Compensation discrepancy

[medstudentmed]

Hi,
I know that this topic has been discussed at length, but it seems that some things don't match up.

On most compensation surveys that I've seen (MGMA (supposedly the 'gold standard'), AAMC careers in medicine, Cejka, etc) Ophthalmologists that are 3+yrs out seem to have an avg of around 300K, yet here on SDN everyone talks about Ophthos making 100s/low 200s and in job postings, I see the majority are in the mid 100s as well.

I understand that starting salary is often much lower than the the salary 3+ yrs out, but the consensus here seems to be that established MDs are making nearly half of the salary that is consistently reported in all the surveys that are supposedly legitimate...why the discrepancy?

Are you guys talking about salaries without including bonuses, which account for the difference, or are there a few ophthos making millions, bringing the whole avg up? Something else?

In any case, it seems that ophthos have a great job and I will likely find myself in the field regardless, but this discrepancy is really puzzling..other fields seem to be reporting avgs consistent with these surveys..why is ophtho different?

Thanks

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[plasticbuddy]

Hi,
I know that this topic has been discussed at length, but it seems that some things don't match up.

On most compensation surveys that I've seen (MGMA (supposedly the 'gold standard'), AAMC careers in medicine, Cejka, etc) Ophthalmologists that are 3+yrs out seem to have an avg of around 300K, yet here on SDN everyone talks about Ophthos making 100s/low 200s and in job postings, I see the majority are in the mid 100s as well.

I understand that starting salary is often much lower than the the salary 3+ yrs out, but the consensus here seems to be that established MDs are making nearly half of the salary that is consistently reported in all the surveys that are supposedly legitimate...why the discrepancy?

Are you guys talking about salaries without including bonuses, which account for the difference, or are there a few ophthos making millions, bringing the whole avg up? Something else?

In any case, it seems that ophthos have a great job and I will likely find myself in the field regardless, but this discrepancy is really puzzling..other fields seem to be reporting avgs consistent with these surveys..why is ophtho different?

Thanks

The averages are correct. Mean starting is around 200k and 3yrs into practice is about 300K. There was a survey done ONLY on ophthalmology by a priivate consulting firm that showed this. I will try to find the link on ophtho management.

However, there are some people starting at 100k and others starting at 300k (these are extremes)
The biggest difference is location, if you are OK with living in a small to medium sized town you can do very well in ophtho, but if money is important to you and you MUST live in a big city then I don't think you will find the compensation on par with the national average.


Good Luck!
(Watchout for negative people on this forum that misinterpret your words!)

 

[medstudentmed]

Thanks for your input--much appreciated. And thanks for trying to find the article.

I'm really curious to know, however, why it seems that the picture of ophthalmology on these forums is SOOO bleak compared to what appears to be accurate compensation data.

From going through previous threads, It seems that a few attendings seem quite confident that the average starting salaries (so i guess in medium--not small or big cities) is about 125K. And then it remains that way for quite some time as they try to make partner. A lot of people seem to be talking about how difficult it is to make partner due to a variety of factors and that ophthos have to put in upwards of 5-7 years only to make something like 250K down the road.

It seems that nearly no-one here contradicts this notion, even thought this is at odds with the survey data...I'm still trying to figure out how to resolve these two seemingly contradictory notions..any thoughts?

also, thanks for the warning re: misinterpretation of my words. In the interest of disclosure, I am an M3 who is planning to match into ophtho, so although the compensation information is not something that is driving any decisions of mine, I think it's important to try and figure out what the true picture is since it is obviously going to affect me directly.

 

[Visionary]

Thanks for your input--much appreciated. And thanks for trying to find the article.

I'm really curious to know, however, why it seems that the picture of ophthalmology on these forums is SOOO bleak compared to what appears to be accurate compensation data.

From going through previous threads, It seems that a few attendings seem quite confident that the average starting salaries (so i guess in medium--not small or big cities) is about 125K. And then it remains that way for quite some time as they try to make partner. A lot of people seem to be talking about how difficult it is to make partner due to a variety of factors and that ophthos have to put in upwards of 5-7 years only to make something like 250K down the road.

It seems that nearly no-one here contradicts this notion, even thought this is at odds with the survey data...I'm still trying to figure out how to resolve these two seemingly contradictory notions..any thoughts?

also, thanks for the warning re: misinterpretation of my words. In the interest of disclosure, I am an M3 who is planning to match into ophtho, so although the compensation information is not something that is driving any decisions of mine, I think it's important to try and figure out what the true picture is since it is obviously going to affect me directly.

As plasticbuddy stated, the posts on this site have to be interpreted with caution. Many on here are dead-set on practicing in large, metropolitan, oversaturated areas. The starting salaries and eventual annual collections in those areas are well below the national average. This is the same reason the cost of living is so high in those same areas. The demand for jobs and real estate is high, so the base salaries/prices reflect that. The level of competition will, likewise, limit your productivity and, therefore, potential collections. If you can be satisfied living in a smaller city (not necessarily the boonies), the numbers will be a lot better. The polls you've been looking at are nation-wide, so the regional discrepancies are averaged out. Furthermore, ophthalmology as a whole is seen to be one of the high growth specialties over the coming years. This is because of the aging boomers and the fact that we tend to cater to older patients.

 

[guttata]

Thanks for your input--much appreciated. And thanks for trying to find the article.

I'm really curious to know, however, why it seems that the picture of ophthalmology on these forums is SOOO bleak compared to what appears to be accurate compensation data.

From going through previous threads, It seems that a few attendings seem quite confident that the average starting salaries (so i guess in medium--not small or big cities) is about 125K. And then it remains that way for quite some time as they try to make partner. A lot of people seem to be talking about how difficult it is to make partner due to a variety of factors and that ophthos have to put in upwards of 5-7 years only to make something like 250K down the road.

It seems that nearly no-one here contradicts this notion, even thought this is at odds with the survey data...I'm still trying to figure out how to resolve these two seemingly contradictory notions..any thoughts?

also, thanks for the warning re: misinterpretation of my words. In the interest of disclosure, I am an M3 who is planning to match into ophtho, so although the compensation information is not something that is driving any decisions of mine, I think it's important to try and figure out what the true picture is since it is obviously going to affect me directly.

Personally, I think the MGMA data are skewed - perhaps they are looking at 'partner' salary. A lot of people don't like to talk about numbers, but the starting average is probably around 120-160k, depending on where you want to live. If the area is really in need of an ophthalmologist, you may be able to start around 200k. IMO, 200k starting is high unless you decide to work for an HMO or work in a semi-remote/remote location. Considering the buy-in, you may have a slight, but not great, increase in salary, once you start your buy-in (usually after two years as an associate). The salary jumps once you make partner and don't have to pay 50-100k/year for a buy-in (prob. 5-7 years after starting). Of course, each practice is different.

Be careful about the recruiting companies. Some times (not all the time), practices hire a recruiting company because they have trouble recruiting through conventional means (word of mouth, AAO). Because their need is greater, the salary may be greater.

 

[OjoCinco]

I think some of you all should put up a consensus explanation of salaries, bonuses, etc and have it stickied. Very common question around here...

 

[Visionary]

I think some of you all should put up a consensus explanation of salaries, bonuses, etc and have it stickied. Very common question around here...

Good suggestion. There are enough posts about this topic that someone could collect a number of them and put them in a sticky. Fearless leaders, what say you?

 

[plasticbuddy]

Good suggestion. There are enough posts about this topic that someone could collect a number of them and put them in a sticky. Fearless leaders, what say you?

Lets just start a list of links.
One complication however is that these don't factor in the value of owning an ASC or optical. Many times these are the factors that make ophthos in smaller towns (~200k) much more profitable.

This is seperated by region.
http://www.hospitalreviewmagazine.c...phthalmology-salary-statistics-by-region.html

 

[Visionary]

Lets just start a list of links.
One complication however is that these don't factor in the value of owning an ASC or optical. Many times these are the factors that make ophthos in smaller towns (~200k) much more profitable.

This is seperated by region.
http://www.hospitalreviewmagazine.c...phthalmology-salary-statistics-by-region.html

Good link. I've never seen one separated by region. As for the ASC/optical angle, that's variable. Optical, perhaps, but initial investment in an ASC and the high overhead can limit its revenue potential, even in the long term, unless it is run very efficiently and at high volume.

 

[MstaKing10]

Doesn't seem that the optical offers a large advantage in terms of profit. I think it is offered more as a convenience and to keep patients and small profits "in house". Similarly, not certain that owning part of an ASC offers much in the way of profit other than having a small say in the way the ASC is run and limiting the number of hospital affiliations thus limiting call. This is the conclusion I've reached after discussing this with several docs in town, not sure if this is a geographic thing. Would be curious to see what others think.

 

[orbitsurgMD]

Doesn't seem that the optical offers a large advantage in terms of profit. I think it is offered more as a convenience and to keep patients and small profits "in house". Similarly, not certain that owning part of an ASC offers much in the way of profit other than having a small say in the way the ASC is run and limiting the number of hospital affiliations thus limiting call. This is the conclusion I've reached after discussing this with several docs in town, not sure if this is a geographic thing. Would be curious to see what others think.

It depends on your idea of profit. The benefit to the owner is that the optical, once the staff and vendors are paid, is an easy source of passive income. Opticians are typically compensated on a salary + bonus structure tied to gross sales. They have an incentive to sell up on features and product, which obviously boosts revenue. Decisions whether to outsource technical services like edging and polishing, which can add to net profit by reducing lab costs if brought in house are dependent on costs of the lab and costs of the capital equipment versus money saved by purchasing un-finished blanks. Volume is the determining factor there, usually.

ASC ownership can be very profitable if your operations costs are well contained and you have adequate volume.

 

[Czeckers]

I see a different discrepancy actually:

The surveys around the net show ophthalmology to be on the mid to lower end of compensation. Current Cejka data has ophtho at like 238k average, similar in compensation to infectious disease and PMandR.

On the other hand all of the private ophthos i know, which practice in medium/largish cities seem to be doing better than 238k. They seem to be living the dream and they recommend going into ophtho and how the money is great. Some people that i know that just matched and who have family in the field talk about the money being great. Others that I know that just matched act like they are monetary martyrs. Some outsiders (non-ophthos) are telling me ophtho is not a good specialty to go into with regards to salary/compensation.

What's the truth? What gives?

 

[Visionary]

I see a different discrepancy actually:

The surveys around the net show ophthalmology to be on the mid to lower end of compensation. Current Cejka data has ophtho at like 238k average, similar in compensation to infectious disease and PMandR.

On the other hand all of the private ophthos i know, which practice in medium/largish cities seem to be doing better than 238k. They seem to be living the dream and they recommend going into ophtho and how the money is great. Some people that i know that just matched and who have family in the field talk about the money being great. Others that I know that just matched act like they are monetary martyrs. Some outsiders (non-ophthos) are telling me ophtho is not a good specialty to go into with regards to salary/compensation.

What's the truth? What gives?

Read the rest of this thread. It's pretty well explained there. Ophthalmologists do fine, but there is a range, depending on your practice location and setup.

Of course, as I've stated before, don't go into medicine (any speciality), if your goal is to make money. Over time, physicians have gradually been getting paid less (compared with economic growth standards). It will only get worse.

 

[Czeckers]

Read the rest of this thread. It's pretty well explained there. Ophthalmologists do fine, but there is a range, depending on your practice location and setup.

Of course, as I've stated before, don't go into medicine (any speciality), if your goal is to make money. Over time, physicians have gradually been getting paid less (compared with economic growth standards). It will only get worse.

as humbly as possible:

the discrepancy this post was discussing is slightly different from the one i am bringing up. With all due respect, the "don't go into medicine/specialty for money" is tired. Not saying its not good advice, it is, especially for a premed. I agree that we should all go into specialties that we love, which is why ophtho is one of my top choices for specialty. If I was basing everything on money, I'd be shooting for spine surgery. That said, to dismiss money as a nonfactor seems ill-advised. This is america, money matters, its the harsh reality of life in this country, especially when considering debt. We as physicians have the same right to discuss and worry about money as your everyday stockbroker, car salesman, and parking lot attendant.

 

[Visionary]

as humbly as possible:

the discrepancy this post was discussing is slightly different from the one i am bringing up. With all due respect, the "don't go into medicine/specialty for money" is tired. Not saying its not good advice, it is, especially for a premed. I agree that we should all go into specialties that we love, which is why ophtho is one of my top choices for specialty. If I was basing everything on money, I'd be shooting for spine surgery. That said, to dismiss money as a nonfactor seems ill-advised. This is america, money matters, its the harsh reality of life in this country, especially when considering debt. We as physicians have the same right to discuss and worry about money as your everyday stockbroker, car salesman, and parking lot attendant.

I refer you back to my first paragraph. There is no perfect salary survey for any specialty. They are, after all, based on selection and response, both if which can be (and usually are) biased. Your spot inquiries to practicing physicians (sort of a personal survey) will also have some inherent bias. That explains the range of numbers you're finding.

Also, I wasn't saying you shouldn't consider and discuss compensation when considering a specialty. And, yes, school debt is considerable. My point was that there are much better ways to make money than medicine--perhaps, this is better advice for pre-meds, as you suggested.

 

[orbitsurgMD]

as humbly as possible:

the discrepancy this post was discussing is slightly different from the one i am bringing up. With all due respect, the "don't go into medicine/specialty for money" is tired. Not saying its not good advice, it is, especially for a premed. I agree that we should all go into specialties that we love, which is why ophtho is one of my top choices for specialty. If I was basing everything on money, I'd be shooting for spine surgery. That said, to dismiss money as a nonfactor seems ill-advised. This is america, money matters, its the harsh reality of life in this country, especially when considering debt. We as physicians have the same right to discuss and worry about money as your everyday stockbroker, car salesman, and parking lot attendant.

Common starting salary is $150K for general ophthalmologists on contract with a productivity bonus. Retina will pay more. Plastics, glaucoma, peds and other subspecialties commonly pay about the same as general. Actual pay will vary with the patient payor mix: lots of medicaid means busy with little pay, not good, better mix means larger and earlier bonus, all things being equal. Big cities mean more patients but more competition and also not always better-paying patients. In the down economy, cash pay practice in plastics and refractive is down as well.

I never believe those surveys, especially when headhunters are using them. Look at offers on the AAO Professional Choices website. Starting jobs with salaries at or above $200K usually have some significant negative, usually a more remote or less attractive community with fewer amenities that most professionals would otherwise want (like better schools, strong economy, shopping, proximity to attractive recreation, air access, etc. . . ."Outdoorsman's paradise!") Headhunters typically are servicing clients who are unable to attract candidates on their own, not uncommonly because they have developed a poor reputation as a professional employer and a history of associates coming then going. There are practices whose ads I see perennially on the throwaway journals that offer big bucks for associates but always seem to be looking.

 

[iluvmac]

Can some of our veteran posters give a consensus on this topic. I recently matched in Chicago and am curious about the market as well.

how accurate is this graph? http://www.ophmanagement.com/article.aspx?article=85973

​

 

[iluvmac]

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[KHE]

Can some of our veteran posters give a consensus on this topic. I recently matched in Chicago and am curious about the market as well.

how accurate is this graph? http://www.ophmanagement.com/article.aspx?article=85973

​

That's strange. Why would compensation do DOWN in the 11-15 year group? I'm assuming that's a typo and it should say $365000 instead of $265000.

 

[orbitsurgMD]

That's strange. Why would compensation do DOWN in the 11-15 year group? I'm assuming that's a typo and it should say $365000 instead of $265000.

It is 9 year-old data.

 

[Mirror Form]

Can some of our veteran posters give a consensus on this topic. I recently matched in Chicago and am curious about the market as well.

how accurate is this graph? http://www.ophmanagement.com/article.aspx?article=85973

​

That data doesn't seem right to me, even considering that it's ten years old.

Although, 2002 might also have been during the big Lasik wave that has since died down. That's really the only explanation i can see for that data. There is no way that the average income for people 15-20 years out is 500k in my city. It's probably 300k at most. Although higher income is definitely possible for people who are business savy.

edit: the data iluvmac above seems much more believable.

 

[KHE]

That data doesn't seem right to me, even considering that it's ten years old.

Although, 2002 might also have been during the big Lasik wave that has since died down. That's really the only explanation i can see for that data. There is no way that the average income for people 15-20 years out is 500k in my city. It's probably 300k at most. Although higher income is definitely possible for people who are business savy.

edit: the data iluvmac above seems much more believable.

Is that really true? I don't know if I feel better about myself or if I feel bad for you guys.

I make more than the median income of a mid-late career ophthalmologist.

And damn....I don't even do surgery. I wonder how it will be once I start doing all those YAGs and PIs!

 

[bungo]

Is that really true? I don't know if I feel better about myself or if I feel bad for you guys.

I make more than the median income of a mid-late career ophthalmologist.

And damn....I don't even do surgery. I wonder how it will be once I start doing all those YAGs and PIs!

Not surprised, a friend's dad makes that much practicing pretty much as an optometrist. He does 3-6 cataracts a month, routine eye exams, and owns an optical. He works 25-30 hours a week Mon-Wed. Made 500k back in the nineties.

 

[Mirror Form]

Is that really true? I don't know if I feel better about myself or if I feel bad for you guys.

I make more than the median income of a mid-late career ophthalmologist.

And damn....I don't even do surgery. I wonder how it will be once I start doing all those YAGs and PIs!

The money is definitely out there for people who are business savy and start (or buy into) a successful practice. But it's not like it's easy to start your own ophthalmology practice in most large cities these days.

 

[Mirror Form]

Not surprised, a friend's dad makes that much practicing pretty much as an optometrist. He does 3-6 cataracts a month, routine eye exams, and owns an optical. He works 25-30 hours a week Mon-Wed. Made 500k back in the nineties.

I dont' know too many optometrists who do cataracts. Nor do I know too many who work 25-30 hr's per week and make 500k. I'm assuming your friend's dad started a successful practice and had other optometrists working for him? Or maybe the optometry practice was a front for organized crime?

 

[bungo]

I dont' know too many optometrists who do cataracts. Nor do I know too many who work 25-30 hr's per week and make 500k. I'm assuming your friend's dad started a successful practice and had other optometrists working for him? Or maybe the optometry practice was a front for organized crime?

He is an ophthalmologist, just practices like an optometrist. Only does a handful of surgical cases a month. Doesn't make 500k anymore, just used to.

 

[orbitsurgMD]

Is that really true? I don't know if I feel better about myself or if I feel bad for you guys.

I make more than the median income of a mid-late career ophthalmologist.

And damn....I don't even do surgery. I wonder how it will be once I start doing all those YAGs and PIs!

I guess I should open an optical and hire an optician and find out, no?

 

[Frumps]

I guess I should open an optical and hire an optician and find out, no?

I might be headed that way soon. An ophthalmologist is still the only eye care provider that can provide the whole range of eye care services.

 

[KHE]

I guess I should open an optical and hire an optician and find out, no?

You can if you want but my optical accounts for less than 25% of my gross billings and with discount vision plans, optical is less profitable than ever.