after dermpath fellowship

[magicballs77]

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this is all hypothetical and for the purpose of future planning, but say i were to complete two sub specialties of dermatology through fellowships (derm path and laser/cosmetic dermatology) following a derm residency (im right now in med school)...if i were to open a private practice that would involve general derm with cosmetic derm, how could i incorporate the derm path fellowship into my practice to, and i kno this is going to sound very inappropriate and stingy but i also care for my lifestyle, boost earnings? if i wanted to utilize my derm path fellowship could i do it in private practice or would i have to go fully into derm path (like in labcorp or something)? or would it be best to just choose one of the two sub-specialties and focus on the chosen one?

 

[pupster]

this is all hypothetical and for the purpose of future planning, but say i were to complete two sub specialties of dermatology through fellowships (derm path and laser/cosmetic dermatology) following a derm residency (im right now in med school)...if i were to open a private practice that would involve general derm with cosmetic derm, how could i incorporate the derm path fellowship into my practice to, and i kno this is going to sound very inappropriate and stingy but i also care for my lifestyle, boost earnings? if i wanted to utilize my derm path fellowship could i do it in private practice or would i have to go fully into derm path (like in labcorp or something)? or would it be best to just choose one of the two sub-specialties and focus on the chosen one?

Well...it's hard to do enough derm path to cover the lab costs, etc. if you aren't doing it full time. Better to just focus on a few high-yield areas, if $ is your interest.

 

[doc MD]

this is all hypothetical and for the purpose of future planning, but say i were to complete two sub specialties of dermatology through fellowships (derm path and laser/cosmetic dermatology) following a derm residency (im right now in med school)...if i were to open a private practice that would involve general derm with cosmetic derm, how could i incorporate the derm path fellowship into my practice to, and i kno this is going to sound very inappropriate and stingy but i also care for my lifestyle, boost earnings? if i wanted to utilize my derm path fellowship could i do it in private practice or would i have to go fully into derm path (like in labcorp or something)? or would it be best to just choose one of the two sub-specialties and focus on the chosen one?

step 1: get into derm first

step 2: think about whether adding more years on your PGY training from fellowship(s) worth it.

 

[asmallchild]

step 1: get into derm first

Porky Pig concurs.

 

[reno911]

Since no one knows or wants to give you the real answer, here it is:

The primary reason why most people want to incorporate dermpath into their practices is to make more money. There is nothing wrong with this and it's not the only reason, but if you want to discuss the issue honesty, then you need to acknowledge this. There's a couple of ways to do this. There are a lot of details, but here's the upshot:

1. If you have a high enough volume, then you can build your own lab. Then you make all of the slides yourself and you read them.

2. If you have low volume, there's plenty of places that you can send the tissue and they will make slides for you at very low cost, so you will still make a profit.

In neither of these scenarios do you have to have done a dermpath fellowship. You will get a lot of dermpath in residency, and it should be enough to read most of your own slides. Also they can be done by a private solo dermatologist.

What most dermatologists who have this setup do is that they just read all of the easy path themselves and then they send out the difficult cases to a real dermatopathologist. Of course if you've done a dermpath fellowship yourself you're less likely to make a mistake and your need to send out cases for consultation will be much less. Also, if you have done a dermpath fellowship, you have some chance of actually getting other people to send their biopsies to you.

 

[magicballs77]

Since no one knows or wants to give you the real answer, here it is:

The primary reason why most people want to incorporate dermpath into their practices is to make more money. There is nothing wrong with this and it's not the only reason, but if you want to discuss the issue honesty, then you need to acknowledge this. There's a couple of ways to do this. There are a lot of details, but here's the upshot:

1. If you have a high enough volume, then you can build your own lab. Then you make all of the slides yourself and you read them.

2. If you have low volume, there's plenty of places that you can send the tissue and they will make slides for you at very low cost, so you will still make a profit.

In neither of these scenarios do you have to have done a dermpath fellowship. You will get a lot of dermpath in residency, and it should be enough to read most of your own slides. Also they can be done by a private solo dermatologist.

What most dermatologists who have this setup do is that they just read all of the easy path themselves and then they send out the difficult cases to a real dermatopathologist. Of course if you've done a dermpath fellowship yourself you're less likely to make a mistake and your need to send out cases for consultation will be much less. Also, if you have done a dermpath fellowship, you have some chance of actually getting other people to send their biopsies to you.

so say i just finished a dermpath fellowship (following a derm residence) and decide to do dermpath fully...how could/would i set up a private lab and get a large clientele base to maximize income potential? again i dont mean to sound stingy...its all for future planning and weighing options

 

[reno911]

so say i just finished a dermpath fellowship (following a derm residence) and decide to do dermpath fully...how could/would i set up a private lab and get a large clientele base to maximize income potential? again i dont mean to sound stingy...its all for future planning and weighing options

The bold is extremely hard. Remember that as a dermatologist, you are only really in direct competition with the other dermatologists in your community. And if you find a community where there are no other dermatologistis, then you have no competition.

However, as a dermatopathologist, you can consider yourself in competition with every other dermatopathologist in the US (since specimens can be sent by fedex anywhere in the US in a day).

Getting a large number of dermatologists to send you their specimens if you are fresh out of fellowship and starting your own lab is virtually impossible. Unless you've got some sort of connections you could depend on or have some sort of amazing business/marketing skills.

The people who did this 20-30 years ago had a much easier time of it. As a result they, for the most part, are incredibly wealthy now. Unfortunately, opportunities like that are essentially nonexistent today.