Pathology Consultants See In-House AP Trend Unfolding

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LOCAL PATHOLOGY GROUP PRACTICES are themselves the “canary in the coal mine” to provide early warning about the exploding interest of specialist physicians at capturing the anatomic pathology (AP) revenues generated by their patients.

THE DARK REPORT interviewed three consultants, each of whom serves multiple pathology groups. Each reported that client pathology groups are in discussions with specialist physician clients about various ways the specialist groups might capture the AP revenues which result from test referrals for their patients.

“This is definitely happening to my clients in several regions,” stated Laurence J. Peterson, President of Torrey Consulting Group of El Paso, Texas. “During the past 18 months, I’ve seen multiple instances of a urology or gastroenterology (GI) group approaching their local pathologists to explore some form of collaboration.

“Sometimes they have asked how to develop a relationship where they build their own laboratory, but have the local pathology group provide the professional service,” continued Peterson. “This allows them to bill the technical component, but preserves their professional relationship with the local pathologists.”

Prior to his retirement as a consultant last December, Dennis Padget, of DLPadget Enterprises, Inc., a Simpsonville, Kentucky-based publisher of business practice guides for pathologists, saw a similar increase in such discussions. “It’s that longstanding—but now growing—interest in lab services as a significant secondary revenue stream for specialists,” he observed.

“These discussions raise two questions that implicate the status and stature of pathologists,” Padget said. “First, are pathologists willing to give up their hard- fought status as medical service ‘retailers’ dealing directly with the public by returning to the days when they were mainly ‘wholesalers,’ as happens with account-bill arrangements? Second, are pathologists willing to let the profession devolve from its stature as a primary medical specialty to one that’s subordinate, as happens when specialists own their own real or faux—e.g., ‘salon’ or ‘condo’—histology labs? The pathology profession will struggle to find the right answers to these questions.”

Specialists Initiate Talks

“Pathology groups I work with in the Midwest, California, and Texas have been approached by their specialist clients over the past year,” stated Mick Raich of Palmyra, Michigan-based Vachette Pathology. “We see a variety of proposals, but the net effect of each is less money for the pathologists.

“Nothing has yet developed from these proposals,” he added. “But loss of revenue from such physicians is becoming a number one concern for a number of my pathology clients.”

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