An Interesting Small Business

In the small business section of the Wall Street Journal today I read an article regarding describing private autopsy companies.  This is apparently an area of high demand with an increase in the requested number of private autopsies in the US over the last 30 years, secondary to the decline in the number of autopsies performed in US hospitals as a result of budget cuts.  The article states that only 2% of US hospitals conduct autopsies today compared to 42% in 1965.  In considering common practice, there are several reasons an autopsy may be requested.  The obvious reason is certainly if an unnatural death is suspected to determine cause of death.  Further reasons include to determine cause of death in sudden deaths, perplexing diagnostic situations and family requests.  In teaching hospitals, there is also emphasis to perform examinations for learning purposes.

The obvious question is who pays for autopsy services, which are performed by an MD trained in pathology.  If the examination is ordered as part of an investigation, the cost is incurred by the requesting county.  If the attending physician requests an autopsy (agreed upon by family), the cost is generally incurred by the institution as part of general pathology services.  If the examination is requested by family, that cost is generally the responsibility of the family.

One firm in Los Angeles estimates they perform 600 exams a year at fees of $2000 to $3500 per body.  For a firm with 4 employees, that is up to $2.1 million per year in gross income.  Some of those mentioned in the article have established franchise business models.  I honestly did not realize that private-autopsy services existed on this scale -- but, given the decline in autopsy rates that I've observed in my short time in the medical field clearly indicates that there is a shortage of supply of services with a fairly consistent demand.  These businesses fill that supply.

Sources:


Nishi, Dennis.  "Demand Breathes Life into Private-Autopsy Companies"  Wall Street Journal, October 13, 2010.


Reichert, CM et al.  "Prognosis for the Autopsy" content.healthaffairs.org/cgi/reprint/4/2/82.pdf. 1985.