News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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More Community Hospital Pathology Laboratories Are Ready to Tackle Molecular Testing for Infectious Disease and Cancer

Clinical pathology laboratories often find it difficult to get accurate information about various molecular and genetic assays

Because of advances in automated molecular systems and less complex technologies, it is now possible for more clinical pathology laboratories in community hospitals to establish their own molecular diagnostics testing program. This is particularly true of testing for infectious disease and cancer.

At the same time that local pathology and clinical laboratories have this opportunity to provide useful new molecular and genetic tests to physicians in their community, questions often remain about how to assess the clinical value of performing a molecular diagnostic test versus the cost of performing that assay. Adequate reimbursement is another equally important part of the decision to offer a new molecular or genetic test.


Market Demand for Top-Performing Pathologists Means Higher Compensation

Number of Employee Pathologists Grows Even as Private Pathology Groups Do Well

Demand for pathologists is strong and growing. That’s good for the profession, but makes it more challenging for labs and pathology groups to recruit top talent. Lots of bidders for the best pathology talent means that skilled pathologists-particularly those with subspecialty expertise-are commanding more money and richer compensation and benefits packages.

“In certain respects, it is a boom time in pathology,” stated Rich Cornell, President of Santé Consulting of St. Louis, Missouri. Cornell has more than two decades of experience in recruiting pathologists for many of the nation’s leading laboratory companies. “This decade has seen a tremendous increase in opportunities within the anatomic pathology profession. New diagnostic technologies, particularly in oncology, are fueling steady increases in test utilization. That means more work for pathologists, particularly for those with subspecialty skills in molecular diagnostics.

“Two other factors contribute to this the current strong demand for skilled pathologists,” continued Cornell. “One is the impending retirement of the baby boomer generation. Pathology groups recognize the need to recruit pathologists to replace partners who are soon to retire. Second, there is a relative shortage of middle-aged pathologists in today’s market because of the reduced number of pathologists who graduated from medical schools during the 1990s-a time when managed care and other financial pressures made anatomic pathology less attractive.”

Another phenomenon that is reshaping the pathology profession is the growing number of pathologists who are employees. Traditionally, most pathology was performed in private practice settings, typically in community hospitals. “Over the past 15 years, many of the new job opportunities in pathology have been created by national pathology companies and specialized testing laboratories-particularly those with patent-protected or proprietary tests,” observed Cornell. “This is one trend that has deep roots and looks like it will continue for some time in the future.”

Cornell has advice for laboratories actively recruiting pathologists, as well as individual pathologists interested in finding their ideal practice setting and compensation package. “It is important to recognize that today’s supply-demand situation does not reward all pathologists equally,” he noted. “To negotiate a win-win package, both the hiring lab and the candidate pathologist should understand how each of these elements plays a role in the specific partner/employment opportunity being considered.

“First, consider compensation,” said Cornell. “Subspecialists generally can negotiate a higher compensation package than generalists. But there are differences even across the subspecialties in pathology. Also, it is important to recognize the advantages and disadvantages of private practice positions compared to employment positions. Younger pathologists, for example, are much more open to employment opportunities compared to the baby boomer pathologists when they were the same age.

“Second, productivity is now a key factor, more than it has ever been in the past,” explained Cornell. “Sustained downward pressure on reimbursement means that both lab companies and pathology practices are linking compensation ever more tightly to the productivity of the individual pathologist. This trend will intensify with each passing year.

Third, any pathology group or laboratory in the recruiting and hiring mode needs to be smart about the market demand for the particular pathology skills and experience they seek,” he stated. “I often see intense bidding for particularly productive, effective pathologists. That may be good for the candidate, but means the hiring group may end up paying more than it had budget for this position.

“This same advice applies to individual pathologists,” continued Cornell. “If you are looking for a position, you’ll negotiate a better position and compensation package if you understand who else is actively in the market looking for the same opportunities as you.”

Rich Cornell will share these, and other secrets, at the upcoming audio conference titled, “Emerging Trends in Pathologist Compensation, Productivity, and Job Prospects.” It will take place on February 18, 2009 at 1 PM EST, 12 PM, CST, 11 AM MST, 10 AM PST.

This is a high-value conference for both laboratories preparing to hire new pathologists and for pathologists entering the job market. Best of all, your entire laboratory team can listen with you to this important audio conference. Reserve your participation in this highly valuable audio conference by registering today at


1. Online

2. Call toll free: 800-560-6363

Registrations accepted until Wednesday, February 18, 2009, noon EST.

Cancellations before 5:00 p.m. EST on Monday, February 16, 2009 may receive a full refund less a $25 service charge.

Your audio conference registration includes:

  • A site license to attend the conference (invite as many people as you can fit around your speakerphone at no extra charge)
  • Downloadable PowerPoint presentations from our speakers
  • A full transcript emailed to you soon after the conference
  • The opportunity to connect directly with our speakers during the audience Q&A session

A Tale of Two Analyzers and Other Thoughts from AACC 2008

There were plenty of new and interesting analyzers, lab tests, and other products on display this week in Washington, DC, at the exhibition during the annual meeting of the American Association of Clinical Chemistry (AACC). Dark Daily was there to take it all in and to identify emerging trends in laboratory and pathology management.

There were new instrument systems galore, because many in vitro diagnostics (IVD) manufacturers use the AACC exhibition as the place to unveil their latest generation of products. Two examples of new analyzers illustrate how technology advances are contributing to useful new capabilities.

For use in the core laboratory, Ortho-Clinical Diagnostics (OCD), a Johnson & Johnson Company (NSYE:JNJ), showed off its new VITROS 5600 Integrated System, which puts chemistry and immunoassay into a single, integrated platform. What caught Dark Daily’s attention is how this instrument incorporated Lean principles in its design and operation. For example, OCD calls it a “one-tube-in, one-tube-out” workflow guided by onboard intelligence to prioritize the next 50 tubes in the queue and handle them independently and in parallel for both chemistry and immunoassay. It has an onboard menu that will support 120 assays. Another intriguing aspect of this new instrument system is that, because it uses dry chemistry, there is no need for water or waste lines. That feature will give this instrument system an interesting appeal for laboratories that want flexibility in placing the instrument while eliminating the need for expensive remodeling to supply a water and waste line to the instrument. This instrument will be available for purchase by early 2009.

A second analyzer is designed to allow community hospitals to expand their molecular testing capabilities. HandyLab, Inc. of Ann Arbor, Michigan, was showing its Jaguar platform. This is an open system for molecular assays that will produce molecular results in 45 to 90 minutes. The random access Jaguar will perform specimen preparation, amplification, and real-time PCR automatically, using room temperature reagents. It can perform 1 to 24 samples at one time and will test up to 200 samples per nine-hour shift. The Jaguar has a competitive price and is designed to support laboratory developed tests (LDPs).

With more than 800 vendors exhibiting at the AACC event and only three days of exhibition hours, it is difficult for any single individual to get by all the booths and evaluate the innovations and new products being shown. One important trend that could be seen in walking around the exhibition is the number of new vendors showing proprietary assays and lab tests. A ballpark guess is that more than 50 firms with new lab tests were exhibiting at AACC for the first time. Also, the number of exhibitors in the international area has increased over the past year.

Finally, a personal comment. Your Dark Daily editor decided to allow himself to be tested at one of the companies offering a free test of their proprietary assay. I thought this would be an easy process, since I give blood regularly and phlebotomists always tell me I have good veins. In conversing with the phlebotomist as the draw was performed, I learned that this individual was a seven-year employee with one of the national laboratories. I also observed that, after inserting the needle in my arm, this phlebotomist was fooling around for more than 30 seconds attempting to get blood to flow from that site. I quietly encouraged her to withdraw the needle and try the other arm. That second venipuncture went successfully. By the way, as a former rugby player with more than two decades of playing experience and my share of stitches, the first attempt at venipuncture was not painful or agonizing. So Dark Daily readers can be assured that your editor was NOT traumatized, only the nearby observers were.

My comment on this experience is that it demonstrates the difficulties laboratories face in providing tip-top service to consumers. Additionally, the folks with me had a chuckle discussing about how the senior executives at that phlebotomist’s home company might react were they to learn that it was the Editor of Dark Daily and The Dark Report who experienced a less-than perfect venipuncture at the hands of their phlebotomist! It is also a reminder of the variability in care delivered to patients and why reducing such variability can give laboratories competitive advantage.

Regards and enjoy the remaining weeks of summer!

Robert Michel

Editor, Dark Daily