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Ophthalmology in Private Practice

Discussion in 'Young Ophthalmologists' started by Pigmentosa, Mar 8, 2007.

  1. Pigmentosa

    2+ Year Member

    Mar 8, 2007
    Likes Received:
    Medical Student
    I have some questions on how does an average Ophthalmologist office works:

    1. Number of patients a day (average)?
    2. Number of staff on an average office?
    3. Amount of loan to open a solo practice?
    4. How much time working before transitioning to a solo private practice?
    5. How much net money before taxes can a general ophtho make after 10 years in private practice?
    6. How many operations a week?

    Thanks again,

  2. orbitsurgMD

    orbitsurgMD Senior Member
    10+ Year Member

    Dec 27, 2005
    Likes Received:
    Attending Physician
    It will depend on your area, costs of your operation, labor hourly rates, amount of local competition, rate of insured coverage in the local patient population, age distribution in the local population, etc. A nice benchmark is 25 patients per day. You can do very well seeing less, if they are mainly surgical referrals, or do much worse seeing more if they are Medicaid, managed-care HMO, "self pay" returns from the ER, etc. Cataract rates vary by as much as $200/ case depending on your region, so averages are not a good or useful way of assessing prospects. A lot is going to depend on your locale and pattern of obtaining patients.

    Again, it will depend. Some small offices make do with a doctor and a receptionist/assistant and send billing out. That saves labor, but limits the effectiveness of the doctor in how many patients he can efficiently see in a day. Ophthalmic technicians can add to your efficiency if they are truly skilled, but their labor costs add to practice overhead, usually at a minimum of $10-12/ hr in the cheapest labor markets and more than $20/hr in high-cost markets(plus benefits). A few years ago, a colleague of mine said he thought the benefit of hiring a tech did not manifest itself until you regularly booked 20 patients per day. I think that is still true today.
    Again, it depends. If you have a low-cost office rental market and labor is cheap, you need less money. If you buy refurbished lane equipment and minimize the bells and whistles, maybe starting with only one single lane at first and minimize other startup costs, then obviously it costs less. But you also want to leave some room for growth, so maybe a larger space with less equipment makes sense. It depends on your market. You also have to factor in costs of buildout if your rented space requires that. Sharing space with an existing practice is another option, but there are compromises you make with that. In any event, you will need to consider:
    -cost of operating in your market, labor rates and space
    -providing for your personal expenses while your practice is starting to build
    -staff costs-the largest expense in mature practices
    -malpractice insurance, usually not bad for the first two years, but higher after that
    -time to getting on local insurance plans and Medicare (you won't get much income until you are at least on Medicare and the major private carriers, Blues, Aetna, etc.)

    I have colleagues who financed their startup on as little as $75,000 lines of credit. Even they recommended planning on twice that figure, minimum.
    It depends on what you are doing to make income in the mean time. Some doctors work private only part-time, doing work for the government or commercial laser centers the rest of the time. It is going to depend on your skills, market, desires, etc.

    Where? Doing what? Is LASIK presumed? Is ownership of an ASC presumed?

    Depends on your practice model: solo, group, HMO-affiliations, co-management activity, affiliation with optometry, local competition. I know surgeons who do 3 surgeries a week. I know surgeons who do more than 60.


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