My father is an ophthalmologist, like half the applicants on here. I can just tell you that ophthalmology is NOT a lifestyle field, at least it hasn't been since the early 1990s.
My father's practice (and yes, being a private practitioner makes it harder, because you also have to run a business) is 70% medicare. Every time they cut the medicare reimbursement, his salary immediately drops, so his hours worked necessarily go up.
Great thing about the doctor fix: In June 2010, when the doctor fix expired and medicare reimbursements were set to go down 30%, everyone knew it was just a matter of time before Congress stepped in and retroactively set the rates back where they were. So what did Medicare do? For about 6 weeks, between the legislated rate cut and the anticipated new fix, they didn't reimburse at the lowered rate. Rather, they didn't reimburse AT ALL, citing the confusion! When you called their offices and demanded accountability, their response was, I'm not kidding, "Call your congressman."
Equipment is expensive and a functional office requires a large, competent staff. How in the world do you survive seeing 70% of your revenue, EARNED REVENUE FROM A FULL OFFICE, cut to zero for six weeks? My father had to take out of his savings to pay the staff.
If you're in an area with a large concentration of ophthalmologists, you have to advertise if you're going to maintain your patient base. If you want any sort of refractive practice, wherever you are, you have to advertise, and you have to have a competitive pricing model.
So, at least in private practice, it aint all golf and Royal Hawaiian Eye Meetings. It's payroll, medicare fights, politics, turf wars, advertising campaigns, and having your most indispensable employee be your insurance manager.
Agreed.
