| R. Lewis Dark:
Pathology Lets the Oncology Cat Out of the Bag
BECAUSE OF GENETIC TECHNOLOGY, the profession of anatomic pathology
may be poised for a golden age. The range of new technologies and diagnostic
assays heading for clinical use have the potential to give pathologists
the ability to detect disease with greater precision. They will also
allow pathologists to guide clinicians to the most effective therapies.
In this golden age of genetic medicine, the biggest market will be oncology.Every healthcare expert predicts explosive growth in rates of cancer,
driven primarily as the baby boomer generation moves into their retirement
years. For the anatomic pathology profession, this is a fortuitous conjunction
of two events—new genetic knowledge and a huge demographic bulge
that will produce growing numbers of cancer cases. Further, this is a fortuitous
conjunction that may never happen again.
However, I fear that the bread and butter pathologist—the physician
practicing medicine in a private group practice in one of the nation’s
many community hospitals—will reap precious little economic benefit
from this approaching opportunity. That’s because the collective anatomic
pathology profession has already let the “oncology cat” out of the bag.
Since 1995, private practice pathologists allowed national lab companies
to compete for cancer diagnostics almost unopposed and capture big shares
of the market. THE DARK REPORT was the first, and for many years, the only,
voice warning the pathology profession that the astounding growth rates of
companies such as UroCor, Inc., and DIANON Systems, Inc., were based
on competing successfully for specimens from office-based physicians practicing
around community hospitals. These office-based physicians have been
the primary sources of specimens for many private pathology groups.
Now an even greater financial menace has emerged. It is the trend of specialist physicians—such as urologists and gastroenterologists—taking steps
to establish their own histology laboratories and perform their pathology
work in-house. This threat challenges not just the private practice pathologist,
but also the national pathology companies that compete for these specimens.
A careful strategic assessment of this new development leads to the
conclusion that, in the future, private practice pathologists are not likely to
be the primary provider of oncology diagnostics to the American healthcare
system, because that oncology cat is now "out of the bag!"
Payer Sues Pathologists For Clin Path Fee Refund
Health plan sues three Virginia pathology groups in dispute over professional component fees
CEO
SUMMARY: In September, Anthem filed three lawsuits
against pathology groups in Virginia, seeking refunds and punitive
damages of up to $ 1 million from each pathology group for
pathology professional services provided in hospital labs by
these pathology groups during the period 2001 through 2005.
These three cases have disturbing implications for pathologists,
as well as all providers with payer contracts.
Molecular Diagnostics Update: Ventana & Cytyc Fall Short,
Danaher Wins the Prize
Goal was Vision Systems’ molecular markers and product line for histology laboratories
Doctors’ Income Survey
Includes Pathologists
2006's increase in physician compensation
was slightly below rate of inflation
CEO
SUMMARY: Information on the year-to-year change in
average total cash compensation for physicians shows that
income is not keeping pace with inflation. That is not news to
the physician community. However, pathologists continue to
earn compensation that is above the midpoint average for 16
specialties. Compensation is rising swiftly for those pathologists
with specific subspecialty skills that are in high demand.
Identity Theft Update: Medical Identity Theft Is Twist
On Identity Theft Crime Wave
Docs' Pricing, Outcomes Available to the Public
New federal executive order on publishing
price and outcome data for hospitals, physicians
CEO SUMMARY: Transparency of provider prices and outcomes is coming to healthcare. A new executive order directs all federal agencies to collect and publish data on prices and
outcomes for healthcare providers serving beneficiaries of government
health programs. At the same time, private payers are putting more information on the Web to help consumers learn what physicians charge and which ones provide the best care.
Lab Trends In Canada
Run Ahead of U.S.A.
Labs in Canada face tight budgets and
an even tighter supply of trained lab staff
CEO SUMMARY: In specific ways, laboratories in Canada are already confronting the future that awaits laboratories in the United States. Many of the challenges are identical,
including shrinking reimbursement and funding, as well as a shortage of skilled lab staff. One unfolding development is pressure on pathologists to accept less compensation,leading pathologists in two provinces to study productivity.
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