job markets for various specialties vs comprehensive

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e4e said:
I hav'n't yet decided about UAE. What do you mean 'less competition for us'? Competition in what? I am just a PGY-2 now; how can I compete with a high and mighty 'attending' already established in practice and making millions?:D
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On a related note... how hard is it to start practicing ophtho in Canada if you're trained and certified in the U.S.? I keep hearing from Canadian colleagues that they get paid the same or more, operate more, and don't have to deal with insurance/coding issues (I don't know how true these claims are, however)
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Dusn said:
On a related note... how hard is it to start practicing ophtho in Canada if you're trained and certified in the U.S.? I keep hearing from Canadian colleagues that they get paid the same or more, operate more, and don't have to deal with insurance/coding issues (I don't know how true these claims are, however)
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I feel like I need to point out that the big downside with that is you have to live in Canada. What the hell would I do with all my guns? They'd miss me.
 
Dusn said:
On a related note... how hard is it to start practicing ophtho in Canada if you're trained and certified in the U.S.? I keep hearing from Canadian colleagues that they get paid the same or more, operate more, and don't have to deal with insurance/coding issues (I don't know how true these claims are, however)
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I am sorry, really don't know much about Canada. Not interested in moving there either. After residency, I'll either remain here in the states (visa permitting) or I shall move to middle east, most likely the latter. From what I've heard (I don't know if any of that is true or not):
1. Canada is very unkind to FMGs almost without exceptions
2. Tax is very high over there. In some provinces may range upto 60% or so.
3. Its effing cold over there
4. Pay is much less than in the US
Whats the point?
 
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How much do we pay as indemnity insurance in practice/in hospital setting? If the net salary is 200K, how much will be take home after paying indemnity+taxes+overhead for:
1. Comprehensive Ophth
2. Oculoplastics
3. Vitreo-retina surgeon?
And which subspecialty has most overhead? Retina?
 
e4e said:
How much do we pay as indemnity insurance in practice/in hospital setting? If the net salary is 200K, how much will be take home after paying indemnity+taxes+overhead for:
1. Comprehensive Ophth
2. Oculoplastics
3. Vitreo-retina surgeon?
And which subspecialty has most overhead? Retina?
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Overhead is definitely lowest in pure Oculoplastics practice. Actually, that's probably one of the benefits of pure Oculoplastics. You don't have to buy a SD-OCT, argon/YAG, IOL Master, FA, etc. You probably don't even need a Humphrey VF machine since insurance companies will let you use a tangent screen VF for your functional ptosis/bleph cases. You probably also only need two rooms, and don't really need all of the bells-and-whistles in your rooms.

Overhead is higher on average for Retina, but then again, the RVU-per-encounter is much higher with Retina than non-refractive comprehensive practices. However, if the comprehensive is also doing lots of refractive, then their overhead definitely creeps up (but again, the pure cash of refractive will eventually more than make up for the higher overhead).
 
WhatNEyeTem said:
Overhead is definitely lowest in pure Oculoplastics practice. Actually, that's probably one of the benefits of pure Oculoplastics. You don't have to buy a SD-OCT, argon/YAG, IOL Master, FA, etc. You probably don't even need a Humphrey VF machine since insurance companies will let you use a tangent screen VF for your functional ptosis/bleph cases. You probably also only need two rooms, and don't really need all of the bells-and-whistles in your rooms.

Overhead is higher on average for Retina, but then again, the RVU-per-encounter is much higher with Retina than non-refractive comprehensive practices. However, if the comprehensive is also doing lots of refractive, then their overhead definitely creeps up (but again, the pure cash of refractive will eventually more than make up for the higher overhead).
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How is RVU for plastics cases in a comprehensive practice? Enough to use as a revenue booster if you managed to get a good number of blephs/ptosis in per year?
 
Retina traditionally runs one of the lowest overheads in practices. I typically see folks running in the 35-45% overhead compared to a general ophthalmology practice which averages in the 60% range. With a high marketing budget, some general practices will run in the 75% range.
 
How about overhead with minimal marketing for comprehensive practices?
 
That would be my group (I'm the only retina). We are around 50-60% with no appreciable advertising. Recent EHR adoption pushed it closer to 60% with hiring of full time IT staff and technical maintenance.

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Are you saving/paying off debts for PP? Just get a slit lamp, indirect BIO, and a PRP/FOCAL laser and you are set.
 
Oh ya and an FA camera and OCT. :D
 
That is total overhead. I'm asking about just malpractice cover? Anybody knows how much will that be for a comprehensive Ophth, retina and the plastics guy? Also if the total overhead was really that high in practice, everybody would want to go into academic Ophth. No overheads, indemnity also covered by the hospital plus health insurance and good retirement plan. Am I missing something here?
Finally how much does a hospitalist make? Anybody knows if there is any veteran hospital/otherwise that actually sponsors J1 waiver for FMGs after rsidency with or without fellowship?
 
e4e said:
That is total overhead. I'm asking about just malpractice cover? Anybody knows how much will that be for a comprehensive Ophth, retina and the plastics guy? Also if the total overhead was really that high in practice, everybody would want to go into academic Ophth. No overheads, indemnity also covered by the hospital plus health insurance and good retirement plan. Am I missing something here?
Finally how much does a hospitalist make? Anybody knows if there is any veteran hospital/otherwise that actually sponsors J1 waiver for FMGs after rsidency with or without fellowship?
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Ummm, there is still overhead in an academic job. I would say the overhead is even higher in academics due to inefficiencies.

If you are talking about what YOU have to pay for malpractice, etc, the practice pays for it, whether it be in a private or academic setting.

I would say that 80-90% of people go into private practice jobs.

Overhead is relatively high for any ophthalmology job. But if you are pulling in 2 million dollars in revenue, but 70% goes to overhead, then you are still bringing home 600k. Not bad. There is no way you will be making that income at the VA.
 
@Lightbox: For a general ophthalmology practice...just a normal practice, you are looking at overheads in the 50-60%. Some might be higher than normal due to "extra" expenses to the practice if you will.

@e4e: Academics will provide you a good guarantee....but forget about a real bonus. You are basically salaried. It is the main reason I see folks leave systems like Kaiser....they get a great salary, work hard, but then after a few years realize that they could make so much more if their bonus was not capped. Great place to get experience and to make money for the first couple years....after that....there is a big difference vs a private practice.
 
Bgladney,

What would you say is the average total compensation for a person 1-2 years into their partnership agreement? For general, retina, and plastics?
 
Oh boy. That is a difficult question just because practices are so different.

Someone in LA might be in the 250K range say where as someone in rural Arkansas could be 400K.

Retina obviously makes more as a general number...but again, depends upon the practice and location. NYC, not going to be good. Rural Texas...could be close to seven figures. Then again, I work with a group in a Metro area where the partners all are close to seven figures. They work hard (70+ a day) but they earn what they work for.

Really depends upon the practice. Not a real set number out there in terms of income.
 
thanks 'bgladney'.
any visa fmg pgy3 or pgy4 around here? what are teh plans? comprehensive with uncertain future, fellowship with visa pain on your head or return to home country? visa fmgs please, not talking about american imgs or gc fmgs. thanks
 
I CCT next month and have been offered a TSC in pediatrics. The advantage of a TSC is that my salary remains pretty the same, but if i choose to do a fellowship, then i have to get my own funding or my salary goes down b about 30-40%....Is doing a TSC as opposed to a fellowship still a good thing? I would like to practice in Canada by the way, even though I am located in the UK
 
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