Pathology and the corporate transformation of American medicine.

Corporate medicine is a cultural response to increasing medical costs, a transformation made possible by an oversupply of physicians. The independence of physicians is being curtailed. Nonetheless, corporate needs for medical efficiency, low costs, and good outcomes match the capabilities of pathology and assure that the specialty will have a major corporate role. Pathologists as individuals may face sharply different outcomes. Those pathologists who own laboratories, who are good managers, who a extremely productive, or who are excellent clinicians have good opportunities, as do a few individuals with highly developed technical or subspeciality skills, Eventually, hospital chains are likely to be replaced by physician-owned or -controlled corporations, further strengthening pathology's role. Pathologists in academic and independent laboratory settings are likely to do well. Pathology organizations must take a leadership role in preparing pathologists for what can be a bright future.