Job listings on the AAO website? What gives?

[Toadkiller Dog]

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Well, I finally found a place that lists some OPS jobs (American Academy of Ophthalmology, found it thru a Google search).

They actually had ~350 jobs listed, and a good amount of info was listed for each one......BUT--here's what made me raise an eyebrow. Under the "Salary" heading, pretty much all general ops jobs were listed at between 96K-120K.

Unfortunately, it did not separate out "starting" $$ from what a "partner" might make. Oddly enough, though, not one add that I looked at mentioned any difference between the salary listed and what one might make later on (like, for example, many recruitment adds do on other sites).

So what's up? Do OPS grads really make that little? I know this topic has been hashed out already, but come on, *primary care* starting offers are usually more than that!

With my $150k in loans (plus interest) hanging over my shoulder, I found the whole thing just a bit depressing. I don't need to be stinking rich, but I don't want to be on the 30-year payback plan, either.

 

[ckyuen]

Starting salaries in ophthalmology are notoriously low. I believe this is b/c a lot of practices are solo practioners and even paying you 120 a year you will be losing money for them your first year. Of course unless they are so busy that they can provide you with a census of 20 patients a day. In optho you rely on numbers and it takes a while to build up this patient base figure on two years or so. When you are partner in a good practice you should make more like 3x that amount. I know some gen op making like 8x that but they are the exception, seeing 90 or more pts a day. Seeing 40 pts a day and generating a few cases a week you'll be just fine. Remember it's where you end up not start. We have a high overhead in optho, so it's a tough start.

 

[GlaucomaMD]

Those figures also represent only the guaranteed base salary. If you're a decent ophthalmologist, you should (granted you negotiated a decent contract) be able to make your incentive bonus during your first or second year out.

Your potential earning depends so much on geography. If you're willing to live in a smaller town, you can make a lot more than if you're determined to live in NYC or LA. That said, good desirable candidates can always expect to get paid more than others.

Fact is, all ophthalmologists will make enough money. At some point, you have to realize that your level of happiness has to depend on something other than the number on your paycheck. Ophthalmology (and medicine in general) yields so much professional satisfaction, if you are willing to open your eyes and look past the dollar figures.

 

[yagmd]

While I agree that there are many other important factors that contribute to professional satisfaction besides salary/compensation, the extremely low starting offers in ophthalmology are concerning. A few points:

1) For comparison, radiology starting offers in most parts of the country are currently $250-$300K.
2) The argument that the salary will increase dramatically once people become a partner in a ophthalmology practice is not necessarily true given the dramatic reductions in compensation for common ophthalmic procedures over the past 5-10 years and the over-supply of eye care providers.
3) While I'm sure that the salaries in smaller or medium-sized towns are better than big cities, most of the job offers posted on the AAO site are in smaller areas. Many major metro areas don't have any postings at all, and the jobs that do exist are probably even lower paying.
4) The argument that "all ophthalmologists will make enough money" is certainly not true if you have children and have to support a family. For example, let's say you are making $125K. In many large cities the public school education is so poor that kids have to go to private school, in many cases up to $15-$20K per year. After taxes, a $125K salary becomes $65K and it may barely cover just your kids private school costs (if you have 3 or 4 kids), not to mention that you need to buy a house, a car, and lots of other significant expenses. These are not extravagences, these are necessities of life (education, a home, transportation).

I'm concerned, and I think others should be as well. There is evidence of an over-supply of ophthalmologists, which is exacerbated by the surplus of optometrists. The job market is much better (more job openings, higher salaries) in most other sub-specialty fields, for example Derm, Radiology, ENT, Urology, etc. We should all be actively advocating for a reduction in the number of ophtho residency spots in order to ensure that ophthalmologists have decent practice opportunities when we complete our training.

 

[mjl34]

. . . sure, just as soon as I get accepted into one 🙂

 

[GeddyLee]

So what about those surveys that Dr. Doan posted in the FAQ? most of them show average salaries in the 200k's for general ophthalmologists. Are those salaries offset by the outliers that we all hear about....LASIK docs making near a million? Or is it just that salaries come up after being in practice a few years?

I would think any doc would make much more after being in practice a few years, after all, not many people start off with a thriving business. I just find it hard to believe that an ophthalmologist would expect to be paid less than an FP...that's just my take on it though.

I think radiology salaries are over inflated....they'll come down soon enough. I don't really understand how insurance and medicare can possibly reason that an MRI should really cost over $1000...

Finding out actual lifestyle of ophthalmologists has been frustrating. I hear anywhere from "oh you can easily make over 500,000" to "you'll be doing well if you make $120K". I doubt we'll really know unless we ask private practicing OPH's.

Anyway, bottom line, I'd still be doing OPH if it paid 80K. Who cares? at least I'll never have to work 100 hour weeks, stand through rounds all day, etc. Besides, Ophthalmology is the coolest specialty there is. No one cares if you regulate their BP or control their diabetes, but if you fix their eyes, you better bet they'll be thankful for that.

Oh well, just my ramblings. Hey glaucomaMD, how about fixin me up with an interview at Bascom! Dang i wish I'd gotten an interview there.

 

[last minute]

I have to agree with you, Geddy. Salaries in medicine will continue to drop...but regardless of how low they go, we will still be able to put food on the table. If you are into extravagant living (there is nothing wrong with that), you will have to consider something more profitable on the side or something different all together.

I don't want to throw in a whole bunch of corn ball into this forum, but in all honesty I'm in medicine for the personal satisfaction of knowing that my efforts will leave a positive impact on people. I am pretty sure that deep down the same holds true for everyone here.

 

[eye3md]

You are all getting worked up over nothing. First of all, ophthalmologist are getting harder to recruit every year and the job offers are numerous. As a matter of fact, a recent study said ophthalmic procedures should increase (or be needed) more than any other.......because of the aging population.

The only places where there are "oversupplies" of ophthalmologist are in large cities like SF and NYC. If you are foolish enough to take one of their offers then you deserve to make $80,000 per yr. Where I practice, there are three separate groups looking very hard for docs and it is just too competitive for them. These are good groups making alot of money (probably over $350,000 but I suspect much more and they have great lives). There are alot of jobs out there but be flexible (open minded).

DO NOT let your starting salary be the judge of where you practice. I had a friend who told me he started at a base of $96,000 but after bonus time he ended up making $220,000 his first year. You need to look at the bonus structure and how likely it will be you will attain your bonus goals (ie, is the practice super busy and needing someone badly or are they just looking for a "boy" to ship off to a satellite). You are correct in stating that we have a low starting salary (and I do not know why ophthalmology is weird like that) but in the end, if you join a good busy practice, in the right area (this includes small, medium, and many large places), you will end up making a very good living and having a great life. If you look at what most ophth. make and then look at their hours worked, we come out really damn good.

 

[ckyuen]

eye3md is absolutely correct about a potentially great bonus structure in optho depending on your contract. At our program we have an excellent launching your career series and this has proved more valuable than any other lecture series we have received.

 

[yagmd]

Thanks for the posts from those who are farther along in their ophthalmology careers. For those who are in close to finishing their residency or fellowship, are you seeing a lot of job offers? What kinds of incentive/bonus structures are you seeing?

Part of the problem is that there's very little good data on physician salaries in small sub-specialty fields. Although the surveys that Dr. Doan and other posters have cited are helpful, we don't have enough information about how many ophthalmologists were surveyed, where they are located, what sub-specialty areas they're in, etc.

A couple of other notes...
1) The Allied Physicians survey that Dr. Doan cited shows that average ophtho compensation (including bonuses) is $138K for the first 2 years. Granted, it does appear to go up from there; however, the ophtho year 1-2 compensation is significantly lower than primary care fields -- Family Practice ($161-182K), Psych ($149K), General Internal Medicine ($154) -- and much lower than other surgical sub-specialty fields -- OB-GYN ($211K), Ortho ($256K), ENT ($194K), Urology ($261K)... The only fields with lower compensation than ophtho in the first 1-2 years are Peds (which has traditionally been the lowest paid field of medicine), and Podiatry. I still think that's concerning.
http://www.allied-physicians.com/salary_surveys/physician-salaries.htm

2) There is evidence that there is a significant overall surplus of ophthalmologists (not just in big cities). A 1998 study showed that under the current mised ophtho / optometry care model "an excess of eye care providers exists." The authors also point out that "If fellowship training programs are not curtailed, the supply of subspecialists will grow faster than the public health need for care within the care categories provided by the subspecialty-trained ophthalmologist."
Lee PP. Relles DA. Jackson CA. Subspecialty distributions of ophthalmologists in the workforce.[comment]. [Journal Article] Archives of Ophthalmology. 116(7):917-20, 1998

Further thoughts on the issues, particularly from those out there in practice, are welcome.

 

[GlaucomaMD]

Originally posted by yagmd

4) The argument that "all ophthalmologists will make enough money" is certainly not true if you have children and have to support a family. For example, let's say you are making $125K. In many large cities the public school education is so poor that kids have to go to private school, in many cases up to $15-$20K per year. After taxes, a $125K salary becomes $65K and it may barely cover just your kids private school costs (if you have 3 or 4 kids), not to mention that you need to buy a house, a car, and lots of other significant expenses. These are not extravagences, these are necessities of life (education, a home, transportation).

I must admit "enough" is a subjective term that means different things to different people. Despite that, I think it's silly to suggest that making $125K is not "enough" to have the "necessities" of life. Are you suggesting that more than 90% of Americans are not making "enough" to meet "necessities of life"?

I would be the last one to suggest that people should not have children because of affordability (being an expectant father myself; if you wait until you can afford a child, you would never have one). But if you really felt that you couldn't afford to provide your family "necessities of life", maybe you should exercise precaution.

I am in agreement that I would continue to be an ophthalmologist, even if US suddenly became a communist country and everyone made same money regardless of your occupation.

Do what you love; love what you do. Life is too precious to leave your family each morning to do something you dread, just for money.

Also, I suggest you should look into finding a better financial advisor, if your 125K is going to become 65K. It's called pre-tax contributions, asset planning, etc. Look into it.

Just my 2 cents...

 

[eye3md]

As far as the article about an oversupply of opthalmologists, do you recall ever hearing "diseases don't read books", meaning that disease does not always follow the course as written. The same can be said for these "studies" about physician supply. They are studies and that is it. You look at all the jobs on the AAO site and the ASCRS site, and talk with docs in the real world, there is a real undersupply of ophth right now. Don't listen to "studies" because things change very quickly. When I finished med school in 1997, anesth. and radiology had no future. Now, 6 years later, they are some of the most desperately recruited specialist.

The reports about physician income also vary alot. I do not know any ophth., in yr one or two of practice (the private world that is) who makes less than $150,000. That is unless they took an idiot job in San Fran, just so they could live there. If that is the case then no complaining. You make your choices. Also, in the long run, you will make more than most other specialties and have a much better life.

 

[Toadkiller Dog]

I felt much better about my original post when I saw something today:

I took my family to Monterey, CA for the weekend (which, coincidentally, is about 2 hours from San Fran!) and noticed at the beach that parked next to me was a new BMW X5 SUV (about a $50k car) with the license plate "EYE DR". I was further heartened when the guy driving it looked about 28 (i.e, younger than me).

Oh well. A sign of assurance from above, perhaps.

Keep the faith.

TKD

 

[yagmd]

While I agree that's it better to see that a young ophthalmologist is driving a new BMW rather than a 1987 Ford Pinto with an "Eye MD" license plate, but don't let things like that alter your interpretation of objective data re: ophtho compensation. If the guy really is 28 yo as you suspect, he's probably only a 2nd or 3rd year resident. For all we know, his parents bought the car for him as a present for graduating from med school or internship or something. Or maybe he has a trust fund. Or maybe he's just in debt up to his eyeballs because he wants a sweet ride to impress the ladies or whatever.

I think compensation is important... but not because I need a luxury car to be happy. I just want to be able to provide a nice home for my family, an excellent education for my kids (which in many areas of the country requires private schooling), vacation with my family once in a while, and save enough to pay for my kids college/med school/law shool/etc education and have a nice lifestyle in retirement... and do it all without constantly worrying about whether or not I can pay the bills. I don't think that's a lot for us to ask after going through pre-med, med school, and residency and given the valuable contribution that we can make to society by improving patients' lives. But I'm not sure that I can do all that on $125K a year (after taxes)... Keep in mind that there are a lot of nurses who make $80K a year and PA's and optometrists that make > $100K a year... and that's with much shorter/less expensive education, without any residency training, and generally working less hours.

I love ophtho, I think it kicks ass, it's a fun, interesting specialty with a great lifestyle... I just think that we need to be vigilent advocates for our specialty to make sure that we are adequately compensated for what we do.