Increasing patients loads?

[med2928]

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Pgy2 here. Since starting ophtho training for the past few months, a lot of attendings have mentioned how decreasing reimbursements have changed practice. It has been increasingly hard to maintain income and as a result, ophthos are increasing volume to make up for the decrease in reimbursements. some guys see up to 50 patients/day which seems insane to me. Other people who have choosen not to go that route have to deal with lower salaries (One guys told me low 200 and he is 15yrs in practice). Is this in all regions of the country? Money is not a primary motivating factor however this is concerning to me. I dont want to practice in a setting where minimal time is spent with each pt like that. Are there anyways to protect yourself? Fellowship?

I would appreciate any perspectives you guys could give.

 

[LightBox]

I dont want to practice in a setting where minimal time is spent with each pt like that. Are there anyways to protect yourself? Fellowship?

I would appreciate any perspectives you guys could give.

Sure, quit medicine... now! Every specialty is being affected by lower reimbursements. And as such, time-spent-per-patient is decreasing across the board. This is not limited to just Ophthalmology.

If someone is seeing 50 patients a day and only making 200k, something is seriously seriously wrong with their overhead. Or that person is stuck in academics 🙂

 

[MullerCell]

Some people in academics may see 50/day, but are only in clinic 1 or 2 days a week. If you are seeing 200 patients/week and doing 1 OR day and you are making 200k, someone else is keeping the remaining ~ 600k. You don't need to see that many people to make a comfortable profit. However, as reimbursements decline, to maintain your revenue you will need to do more work. Seeing 50/day isn't really that hard if you have a good EMR and efficient office. >70 I think becomes difficult without cutting corners and results in a really long day. As a PGY 3 I thought 5 cataracts in a surgery day at the VA was pretty good....then you realize that at an efficient surgery center you can do 5 or more per hour.

Anything that avoids insurance and allows cash payments will make you less sensitive to declining reimbursements, but isn't easy to just generate a practice full of refractive surgery, premium IOLs, or cosmetics.