Until a few years ago, the business environment for the practice of pathology was robust: stable third-party reimbursement, high revenues, content customers, and negligible competition. However, that environment is changing and the future does not look so favorable. Reduced federal and third-party reimbursements will diminish practice revenues. Fee-for-service is on track to morph into value-based remuneration, a paradigm shift that will likely have pathologists bickering with their colleagues for a fair share of the reimbursement check. The proliferation of pathology specialty training programs will likely escalate customers’ demand for specialized pathology expertise, diverting yet more work from generalist pathologists who never dreamed that work to be at risk. Mergers, consolidations, and acquisitions may eliminate pathology positions altogether.
Pathology groups may be forced, perhaps for the first time, to engage in high-level business strategic planning, the stakes of which are the very preservation of their livelihoods. In many practices, several partners hold equal equity and hence equal voices in decision making. Finalizing strategic business decisions requires group consensus. For some groups, reaching consensus decisions may be difficult. As requisite to strategic planning, partners in those practices might be well served by answering several questions.