Pros
In some ways it was great as a first opportunity in medical sales. At one time Bostwick Laboratories showed such promise. The urinary pathology expertise of the founder carried this company to remarkable growth until about three years ago. Additional divisions were added in dermatology, GI, GYN, nephrology, neuropathology and hematopathology. None of the add-on divisions saw quite the success of the urology division. Although base pay was quite modest for sales reps ($50k), high reimbursement on multiple biopsies, FISH and the prognostic panels could add up to high commissions. Higher earning reps earned above $250k.
Cons
Aside from the internal challenges Bostwick faces the headwind of changing economics for anatomic pathology. The company's business model relies on increasing test volumes for services that are experiencing declining reimbursement. But they're being squeezed from both sides. Volume: practices are increasingly insourcing the lab work on their biopsies, so that companies like Bostwick are left with a smaller share of the market. Next, more and more specialty practices are being folded into hospital systems that require their doctors to use the in-house lab. And finally, outside groups are increasingly pressuring doctors like urologists to cut back on the volume of invasive procedures that cost a lot but do little to improve patient outcomes. Bostwick has been a leader in advancing the idea that it's "standard of care" to perform 12 or more prostate biopsies, but these outside groups have had the effect of scaring patients away from being biopsied. Declining Reimbursement: in early 2011 Medicare reimbursement for FISH testing was slashed by two-thirds. Bostwick was reputed to perform more FISH than anyone in the world, so you can imagine the negative impact on the company's top line. Now Medicare is planning to cut the technical component of the main anatomic pathology CPT code (88305) in half. This will really hurt the company. In early 2012 new leadership was recruited. They seem to have a vision to make sorely needed improvements, but so far this has resulted in numerous layoffs in the field and at corporate. My take is that the gravy train that once was Bostwick Laboratories is ended. Pathology services are more of a commodity than a specialized service. Since Bostwick was first established, numerous copycats have duplicated their level of services, making it harder to differentiate. A good rep could build a relationship with the account, but that says more about the rep than the company's capabilities. The company did release some new innovations a couple of years ago. People showed interest in the prognostic panels, but the company did no research that might sway skeptical doctors. Uptake went well in some areas, however, and other labs have copied them.