CEO SUMMARY: Demand for top-level pathologists is surging. A strong rise in the number of job openings for pathologists results from a combination of factors, some related to COVID-19. Now that physicians are seeing patients again, the number of specimens has risen after falling last year, creating demand for new hires, a consultant said. The average age of pathologists continues to rise, causing some to retire. At the same time, residency programs are training fewer pathologists.
FOR THE ANATOMIC PATHOLOGY PROFESSION, a good-news and bad-news story is developing. As demand for sub-specialized pathologists is increasing, the number of pathologists qualified to do complex diagnostic testing is inadequate to meet the demand.
For individual pathologists, it is good news that demand for their services is growing.
But it is bad news for pathology groups, academic institutions, and pathology companies seeking to hire more skilled pathologists to handle a rising number of tests while supporting growth in test volume and revenue.
Demand Exceeds Supply
“In today’s job market, the demand for pathologists with director-level experience and with sub-specialty skills exceeds the available supply of pathologists,” said Rich Cornell, President and founder of Sante Consulting, a pathologist and laboratory medicine recruiting firm.
“As the volume of diagnostic testing continues to grow, the number of pathologists available to do this work declines because older pathologists are retiring, and fewer pathologists are graduating from residency and fellowship programs,” he added.
The imbalance in the supply of pathologists versus the demand for clinicians with those skills is changing the dynamics in the job market for anatomic pathologists. For pathology group practices and pathology lab companies actively recruiting pathologists, it is important to understand the current dynamics in the recruitment market.
Four Biggest Factors
Pathology groups and companies seeking to hire pathologists will want to understand the four biggest factors driving these trends.
First, data show that the number of jobs available for skilled pathologists exceeds the number of pathologists qualified and who are currently looking for positions.
Second, the economics of supply and demand mean that hiring labs must offer highly-competitive compensation and benefits packages when recruiting pathologists who have the requisite skills to meet the lab’s needs.
Third, the pandemic has changed the way pathologists are recruited, interviewed, and hired.
Fourth, the coronavirus pandemic has caused some pathologists to restrict their job searches to regions of the country where they can be closer to family and to avoid the need to fly or commute over long distances.
Greatest Demand in 20 Years
In August, more openings existed for sub-specialized pathologists than at any time in the past 20 years, Cornell reported. Cornell’s recruitment firm in Chesterfield, Mo., specializes in filling positions in anatomic and clinical laboratories at the director level and above, including those in molecular diagnostics, clinical chemistry, microbiology, and immunology.
In an exclusive interview with The Dark Report, Cornell noted that the shortage of pathologists nationwide is unprecedented.
“One popular website for jobs that pathologists use listed 600 pathology jobs as being open in early August,” he said. “We often see that an advertised pathology job is filled within a few days and sometimes less than that.”
Also, pathology groups seeking new talent to replace senior, retiring pathologists are recruiting virtually, meaning hiring groups are conducting interviews via Zoom, WebEx, and other online sites.
Virtual Negotiating Process
“Some current candidates looking for jobs have done all of the negotiating with hiring labs virtually,” Cornell said. “That means that the first time the new hire meets anyone on staff is day one of the new job.” (See sidebar, “New Normal Is Real-Time Recruitment for Both Clinical and Anatomic Pathologists,” below.)
One reason for doing interviews online is the need to reduce travel time for desirable candidates. Another reason is to keep all parties safe during COVID-19.
“Also, a growing proportion of anatomic pathology work today can be done virtually via fully-digital pathology systems,” Cornell commented. “That means some newly-hired pathologists can work remotely, and many may not need to move at all to take new jobs. Not having to sell a home or find a new one saves time, which enables new hires to often start right away.”
In a presentation two years ago at the Executive War College, Cornell cited data from researchers showing that the workforce of pathologists in the United States is smaller relative to that of other countries that have experienced significant adverse events in clinical laboratory quality and delays in diagnosis.
At the time, the market for pathology jobs was already competitive, starting salaries for pathologists were rising, and AP groups were offering competitive benefits and hiring bonuses, he said. (See, “Fewer Pathologists Means Tighter Market for Jobs,” TDR, June 10, 2019.)
‘Looming Shortage’ Predicted
Cornell’s prediction was based on research published online by the Journal of the American Medical Association (JAMA) in 2019. “The JAMA workforce study showed that there would be a looming shortage of pathologists. That’s exactly what we see now,” he commented.
In its coverage of the pathologist workforce study published by JAMA, The Dark Report noted that the researchers had determined the number of pathologists practicing in the United States declined by 17.53% from 2007 to 2017. Using their definition of active pathologists, researchers found that the number of active pathologists in the United States in 2007 was 15,568. By 2007, that number had shrunk to 12,839 active pathologists.
Pathologist training programs are another factor contributing to fewer active pathologists in the United States. In 2019, college and university pathology residency programs were training fewer pathology students compared with the number they had trained in earlier years.
The website PathologyOutlines.com showed on Aug. 6 that there were 600 job openings for pathologists. This number represents almost twice as many open positions as the site had shown on Aug. 3 last year.
“Those numbers are a good barometer for the pathology job market, and I don’t believe they have ever had that many job openings for pathologists in their 20 years of tracking the market,” he commented. “Here at Sante Consulting, our business has risen dramatically as well. Our clients are contacting us almost every day asking for help in recruiting pathologists.”
Pandemic’s Effect on Jobs
Multiple factors contributed to the rise in job openings for anatomic pathologists. “It’s a combination of factors,” Cornell noted. “One reason is that physicians are seeing patients again after not seeing the normal level of patients during the pandemic.
“All the patients who didn’t see their doctors during the COVID-19 lockdown meant that physicians fell behind on the normal level of procedures they do,” he explained. “Now those patients are getting biopsies done, which creates a rising demand for anatomic pathologists.
“A second reason is that many pathologists working today are nearing retirement age and leaving the profession as they retire,” he added. “The JAMA study showed how the average age of pathologists was rising compared with other physician specialties.
“Also, for many years, pathologists tended to stay on the job, even past the typical retirement age that was common years ago,” Cornell explained. “As long as their eyes were good and their minds remained sharp, they were inclined to continue working as long as possible.
“But then the pandemic hit, and now many older pathologists realized there’s more to life than work,” he continued. “They also may see that with COVID-19, life is short, particularly if they have lost loved ones, such as some front-line workers in healthcare. Many physicians—including pathologists—have lost colleagues due to the pandemic.
“All these factors cause pathologists to look at their priorities differently,” he added. “In many cases, if they can afford to retire, they do just that. They’re throwing in the towel on their careers and moving on to enjoy their lives.
“Another factor related to the pandemic is that pathologists are leaving groups, not because they’re unhappy, but because they’re moving to be closer to family,” Cornell remarked. “Maybe they’re reluctant to fly and want to be closer so that they can drive to be with their children and perhaps grandchildren too.
“If a pathologist has strong family ties in another region, there’s probably going to be an opportunity to take a position that opens up near where they want to be,” he commented. “Moving to that area may be more likely than it would be in a tight labor market.
Cost-of-Living as a Factor
“The booming market for pathologists seeking jobs gives candidates the option to move to a community where the cost of living is lower,” Cornell stated. “We’ve seen the out-migration among individuals leaving areas where the cost of living is high. Those pathologists are moving to places where their money goes further, such as Florida, Texas, or the Carolinas.
“If a pathologist is getting closer to retirement, he or she is thinking about how to live on a fixed income,” he continued. “If so, a state with a lower cost of living could be more attractive than staying in New England, New York, or California where the cost of living is higher.”
New Normal Is Real-Time Recruitment for Both Clinical and Anatomic Pathologists
AMONG THE MANY WAYS THE CORONAVIRUS PANDEMIC HAS TIPPED THE SCALES in favor of anatomic and clinical pathologists seeking new jobs is that the pandemic itself helped to create a shortage of pathologists. That shortage has forced anatomic pathology (AP) groups and some clinical laboratories to change how they recruit new candidates.
Just as homes in some areas of the country have caused buyers to offer more than owners are asking, so too are AP groups and clinical labs competing for candidates by offering higher pay, more time off, and a strong work-life balance. Also, AP groups and some clinical labs have started adopting what Rich Cornell of Sante Consulting called a real-time recruitment methodology.
“Anatomic pathology groups have a big challenge recruiting candidates for open positions and in hiring those candidates,” said Cornell, the President and Founder of Sante Consulting.
“Groups using the old method of inviting candidates for in-person interviews are struggling to recruit talent,” he said. “The golden days of simply posting an ad on a job board and expecting to get 20 or 30 resumes are over. That’s not the market today. By today’s standards, if your group posts an ad and gets five to 10 applicants, you’ve done well.”
Once an AP group or clinical lab identifies a viable candidate, those responsible for interviewing and hiring need to move with all deliberate speed. “Your lab needs to move any viable prospect through the hiring process expeditiously,” Cornell cautioned.
“If the hiring team at your lab sits on a CV and does not respond quickly to each candidate, you could lose out,” he stated. “Academic medical centers, for example, have layers of bureaucracy in their hiring processes. That slows everything down. They’re going to lose candidates 90% of the time unless they react faster,” he said.
Many of today’s candidates were born between 1980 and 1995, meaning they are now in their late 20s to early 40s. These millennials are accustomed to getting what they want quickly. “This generation of pathologists is very demanding,” Cornell noted. “Demographic data show that 75% or more of the physician workforce will be millennial physicians by 2025, just 40 months from today.
“Millennials think differently than older pathologists,” he added. “Quality of life is very important to them, as is work-life balance. They want to be treated fairly and they want to have a voice in how their employer—meaning the AP group or clinical lab doing the hiring—treats staff.”
All these factors mean anatomic pathology groups must be nimble, particularly in today’s candidate-driven market. “If your AP group is hiring, you must let any top candidates know you’re interested and what you’ll do to land them,” Cornell said. “If your group does not take these steps, somebody else will step in and snap up those candidates.”
The fastest-moving AP groups will hold virtual interviews in which several members of the group will meet with candidates being interviewed online via Zoom, WebEx, or other platform. “Anatomic pathology groups also may need to make competitive offers to candidates as soon after an interview as possible. Otherwise, the best candidates are likely to go elsewhere,” Cornell warned.
Contact Rich Cornell at 636-777-7885 or email@example.com.