Positive aspects about training in pathology

[sagat]

The form is filled with warnings about going into pathology. I was wondering if there is a silver lining or if there are any perks. Pathologist I meet in real life are very optimistic about the future but veterans on this form have a complete opposite outlook. I would like this thread to help us all who are sincerely interested in this great speciality make decisions about our future. Thank you.

---

Members don't see this ad.

 

[postbacpremed87]

The form is filled with warnings about going into pathology. I was wondering if there is a silver lining or if there are any perks. Pathologist I meet in real life are very optimistic about the future but veterans on this form have a complete opposite outlook. I would like this thread to help us all who are sincerely interested in this great speciality make decisions about our future. Thank you.

No Intern Year, no patients, high learning to service ratio compared to other specialties, good hours, non-existent call...

 

[darknecrosforte]

A perception that the job market is tougher than it actually is really only helps everyone overall - the ones who love the field or have enough business skill (bypassing "employment" needs) are undeterred and saturation decreases. We don't need people to treat path like psych, thinking it's a great lifestyle but then realizing how much they hate microscopes a year in.

 

[salingercrumbs]

No Intern Year, no patients, high learning to service ratio compared to other specialties, good hours, non-existent call...

Forgive my ignorance, what do you mean by "no intern Year"?

 

[Thrombus]

Instead of finding out how hopeless the job prospects are in your city of choice, you will be slow cooked like a frog as the water begins to warm to a boil. This will help you accept the realization that you are nothing more than a commodity to those who write your paycheck in most cases while you consider "what could have been" had you done what you knew you should have done for residency.

 

[icpshootyz]

Forgive my ignorance, what do you mean by "no intern Year"?

Pathology residents do not do a traditional intern year on the floors, they go straight into pathology residency. No rounding on patients, no night float, no writing orders and discharge summaries. Just pathology. Only field that does this.

 

[pathslides]

Instead of finding out how hopeless the job prospects are in your city of choice, you will be slow cooked like a frog as the water begins to warm to a boil. This will help you accept the realization that you are nothing more than a commodity to those who write your paycheck in most cases while you consider "what could have been" had you done what you knew you should have done for residency.

Do you hate your job or feel overworked and underpaid? How long have you been in practice, what's your workload like, and what is your salary range? Just curious since you have numerous postings in numerous threads about not doing path, saying path is dead, and how you feel like a commodity.

 

[Thrombus]

Do you hate your job or feel overworked and underpaid? How long have you been in practice, what's your workload like, and what is your salary range? Just curious since you have numerous postings in numerous threads about not doing path, saying path is dead, and how you feel like a commodity.

I and many of my friends/colleagues have been exposed to "take it or leave it" negotiations from other entities giving us a fraction of what we had been getting paid. These entities include CMS, insurance companies, hospitals, and other physicians in other fields. This is all because we are in such oversupply that we have no leverage.

We are in oversupply because Big Academia sits on their asses all day and gets subsidized by the work and paycheck that come along with their residents. Big Academia is not exposed to the same market forces that we are. They get a big fat check for having each resident. They then perpetuate the myth that there is a demand for more pathologists.

 

[gbwillner]

I and many of my friends/colleagues have been exposed to "take it or leave it" negotiations from other entities giving us a fraction of what we had been getting paid. These entities include CMS, insurance companies, hospitals, and other physicians in other fields. This is all because we are in such oversupply that we have no leverage.

We are in oversupply because Big Academia sits on their asses all day and gets subsidized by the work and paycheck that come along with their residents. Big Academia is not exposed to the same market forces that we are. They get a big fat check for having each resident. They then perpetuate the myth that there is a demand for more pathologists.

This is not an atypical response from a pathologist that has been in the field for 20+ years. They have seen their relative reimbursement get cut time and time again.

However, I do think the cause cited here (also frequently stated on this form) is a little misleading at least, and disingenuous at worst. There are a lot of factors at play here beyond oversupply of pathologists. For example, having fewer pathologists would not help CMS redefine billing code reimbursement, which has far more of a role in declining rates than does oversupply. Oversupply is relative- and only one of two floating variables here- it could be argued we need fewer pathologists than before because reimbursement is down and we want to maintain our income by just working a lot more. Or we could just as reasonably state that there is no oversupply if we work just as hard and accept lower rates and salaries. The idea that pathology reimbursement follows free-market principles is just crazy. BTW, this same phenomenon is seen across many (if not all) specialties. Ask an oncologist or radiologist how happy they are with reimbursement- they have also seen ~50% loss of relative revenue over the last decade and have the same complaints.

The last statement, that academics ("big academia") is the cause of oversupply because it doesn't affect them is a Trumpian scapegoating tactic. Stating that there is no market pressure on academia is crazy; they have the same issues, only that the physicians themselves are often (or mostly) blinded to those facts because they are always removed from billing. The only subsidized work that you can consider really is grossing. Faculty spend time training pathologists (for which there is no reimbursement), and additionally give up a lot of their revenue to overhead that someone in the private world does not have to consider (like supporting other departments hemorrhaging cash and research efforts). Case review by trainees is not billable. The difference is that academic pathologists are content with a smaller piece of the pie. But when there is a lack of revenue and salaries cannot be paid, the truth of it is seen- these issues affect EVERYBODY.

 

[Thrombus]

This is not an atypical response from a pathologist that has been in the field for 20+ years. They have seen their relative reimbursement get cut time and time again.

However, I do think the cause cited here (also frequently stated on this form) is a little misleading at least, and disingenuous at worst. There are a lot of factors at play here beyond oversupply of pathologists. For example, having fewer pathologists would not help CMS redefine billing code reimbursement, which has far more of a role in declining rates than does oversupply. Oversupply is relative- and only one of two floating variables here- it could be argued we need fewer pathologists than before because reimbursement is down and we want to maintain our income by just working a lot more. Or we could just as reasonably state that there is no oversupply if we work just as hard and accept lower rates and salaries. The idea that pathology reimbursement follows free-market principles is just crazy. BTW, this same phenomenon is seen across many (if not all) specialties. Ask an oncologist or radiologist how happy they are with reimbursement- they have also seen ~50% loss of relative revenue over the last decade and have the same complaints.

The last statement, that academics ("big academia") is a Trumpian scapegoating tactic. Stating that there is no market pressure on academia is crazy; they have the same issues, only that the physicians themselves are often (or mostly) blinded to those facts because they are always removed from billing. The only subsidized work that you can consider really is grossing. Faculty spend time training pathologists (for which there is no reimbursement), and additionally give up a lot of their revenue to overhead that someone in the private world does not have to consider (like supporting other departments hemorrhaging cash and research efforts). Case review by trainees is not billable. The difference is that academic pathologists are content with a smaller piece of the pie. But when there is a lack of revenue and salaries cannot be paid, the truth of it is seen- these issues affect EVERYBODY.

Big Academia received 100-200K per resident. Plus they get free work, get their tumor boards done, get research help, get secretarial help from residents, etc. That greatly distorts the market and incentivizes them to train more residents!!

 

[Chimichica]

I would like to hear a bit more positivity please, can we remove money as a factor if let's says everyone in the field is content with pay

Sent from my SM-G900T using Tapatalk

 

[Thrombus]

I would like to hear a bit more positivity please, can we remove money as a factor if let's says everyone in the field is content with pay

Sent from my SM-G900T using Tapatalk

Okay then we lose work because there are too many pathologists. Then you don't have enough work to do either. That is boring quite honestly.

 

[darknecrosforte]

I would like to hear a bit more positivity please, can we remove money as a factor if let's says everyone in the field is content with pay

No?
Reality is better.

But when there is a lack of revenue and salaries cannot be paid, the truth of it is seen- these issues affect EVERYBODY.

This sounds like the most logical issue. I was under the impression that the people who thrive in pathology are highly independent, have slightly lower agreeable tendencies (Big 5 traits), and are more entrepreneurial.

Like with tech, over time, we end up paying less money for devices that can do more than older machines. If someone's intention is to work for a hospital interpreting frozen sections and slides, how could they expect any different. If we had more Martin Shkreli's getting into path, best believe there would be much more revenue coming in. Instead, there are a lot of people who want to hear about how path has no call, sits in academia, or doesn't have to deal with darn patients (yay! I get to deal with other flippin' doctors instead)

 

[Nilf]

I would like to hear a bit more positivity please, can we remove money as a factor if let's says everyone in the field is content with pay

Sent from my SM-G900T using Tapatalk

There is no positivity to be had, chief. It's a downward spiral. Thrombus is 100% correct. The field has been commoditized like almost no other.

Even if you remove 'money' as a factor, then you still have to deal with pesky things like autonomy, jobs, benefits.

 

[Chimichica]

But I'm in love with the field I work so closely with my BB/heme path and heme/onc just screams depression. Hmm...well I guess I have plenty of time to figure it out.

Sent from my SM-G900T using Tapatalk

 

[salingercrumbs]

Any opinions on the field of Forensic Pathology? Are the job/pay prospects there pretty hopeless as well?

 

[sagat]

What pay range should I expect after finishing GI fellowship?

 

[deleted314957]

Any opinions on the field of Forensic Pathology? Are the job/pay prospects there pretty hopeless as well?

Job prospects for fellowship trained F.P.'s are great. I last did FP in the 80's
for just 2 years. I have been retired since 2013. I STILL get job offers!
Pay is adequate but at the low end of the medical field and will probably remain so.
The supply-demand equation governing pay is disrupted by the fact that most employers are a gov't entity who have limited pay scales.

 

[gbwillner]

Big Academia received 100-200K per resident. Plus they get free work, get their tumor boards done, get research help, get secretarial help from residents, etc. That greatly distorts the market and incentivizes them to train more residents!!

This has been debunked on this forum many times.

Academia cannot generate revenue for the work done by trainees
Academia has to spend clinician time (that otherwise could be used to generate revenue) to train and lecture residents
Academia has to pay salaries to the trainees
Academia has to pay benefits (healthcare, life, disability, malpractice, sometimes retirement)

There is no academic pot of gold for getting trainees.

If academia is free from the restraint of the negative revenue sources, as you claim, why not have everyone go into academics, where they would have all the advantages you claim? Oh, wait, they don't, because this narrative is false.

 

[Thrombus]

This has been debunked on this forum many times.

Academia cannot generate revenue for the work done by trainees
Academia has to spend clinician time (that otherwise could be used to generate revenue) to train and lecture residents
Academia has to pay salaries to the trainees
Academia has to pay benefits (healthcare, life, disability, malpractice, sometimes retirement)

There is no academic pot of gold for getting trainees.

If academia is free from the restraint of the negative revenue sources, as you claim, why not have everyone go into academics, where they would have all the advantages you claim? Oh, wait, they don't, because this narrative is false.

WRONG!

Academia can have residents gross, prepare report, order studies, do autopsies etc. then academic only has to click "sign report" to generate revenue.
Academia get paid to train and lecture residents through 100-200k PER RESIDENT PER YEAR while paying resident a fraction of the cost.
Resident then also works to train medical students, does other grunt and secretarial work, train residents themselves.

Many people go into academics for various reasons. Perhaps it is what they are familiar with. Perhaps they like a swarm of residents doing their work. Perhaps they like the attention and ego boost they receive by having a bunch of residents around them who must adore them or it is career suicide potentially. I don't know. All I know is that the overtraining has got to stop and academics are the cancer on the profession!

 

[yaah]

I don't know anymore.

As a partner in a group that is losing 6 of our 12 "general" (i.e. not dermpath) pathologists in the next 5 years to retirement, I am a bit worried about finding competent people to replace them. I would not be worried about finding bodies to replace them, but for our group which is partially subspecialized, partially generalist (we all do multiple things but not everything) group that has a lot of interpersonal interaction and established relationships with admin and clinicians, it is harder. There are lots of people looking for jobs who have done surg path fellowships and have problems in their application (poor language skills, weaker training, weak references, narrow focus of practice, lack of clinical understanding, bounced around to lots of different jobs). There are fewer that would fit in with our group. The candidates we like tend and ultimately hire tend to have multiple offers - usually we get them but not always. So we put out an ad for a pathologist with blood bank boards and surg path ability and we get 50 applications from people without blood bank boards or any surg path experience and about 5 with red flags in their application and maybe 1 person we want to interview.

So we are a picky group. I would not change anything about my training or career choice. I love my job.

One problem with this forum is that too many posters tend to be splitters - i.e. either you are a polyanna about the job market or you're a doomsayer. Nuance is not respected. And the problem with this is that life is mostly nuance unless you are looking at broad trends and groups. Nuance is important.

Do I think too many pathologists are being trained? I really have no earthly idea. I don't know very many unemployed pathologists. I know some less than stellar pathologists who keep managing to find jobs, which suggests to me the job market isn't terrible. There are bad jobs out there, to be certain. Jobs where you aren't really respected and you're treated like a commodity. That is a bad thing. If that was all there was I might consider another field too. If I had to posit an opinion it would be that there are too many subpar pathologists being trained and not enough great pathologists being trained. But I would also opine that there are too many bad jobs out there - I don't know whose "fault" these things are. How do you make a bad job into a better job if you have no leverage to do it? Pathologists need more leverage in many situations. Having fewer graduates may or may not help this. If there are too few pathologists then things we do will start getting taken over by other specialties. Hospital will hire a hematologist to run the heme lab, an ID doc to run the micro lab, a clinician to run the blood bank, a chemist to run the CP lab. That would be a bad thing too.

 

[sagat]

I don't know anymore.

As a partner in a group that is losing 6 of our 12 "general" (i.e. not dermpath) pathologists in the next 5 years to retirement, I am a bit worried about finding competent people to replace them. I would not be worried about finding bodies to replace them, but for our group which is partially subspecialized, partially generalist (we all do multiple things but not everything) group that has a lot of interpersonal interaction and established relationships with admin and clinicians, it is harder. There are lots of people looking for jobs who have done surg path fellowships and have problems in their application (poor language skills, weaker training, weak references, narrow focus of practice, lack of clinical understanding, bounced around to lots of different jobs). There are fewer that would fit in with our group. The candidates we like tend and ultimately hire tend to have multiple offers - usually we get them but not always. So we put out an ad for a pathologist with blood bank boards and surg path ability and we get 50 applications from people without blood bank boards or any surg path experience and about 5 with red flags in their application and maybe 1 person we want to interview.

So we are a picky group. I would not change anything about my training or career choice. I love my job.

One problem with this forum is that too many posters tend to be splitters - i.e. either you are a polyanna about the job market or you're a doomsayer. Nuance is not respected. And the problem with this is that life is mostly nuance unless you are looking at broad trends and groups. Nuance is important.

Do I think too many pathologists are being trained? I really have no earthly idea. I don't know very many unemployed pathologists. I know some less than stellar pathologists who keep managing to find jobs, which suggests to me the job market isn't terrible. There are bad jobs out there, to be certain. Jobs where you aren't really respected and you're treated like a commodity. That is a bad thing. If that was all there was I might consider another field too. If I had to posit an opinion it would be that there are too many subpar pathologists being trained and not enough great pathologists being trained. But I would also opine that there are too many bad jobs out there - I don't know whose "fault" these things are. How do you make a bad job into a better job if you have no leverage to do it? Pathologists need more leverage in many situations. Having fewer graduates may or may not help this. If there are too few pathologists then things we do will start getting taken over by other specialties. Hospital will hire a hematologist to run the heme lab, an ID doc to run the micro lab, a clinician to run the blood bank, a chemist to run the CP lab. That would be a bad thing too.

Thank you so much for your post. Im currently contemplating path and this was very insightful

 

[y2k_free_radical]

I don't know anymore.

As a partner in a group that is losing 6 of our 12 "general" (i.e. not dermpath) pathologists in the next 5 years to retirement, I am a bit worried about finding competent people to replace them. I would not be worried about finding bodies to replace them, but for our group which is partially subspecialized, partially generalist (we all do multiple things but not everything) group that has a lot of interpersonal interaction and established relationships with admin and clinicians, it is harder. There are lots of people looking for jobs who have done surg path fellowships and have problems in their application (poor language skills, weaker training, weak references, narrow focus of practice, lack of clinical understanding, bounced around to lots of different jobs). There are fewer that would fit in with our group. The candidates we like tend and ultimately hire tend to have multiple offers - usually we get them but not always. So we put out an ad for a pathologist with blood bank boards and surg path ability and we get 50 applications from people without blood bank boards or any surg path experience and about 5 with red flags in their application and maybe 1 person we want to interview.

So we are a picky group. I would not change anything about my training or career choice. I love my job.

One problem with this forum is that too many posters tend to be splitters - i.e. either you are a polyanna about the job market or you're a doomsayer. Nuance is not respected. And the problem with this is that life is mostly nuance unless you are looking at broad trends and groups. Nuance is important.

Do I think too many pathologists are being trained? I really have no earthly idea. I don't know very many unemployed pathologists. I know some less than stellar pathologists who keep managing to find jobs, which suggests to me the job market isn't terrible. There are bad jobs out there, to be certain. Jobs where you aren't really respected and you're treated like a commodity. That is a bad thing. If that was all there was I might consider another field too. If I had to posit an opinion it would be that there are too many subpar pathologists being trained and not enough great pathologists being trained. But I would also opine that there are too many bad jobs out there - I don't know whose "fault" these things are. How do you make a bad job into a better job if you have no leverage to do it? Pathologists need more leverage in many situations. Having fewer graduates may or may not help this. If there are too few pathologists then things we do will start getting taken over by other specialties. Hospital will hire a hematologist to run the heme lab, an ID doc to run the micro lab, a clinician to run the blood bank, a chemist to run the CP lab. That would be a bad thing too.

FWIW-I have been in practice for decades and am a product of first rate universities;however,in the market place, the value of any product or service is largely determined by SUPPLY vs. DEMAND

 

[jupiterianvibe]

I don't know anymore.

As a partner in a group that is losing 6 of our 12 "general" (i.e. not dermpath) pathologists in the next 5 years to retirement, I am a bit worried about finding competent people to replace them. I would not be worried about finding bodies to replace them, but for our group which is partially subspecialized, partially generalist (we all do multiple things but not everything) group that has a lot of interpersonal interaction and established relationships with admin and clinicians, it is harder. There are lots of people looking for jobs who have done surg path fellowships and have problems in their application (poor language skills, weaker training, weak references, narrow focus of practice, lack of clinical understanding, bounced around to lots of different jobs). There are fewer that would fit in with our group. The candidates we like tend and ultimately hire tend to have multiple offers - usually we get them but not always. So we put out an ad for a pathologist with blood bank boards and surg path ability and we get 50 applications from people without blood bank boards or any surg path experience and about 5 with red flags in their application and maybe 1 person we want to interview.

So we are a picky group. I would not change anything about my training or career choice. I love my job.

One problem with this forum is that too many posters tend to be splitters - i.e. either you are a polyanna about the job market or you're a doomsayer. Nuance is not respected. And the problem with this is that life is mostly nuance unless you are looking at broad trends and groups. Nuance is important.

Do I think too many pathologists are being trained? I really have no earthly idea. I don't know very many unemployed pathologists. I know some less than stellar pathologists who keep managing to find jobs, which suggests to me the job market isn't terrible. There are bad jobs out there, to be certain. Jobs where you aren't really respected and you're treated like a commodity. That is a bad thing. If that was all there was I might consider another field too. If I had to posit an opinion it would be that there are too many subpar pathologists being trained and not enough great pathologists being trained. But I would also opine that there are too many bad jobs out there - I don't know whose "fault" these things are. How do you make a bad job into a better job if you have no leverage to do it? Pathologists need more leverage in many situations. Having fewer graduates may or may not help this. If there are too few pathologists then things we do will start getting taken over by other specialties. Hospital will hire a hematologist to run the heme lab, an ID doc to run the micro lab, a clinician to run the blood bank, a chemist to run the CP lab. That would be a bad thing too.

If the job market were favorable, you'd not be as selective. That would probably be bad for your group.

HOWEVER

A favorable job market would attract better candidates to the field, so you wouldn't have to be so selective because the overall quality would increase.

The whole fact that you have to decline so many job applicants speaks volumes to the state of poor training and recruitment in pathology.

Lots of idiots go into pathology. Really, really stupid people who can barely give you a differential diagnosis for epigastric pain.

 

[Thrombus]

Yep. Why do the useful lemmings and foreign nationals dominate in path and not derm, neurosurgery, etc? Because the field is protected in balancing supply and demand.

 

[postbacpremed87]

If the job market were favorable, you'd not be as selective. That would probably be bad for your group.

HOWEVER

A favorable job market would attract better candidates to the field, so you wouldn't have to be so selective because the overall quality would increase.

The whole fact that you have to decline so many job applicants speaks volumes to the state of poor training and recruitment in pathology.

Lots of idiots go into pathology. Really, really stupid people who can barely give you a differential diagnosis for epigastric pain.

If that's what's holding up the market, then maybe I should go into Pathology.

 

[WEBB PINKERTON]

The field is caught in a death spiral. Constantly tight job market and uncertain future keeping good candidates away. Who can blame them?

The "Pathologists are Groovy" campaign from CAP didn't do much for our image either.

 

[path24]

Don't doctors want to be a "surgical pathology instructor" in LA after doing your fellowship. You can be employed by a private group and paid peanuts (don't list salary in the ad, but would guess its not much) while you gradually signout individually. Another instance of a (private) group taking a financial loss to help train a pathologist....haha. Making money off the crappy job market. (training doctors is a financial loss....please, are you kidding me) Yep, this happens all the time in other specialties. Another reason why bright people should and do stay away from pathology.

 

[salingercrumbs]

Job prospects for fellowship trained F.P.'s are great. I last did FP in the 80's
for just 2 years. I have been retired since 2013. I STILL get job offers!
Pay is adequate but at the low end of the medical field and will probably remain so.
The supply-demand equation governing pay is disrupted by the fact that most employers are a gov't entity who have limited pay scales.

Wow! That's a positive for Forensic : ) Thanks for the reply.

 

[y2k_free_radical]

The CAP is a monopoly which has become profit driven and self serving rather than a support organization.CAP income largely derives from proficiency testing and inspections,the latter costing them almost nothing since it pays nada to the inspectors.The CAP is essentially controlled by ACADEMIA,LARGE PRACTICES & BIG LABS and does not give a RAT'S PETUNIA about community pathologists. It's contention of a looming shortage of pathologists is farcical imo.The possible increase in surgicals though population and aging and massive pathologists retirement is countered by decrease reimbursement,consolidation causing loss of jobs,increased productivity by community pathologists and para pathologists and procedures no longer requiring surgicals.Their efforts to change the publics and fellow doctors impression that we only deal with dead people has been largely non existent or impractical(PATHOLOGISTS ARE GROOVY-OMG) adding to remuneration difficulties.The CAP gives very little to its' advocacy group and we are outgunned by the AMA.More pathologists means more money to both ACADEMIA and the CAP.We are a house divided.ACADEMIA and the CAP are in many ways at cross purposes to the wellfare of community pathologists in reality.

 

[sagat]

I really want to do Pathology but there isn't a single reassuring opinion on the internet. truly a shame

 

[Chimichica]

So is a salary of at least 200K out of the question, I mean I'm not sure what kind of compensation you all are upset about?

Sent from my SM-G900T using Tapatalk

 

[postbacpremed87]

I really want to do Pathology but there isn't a single reassuring opinion on the internet. truly a shame

Sometimes you have to do what you love. There are days where I can't fathom doing clinical medicine.

 

[gbwillner]

So is a salary of at least 200K out of the question, I mean I'm not sure what kind of compensation you all are upset about?

Sent from my SM-G900T using Tapatalk

I have medical oncology friends who complain about $400k being unfair. But that's only because they used to pull in double that.

As others have said, the pay is all over the place. I started in academia as an instructor making under $80k. Now I am well-off by any standard.

 

[pathslides]

I have medical oncology friends who complain about $400k being unfair. But that's only because they used to pull in double that.

As others have said, the pay is all over the place. I started in academia as an instructor making under $80k. Now I am well-off by any standard.

80k as an instructor. Geez. Academic jobs are terrible. Bunch of people in academics pretending to do research wasting time splitting entities and convincing themselves they found something different since they added some esoteric stain or did some next gen rubbish that has zero clinical significance all so they can be promoted from within their institution. 75% of research in academic pathology is useless.

 

[y2k_free_radical]

I though

The CAP is a monopoly which has become profit driven and self serving rather than a support organization.CAP income largely derives from proficiency testing and inspections,the latter costing them almost nothing since it pays nada to the inspectors.The CAP is essentially controlled by ACADEMIA,LARGE PRACTICES & BIG LABS and does not give a RAT'S PETUNIA about community pathologists. It's contention of a looming shortage of pathologists is farcical imo.The possible increase in surgicals though population and aging and massive pathologists retirement is countered by decrease reimbursement,consolidation causing loss of jobs,increased productivity by community pathologists and para pathologists and procedures no longer requiring surgicals.Their efforts to change the publics and fellow doctors impression that we only deal with dead people has been largely non existent or impractical(PATHOLOGISTS ARE GROOVY-OMG) adding to remuneration difficulties.The CAP gives very little to its' advocacy group and we are outgunned by the AMA.More pathologists means more money to both ACADEMIA and the CAP.We are a house divided.ACADEMIA and the CAP are in many ways at cross purposes to the wellfare of community pathologists in reality.

t

The CAP is a monopoly which has become profit driven and self serving rather than a support organization.CAP income largely derives from proficiency testing and inspections,the latter costing them almost nothing since it pays nada to the inspectors.The CAP is essentially controlled by ACADEMIA,LARGE PRACTICES & BIG LABS and does not give a RAT'S PETUNIA about community pathologists. It's contention of a looming shortage of pathologists is farcical imo.The possible increase in surgicals though population and aging and massive pathologists retirement is countered by decrease reimbursement,consolidation causing loss of jobs,increased productivity by community pathologists and para pathologists and procedures no longer requiring surgicals.Their efforts to change the publics and fellow doctors impression that we only deal with dead people has been largely non existent or impractical(PATHOLOGISTS ARE GROOVY-OMG) adding to remuneration difficulties.The CAP gives very little to its' advocacy group and we are outgunned by the AMA.More pathologists means more money to both ACADEMIA and the CAP.We are a house divided.ACADEMIA and the CAP are in many ways at cross purposes to the wellfare of community pathologists in reality.

 

[y2k_free_radical]

I thought my rant would at least receive one negative comment.I have heard the CAP earns $180,000,000/year with dues contributing less than $5,000,000 and the CAP giving its' PAC only $5,000,000.My numbers may be as errorneous as those of DR. REMICK.

 

[WEBB PINKERTON]

I stayed at a nice hotel and ate well on my last CAP inspection. Even used a van to take me and my crew. Those inspections ain't free.

 

[y2k_free_radical]

I stayed at a nice hotel and ate well on my last CAP inspection. Even used a van to take me and my crew. Those inspections ain't free.

lol-how much money were you and your team paid per diem ?????? :>}

 

[AZpath]

The field is caught in a death spiral. Constantly tight job market and uncertain future keeping good candidates away. Who can blame them?

The "Pathologists are Groovy" campaign from CAP didn't do much for our image either.

I can only speak to my personal experience. I originally wanted to go into Dermpath.

Unfortunately, I did see not see what was happening in the job market in 1994 as the first wave of managed care hit.
I applied over a year out for a Dermpath fellowship but they were only accepting applications two and three year out for 1997 and 1998.

I said to hell with that. I managed to find locums work rather excepting a fellowship I did not want.
The Wall Street Journal reported 10% of the pathologists were unemployed at the time. CAP was predicting and mass shortage of Pathologists that never came. They have done so repeatedly ever since.

Most of my fellow residents ended up taking two or three fellowships at the time. Some left pathology all together.
I ended up with a very good gig in the Midwest.

I wanted to move to a rural location the southwest ,CA, AZ, NM.
I did not know anyone from the region so took it 5 years. (I admit that I did not go to great lengths to move. )
Right now this what I think:


1) Totally an employers market . If even rural locations are easy to fill then this not good.
A higher percentage of positions are lower paid.

2) Hospital have no incentive to pay for medical directors ( Part A).
Many hospital get away with not paying for real work and call time.

3) If any lab, hospital, clinic can make a huge margin on your labor then there are too many us working at a cut rate.
There are not many specialties that have such excess that folks will let the house take 40-50% of the professional pay.

We are small specialty with no clout and we don't control patient flow.

CMS sees that we work for cheap. We will eventually take a big hit as a result.
We are very lucky if a major change in payments does not hit us like in the 1980s and 1990s.
Nothing that we have seen recently comes close in term of disruption and changes in employment.

My bottom line:

Things are not dismal many still do very well in this profession.
However, there is an excess and has been for a while.
This make us an extra vulnerable profession.

 

[AZpath]

I stayed at a nice hotel and ate well on my last CAP inspection. Even used a van to take me and my crew. Those inspections ain't free.

Ya we just work for free.

 

[WEBB PINKERTON]

lol-how much money were you and your team paid per diem ?????? :>}

The hotel, restaurants and taxi drivers were paid well at least.

 

[coroner]

The Wall Street Journal reported 10% of the pathologists were unemployed at the time.

I didn't know our specialty was national news level material fit for print in the WSJ. Even though that was an old article, when people with a doctor of medicine degree and board certification in their specialty have an unemployment rate higher than the national average mostly comprised of people who haven't even completed undergrad, that's not a good thing...

Most of my fellow residents ended up taking two or three fellowships at the time.

Surprising even back in the mid-late 90's people were doing 2-3 fellowships. I thought it was rare back then and only became a trend within the last 10-15 years after Pathology became a 4 yr residency.

Things are not dismal many still do very well in this profession.
However, there is an excess and has been for a while.
This make us an extra vulnerable profession.

If there's an "excess" and we are "extra vulnerable", it may not be dismal, but far from ideal...