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Fabulously wealthy ophthalmologists? What gives?

Discussion in 'Ophthalmology: Eye Physicians & Surgeons' started by Toadkiller Dog, Jun 21, 2002.

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  1. Toadkiller Dog

    Toadkiller Dog Senior Member

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    I've read a few posts here and elsewhere that state that ops is one of the few fields where one can be "fabulously wealthy".

    However, if you look at any salary survey anywhere, they generally have ops as being in the low-mid 200's, usually *below* most of the medical and surgical specialties (but above primary care). How'n the heck does this add up? What gives?

    As someone who is seriously considering ops, here's my take on it: If you do general ops, you will make 200-250, with much less to start (like 130-150) because the market is so saturated right now.

    BUT, if you can do a fellowship in something where you can maximize the amount of surgery you do and minimize your medical visits, you can make a LOT more (like 800k or so).

    I know two ops docs who make tons of money, but one is a LASIK monkey and the other is oculoplastics.

    Any comments on my theory? I call it Toadkiller's Theory of Maximizing Eyeball Returns, or TTME for short.
    :D
  2. JasonDO

    JasonDO Removed

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    I'd say the average general ophthalmologist not withstanding all other factors (ie. years in practice, geographical location, market demand, ect..) will expect to make in the mid 300-400k. However, the overall salary range for ophthalmology is huge. There are some ophthalmologists out there making 7-8 figures annually. These are the guys with the established practices, multi-site ASC's, who practice little if any general ophthalmology and focus primarily on very high surgical volume.
  3. Sheerstress

    Sheerstress Senior Member

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    I'm not sure that all ophthalmologists make quite that much. I have a friend who is a pediatric ophthalmologist who I'm pretty sure makes somewhere between 100-200K. He says that he COULD be making more money by doing a lot of surgery (e.g. opening up a cataract surgery "mill"), but in doing a fellowship, he opted for more specialized training, and ended up making less.

    He has another ophthalmologist in his office who was looking for a faculty position at a medical school in pediatric ophthalmology. The offer she got was for Georgetown, which would have encompassed patient care, teaching, and reasearch. Believe it or not, the pay: $85,000.

    Sheerstress
  4. Jive Turkey

    Jive Turkey Member

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    What Sheerstress says is consistent with what I know about Pediatric Cardiovascular Surgeons. I used to work with one who (based on what I heard from coworkers) actually was making less having specialized into pediatric CV surgery. I was explained that the people who do it really have a love for working with kids and and better environment (ie, pediatric surgical specialties are NOT for people who are looking to make more $$$).

    Having said that, I'm not sure what would happen if one specialized in retina or whatnot. I'd guess that if it meant more surgeries/procedures, then you'd earn more. But thats my guess.
  5. Darth Vader

    Darth Vader Removed

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Sheerstress:
    <strong>I'm not sure that all ophthalmologists make quite that much. I have a friend who is a pediatric ophthalmologist who I'm pretty sure makes somewhere between 100-200K. He says that he COULD be making more money by doing a lot of surgery (e.g. opening up a cataract surgery "mill"), but in doing a fellowship, he opted for more specialized training, and ended up making less.

    He has another ophthalmologist in his office who was looking for a faculty position at a medical school in pediatric ophthalmology. The offer she got was for Georgetown, which would have encompassed patient care, teaching, and reasearch. Believe it or not, the pay: $85,000.

    Sheerstress</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Yup, that's the lifestyle of academic physicians. Makes you have more respect for your professors once you realize how much they are sacrificing financially to be where they are. One of our GI professors was telling us how GI docs can start at $350,000 in a private practice with fewer and better hours, or work in an academics and start at $85,000. $85,000 isn't poor, but you really do have to love academics to agree to that trade off. That's why there are a ton of med and pre-med students that go through med school saying that they want to be a professor one day until the reality of their student loans becomes realized after graduation.
  6. Voxel

    Voxel Moderator Emeritus

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    Opthamology is one of those field were the potential is there to make millions of dollars per year. Yet those are mainly the exception than the rule and most of these eyeballs (aka opthamologists) have an "in". The national average hovers near 300K, which varies widely based on geographic area and type of practice. The speed at which cataract surgery can be perfomed these days is amazing. Yet you really have to be business savy or have a practice set up for you by your father or mother to make it big. There are a few eyeballs (aka opthamologists) where my parents live that make millions. They both do lasix and they both inherited/joined a mostly Lasix surgery practice from their fathers. Granted they don't make as many millions as before, but they still blow almost any other physician (except maybe plastic surgeons in beverly hills) out of the water. These eyeballs have it made; well until the price of lasix goes down to the point where they will be making under a million. Then there are many opthamologists who are new and try to hang shingles. They have to take opthamology call at the local ER to get patients and are sweating to get referrals and they make less than 300K. Then there are the regular "know somebody" new guys who join a decent group practice who make slightly more about $350K. Not bad. And the residency is a joke in terms of hours and physical difficulty, especialy for a "surgical" residency. If you thought radiology was easy, you should see the opthamology residents I know. The reason why fields like opthamology and plastic surgery have the potential to make millions is that they do procedures that patients are willing to pay for out of their own pockets and these guys/gals can charge a fortune for each procedure. Nothing really compares in the insurance market to the cash these guys get from patients up front. These guys are even hooked up with banks that will "loan" patients money for the procedure. "5-double 0 on the cover of fortune."
  7. LoneSEAL

    LoneSEAL Senior Member

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    I too am interested in ophthalmology. What are the different fellowships in ophthalmology? What is the current deal with optometrists versus ophthalmologists competing over patients?

    Incidentally, what does it take to match Wilmer Eye Institue or Bascom Palmer Eye Institute or Mass Eye and Ear? In the past eight years at my school, *no one* has matched into these top programs. What are these places looking for? Awesome research? Connections?

    How many people do the above three programs take in each year?
  8. aye_eye

    aye_eye Junior Member

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    I matched into ophthalmology this past year, about to start prelim year. I know nothing about ophthalmologist's salaries except that, as oft stated, the high end salaries are usually those doctor's who perform LASIK (not lasix). Only a portion of ophthalmologists do LASIK, not all or even most.

    Although the eye is relatively small, the specialty has several subspecialties including: retina/virtreous-surgical, retina nonsurgical, cornea, pediatric, oculoplastics, glaucoma, and, relatively new, uveitis. Ophthalmologists further trained in cornea are the one's who usually perform LASIK.

    As to previous poster's question about Wilmer, Bascom Palmer, etc. All things listed help (good Step I, class standing, research, contacts). You will find at these top programs (Mass, Wills, and Emory included - I just know eastern U.S. programs)that the name of your medical school does count, especially in getting an interview. What I would recommend to improve your standing is a rotation at one of these programs if you know that you want to interview at a top program. Also, look at your department faculty - most of them will have fellowship training. Look at where they did their training and try and make some connections through them.
  9. medstud721

    medstud721 Member

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    I'm a recent ENT matchee. It came down to the wire in choosing between ophthalmology and ENT. Eye surgery was a bit delicate for me, but
    I have a brother who is an ophthalmologist. He is 34 years old and just dropped $1.5 mill on a house. He works less than 40 hrs/week and makes around $700,000.

    Some facts:

    Having spent a lot of time learning about ophtho and hanging out with guys in private practice I can tell you a few things--

    Having met many ophthalmologists:

    Not one worked more than 40 hrs/week.
    Not one had less than 4 weeks vacation/yr.
    Not one made less than $300,000/yr.
    Not one let a week pass without playing 18 holes.

    The highest paying subspecialty(average) within the field of ophthalmology is Retina--these guys average around $800K mid career. The most ludicrous salary I've heard of(from a high volume LASIK surgeon) was &gt;$10 million!!

    It's safe to say that out of all the physicians and specialties--the field with the highest "high-end" salary is ophthalmology. Cosmetic Plastic Surgery is a close second.

    The average "mid-career" salary of a general ophthalmologist(non-pediatric, non-academic) is around $350-400K. Similar to ENT.
  10. droliver

    droliver Moderator Emeritus

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    Cosmetic plastic surgery is wayyyyyyy down the list from salaries like those. There are a VERY few Plastic Surgeons in the country pulling seven figures these days, for that matter there are a lot struggling to make ends meet. The margins on aesthetic surgery are very tight due to competition and the reconstructive procedures took the hits with everyone else in the 3rd party payer system back in the late 80's. Your successful cardiothoracic surgeon, Neurosurgeon, orthopedist, or spine surgeon does better salary wise than most (but not all) plastic surgeons.

    If historical trends play out (as with every other area of medicine thats highly profitable (and expensive), I would not count on the extreme salaries of opthomology to hold up. LASIK or its successors will eventually become incorporated into the insurance system (where prices will fall sharply)
  11. aye_eye

    aye_eye Junior Member

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    I find it funny how discussions of ophthalmology tend to gravitate towards compentsation on these boards. Granted, the nature of the original post was asking about salaries for ophthalmology. In my opinion, Ophtho is a great and rewarding field regardless of salary and lifestyle.
  12. Hornet871

    Hornet871 Senior Member

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    I'm tired of all this exaggerated salary crap. Sure, there might be a handful - or even many - opthalmologists who make $300k or $800k or whatever, but the AVERAGE salary is in the low 2's. This has been verified over and over from many salary surveys.

    I am sick and tired of people quoting numbers out of their ass about the average "hovering around 300" or being "between 300 and 400". How about some sources? How about some facts to back up your outrageous claims?

    To quote but one study - out of at least 5 that I have seen - First Aid for Match (albeit a 2000 publication) shows that the average ophtho guy makes around 210. Salaries are trending downward, however, so the average may be even lower today.

    Will people please back up their claims with sources, numbers, etc., or be willing to admit, if they have no facts, that they are simply bullsh*tters?
  13. wake up sir your surgery is over

    wake up sir your surgery is over Junior Member

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    I am not going into optho, but I do know good friends who are, and you better freaking believe that they make over 300K. First aid for the match is about the most unreliable salary source you could possibly come across. Salary surverys that we see online are so watered down it is disgusting. I saw one that said that critical care avegages 110K.

    These are surveys. Do you think that on optho is going to admit that he makes 500K. Hell no. He is going to downplay his salary. Until I see a survey of tax returns of optho, I will never believe this watered down bullshXt in the surveys. People in the community are a hell of a lot more reliable than stupis ass surveys of some schmuch showing up on your doorstep and saying, how much money do you make, doctor.

    Although 800K is definately the exception, 200 is a low estimate. You can take that to the bank.
  14. wake up sir, your surgery is over wrote:

    "I am not going into optho, but I do know good friends who are, and you better freaking believe that they make over 300K"

    Well this guy is even more reliable than first aid for the match (yea right). How many ophtho friends can a med. student have and how many of those will reveal their salaries?
  15. Crusher

    Crusher Member

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    I'm with you Hornet...I am perplexed at the million different salary quotes I get. I find time and time again that when I ask a med student or a resident for an average salary in field X that the average is usually 100-150K higher than the response I get when I ask an attending...

    Now, either there are going to be some sorely dissapointed med students/residents or attendings are downplaying their salaries (I'm not talking about academic only docs either)...

    I would love to hear I'm gonna make 350-400K in my chosen field but somehow I just don't believe it when doctors in this field tell me 220-230K...

    What gives?
  16. crusher,

    One of two possibilities. You are probably asking academic physicians who make significantly less than private practitioners.

    Physicians generally make more money in areas that are not concentrated with physicians and managed care. These areas are frequently far from where many medical schools are located.
  17. Goofy

    Goofy Senior Member

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    Most of what posters have listed on this thread is utter nonsense.

    Here is a dark secret about Optho that most med-students are unaware of, the job market is rather unfavorable, particularly in the cities. This means compensation and opportunity is getting more and more limited.

    Salary surveys, which tend to be wild and inconsistent have very little meaning, as the few eye docs hogging all the lasik procedures tend to skew the statistics. Certainly a number of old timers can generate fantastic salaries, but this is not typical, and you will be hard pressed to find one who readily gives up these cash procedures to a new recruit.

    Worse, many of the elective procedures that they do are luxury purchases. This translates into a job that depends on the economy. For those of you who don't follow or know little about the economy, it sucks right now. Further, there is a finite number of these luxury procedures to go around. This leaves a lot of insurance covered procedures like cataract and glaucoma. Reimbursement for these procedures is also trending downward.

    All is not lost, as many opthomologists I know, claim to be making a decent salary, but nowhere near the wild and hysterical claims some posters on this board claim. Additionally, they have had an exceptionally difficult time finding employment in even semi-desirable locales. One in particular has changed practices 3 times in the past two years, and has only done his 3rd lasik in the same time.

    Optho is an exciting and fantastic field. Just don't go into expecting an inviting job market and compensation. Eye docs graduating these days make fairly typical physician salaries 'on average' with a bit more trouble landing the job than most.
  18. Jive Turkey

    Jive Turkey Member

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    Klebsiella -
    I think you make an excellent case. Salary surveys are difficult things to interpret. Unfortunately for those of us who don't know physicians in the field we are planning to enter, we often look to these surveys (of which many, if not most, do not explain how the survey was conducted). It just like any other study in the medical literature guys. We need to be critical of the numbers that people post on the web and such.

    So for some of us (like me) to get a GENERAL IDEA as to the financial gain to be had in any field, which study or report do you guys most trust and why? Do we trust 1st aid for the match? Do we trust the surveys online?

    If anyone has a link or can publish accurate numbers and support their case, I'd like to read it.
  19. Blitzkrieg

    Blitzkrieg 1K Member

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    I hear that the local neurosurg makes mid 7 digits...and I hear that his lifestyle is similar to that of the local optho.

    Is it true that neurosurg guys have plenty of time to work relatively few hours, yet make massive amts of money? (500 k and more)?

    Optho..ENT....an ENT told me the other day that dermatological surgeons make MASSIVE amounts, and live a completely EASY life.
  20. Pilot Doc

    Pilot Doc SDN Angel Moderator Emeritus

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    Blitkrieg,

    I assume you're being facetious. Neurosurgeons have one of the roughest lifestyles around. Every trauma patient with a crunched head sees a neurosurgeon. Neurosurgeons work all hours on deathly ill, unstable patients and get sued frequently for their efforts.
  21. droliver

    droliver Moderator Emeritus

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    Pilot Doc,

    Most neurosurgeons in private practice in metropolitan areas take little if any trauma these days, it tends to get triaged to level I trauma centers. The majority of their cases are elective, and in the case of spine surgery it stills pays exceedingly well for an insured procedure. Competition for spine surgery is a very tense political issue b/w neurosurgery & orthopedic spine surgeons or so I'm told by the spine fellows they have here.

    Emergencies requiring NES (trauma nonwithstanding) are usually related to drainable intracrainal bleeds & shunt malfunctions in kids and tend to not be anywhere near as common as problems requiring some of the other surgical specialties (GU, Gen. Surg,Vascular)
  22. Blitzkrieg

    Blitzkrieg 1K Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Pilot Doc:
    <strong>Blitkrieg,

    I assume you're being facetious. Neurosurgeons have one of the roughest lifestyles around. Every trauma patient with a crunched head sees a neurosurgeon. Neurosurgeons work all hours on deathly ill, unstable patients and get sued frequently for their efforts.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">actually, no. This guy's lifestyle rules. He has 3 months of vacation each year, and I'm told he only has 60 hour work weeks. I was wondering if this is the norm, or not. He makes massive amts of money as well. Two questions:

    1) what are the average hours for a neurosurg?
    2) what is the pay like?
  23. Blitzkrieg

    Blitzkrieg 1K Member

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  24. Hornet871

    Hornet871 Senior Member

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    "Bizump".

    I like that.
  25. Bikini Princess

    Bikini Princess

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    My understanding:

    1) ~55 hrs/week
    2) Average: 350K, Ceiling: ~800K

    (excellent compensation for bad hours)
  26. 7ontheline

    7ontheline Member

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    This is my impression, from speaking with a neurosurgery resident. I make no claims to proof, reliability, etc.

    He told me that 500k was the minimum he would accept a job for, since that was easily within the average range of neurosurgeons. That's a lot of money, but look at the neurosurg residency. Can you imagine the pain? Thank goodness I'm going into ophtho. Now if only I could figure out what my average salary would be. . .seems everybody in this thread is confusing me more and more!
  27. chef

    chef Senior Member

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    What ophthy procedures are NOT covered by HMO, medicare/aid? I can understand cosmetic plastic surgery procedures like nose jobs, breast augmentation, etc not being covered, but when someone gets a surgery (including LASIK) done on the eye, it's b/c they have a serious problem in the eye w/ diminished vision?
  28. chef

    chef Senior Member

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    Hello,
    I know a bit about Hopkins/Wilmer/Sinai b/c I know 2 residents there - this is what I know:

    Wilmer used to pick 5 residents, but several yrs ago their program 'merged' w/ Sinai (and 1 other program I think in Baltimore area) and the # went up to 8.

    Here's the schools represented in the last 3 yrs, you can see if the "name" of your med school helps in obtaining a residency spot there...

    University of Michigan combined BS/MD program
    University of North Carolina
    UCSF
    UC San Diego
    Yale
    Hopkins MD/PhD
    Robert Wood Johnson Medical School
    University of Michigan
    Johns Hopkins

    Johns Hopkins
    Mount Sinai
    University of Chicago-Pritzker
    Johns Hopkins
    University of Michigan
    Yale
    M.D./Ph.D. Medical College of Wisconsin
    UCSF

    Yale MDPhD
    Yale
    Harvard
    JHU
    Hopkins MD/PHD
    USC-Keck
    UCSF MD/PhD

    Sorry do not know the # of slots/yr at other places..

    Oh, BTW, the dept chair will retire next yr, so who knows what the new chair will prefer...
  29. droliver

    droliver Moderator Emeritus

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    Most neurosurgeons in private practice will not take trauma & thus they tend to get triaged to academic medical centers. Their cases tend to be elective & not on the deathly ill & unstable. In private practice that tends to be limited to the occasional head-bleed that can drained (a distinct minority)
  30. Blitzkrieg

    Blitzkrieg 1K Member

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    I have been told that the worse part about neurosurg residency is that the first 3-4 years are 100+ hour weeks, but then it gets down to about 70 in years 5-7.....

    I've been told that the worse part about a neurosurg practice is the :a) malpractice lawyers and b) severity and pressure of working on the brain.

    Thoughts?

    Also, what about gen surg? I heard that it is way worse than a neurosurg life. What happens to gen surg residents hours over time? Do they decrease from the intern/PGY-2 years, or do they stay high for all 5 years?
  31. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur Moderator Emeritus Lifetime Donor

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    Salaries vary depending on how you setup your practice. If you have a surgical center, then you can make a lot more because you can bill for the surgical services too in addition to your professional fees. Some can make over $500,000 with this setup. In general, the average ophthalmologist makes much less. Here is a national average from:
    http://www.allied-physicians.com/salary_surveys/physician-salaries.htm


    *Survey includes base salaries, net income or hospital guarantees minus expenses

    October, 2000 - Present




    SPECIALTY Min Median Max
    Ophthalmology $131,000 $211,000 $251,000
    Ophthalmology Retina $219,000 $360,000 $386,000


    These numbers are still great. How much money do you really need? Furthermore, you must remember that the average ophthalmologist works 4 days a week too! :) If you work more, then you'll make more.

    I'm in the Navy, so my income will be set. I'm not out to make money. :)
  32. chef

    chef Senior Member

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    hey andrew, I thought ophthos specializing in cornea/LASIK and doing private practice would make much more $$ than retina folks? Is this not true? It's surprising that retinas make $150k more than other ophthos. Isn't retina fellowship only 2 yrs? It must be darn competitive to get in.

    BTW, it's awesome to see all the last posts in this forum done by you.. keep it up!! (also in other forums of course!)

    chef
  33. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur Moderator Emeritus Lifetime Donor

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    Hi,

    The salaries posted by this website are averages. Some hard-core LASIK physicians can make three times more than what's posted. Retina is 2 years more and is very competitive. There's about 60-70 spots per year I think. It's less than 100 for sure.
  34. OwlMyste

    OwlMyste Removed

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    :laugh: :laugh: LASIK monkey....thats hilarious....I've never heard opthos called that before....:laugh: :laugh:
  35. opthamologist

    opthamologist

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    Retina is 2 years, but is hard to get in.

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