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Ophtho renumeration - the elephant in the room
- Thread starter paging_dr
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Something to understand about retina is that the billing does not completely reflect the actual salary of physicians. Intravitreal injections are a huge part of that. I worked in a retina clinic for about 2 years before starting medical school and saw the order balances for medications. While Avastin is pretty cheap, things like Eylea, Ozurdex, and Lucentis cost thousands of dollars a pop. That is for the medication only, not counting the injection fee assessed in the clinic. Out of the 50ish patients we saw a day, probably 10-15 were injections. So per day, we billed somewhere between $15,000 and $30,000 for the medications alone. In a year, those numbers really add up.
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As Dr Redstone states, the billing issue is often confounded by drug. Intravitreal injections are quite costly and if they are incorporated into reimbursement calculations they can give you a false sense of things. There is no doubt that cuts are coming, just a function of degree more than timing. Choose a path that you enjoy and the financials will work themselves out.
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Not only are our medications expensive, but the procedures are reimbursed fairly decently (PRPs, focals, retinopexies reimburse fairly well once you're fast at doing them). The billing issue is a bit misleading as other posters have stated. The real information to obtain is take-home pay after overhead and expenses are covered, which I suspect will be much more difficult to find out.
Even then, don't choose medical retina simply because of the potential for higher pay. The issue with strictly medical is that your referral base will typically need whoever is taking care of their medical retina patients to also take care of their surgical retina patients as well. When a ophthalmologist or optometrist have to refer out patients for subspecialty care, usually they will pick someone surgical over someone medical. If you're living in a rural area, you should be ok with a solo medical retina practice but if you're in a more saturated area, it'll be much tougher.
Even then, don't choose medical retina simply because of the potential for higher pay. The issue with strictly medical is that your referral base will typically need whoever is taking care of their medical retina patients to also take care of their surgical retina patients as well. When a ophthalmologist or optometrist have to refer out patients for subspecialty care, usually they will pick someone surgical over someone medical. If you're living in a rural area, you should be ok with a solo medical retina practice but if you're in a more saturated area, it'll be much tougher.
