A NATIONAL SURVEY OF AUTOPSY COST AND WORKLOAD

We mailed survey questionnaires to a random sample of medicolegal offi ces throughout the USA. The survey asked how many forensic pathologist s were used, their American Board of Pathology forensic examination (B oard) status, how many autopsies they performed, and, if payment were fee-for-service, what fees were paid for medicolegal autopsies. Respon se rate was 61%, with 188 offices returning questionnaires. The averag e fee, was $518 with a standard error of $27. The number of fee-for-se rvice autopsies was split evenly between Board qualified and Board ine ligible pathologists, accounting for about one-third of medicolegal au topsies nationwide. Although smaller offices used more pathologists in eligible for forensic Boards, they paid a premium for such qualificati on. Larger offices used more forensic Board qualified pathologists, bu t paid them less than those ineligible to take the examination!. Overa ll there was no significant premium paid for Board qualification. The average fee paid is far less than the published estimates of the cost of an autopsy. The low fees paid may reflect: (1) the value of the tea ching experience supplied to medical students and/or residents; (2) pa thologists performing medico-legal examinations as community service; and (3) the lower marginal cost of additional autopsies.