I know this is highly variable but just wanted to see some actual numbers if possible so that I know what to expect once I graduate!
Seems like a taboo in our specialty
Seems like a taboo in our specialty
I know this is highly variable but just wanted to see some actual numbers if possible so that I know what to expect once I graduate!
Seems like a taboo in our specialty
Thanks! Sounds a lot like dentistry, is there usually a buy in involved too?I looked in urban/suburban (not LA/NYC, but places like Dallas/Fort Worth) and rural areas. Starting offers with small, private groups were $200-300k/year (the vast majority were ≤$240k) + production (variable, but usually 20-30% after 2.5-3x base salary), usually with a ~$20k signing bonus. Parternship tracks were 1-3 years (most were 2). It was easy to see what partners were making and get an idea of what is your ceiling -- this number was often ~$650k, though the range was $500 to comfortably over $1M (and this did not include income from real estate, ASC, etc).
HMOs averaged $350k starting salary with perks like loan repayment and RVU bonuses. It was more difficult to get details on what others are or were making with RVU bonuses. Realistic ceiling seemed to be about $500k at most places, but lots of reasons to consider it, especially if you can utilize public service loan forgiveness or plan to stay until retirement.
I did not look at private equity, but I've heard that compared to private practices, they offer a higher starting salary, decent incentives, and a lower ceiling. I can see why people are tempted to sell to private equity, but I did not want to support it and hate it changing the landscape of our private business models.
I looked at one job in academics that offered $190k starting. I did not negotiate or look around. Most salaries are public information, so you can see what these positions pay.
It was easy to feel a bit disappointed by our relatively low starting salaries (compared to any other surgical sub-specialty), but it's very short term.
I looked in urban/suburban (not LA/NYC, but places like Dallas/Fort Worth) and rural areas. Starting offers with small, private groups were $200-300k/year (the vast majority were ≤$240k) + production (variable, but usually 20-30% after 2.5-3x base salary), usually with a ~$20k signing bonus. Parternship tracks were 1-3 years (most were 2). It was easy to see what partners were making and get an idea of what is your ceiling -- this number was often ~$650k, though the range was $500 to comfortably over $1M (and this did not include income from real estate, ASC, etc).
HMOs averaged $350k starting salary with perks like loan repayment and RVU bonuses. It was more difficult to get details on what others are or were making with RVU bonuses. Realistic ceiling seemed to be about $500k at most places, but lots of reasons to consider it, especially if you can utilize public service loan forgiveness or plan to stay until retirement.
I did not look at private equity, but I've heard that compared to private practices, they offer a higher starting salary, decent incentives, and a lower ceiling. I can see why people are tempted to sell to private equity, but I did not want to support it and hate it changing the landscape of our private business models.
I looked at one job in academics that offered $190k starting. I did not negotiate or look around. Most salaries are public information, so you can see what these positions pay.
It was easy to feel a bit disappointed by our relatively low starting salaries (compared to any other surgical sub-specialty), but it's very short term.
How was it easy to see what the partners were making?I looked in urban/suburban (not LA/NYC, but places like Dallas/Fort Worth) and rural areas. Starting offers with small, private groups were $200-300k/year (the vast majority were ≤$240k) + production (variable, but usually 20-30% after 2.5-3x base salary), usually with a ~$20k signing bonus. Parternship tracks were 1-3 years (most were 2). It was easy to see what partners were making and get an idea of what is your ceiling -- this number was often ~$650k, though the range was $500 to comfortably over $1M (and this did not include income from real estate, ASC, etc).
HMOs averaged $350k starting salary with perks like loan repayment and RVU bonuses. It was more difficult to get details on what others are or were making with RVU bonuses. Realistic ceiling seemed to be about $500k at most places, but lots of reasons to consider it, especially if you can utilize public service loan forgiveness or plan to stay until retirement.
I did not look at private equity, but I've heard that compared to private practices, they offer a higher starting salary, decent incentives, and a lower ceiling. I can see why people are tempted to sell to private equity, but I did not want to support it and hate it changing the landscape of our private business models.
I looked at one job in academics that offered $190k starting. I did not negotiate or look around. Most salaries are public information, so you can see what these positions pay.
It was easy to feel a bit disappointed by our relatively low starting salaries (compared to any other surgical sub-specialty), but it's very short term.
I looked around in multiple different places when looking at positions. Employed spots start often at 250-300K. After that what you make often depends on how busy you are and your compensation model. In the states I looked at, if you're employed and busy with a good compensation model you can make between 400-600k (including benefits) when up and rolling. The busier you are, the more you make if you're in a good employed compensation model. If you're not busy and in a saturated area, you may be stuck around 300k if you're just moderately busy.
Volume is king. Being in a saturated market hurts the chance of getting the volume needed to make more. Not impossible. If you're busy, you should make >500k whether employed or in a group. Busy is a bit subjective I guess, but I'd guess if you are seeing ~ 110 patients per week and doing 10-15 cataracts per week you should make over 500k easily. If not you should question your compensation model.
Private has a much wider range of what you can make. Ceiling much higher than employed, with partners making over a million if in good market and own an ASC. Sometimes easier said than done to make partner and to find a good, trustworthy group or partner to join though. If it were that easy that is what everybody would do. I've seen plenty of people join a group or solo partner out of training and get hosed in the end with unkept promises of partnership, or just getting let go (churning associates).
Thanks! Sounds a lot like dentistry, is there usually a buy in involved too?
What do you mean by HMOs? Are you employed by the HMO? The practice takes HMO? Are we referring to practices with capitation?
How was it easy to see what the partners were making?
Enjoy your posts. I keep hearing declining reimbursements especially cataracts and unexpected economic climate in the next several years from prospective employers. I wonder how much that affects how private practice owners in terms of hiring associates; any idea?Unless you are an idiot, you should be making at least mid-6 figures as a partner. 7 digits for non-idiots.
Unless you are an idiot, you should be making at least mid-6 figures as a partner. 7 digits for non-idiots.
In private practice, you could see anything from $150-$225,000 in those areas. I have heard of offers as low as $100,000 even in recent years in the SF area.Does anyone have any ball park estimates for ophthalmologists practicing in these saturated areas like SF and LA? Unfortunately, that's where my family is from...
I am assuming starting salaries. Please refer to @Hanky's first post above. Low starting, high ceiling with partner.
It still boggles my mind why someone would subject themselves to be treated like trash by living in dense cities like NY/SF when you can easily live 45 min-1.5 hours away and have a much better job.
I think this phenomenon is because residents/fellows are paid so poorly, that they think that 200k is a "huge" salary relative to how they were living
I am assuming starting salaries. Please refer to @Hanky's first post above. Low starting, high ceiling with partner.
It still boggles my mind why someone would subject themselves to be treated like trash by living in dense cities like NY/SF when you can easily live 45 min-1.5 hours away and have a much better job.
For real. Also, just because you practice outside the city doesnt mean you have to physically live there. You can practice 45 min outside LA and still live in LA if you really want to. A 45 min commute against traffic isn’t a huge deal if you get to live where you want and join a practice where you are treated well.
For real. Also, just because you practice outside the city doesnt mean you have to physically live there. You can practice 45 min outside LA and still live in LA if you really want to. A 45 min commute against traffic isn’t a huge deal if you get to live where you want and join a practice where you are treated well.
Let's not give the false impression that the job market for ophthalmology is great 45 minutes outside of LA. The only non saturated areas in California are in Bakersfield, Stockton, etc.
Haha true. Apologies for the snarky remarks, but it seems like we get a "How much will I make?" thread every few weeks. A lot of noobs think they are going to get offered 800k/year for their first job out of training. My first job out of fellowship was terrible (e.g. 175k) though in a very desirable location. I'm now making >10x more and chuckle at how foolish I was back then. Money isn't everything, but it definitely makes things better!
Also, once you have a good chunk of dough, you need to start diversifying your income streams. Don't get stuck making money just from seeing patients and operating! That's not sustainable and you risk it all going to hell when you get sick or just get sick of practicing Medicine.
so You’re making >1.75 million per year? Wow
I'm not saying that's impossible but I would say >1.75million is a HUGE outlier. The other numbers you quoted are pretty reasonable.This is seriously not unheard of if you know what you're doing. Ophthalmology is known for having a low floor and sky-high ceiling. As a comprehensive you'll probably make $200-$300k your first year if you count both salary and production bonus. Once (if) you make partner you should get over $400,000. Between $400,000 and $600,000 is the norm as a partner in a good comprehensive practice.
Retina starts closer to $300-350k and should be making at least $500,000 as partner. $500,000-$1,000,000/year is the norm as a partner in a good retina private practice.
If you're really good at running a business you could certainly make >1.75 million per year.
Depends on where you practice and what type of practice. Hospital/multi-specialty clinic you will see more than this, private practice you could see this number although I would peg $300K at the top end of what you could expect to see. One thing to note for your experience as a military doc is that if you pursue a position with a lot of refractive patients. You will see a slightly higher multiple before you reach bonus based on higher overhead in the practice from equipment cost, co-managed liaisons/managers potentially, and marketing as compared to your more broad scoped comprehensive colleagues(if you didn't do a fellowship).Interjecting bc I'm interested to see if the starting salaries listed here are for people straight out of residency? I went HPSP and after I leave the military I'll have 4 years experience as an attending. Would I be able to expect 300K starting salary, or lower?
Interjecting bc I'm interested to see if the starting salaries listed here are for people straight out of residency? I went HPSP and after I leave the military I'll have 4 years experience as an attending. Would I be able to expect 300K starting salary, or lower?
Very well put @mjohnsonets & @Dr.K124 . As of now I'm undecided about a fellowship. If I were to do it within in the military, it would add to my commitment, so one alternative is to do it after separation. I do want to do one but I will be satisfied if I can find a 2-3 year partner track making >$500,000 [In the southeast]. If such job would be difficult to find then I will probably end up doing a fellowship regardless.
Hijacking the thread, sorry OP. Southeast is a good market?
Current medical student here hoping to go in to ophthalmology. My wife wants to know where we will be able to live in the future (in other words can we avoid the Midwest where we’re from, haha). I go to school in New Orleans and would like to either stay here or stay in the area at least, but I keep reading online about the Midwest being the place to go.
Finding a good position is like anything else; the more qualifiers you put on it, the less options you have. Stay open minded and seek balance in your professional and personal life and you will be happy.Hijacking the thread, sorry OP. Southeast is a good market?
Current medical student here hoping to go in to ophthalmology. My wife wants to know where we will be able to live in the future (in other words can we avoid the Midwest where we’re from, haha). I go to school in New Orleans and would like to either stay here or stay in the area at least, but I keep reading online about the Midwest being the place to go.
I have asked this question a lot. Why do we start low and end high. No one really knows. It may be due to the cost of starting a practice with all the equipment. For example, each slit lamp costs $4-6k+, OCT machine $30-100k, Humphrey $30k+ to name a few. Imagine the cost of phaco machines, surgical scopes, etc. I believe a surgical scope costs $200k. Also I do think it takes longer to gear up to 100% patient volume capacity in clinic and surgery.
Could it also have to do with job markets and over supply? Idk much about optho "shortages" etc.
Ophthalmology is facing shortages just as much as anyone else. The exact reasoning behind the difference in pre-partner salary for those 1-3 years isn't well-known.
But, to be frank, who cares?
Radiology and Anesthesia are around $350k pre-partner and $500-600k post-partner. They also work much more hours than we do. You realize Ophthalmology averages 35-45 hours a week for comprehensive and 40-50 hours a week for retina, right? Not to mention very minimal call. Even in Retina trauma call is very optional. So 1-3 years making $100k less than them, to then make the same partner salary and work 10-15 hours per week less... who comes out ahead? 😉
The only other field that has such a great $/h ratio is Dermatology, and, come on man... skin. Eyes.... skin. Enough said.
Edit: And this is comprehensive. If you go into Retina you'll have around the same pre-partner compensation as them with a significantly higher post-partner compensation while still working less than them.
As pointed out previously, I think the start up costs and high overhead likely have something to do with it. When it comes to a starting salary as well, it is technically a bet on future production with the assumption year 1, maybe year 2 being a loss for a practice. With CMS consistently cutting cataract reimbursement because it is the most common type of surgery in the US, a lower base salary is a hedge against anything they do in the future to cut reimbursement. Sure they cut all reimbursement as time goes on but ophthalmology has been hit particularly hard for it's most common type of procedure.Yeah I understand the training differences and work differences... Was just curious because the low partner salary still seemed off even if in the long run it doesn't matter.
As pointed out previously, I think the start up costs and high overhead likely have something to do with it. When it comes to a starting salary as well, it is technically a bet on future production with the assumption year 1, maybe year 2 being a loss for a practice. With CMS consistently cutting cataract reimbursement because it is the most common type of surgery in the US, a lower base salary is a hedge against anything they do in the future to cut reimbursement. Sure they cut all reimbursement as time goes on but ophthalmology has been hit particularly hard for it's most common type of procedure.
Also, in hospital/multi-specialty clinic settings ophthalmologists can see $350,000+ starting salaries. Not sure how that compares to other specialties in the same setting though.
I was not in the field 20 years ago. Anyone who was starting out 20 years ago have a reference for starting ophtho salaries vs other specialties starting salaries back then?
Why are optho starting salaries still so much lower compared to others... Don't understand why this specialty is really competitive... Please elaborate. A radiologist/gas/IM fellowship will make like 400k+ pre partner, then jump to 600K+ after usually... Does optho just reimburse poorly compared to others? Is there just a culture of being okay with what appears to me to be SUPER LOW pre partner money (sub 300K) then jump to partner money?
Answer: I go into the hospital once or twice per year and thus don't have to deal with that mess of an organization. I work ~35 hours a week (I will be taking off every other Friday soon to boot). I'm home by 4 pm on most days so I can spend time doing homework with my kids. I don't deal with anything messy -- I'm not cutting through fat and miscellaneous tissue to get to the area of interest. My patients see an immediate improvement. I have autonomy. I make 7 figures. Ophtho gives me free time to pursue 10 other entrepreneurial activities and to stay in shape.
Pre-partnership salaries are lower because owners like me can offer that rate and get 20 CVs to fill the spot. And why are applicants beating down the gates? Because they want the partner's financial situation and lifestyle.
what does it mean to be a partner? I don’t understand how a doctor can work 35 hours a week and make 1.5 million dollars as you do..is optho making too much? Are you guys too highly reimbursed for your surgeries? Doesn’t seem right when others are working 50 hours a week to make 400k
what does it mean to be a partner? I don’t understand how a doctor can work 35 hours a week and make 1.5 million dollars as you do..is optho making too much? Are you guys too highly reimbursed for your surgeries? Doesn’t seem right when others are working 50 hours a week to make 400k
I had a friend who completed EM residency and had opportunities to make close to 7 figures (emergency medicine) but it was in the a city that I don’t remember the name of at this point.
Edit: and if you can find the volume, a modern cataract surgeon can still earn 7 figures without much difficulty, so long as you focus entirely on cataracts.
These are always some of the most annoying threads. When you post your comp #'s, there always will be critics ("you guys make too much money waaaa!") or doubters ("that's impossible" or "you must be practicing in rural Iowa!"). This is why most people don't disclose their #'s -- because there really is no advantage to us doing so.
im just trying to understand what it means to be a partner, what is generating you so much revenue that you can make 1.5 million working 35 hours a week? Is it the surgeries themselves or do you hire a bunch of mid levels and skim off of them or do u hire a bunch of other surgeons or where is that crazy revenue coming from