.

[i-doctor]

Also, some posters above who make millions are definitely the outliers. The average general ophth who’s in the prime of their career makes between $350-$600K per year. It will take a lot of hussle for any new doc to make over $1M. Even with ASC ownership, nobody gives it to you. You either have to take out loans of $1.5-4M to build one, or pay up for partnership in an existing one. Also, a lot of general ophthalmologists don’t even have ownership in ASC’s, especially in “Certificate of Need” states where it can be almost impossible to get the required state approval to build a new ASC.

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[superfan56]

Is this type of lifestyle/income only possible in certain areas (ie. not the coasts or right outside a major city)?

Already mentioned this above but no, my cousin in orange county making 1.5-2 million doing retina in private practice group/partner.
A lot of it is eat what you kill and performance based though. Weird concept to think about but if you're not working you're not particularly earning either. From what he told me he does have a W2 base and then everything after a certain amount is factored in.

 

[ball123]

I personally think ophthalmology is the best field in medicine. I think you’ll find most surgical specialties will generally have a lower starting salary (due to not having built up volume yet) and ophtho is maybe more notoriously lower. My friend in ENT started out making 250k but makes a lot more now.

Several of my alumni started around 200-250 but now make >400-500k (about 2-3 years out) and in a few years should make >600-700k. Both glaucoma trained but do about 60% comp 40% glaucoma.

Money aside, ophthalmology is just extremely rewarding. Most patients are happy and love you. Some will even cry after you give them the sight back. It’s just amazing.

I’m biased but my friends in anes/rads just feel like cogs in a wheel for a huge hospital entity that just wants you to read more and more images. It can often feel like a thankless job, and ergo, the burn out rate will be higher.

 

[ball123]

The new grads probably get taken advantage of in PP by their senior colleagues (who profit significantly from their work, in exchange for the new grads becoming partner a few years down the line), and as a new grad you also probably don't have the patient volume that the more senior ophthalmologists have (ophtho is mostly outpatient so it's up to you to attract and retain your patient panel). In contrast, in rads and anesthesia you generally don't own your patients, but instead do shift work for a hospital, so it's easier to have adequate volume on Day 1 on the job.

Also, only the fellowship-trained procedural/surgical ophthalmologists will make a lot more. The ones that are only doing medical management (and are usually not fellowship-trained) make a lot less, so $200ks starting out doesn't seem low for ones that don't do procedures. And with steep declines in insurance reimbursement for many bread and butter ophtho procedures like cataract surgery, even those procedures have small profit margins nowadays and require large volumes to maintain a decent salary. The procedure that are most profitable are the cash-based elective ones like LASIK, but of course that relies on being a good marketer to get people to pay cash for them.

Not sure if I agree with this. Anterior segment fellowship trained ophtho does not necessarily mean more money. The lucrative surgeries in ophtho don’t need a fellowship - premium IOLs, minimally invasive glaucoma surgery, refractive surgery.

Trabs/tubes/corneal transplants are generally money losing and done for the patient’s sake.

 

[Dr. Wrong]

Also, some posters above who make millions are definitely the outliers. The average general ophth who’s in the prime of their career makes between $350-$600K per year. It will take a lot of hussle for any new doc to make over $1M. Even with ASC ownership, nobody gives it to you. You either have to take out loans of $1.5-4M to build one, or pay up for partnership in an existing one. Also, a lot of general ophthalmologists don’t even have ownership in ASC’s, especially in “Certificate of Need” states where it can be almost impossible to get the required state approval to build a new ASC.

It's just rich that 35 states have CoN laws restricting free market healthcare and we wonder why healthcare in this country is exorbitantly expensive.

 

[RetinaDude]

What can the average retina specialist make? Obviously some really successful retina docs on here but I imagine it is pretty rare to earn 7 figures even in retina

It’s not rare at all

 

[DarkHorizon]

I can tell you, because I currently live that life.

Ever since I've been in PP, I've heard "this is the Golden Era and soon our incomes are going to go down". Well, so far that has not come true. My income has pretty much gone up or stayed similar for the past 10-12 years.

Never ever let starting salary be your determining factor to decide on a specialty or practice. I think I started at like $150,000 my first year, but I saw what the potential was for the future and bet on myself instead. Glad I did because, once I became partner, I've not made less than $1M per year (usually much more).

I'm retina but the general ophthalmology docs are killing it too. I know retina docs who "only" make $750k/year, but I also know retina docs who bring in $2.5M+/year. Same with general......I'd say a lot of these docs are in the $500k range, but there are a lot who are bringing in $900k-$1M+.

The ones on the higher end do see a lot of pts but there's other ways to bring in side income. Many ophth own (or jointly own) an ASC. A productive, and well run, ASC can generate $150k-$250k per partner per year in additional income. I just show up and do my surgeries every Tuesday and I get an additional $225,000 in my pocket every year. Typical day is starting at 7:30 and being done by 1-2:00 (sometimes done by noon and rarely past 3:00). Pretty good money for a day's work. One of the best investments I've ever made (and I bet a lot of ophthalmologists would tell you the same).

My call is not bad. I don't operate in the middle of the night, and handle most of my call by phone. General ophth is similar. A typical workweek is rarely ever over 40 hours for me, and I'd say its more like 35-38 hours per week. Many of the cataract docs I know only work 4 days per week (including their surgery day) so they are probably only working about 30 hours per week.

There are more ophth retiring each year than are coming out of training. Our population is getting older and requires A LOT of eye care. Yes, ophthalmology is a great field and I would have zero concerns advising any med student to choose it as a career.

Wow, that sounds like a sweet set up. I’m Ortho and I do well, but not in the 7 figures. Work a lot harder.

 

[GB4ME]

I can tell you, because I currently live that life.

Ever since I've been in PP, I've heard "this is the Golden Era and soon our incomes are going to go down". Well, so far that has not come true. My income has pretty much gone up or stayed similar for the past 10-12 years.

Never ever let starting salary be your determining factor to decide on a specialty or practice. I think I started at like $150,000 my first year, but I saw what the potential was for the future and bet on myself instead. Glad I did because, once I became partner, I've not made less than $1M per year (usually much more).

I'm retina but the general ophthalmology docs are killing it too. I know retina docs who "only" make $750k/year, but I also know retina docs who bring in $2.5M+/year. Same with general......I'd say a lot of these docs are in the $500k range, but there are a lot who are bringing in $900k-$1M+.

The ones on the higher end do see a lot of pts but there's other ways to bring in side income. Many ophth own (or jointly own) an ASC. A productive, and well run, ASC can generate $150k-$250k per partner per year in additional income. I just show up and do my surgeries every Tuesday and I get an additional $225,000 in my pocket every year. Typical day is starting at 7:30 and being done by 1-2:00 (sometimes done by noon and rarely past 3:00). Pretty good money for a day's work. One of the best investments I've ever made (and I bet a lot of ophthalmologists would tell you the same).

My call is not bad. I don't operate in the middle of the night, and handle most of my call by phone. General ophth is similar. A typical workweek is rarely ever over 40 hours for me, and I'd say its more like 35-38 hours per week. Many of the cataract docs I know only work 4 days per week (including their surgery day) so they are probably only working about 30 hours per week.

There are more ophth retiring each year than are coming out of training. Our population is getting older and requires A LOT of eye care. Yes, ophthalmology is a great field and I would have zero concerns advising any med student to choose it as a career.

I agree and to expand on the side businesses/“other ways” to make money, I know a couple rads who make maybe 600k a year salary but make millions from the imagine centers they opened starting with just one. Another example is James Andrews the famous ortho. He got lots of money from famous people getting surgery with him but he did lots of charity work like doing knee surgery on a 17 year old me where his gratuity was my mom made him cookies. The guy next to me in rehab the day after was some royal prince from Abu Dhabi who hurt his knee racing camels. His gratuity was to give the Dr a Bentley. But Dr Andrews made his big money in side businesses like rehab centers and outpatient surgical centers.

 

[Iamnew2]

Many ophtho start at $200-$280k for a 2-4 years but the lifestyle is unbeatable and more autonomy than Rads/Anes which is why its much more competitive. So if you consider that rads/anes start ~$450-550k (in the right locations), going the ophtho route is like paying a $1m tax in exchange for a better longterm lifestyle (and pay goes up to $450k)

Umm Rads and Anes don't start at 450-550k - those are more mid career salaries not starting salaries.

 

[Iamnew2]

Also, some posters above who make millions are definitely the outliers. The average general ophth who’s in the prime of their career makes between $350-$600K per year. It will take a lot of hussle for any new doc to make over $1M. Even with ASC ownership, nobody gives it to you. You either have to take out loans of $1.5-4M to build one, or pay up for partnership in an existing one. Also, a lot of general ophthalmologists don’t even have ownership in ASC’s, especially in “Certificate of Need” states where it can be almost impossible to get the required state approval to build a new ASC.

I agree - suggesting that everyone is making millions is not a realistic view, particularly for newcomers. Some doctors make that kind of money but it's not the typical doctor who makes that.

 

[NDcienporciento100]

Umm Rads and Anes don't start at 450-550k - those are more mid career salaries not starting salaries.

Wrong. Maybe not in New York City. 450k starting would be easy to find. Just look at the job posting.

 

[NDcienporciento100]

Wrong. Maybe not in New York City. 450k starting would be easy to find. Just look at the job posting.

Rads that is. I don’t know about anesthesia. But there specialty will continue to be devalued by nurse anesthetist. The reason optometrist have not devalued optho is because they don’t do surgery other then in Oklahoma.

 

[doctorsharukhan]

Wrong. Maybe not in New York City. 450k starting would be easy to find. Just look at the job posting.

You must be in NYC or SF. Even mommy track where I'm at pays 350k+ and I have colleagues getting >450k offers as fresh attendings. This isn't an "undesirable" place by any means. Know your worth

 

[doctorsharukhan]

Referring to rads?

Anesthesia. Rads pays even more where I'm at

 

[doctorsharukhan]

And yet people on the anesthesia forum are saying it is a dying field, literally the second highest paying 4yr training, and looks like it is honestly gaining on derm

What are the hours like for a 450k starting position?

A dying field? LOL. The demand for anesthesia (MDs and CRNAs) is the highest it's ever been. The ones crying that it's dying have been saying that for the last thirty years. The doctor I work with told me his daughter just signed a contract making $200k 3 days a week as a CRNA. The ceiling is much higher even for CRNA.

Those same people will tell you psych is dying and NPs are taking over when the reality is any competent psych MD (if they wanted to) can set up a cash-only shop and charge $300/hr with a line out the door

 

[maskman]

I can tell you, because I currently live that life.

Ever since I've been in PP, I've heard "this is the Golden Era and soon our incomes are going to go down". Well, so far that has not come true. My income has pretty much gone up or stayed similar for the past 10-12 years.

Never ever let starting salary be your determining factor to decide on a specialty or practice. I think I started at like $150,000 my first year, but I saw what the potential was for the future and bet on myself instead. Glad I did because, once I became partner, I've not made less than $1M per year (usually much more).

I'm retina but the general ophthalmology docs are killing it too. I know retina docs who "only" make $750k/year, but I also know retina docs who bring in $2.5M+/year. Same with general......I'd say a lot of these docs are in the $500k range, but there are a lot who are bringing in $900k-$1M+.

The ones on the higher end do see a lot of pts but there's other ways to bring in side income. Many ophth own (or jointly own) an ASC. A productive, and well run, ASC can generate $150k-$250k per partner per year in additional income. I just show up and do my surgeries every Tuesday and I get an additional $225,000 in my pocket every year. Typical day is starting at 7:30 and being done by 1-2:00 (sometimes done by noon and rarely past 3:00). Pretty good money for a day's work. One of the best investments I've ever made (and I bet a lot of ophthalmologists would tell you the same).

My call is not bad. I don't operate in the middle of the night, and handle most of my call by phone. General ophth is similar. A typical workweek is rarely ever over 40 hours for me, and I'd say its more like 35-38 hours per week. Many of the cataract docs I know only work 4 days per week (including their surgery day) so they are probably only working about 30 hours per week.

There are more ophth retiring each year than are coming out of training. Our population is getting older and requires A LOT of eye care. Yes, ophthalmology is a great field and I would have zero concerns advising any med student to choose it as a career.

Was thinking about buying into a surgery center that I do procedures in. Can somebody explain how the Anti-kick Back Statute or the Stark Law do not preclude this arrangement?

 

[drnateandy]

What is the lifestyle like of a 7 figure ophthalmologist? What did it take to get there?

Work 35-40 hours a week and weekends off. High volume clinic/surgery but nothing too crazy. From my experience working as an ophthalmic surgical tech in my gap year before med school, I can tell you it's nothing too bad. The owner of our practice makes this amount easily as he owns an ASC and has 5 MDs and 2 ODs operating out of his practice, but even one of his MDs is generating 7 figures now. That surgeon (cataract, cornea and refractive) only work 4 days out of the week, occasionally 5 days, but definitely puts their work in day in day out. Nothing insane or over the top though.

 

[Neopolymath]

Must be true that high earning ophthos never fill out salary surveys because it always appears low, even though many actual ophthalmologists say it is a lucrative field. Makes sense given how targeted they are by CMS, sadly. Don't need the general public targeting them too

Same for Rads. Very hush hush about real PP numbers since that one incident where online talk was specifically cited as a reason to cut pay.

 

[Dr. Wrong]

Same for Rads. Very hush hush about real PP numbers since that one incident where online talk was specifically cited as a reason to cut pay.

Mind DMing the real PP numbers for rads? Still deciding between rads and ophtho

 

[person889]

Mind DMing the real PP numbers for rads? Still deciding between rads and ophtho

I'm in the same boat with these specialties. I figure rads probably gets paid a lot more, but it's kind of hard to estimate the real difference. Let me know what you find out! Seems like some individuals on here mention doing very well in ophtho, but that's not always the sentiment I see.

 

[i-doctor]

Honestly speaking, rads and ophtho are very different specialties. Night and day. I would base the decision more on what you would imagine yourself enjoying ( or, to some, “tolerating”) on a daily basis. Both have a good income and lifestyle.

 

[person889]

Honestly speaking, rads and ophtho are very different specialties. Night and day. I would base the decision more on what you would imagine yourself enjoying ( or, to some, “tolerating”) on a daily basis. Both have a good income and lifestyle.

At this point, it feels like I could enjoy a lot of things similarly. I feel like some of my main values are consistent schedule and reasonable hours, which both fields offer, along with each having unique features to enjoy as well. It's pretty hard for me to imagine life in either since my school doesn't let you rotate in either until fourth year, long after aways/4th year rotations are scheduled. So it seemed like if there was a huge difference in compensation, that might be a good tiebreaker.

 

[Neopolymath]

At this point, it feels like I could enjoy a lot of things similarly. I feel like some of my main values are consistent schedule and reasonable hours, which both fields offer, along with each having unique features to enjoy as well. It's pretty hard for me to imagine life in either since my school doesn't let you rotate in either until fourth year, long after aways/4th year rotations are scheduled. So it seemed like if there was a huge difference in compensation, that might be a good tiebreaker.

Ceiling is higher in ophtho easily.

 

[RetinaDude]

recent reddit discussion about this...decent amount of negativity weirdly

It’s always entertaining reading comments from a bunch of people who really have no clue. The only info you can trust in that whole discussion is from anyone who says they are currently an ophthalmologist.

As I mentioned before, do NOT decide on a job based on your starting salary. If I had done that, I would’ve made a very bad financial decision. Coming out of fellowship, I had a job offer from a group offering me around $400k starting. For a new grad, full of loans, this was tempting, but I took the lower starting salary job because the potential was greater….and it worked out way better than I even dreamed.

Very few academic physicians will ever make as much money as a private practice doc. I actually worked for a few years as a faculty member and there is NO comparison. As someone mentioned, it’s almost criminal what the retina docs are paid in academics vs what they can make in the “real world”. Some places do pay a lot more than others but it would be extremely rare to find an academic retina doc making anywhere near what a private practice retina doc makes. Same goes for high volume cataract surgeons. I have A LOT of respect for docs who choose to devote their lives to the academic world. They are truly doing it for the love of teaching and research.

Another poster on here has already mentioned their family member, who is an ophthalmologist, who is killing it in southern California. So, believe what you want. You can either listen to those of us who are actually ophthalmologists, or you can believe all the med students who “know a friend who told them X”. Do so at your own peril. There’s a damn good reason ophthalmology is so freaking competitive, and it’s not just the great lifestyle

 

[cal75]

It’s always entertaining reading comments from a bunch of people who really have no clue. The only info you can trust in that whole discussion is from anyone who says they are currently an ophthalmologist.

As I mentioned before, do NOT decide on a job based on your starting salary. If I had done that, I would’ve made a very bad financial decision. Coming out of fellowship, I had a job offer from a group offering me around $400k starting. For a new grad, full of loans, this was tempting, but I took the lower starting salary job because the potential was greater….and it worked out way better than I even dreamed.

Very few academic physicians will ever make as much money as a private practice doc. I actually worked for a few years as a faculty member and there is NO comparison. As someone mentioned, it’s almost criminal what the retina docs are paid in academics vs what they can make in the “real world”. Some places do pay a lot more than others but it would be extremely rare to find an academic retina doc making anywhere near what a private practice retina doc makes. Same goes for high volume cataract surgeons. I have A LOT of respect for docs who choose to devote their lives to the academic world. They are truly doing it for the love of teaching and research.

Another poster on here has already mentioned their family member, who is an ophthalmologist, who is killing it in southern California. So, believe what you want. You can either listen to those of us who are actually ophthalmologists, or you can believe all the med students who “know a friend who told them X”. Do so at your own peril. There’s a damn good reason ophthalmology is so freaking competitive, and it’s not just the great lifestyle

Any truth in the comments talking about associate ophthos getting screwed before being made a partner?

 

[i-doctor]

Any truth in the comments talking about associate ophthos getting screwed before being made a partner?

Yes, there are some bad apples, as in every field. You just need to do your homework. There are plenty of practices that will treat you fairly in regards to partnership.

 

[Meerkat_Initiate]

@RetinaDude How is the partnership model set up in your practice? Partner after 2/3 years? Does a new partner make the same money as an old timer?

 

[Neopolymath]

Any truth in the comments talking about associate ophthos getting screwed before being made a partner?

Every single field has these greedy jerks at certain PP groups. Not a reason to avoid ophtho.

 

[RetinaDude]

Any truth in the comments talking about associate ophthos getting screwed before being made a partner?

I heard the same stories, about almost any specialty, throughout med school and training. Out of all the places I’ve lived, through training and post fellowship, I’ve never actually met anyone who this has happened to. Yes it can happen but, i Don’t think it’s as common as we were all lead to believe

 

[RetinaDude]

@RetinaDude How is the partnership model set up in your practice? Partner after 2/3 years? Does a new partner make the same money as an old timer?

We have a 3 year path to partnership, but from day one (even as a non-partner), you are treated like a partner. We involve new docs in all decisions, call is shared equally, all financial info is freely shared among all docs, etc…. We try to direct a lot of new patients to the new doc to help build their practice up quicker.

Yes, a new partner makes as much as the old timers. Some even make more, based on how hard they want to work. We have an “eat what you kill” set up so the harder you work, the more you make (and vice versa). Our most recent doc, she became partner two years ago, and she’s already making more than me (and I’m glad she wants to do so)