Re-shaping the Profession of Anatomic Pathology

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WHEN JANUARY 1, 2011, ARRIVED, IT MARKED AN IMPORTANT MILESTONE for the anatomic pathology profession. That is the day that the oldest pathologists in the Baby Boomer generation turned 65 years old and became eligible for Social Security and Medicare.

This is an event we have discussed our entire adult lives. The question is asked constantly. How will the “me generation” transform American society as they enter their retirement years? Now we are about to find out. Demographics indicate that the number of individuals reaching the age of 65 this year will be 50% greater than in any single year of the past decade.

One obvious consequence of this demographic fact is that clinical laboratories and independent pathology group practices will likely see a similar 50% increase in the rate at which pathologists and staff members reach retirement age. As you will read on pages 17-19, many laboratories are failing to put an effective succession plan into place. That leaves them vulnerable to the unexpected retirement of key physicians and managers.

Another consequence of this demographic fact is that many of the nation’s thousands of smaller, community hospital-based pathology groups will find it difficult—if not impossible—to recruit a younger pathologist to replace a retiring pathologist partner. Certainly that was a factor in the decision of Davis-Sameh-Meeker Laboratory (DSM) of Walla Walla, Washington, to sell itself to InCyte Pathology, P.S., of Spokane Valley in recent weeks. (See pages 3-7.)

It is for that reason, among several others, that a growing number of independent pathology groups are beginning to explore consolidation and integration with cross-town colleagues. A full consolidation does not have to happen. Some form of collaborative test services may be the answer and shared laboratory testing networks are a visible sign of this trend. (See TDR, March 21, 2011.)

Add to these marketplace dynamics the triple threat of ObamaCare’s accountable care organizations (ACO), medical homes, and value-based purchasing. Each has the potential to change the way providers buy and use laboratory tests. When you consider the collective impact that all these trends may have to the profession of anatomic pathology, it is easy to conclude that a major transformation of this medical specialty is already under way. How fast this transformation occurs has yet to be determined.

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