Does glaucoma make less than comprehensive ophthalmology?

[Smelt]

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Serious question. There is no doubt that glaucoma has higher demand, especially in big cities. I gather that the starting salaries are generally higher with sign on bonuses. However, after the first 1-3 years, does a busy comp practice generally make more?

For example, a busy glaucoma practice may see 40-50 patients, many of them severe and requiring additional chair time. You'll get all the bad glaucoma dumped on you so I'm not sure how you can control that. A comp practice at the same clinic can probably see 10-20 more patients and have a higher premium lens conversion rate

I like glaucoma and I'm considering fellowship....but comp can also take care of glaucoma patients. What am I missing here? Aside from the big draw of being easier to hire and landing a partnership role?

 

[Ophthodoc2018]

I initially applied to glaucoma fellowship and had completed my interviews and realized the same things you are … I wouldn’t worry about the income portion because a glaucoma surgeon will do well wherever. However you will be dumped with a lot of train wreck end stage glaucomas that need tubes or trans or diode laser which are inherently stressful.

 

[Gonio5]

Glaucoma specialists also get very manageable glaucoma patients who seek out a glaucoma specialist. Some glaucoma specialists practice pretty much comprehensive with a few surgical glaucoma cases. This is particularly true in many other countries.

 

[Smelt]

I initially applied to glaucoma fellowship and had completed my interviews and realized the same things you are … I wouldn’t worry about the income portion because a glaucoma surgeon will do well wherever. However you will be dumped with a lot of train wreck end stage glaucomas that need tubes or trans or diode laser which are inherently stressful.

Did you end up following through with fellowship? What went into your decision one way or the other and do you have any regrets?

 

[Ophthodoc2018]

Did you end up following through with fellowship? What went into your decision one way or the other and do you have any regrets?

I did not go through with fellowship, and I do not have any regrets. I still practice glaucoma but am not the sole glaucoma provider and am still able to keep in touch with other parts of comprehensive ophthalmology.

Anyone will say, don’t choose anything for the money. If you have a passion in glaucoma than you should complete fellowship.

 

[eyeeye_captain]

*Grain of salt since my employment has been retina-only from the start.

Given the major lack of glaucoma docs out there, you should in theory have a better job market and similarly better starting pay. With the possibility of dealing with the pain/money pit that is incisional surgery, you can try to negotiate a subsidy from the group to cover some of that. My glaucoma friends basically make what their partners make, but I second that you should really love it to pursue it.