JAMA Study: Pathology field loses almost 18% Since 2007

Significant shortages will reshape the pathology field – and pay off for those in pathology careers

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This is a synopsis of two articles in the June 10, 2019 issue of THE DARK REPORT (TDR). The full articles are available to members of The Dark Intelligence Group.

CEO SUMMARY: The number of professionals working in the pathology field in the United States declined by 17.53% from 2007 to 2017 – leaving the U.S. with even fewer pathologists than other countries who have already suffered adverse clinical lab quality events. But TDR has dug deeper and finds that bad news for patients may be good news for pathologists, as salaries and benefits are increasing. At the same time, higher pay will come with a heavier workload. 

FEWER PATHOLOGISTS ARE WORKING IN THE UNITED STATES TODAY compared with the number in practice in 2007, according to research published online on May 31, 2019, in the Journal of the American Medical Association (JAMA).

“Between 2007 and 2017, the number of active pathologists in the United States decreased from 15,568 to 12,839,” wrote the study’s authors. That’s a decrease of 17.53%. “In contrast, Canadian data showed an increase from 1,467 to 1,767 pathologists during the same period,” they said. That’s an increase of 20.45%.

In addition to analyzing the number of professionals working in the pathology field in the two countries, the researchers also reported on the number of cancer cases per year as a way to assess pathologists’ workload and the effect an over-stretched workforce could have on patient care.

This also means that those seeking jobs will find that a more competitive job market is pushing pathologist salaries up over $300,000 per year on average, and most new jobs come with a hiring bonus and funds for relocation of as much as $12,000 and for continuing medical education of $3,500.

The catch is that these higher salaries also come with a requirement for pathologists to handle more cases per year, and fewer pathology jobs come with opportunities to reach partner level.

Patient Care Is In Jeopardy

When the researchers adjusted for new cancer cases per year, the diagnostic workload per U.S. pathologist rose by 41.73%. Over the same period, the Canadian diagnostic workload increased by 7.06%, the research showed.

Also, after the researchers compared the number of pathologists in United States against the U.S. population, they concluded that the U.S. pathologist workforce is smaller compared to the pathologist workforce in other countries that have experienced major adverse events in clinical lab quality and delays in diagnosis.

In other words, patient care is in jeopardy because specimen volume has risen by more than 40% while the number of professionals in the pathology field has failed to keep pace and has actually declined by almost 18%. The increased workload and the decline in the number of pathologists raise concerns about delayed diagnoses and an increased possibility of diagnostic errors.

“Pathologist shortages in the Canadian and UK health systems have resulted in suboptimal patient care, including delayed cancer diagnoses and diagnostic errors,” the researchers wrote. “A 2017 survey conducted by the UK Royal College of Pathologists found adequate staffing in only 3% of National Health Service histopathology departments.

“This inadequate staffing has resulted not only in diagnostic delays but also in increased costs due to the need to hire temporary workers or outsource services,” they said. “Because of the potential consequences of a pathologist shortage, a comprehensive understanding of the current and future pathologist workforce is imperative.

“When adjusted for each country’s population, the number of pathologists per 100,000 population showed a decline from 5.16 to 3.94 in the United States and an increase from 4.46 to 4.81 in Canada,” the authors added. “As a percentage of total U.S. physicians, pathologists have decreased from 2.03% in 2007 to 1.43% in 2017.”

Demographic Shifts

For Rich Cornell, President and Founder of Santé Consulting, a recruitment firm specializing in laboratory medicine with a core concentration in the pathology field, a shrinking workforce is visible throughout the profession. In his work as a recruiter for AP and CP positions, Cornell has seen shortages among pathology groups nationwide.

“As members of the baby boom generation retire, the number of pathologists is declining, and those same boomers, as patients, need more anatomic and clinical pathology testing,” he said.

Also, while medical schools have increased enrollment, the number of those choosing the pathology field is not growing proportionately so that they are not replacing their older counterparts in sufficient numbers, he added.

After reviewing the JAMA study, Cornell suggested that researchers should have used data on the number of pathologists from the American Board of Medical Specialties.ABMS shows there are 26,321 board-certified pathologists in the United States, including those in all subspecialties, of which approximately 19,000 are boarded in Anatomic and Clinical Pathology. “The data would have been that much more accurate if the researchers had used the ABMS numbers,” he commented.

Contact Rich Cornell at 636‐777‐7885 or rcornell@santellc.com.

Is your lab suffering from the labor shortage in the pathology field, and if so, how will you deal with the problem? Please share your thoughts with us in the comments below.


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