For better or for worse, the practice of pathology has evolved rapidly in the last decade, particularly the last several years. The dominance of certain national and regional pathology providers and the in-sourcing of pathology services as a revenue stream by nonpathology specialists have transformed pathology services into a commodity in many market, rather than a professional medical service. Despite significant health care reform and a myriad of compliance laws and regulations, it is unlikely that pathology practice will return to "the good old days." As a result, it is important for pathologists to become familiar with the trends in their specialty and have familiarity with the legal issues presented by these trends.