow. The oversupply is definitely gutting mine.
The oversupply is already out of control, why add to it.
Academics won't address the lack of jobs, so I am against anything that guts their cash flow. The oversupply is definitely gutting mine.
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I have asked the same thing repeatedly. But the CAP residents forum (who wrote the letter) has remained silent.
NIH funding is one of the good things the government does. While there is a lot of academic nonsense that goes along with it, there is also a lot of great research that comes out. Government needs to be funding research and education, education is already going down the tubes in this country anyway. Part of the problem is because all the money in "education" is going to teacher healthcare, teacher pensions, helping students out with loans, and new buildings and technology for schools. So "unnecessary" stuff like research funding gets crowded out. That's sad.
But hey, at least americans will always know more about celebrity pop culture than any other country.
But hey, at least americans will always know more about celebrity pop culture than any other country.
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Beats me. It also seems that hiring more techs is not a given option. If the number of residents increases, then there is less scut per resident. Maybe residents are confused as to what a pathologist does and what histo techs and PAs and lab staff do? Also, it seems like a specific group of residents signed off- not like there was a vote across all residents.
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No matter how much you say this forum is anonymous, it's really notsomuch. I also think there is a grey zone- you can't just divide programs into crap and not crap. Why don't you put together a list of factors like preview time and average grossing and let people fill it out.. Slightly less offensive and slightly more objective.
Residents are also by nature "yes men/women" to academia. I wonder why the academic who started this thread disappeared and deleted the initial post? I would think academics would be open-minded enough to discuss the issues instead of burying their head in the sand?
From my experience too often grant money goes to the best science fiction writer. (Again, lets not kid ourselves, most of us have been immersed in this). This propagates academia which has its own self serving interests/gravy train. Academia puts out little that "advances the science" now-a-days and spends more time causing the field of pathology problems in my view, refusing to recognize/acknowledge the issues. Until they do, they will get a firm and vocal "no" vote from me for anything that helps prop them up.
From my experience too often grant money goes to the best science fiction writer. (Again, lets not kid ourselves, most of us have been immersed in this). This propagates academia which has its own self serving interests/gravy train. Academia puts out little that "advances the science" now-a-days and spends more time causing the field of pathology problems in my view, refusing to recognize/acknowledge the issues. Until they do, they will get a firm and vocal "no" vote from me for anything that helps prop them up.
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I'm not sure I understand your logic-
A: there is too much supply (of pathologists), not enough demand (for their services)
B: NIH funds would add DEMAND for pathologist services...
Your solution: cut NIH funding????
/Does not compute
I do not want to speak for the poster, but with the going trend more academia = more residents.
If you cut academia fundings whether it by the NIH or resident funding, you get less academia and less residents.
You prop up academia and you end up with more residents to do their bidding, further burdening the supply issue.
That at least is the thought behind mine (and many of my colleagues) opinions. You can debate it all you want, but that is the line of thinking. Of course academics do not want this inconvenient discourse to gain any traction. There is a gravy train to protect coming from the US Taxpayer.
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Let me show you why this may be completely counter-intuitive....
Let's assume you get your wish, and NIH funding disappears (or is drastically cut)... what happens next?
1. Most of the NIH-funded pathologists in academics who receive a portion of their salary from NIH grants (those that DO RESEARCH) will not be able to renew those grants
2. Pathologists who are on NIH grants for clinical research as part of large studies will also lose a portion of their salary support
3. The academic institutions who employ these pathologists will not be able to pay their salaries to sign out 20-50% of the time without NIH support. The overhead the institutions collected from the grants will evaporate
4. These institutions will require that these pathologists sign-out more to make up for the lack of departmental revenue
5. There will not be enough volume to support all these pathologists, so many will be forced to leave and look for other jobs
6. the market will be even more saturated with pathologists looking for income, so employers can offer less for their services since more people will be desperate (i.e., you've increased the supply-side even more)
7.... profit?
The fact is, there is a subset of pathologists who try to advance medicine through research. This is another revenue stream you are currently NOT tapped into (i.e., research funds are a source of DEMAND). By cutting off that well, you will now have to compete with them, whereas you did not have to before.
Also, I'm sorry you had such a bad experience with research. Many of us do research and enjoy it without being deceitful. Without NIH funds research would be serverely decimated in this country and around the world. That would kill innovation. When drug companies create new compounds or treatments or tests, where do you think those ideas come from? Do you want medicine to stagnate in the form it is currently in?
Is everyone a charlatan but you? Because that's what it sounds like you are saying (that, and that you want yours and f*ck everyone else).
You think there is an oversupply of pathologists? fine. Deal with those that can actually fix the problem (ABP, ACGME, etc.). The NIH has nothing to do with it.... It's basically like saying that the government should cut medicare. Guess what? That how they pay YOU! If they cut medicare your reimbursement would decrease, both directly from medicare and from all private insurance that pays a multiplier of medicare payments.
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Part of the problem is that academic pathologists do not feel the market effects and so they only have incentive to add to the glut. You cut off the gravy train (funding and free residents), they feel market effects, and you will see the supply of pathology residents cut immediately and drastically. So yes, I feel all sources of government grant money contribute indirectly and directly to the pathologist glut. My feelings are validated by other pathologists, notably not you from your tone.
That is my and others' opinion. You have your opinion. Of course I realize what happens when patient care funds gets cut. (memo: this has been going on for years).
Of course academics feel the market effects. Perhaps not in the same direct way as do private practice pathologists, since academia draws funding from various sources, but they do. Research funding has been slashed dramatically across the board. Megalabs are eating into their clinical RVUs. Etc. Perhaps the few older pathologists who still have tenure are somewhat insulated, but I very much doubt that the younger crowd feels much job security. The latter have more service obligations, teaching duties, doing presentations, etc. while still being expected to do research, seek funding, write grant applications, publish, etc. in order to maintain their positions and not get thrown under a bus in 3-5 years if they don't produce adequate results, and all that at about half the pay of their colleagues in private practice.
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The point is that going after NIH funds is cutting off your nose to spite your face. It is counter-intuitive to your goals. Yes, cutting off all government funds may result in lower pathology resident numbers (your goal). But so would a nuclear holocaust. There are more reasonable, straight forward ways to address your problem. As I've said before, I have no real opinion on the "oversupply of pathologists" problem and am not opposed to cutting spots. But it seems like the only people who really scream bloody murder about this do so only in these internet chatrooms, which makes me wonder just how valid these complaints are. Why not bring it up in your state pathology organization (from what I've seen these are dominated by those in PP).
Also, having others agree with you does not validate your claims. There are a lot of people who believe in creationism and Santa Claus.
You seem to be in the same internet chat room as I so I am not sure why this serves as an invalid way to voice an opinion. Academia/CAP/ASCP/USCAP have all failed at maintaining demand for pathology and I blame academic funding and free resident supply. I am not asserting my opinion as superior to yours or others but feel free to be able to voice it on this outlet and find any debate worthwhile concerning the state of pathology. I find defunding academia reasonable so that they can face the same market pressures I face. I would like to see academia face clinicians who threaten to pull specimens to save a penny, low-ball hospital offers for services expecting many services for free of charge, etc. etc. I feel that is what it has come to as academia has failed us all in the oversupply. I see no other way than to pull the plug on their gravy train as it has destroyed our market (the free market will not work when certain people such as academia maintain advantages that other don't). At this point, I will leave the discussion.
But this is precisely what is going on in many parts of the country. Again, some larger centers can in part cost-shift by expanding other (usually non-pathology) markets. It's not like NIH/Medicare/etc fund ONLY pathologists' pet projects. In fact, I'm pretty sure pathology is pretty low on the funding list and most projects that pathologists are involved with are invariably thanks to money trickled down by, for example oncologists, since that's were the big funding bucks go anyway. The pathologist over supply issue is completely separate from any of that and I doubt will be affected much by funding changes at the level of the NIH.
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There is still time to sign the petition to ask the White House to increase NIH funding. Here is the URL
https://wwws.whitehouse.gov/petitio...dollars-will-hurt-econmy-and-medical/FNr0kRbj
5,791 signatures are needed by tomorrow, by noon.
https://wwws.whitehouse.gov/petitio...dollars-will-hurt-econmy-and-medical/FNr0kRbj
5,791 signatures are needed by tomorrow, by noon.
I refer to it as a pyramid scheme
http://www.nytimes.com/2012/04/17/s...nal-retractions-prompts-calls-for-reform.html
http://www.nytimes.com/2012/04/17/s...nal-retractions-prompts-calls-for-reform.html
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NIH does not fund residency training.
Medicare funds graduate medical education. It is mostly funded by part A of the medicare using direct payments with "per-resident payment" (approximately 200k) and indirect payments for graduate medical education.
NIH funds research and apparently a certain amount of the NIH funds (like approximately 400 million as per apcprods.org powerpoint at "<cite>www.apcprods.org/Library/recruit.ppt" slide #14 of 31)</cite> goes to anatomic pathology. It's not something that I know very much about. However, now that the data on how much money is actually going to various institutions or at least not coming to your institution is clear, I am sure that others are vying for it and this money is going to be sought after in a very aggressive manner by so-called academia in major cities, hehe. It's just too amusing.
Errr... The "http://www.pathologytraining.org/" publishes the booklet on fellowship and residency training.
Medicare funds graduate medical education. It is mostly funded by part A of the medicare using direct payments with "per-resident payment" (approximately 200k) and indirect payments for graduate medical education.
NIH funds research and apparently a certain amount of the NIH funds (like approximately 400 million as per apcprods.org powerpoint at "<cite>www.apcprods.org/Library/recruit.ppt" slide #14 of 31)</cite> goes to anatomic pathology. It's not something that I know very much about. However, now that the data on how much money is actually going to various institutions or at least not coming to your institution is clear, I am sure that others are vying for it and this money is going to be sought after in a very aggressive manner by so-called academia in major cities, hehe. It's just too amusing.
Errr... The "http://www.pathologytraining.org/" publishes the booklet on fellowship and residency training.
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