Tough times demand superior business savvy

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Ron Shinkman

January 2017—Reimbursement policies, competitive forces, and pathologist workforce numbers will reshape pathology groups in the coming years, say Barry Portugal, president of Florida-based Health Care Development Services, and Edward P. Fody, MD, president of Western Michigan Pathology Associates. They spoke last October at G2 Intelligence’s Lab Institute on how Medicare rates, insurers’ narrow networks, MACRA, new technologies, and outsourced hospital lab management will bring change—as will the declining numbers of pathologists. But there are clear steps pathology groups can take.

Portugal

The number of pathologists in the U.S. will fall from 5.7 per 100,000, as of 2010, to 3.7 per 100,000 by 2030, says Dr. Fody, who presented data from the CAP Workforce Project Work Group published in Archives of Pathology & Laboratory Medicine (Robboy SJ, et al. 2013;137:1723–1732). That’s a decline of 35 percent, which Dr. Fody says is “baked in” by the current demographics of pathologists aging out of the workforce versus the number of pathology residency slots at the nation’s teaching hospitals.

To stop the decline, the number of those residency slots would have had to increase by 8.1 percent as of a few years ago, Dr. Fody says, an unlikely change given the demand for primary care physicians and other specialties. “You don’t have to be a PhD in demographics to see what’s going on,” he says.

At Emory University Hospital, the number of U.S. medical graduates applying for pathology is flat or declining, Charles E. Hill, MD, PhD, tells CAP TODAY. “Much of this may be attributed to the new models of medical school curricula, but there is likely some influence from changes in reimbursement for pathology services as well,” says Dr. Hill, director of the Emory pathology residency program and director of the hospital’s molecular diagnostics laboratory.