Cataract volume?

[NPDR]

Curious - what's the cataract volume per year you are doing in your practice? What's "normal" volume for a starting ophthalmologist in a major metropolitan area? I understand numbers vary and thats why I'm curious how many cataracts people are doing. I live in major Midwest city and am doing 200-300 cases a year... I feel that I could be much busier but that could be "normal" in this area.

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[Eyefixer]

My projected volume for next year is probably around 350 cataracts plus blephs and other plastics stuff. I think that's not bad for a major metropolitan area.

 

[OphthoQuestions]

Each of the providers in our practice does approximately 15-30 cataracts a week with about 35% premium lenses. We are 1.5 hours from a major city. We will be getting a femto-cataract system soon and hope to convert >50% of patients to it. We'll see how it goes.

 

[Eyefixer]

That sounds great ophthoquestions.

 

[Mirror Form]

That sounds great ophthoquestions.

It also sounds completely different from what a starting ophthalmologist in a major metropolitan area will be doing. I would imagine that a typical starting ophthalmologist in one of the saturated major metro areas would be happy with 100 on their first year.

 

[Eyefixer]

He said major city. That does not mean major metropolitan area. This is probably rural or semi rural area worn large catchment zone.

 

[Dusn]

Honestly... from what I've seen in the major east coast cities like DC and NY... <25 cataracts the first year can be typical. Often the senior partners will take the surgical cases for themselves and send you the patients with corneal ulcers and pink eye.

 

[OphthoQuestions]

Honestly... from what I've seen in the major east coast cities like DC and NY... <25 cataracts the first year can be typical. Often the senior partners will take the surgical cases for themselves and send you the patients with corneal ulcers and pink eye.

I personally live 40 min from the practice (reverse commute) and thus live about 45 min from the "big city" which is fine with me since I am married and am from this geographic area originally. Yes, we have a fortunate practice situation which some people could only realize after 20 years in practice. I personally would never stay at a practice that would only "allow" me to do 25 cataracts a year. Your skills would definitely atrophy.

So yes, there is hope for the starting young eye doc depending on the services you can provide and whether you are flexible geographically.

 

[90 diopter]

I do around 200-300 a year. I'm not sure I'd want to do many more on a routine basis. On days where I have 10 surgeries, I'm exhausted afterward.

 

[odieoh]

Each of the providers in our practice does approximately 15-30 cataracts a week with about 35% premium lenses. We are 1.5 hours from a major city. We will be getting a femto-cataract system soon and hope to convert >50% of patients to it. We'll see how it goes.

Out of curiosity, what kind of clinic volume are you seeing to generate that many cataracts? You mention 30 cataracts in a week, would that be on a single surgery day?

 

[OphthoQuestions]

Out of curiosity, what kind of clinic volume are you seeing to generate that many cataracts? You mention 30 cataracts in a week, would that be on a single surgery day?

We probably see 40-50 per day (per provider) max. But we have a few ODs who internally refer surgical cases as well.

Yes, the 15-30 is per day in a one-room ASC. Yes, the turnover is ridiculously quick.

 

[LightBox]

I do around 200-300 a year. I'm not sure I'd want to do many more on a routine basis. On days where I have 10 surgeries, I'm exhausted afterward.

With the decline in reimbursement for cataract sx, it might be better to stay in clinic if you are doing 6 or less cataracts on a given day. And instead, operate every other week and do 12 or more cataracts in a single day.

Alternatively, do the 6 cataracts in a morning, and then see patients in the afternoon. I personally would rather stack all of the surgeries in one day and not go back to clinic.

 

[90 diopter]

With the decline in reimbursement for cataract sx, it might be better to stay in clinic if you are doing 6 or less cataracts on a given day. And instead, operate every other week and do 12 or more cataracts in a single day.

Alternatively, do the 6 cataracts in a morning, and then see patients in the afternoon. I personally would rather stack all of the surgeries in one day and not go back to clinic.

Most weeks I have between 5-7 cataracts. I operate between 8 to 10:30 or 11 (turnover is a bit slow), take a few hours for lunch, and see a light load of patients at the office in the afternoon. This schedule has worked out well so far. I could try to cram 2 weeks of cataracts into one day and do a little better financially, but at this point in my life the extra cash is not worth the added stress of having to operate all day.

 

[Eyefixer]

I have one surgical day per week. Do about 7-8 cataracts plus plephs, ectropions, etc. also a few lasers. Usually done by 1:30 or so. I see my post ops the same day on in the afternoon. So far I am happy with this arrangement.

 

[MstaKing10]

I have one surgical day per week. Do about 7-8 cataracts plus plephs, ectropions, etc. also a few lasers. Usually done by 1:30 or so. I see my post ops the same day on in the afternoon. So far I am happy with this arrangement.

I'm a bit out of training (at least from residency) and now do retina, but has it become standard for docs to check their post op's on the same day for uncomplicated cataract surgery? Any concerns for delayed endophthalmitis or IOP spikes within the first 24-48 hours? Retina surgery may not be comparable but even with uncomplicated vitrectomy or buckles I would not feel comfortable seeing post ops same day. I understand that cataract surgery is a different ball of wax. Just curious.

 

[Eyefixer]

I'm a bit out of training (at least from residency) and now do retina, but has it become standard for docs to check their post op's on the same day for uncomplicated cataract surgery? Any concerns for delayed endophthalmitis or IOP spikes within the first 24-48 hours? Retina surgery may not be comparable but even with uncomplicated vitrectomy or buckles I would not feel comfortable seeing post ops same day. I understand that cataract surgery is a different ball of wax. Just curious.

I don't think its a standard; for me its just convinient. I don't see regular patients afternoons of my surgical days. I think most people in my area see post-ops next day still. This way post ops don't clog up my schedule next day. If I do a retrobulbar block, I do have them come back next day.

 

[LightBox]

I'm a bit out of training (at least from residency) and now do retina, but has it become standard for docs to check their post op's on the same day for uncomplicated cataract surgery? Any concerns for delayed endophthalmitis or IOP spikes within the first 24-48 hours? Retina surgery may not be comparable but even with uncomplicated vitrectomy or buckles I would not feel comfortable seeing post ops same day. I understand that cataract surgery is a different ball of wax. Just curious.

I think seeing post-ops 6-8 hours after the surgery is okay. That timeframe is actually when most IOP spikes occur anyways, so it is nice to be able to burp these patients before they have eyepain and/or corneal edema all night. I've never had a personal case of endophthalmitis, so I never worry about missing that in the first day. Doesn't endophthalmitis typically occur at 5-6 days after surgery anyways?

 

[Eyefixer]

If you have endophthalmitis on the first day it's not endophthalmitis 🙂. Usually TASS presets that way.