I’m surprised, from your description, that a similar kind of thing doesn’t happen with mariners — that pay does not keep up until there is a series of mishaps, and then money falls from the skies, and then becomes stagnant again.

In fact, Anatomic and Clinical Pathologists do pretty good. Anatomic Pathologists are the people who make tissue diagnoses (e.g. look at biopsies and tell you if you have cancer or not) and Clinical Pathologists run medical laboratories, blood banks, etc. Forensic Pathologists are board certified in either Anatomic or combined Anatomic and Clinical Pathology and then do a 1-2 year fellowship following that in Forensic Pathology. For that extra training, they get about a 50% cut in salary.

The problem, though, is a little bit consistent with what you say. Unlike private practice pathologists, Medical Examiners must compete with other public health services for funding. If the Medical Examiner office is in the Department of Health and Human Services, for instance (some are part of other units), then they have to compete with stuff like vaccinations for kids or home health care for funding. Of course, people tend to direct money to these others first. The Medical Examiner office just has to make do — until there is a major scandal.

The classic pattern for ME offices is that funding slowly gets cut, or is not increased with inflation, and performance slowly degrades. It can degrade gracefully for a long time, but eventually there is a big scandal because a case is not thoroughly investigated or some quality control issue is not taken care of, and everybody gets fired.

Then they hire a new Chief and promise him or her the world — often involving new facilities, more people, increased salary, etc. Everybody says they’ve learned an important lesson and this will never happen again. And they may even keep much of that promise. But then, from that point on, funding is either flat or is slowly cut every year, and the service degrades. Little by little, each case gets fewer resources, the facilities become obsolete, and each pathologist gets overloaded with cases until there is a major scandal again, and the cycle repeats.