Salary as a Percent of Revenue

[liealgebra]

Hi All,

I have a hunch I am being underpaid in my PP situation. To not reveal too much about my identity, etc.:

1. Small PP (dermpath only) on the East coast. Not partnership track.
2. Average about 120 cases per day
3. Take home a hair above 10% of revenue as my salary (benefits not included).

This seems very low to me.

I'd love to hear from other dermpaths what percent of revenue they take home per year in base salary.

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[Thrombus]

Hi All,

I have a hunch I am being underpaid in my PP situation. To not reveal too much about my identity, etc.:

1. Small PP (dermpath only) on the East coast. Not partnership track.
2. Average about 120 cases per day
3. Take home a hair above 10% of revenue as my salary (benefits not included).

This seems very low to me.

I'd love to hear from other dermpaths what percent of revenue they take home per year in base salary.

This is absolutely HORRID! No other physicians would stand for this. Big Academia has absolutely destroyed our profession and should be ashamed of themselves for overtraining so many pathologists that we are treated like this. When we are able to hire dermatologists and take nearly 90% of their revenue, I will consider the market corrected.

 

[octopusprime]

Hi All,

I have a hunch I am being underpaid in my PP situation. To not reveal too much about my identity, etc.:

1. Small PP (dermpath only) on the East coast. Not partnership track.
2. Average about 120 cases per day
3. Take home a hair above 10% of revenue as my salary (benefits not included).

This seems very low to me.

I'd love to hear from other dermpaths what percent of revenue they take home per year in base salary.

so...you're getting 10% of the rev you're generating and you have a hunch you're being underpaid?... i mean, well, duh. if you're employ only and no partnership, well, yeah, you're being underpaid.

 

[AZpath]

10% of net revenue would pretty bad. ( I assume you are talking about the net. )
In your market Dermpaths must be on every street corner.

 

[liealgebra]

I am having trouble discerning if the first two replies are tongue-in-cheek or not. My question was an honest one as I do not have any reference for salary and am new to practicing.

Assuming these replies are earnest, what should a practicing DP expect to be making as a percent of revenue. I understand that this number will vary greatly by experience and location. I am looking for ballpark numbers here.

I looked at this MGMA article (http://www.mgma.com/Libraries/Assets/Education and Certification/Are-You-paying-Your-Physicians-Market-Competitive-Compensation-How-Do-You-Know.pdf?ext=.pdf) It gives the median as 1.3M and the 25th percentile as 1M. Both of those numbers sound extremely high to me. This 2011 pubmed article (A survey-based evaluation of dermatopathology in the United States. - PubMed - NCBI) gives a median of 525K.

 

[liealgebra]

10% of net revenue would pretty bad. ( I assume you are talking about the net. )
In your market Dermpaths must be on every street corner.

I worked it out as an average of $90 payout per signed-out case (standard code + stains on some cases). I then worked out how many cases I sign out per day and then divided that by my salary. Not sure how else to work it with the numbers I have available to me. Like I said, I am new to practicing.

 

[octopusprime]

10% of revenue--so you know how much the group is getting in net receipts or is this just based off charges? net collects are different than charges.
SOO many variables it depends on...are you employed by derms that have clinical income or pahtologists? I assume the group owns the lab? how much overhead? are you the only one reading slides for a large derm group? or just the lowest dermpath on the totem pole?
regardless of the answer to all those questions, bottom line is this: of course you're being taken advantage of given you're a green dermpath on the east cost in an employed position...are you ok with that? is there eventual partnership potential? would you rather get taken advantage of doing derm only in the setting you're in or move to a PP group where things are more equitable yet require CP and other AP responsibilities?

Hold up--so you're currently getting $90/case, at 120 cases/day? $10k a day?

 

[AZpath]

I worked it out as an average of $90 payout per signed-out case (standard code + stains on some cases). I then worked out how many cases I sign out per day and then divided that by my salary. Not sure how else to work it with the numbers I have available to me. Like I said, I am new to practicing.

90.00 x 120.00 . That works out 10,800.00 USD per day. Not enough for you ?

 

[Dave CX]

I am skeptical about your math. You need to calculate how many 88305's, 313's and 312's per year. Multiple by approx. 120% of the medicare allowable for your district. Then calculate your salary and benefits as a percentage. Just off the top of my head (based on an avg of 2 jars per accession and 1 special stain code per 10 biopsies), I would guess that 10% would equal 120K. I am sure you are being paid more than that.

 

[liealgebra]

I am skeptical about your math. You need to calculate how many 88305's, 313's and 312's per year. Multiple by approx. 120% of the medicare allowable for your district. Then calculate your salary and benefits as a percentage. Just off the top of my head (based on an avg of 2 jars per accession and 1 special stain code per 10 biopsies), I would guess that 10% would equal 120K. I am sure you are being paid more than that.

This is essentially what I did. For clarity:

120 charges of 88305/312/313 for an average of $90 billable. (Main assumption, lowball. Only number I know for certain is 120 charges.)
As AZPath points out, this works out to 10800/day of revenue I bring to the practice.

My assertion is that I am bringing home as salary $1080 of that $10800 chunk.

 

[octopusprime]

Yes you are being underpaid, though that's part & parcel to dermpath mills, if that's your employment situation.

 

[icpshootyz]

90.00 x 120.00 . That works out 10,800.00 USD per day. Not enough for you ?

I read it as the group is getting $90/case, likely the global PC/TC for an 88305, and the poster is getting 10% of that, so $9/case? That's definitely underpaid. But like others said, there's a lot of variables involved in what you get paid and there's no agreed upon percentage of what it should be based on the group's revenue. Expenses of the group will have a large play as well. It sounds like you're brand new, so you're definitely going to be paid less than others. No partnership track, so really the partners will be taking home the bulk of the pay. That's why they put out ads for non-partnership track and not partnership track - if you agree to it, they bank off you. Personally I'm in a general path group doing a mix of dermpath and general, depending on the day. Private group, I'm a full partner (we have no employed docs). I don't have any breakdown of what I make as a percentage of the revenue I bring in, as we don't separate out who signs out x number of what billing code, it's all pooled together. But if I divide the overall revenue of the group last year by the number of group members and then by my pay last year, it worked out that full partners take home 80% of the revenue they generate, all things being equal. So 20% of our revenue goes to overhead and non-partner pay expenses (techs, secretaries, etc). The other 80% goes directly to us.

So yeah, you're getting royally screwed if you're getting 10%. I started out much lower than I am now, but when I do the math that still works out to more like 40% of revenue generated. Chances are your current employer has no intentions of paying you more so you may have to shop around.

 

[icpshootyz]

This is essentially what I did. For clarity:

120 charges of 88305/312/313 for an average of $90 billable. (Main assumption, lowball. Only number I know for certain is 120 charges.)
As AZPath points out, this works out to 10800/day of revenue I bring to the practice.

My assertion is that I am bringing home as salary $1080 of that $10800 chunk.

Yeah this is super low. We pay our locums people more than that daily. A dermpath should be making more than a general path locums. Start sending out your resume to other places.

 

[Dave CX]

This is essentially what I did. For clarity:

120 charges of 88305/312/313 for an average of $90 billable. (Main assumption, lowball. Only number I know for certain is 120 charges.)
As AZPath points out, this works out to 10800/day of revenue I bring to the practice.

My assertion is that I am bringing home as salary $1080 of that $10800 chunk.

The 90 dollars is a global then. You should not expect to gain anything from the tc portion. You are not the lab owner. The average reimbursement for an 88305PC will be around 45 and 312/313 maybe 18. If you recalculate, then you are getting 25% of what YOU generate in payments. This is still low, but not as bad as you described. Will you get raises?

 

[Dave CX]

Keep one other thing in mind before storming out the door. You are earning 250K for a workload that is not exactly crushing. The volume you describe may be a days work for you as a new person. But a seasoned dermatopathologist can rip that out in an hour and a half, tops.

 

[liealgebra]

The 90 dollars is a global then. You should not expect to gain anything from the tc portion. You are not the lab owner. The average reimbursement for an 88305PC will be around 45 and 312/313 maybe 18. If you recalculate, then you are getting 25% of what YOU generate in payments. This is still low, but not as bad as you described. Will you get raises?

I did misfigure the reimbursement. Thank you for pointing that out; 25% doesn't seem as disheartening. (Of course, it is nowhere near your 80%!) Dave CX, your perspective is quite helpful.

As for raises, it was never spelled out in my contract. I was happy to have a job because the market was so tight.

 

[AZpath]

Evaluate the market. 250k is a fair starting salary.
You can likely make more elsewhere. That depends on the opportunities verses the expense of moving.
If you are in a saturated market 250k may be good pay.

 

[Dave CX]

I did misfigure the reimbursement. Thank you for pointing that out; 25% doesn't seem as disheartening. (Of course, it is nowhere near your 80%!) Dave CX, your perspective is quite helpful.

As for raises, it was never spelled out in my contract. I was happy to have a job because the market was so tight.

Actually, when you consider benefits, you may be close to 30%, which is not bad. I earn 38 - 39% as an independent contractor doing GI path. I have to commute 100 miles roundtrip though. Beats the **** out of working in a hospital though.

 

[mario2010]

Hi All,

I have a hunch I am being underpaid in my PP situation. To not reveal too much about my identity, etc.:

1. Small PP (dermpath only) on the East coast. Not partnership track.
2. Average about 120 cases per day
3. Take home a hair above 10% of revenue as my salary (benefits not included).

This seems very low to me.

I'd love to hear from other dermpaths what percent of revenue they take home per year in base salary.

Dude....you are absolutely getting getting underpaid !! Even pathmills like Miraca and DD are starting new fellows in late $300K base, with bonuses they can do $400Ks , even in the northeast market ! you are doing the same volume range that they are doing. In a small private set-up that you are describing, for 120 biopsies you should at least be in $500K range, now I can understand initial lower salary if its a partnership tract position BUT if its non-partnership tract you should seriously consider applying for other jobs or re-negotiate your compensation, you are getting low balled !! Even hospital employed dermpath/surg path positions are in mid $300Ks these days and keep in mind these are low volume positions where you are doing 50-60 specimens per day as compared to doing 120 plus every day in path mills.

 

[Dave CX]

Dude....you are absolutely getting getting underpaid !! Even pathmills like Miraca and DD are starting new fellows in late $300K base, with bonuses they can do $400Ks , even in the northeast market ! you are doing the same volume range that they are doing. In a small private set-up that you are describing, for 120 biopsies you should at least be in $500K range, now I can understand initial lower salary if its a partnership tract position BUT if its non-partnership tract you should seriously consider applying for other jobs or re-negotiate your compensation, you are getting low balled !! Even hospital employed dermpath/surg path positions are in mid $300Ks these days and keep in mind these are low volume positions where you are doing 50-60 specimens per day as compared to doing 120 plus every day in path mills.

I disagree. 120 biopsy specimens is not mill volume. I know Miraca and former Bostwick mill workers and they did make the 500+ that you are describing, but their daily volume was upwards of 300 biopsies as mine is. And there is no partnership in a mill,

 

[mario2010]

I disagree. 120 biopsy specimens is not mill volume. I know Miraca and former Bostwick mill workers and they did make the 500+ that you are describing, but their daily volume was upwards of 300 biopsies as mine is. And there is no partnership in a mill,

My friend...I hate to say this but you are mistaken here....for dermpath, base at most commercial labs (exception is SOME not ALL aurora labs these days) is ranging from 120-140 jars with bonus kicking in after base, there are some other commercial labs with base at 75 jars and bonus after that, then there are also independent contractor arrangements with Labcorp etc. with a flat rate per CPT code, these are actual numbers that myself and some of my colleagues got offered during last few years (I did not take these jobs though-respectfully declined them). Yes, there are some commercial labs where you end up doing 200 plus jars (I know which they are) but its no way normal across the board. BTW, I do understand your point of view, I know you are most likely doing on-site professional reads for GI groups with TC done by third party, GI group keeps most of your PC and third party lab makes money off TC, you drive to the physician office do the read and get out quickly, in all fairness if you are happy with it no one has the right to judge- whatever makes you happy my friend! but I can tell you based on first hand experience that 40%PC is quite low as I know people getting paid way more than that even in these set-ups. Personally, I would rather prefer to sign out less number of cases and get paid more per case rather make money on volume, we are all human (at least I am- I think..) and all it takes is one missed nevoid melanoma or one missed signet ring to get permanently knocked down unless someone is Jon Snow and get resurrected...which is unlikely as the long night is almost here.

 

[Dave CX]

My friend...I hate to say this but you are mistaken here....for dermpath, base at most commercial labs (exception is SOME not ALL aurora labs these days) is ranging from 120-140 jars with bonus kicking in after base, there are some other commercial labs with base at 75 jars and bonus after that, then there are also independent contractor arrangements with Labcorp etc. with a flat rate per CPT code, these are actual numbers that myself and some of my colleagues got offered during last few years (I did not take these jobs though-respectfully declined them). Yes, there are some commercial labs where you end up doing 200 plus jars (I know which they are) but its no way normal across the board. BTW, I do understand your point of view, I know you are most likely doing on-site professional reads for GI groups with TC done by third party, GI group keeps most of your PC and third party lab makes money off TC, you drive to the physician office do the read and get out quickly, in all fairness if you are happy with it no one has the right to judge- whatever makes you happy my friend! but I can tell you based on first hand experience that 40%PC is quite low as I know people getting paid way more than that even in these set-ups. Personally, I would rather prefer to sign out less number of cases and get paid more per case rather make money on volume, we are all human (at least I am- I think..) and all it takes is one missed nevoid melanoma or one missed signet ring to get permanently knocked down unless someone is Jon Snow and get resurrected...which is unlikely as the long night is almost here.

I have seen a few seriously sneaky signet rings in the last year. That scares me more than anything.

 

[Dave CX]

Lab Corp in research triangle NC currently pays 12$ per bottle and 4$ per pap smear. That's less than 40%

 

[AZpath]

Goody, Goody. 12$ There is a chance to do 500+ and miss more stuff. Sign me up!

 

[LoaLoa]

It sounds like you are not being paid very well, but, unless you are willing to relocate, you are probably stuck. Read the non-compete covenant in your employment agreement carefully. If you don't own or cannot influence relationships with referring clients, you have very little leverage in this market, at least in my experience.