pediatric ophthalmology

[syri]

Hello!
I would like to start a discussion on the differnt subspecialties of ophthalmology. I will start my PGY 2 in July and as it approaches I am already thinking about the fellowships. Unfortunately with medicine being as it is today it will be difficult for a general ophthalmologist to practice the full scope of ophthalmology, therefore subspecialization seems necessary in order to be competitive in the job market.
So far I find all the the main subspecialties appealing, but pediatric ophthalmology sounds more exciting to me. I like dealing with children and their parents. Strabismus surgery is exciting and gratifying. I also feel that it will add a different population to my pracice which will bring in variety and excitement. I get very discouraged though when I see the pathetic compensation that peds. ophthalmologis get . For me money it is not the first thing when I look at what i want to do with my life but honestly it is not too far down the list either. I would appreciate your input in the future of pediatric ophthalmology as a career.

I would also appreciate your comments in other fields. Which field would allow me to be a more comprehensive ophthalmologists (i.e. to be able to do cataracts, strabismus surgery, simple plastics, basic glaucoma and basic retina procedures).
Thank you for your input

---

Members don't see this ad.

 

[TicToc22]

Hey,

I'm a 4th year med student who matched in ophtho and I'm also very interested in peds ophtho. I really love working with kids; however, I'm also discouraged about the salaries of pediatric ophthalmologists. I've had a hard time finding info in regards to their hard numbers, but the best i've gotten is that they make approximately 150-200,000 per year. I'm not sure if this is academics or private. Keep in mind that it's still a pretty good salary if that's really what you want to do with your life....but it's still hard to do an extra year of training to make 50-100,000 less than a general ophthalmologist makes. Not to mention that doing the eye exams on kids is REALLY hard...they just don't want to comply. I'm keeping my options open, but still my primary interest is pediatrics. Good luck

 

[DrEyeBall]

To my knowledge, there are few if any pediatric ophthalmologists using food stamps. You can make a great living doing it. If you are concerned that making "only" 200k a year might be hard (if that is even the correct salary), than you need to see the rest of the world. 99.9% of the world would quickly trade places with someone making 200k a year.

The bottom line is do what you love doing. Going to work each day just to make a bunch of money is not what you or your patients need.

 

[Mirror Form]

To my knowledge, there are few if any pediatric ophthalmologists using food stamps. You can make a great living doing it. If you are concerned that making "only" 200k a year might be hard (if that is even the correct salary), than you need to see the rest of the world. 99.9% of the world would quickly trade places with someone making 200k a year.

This is a very naive attitude, and it's part of the reason that physicians have continued to take such drastic pay cuts over the past 20 years. According to your logic, doctors should be happy to make 30K per year, b/c that's still more than the majority of the world's populations earns.

Although we don't like to talk about, income must be taken into consideration. Just b/c it's not the most important thing doesn't mean that it isn't a factor.

 

[DrEyeBall]

You missed the point of that post.

The day you start wishing you made more money, is the day you will never make enough to stop wishing that. I hear physicians complain all the time that some other physician type is making more than they are, they are not making enough, etc.

the reality is that physicians make a nice living. If you are reluctant to pick a field because you will ONLY make 200k a year, you have not seen enough of how most other people live. This is a common issue among doctors and why many are unhappy with their jobs.

Too many physicians place too much weight on salary. It is easy to spot the ones who view their work as just a job and get tired of doing it. The point was do what you like, you can make a great life AND enjoy your work on "only" 200 thousand dollars a year.

That is NOT in any way the same as saying we should let the insurance companies pay us less just because we could live on less. While I give plenty of free care to patients, I am not advocating we give free care to health insurance companies.

 

[KHE]

You missed the point of that post.

The day you start wishing you made more money, is the day you will never make enough to stop wishing that. I hear physicians complain all the time that some other physician type is making more than they are, they are not making enough, etc.

That is a very perceptive comment. I know physicians who make $400k per year and are miserable because someone else makes $410k per year. I worked with one LASIK cowboy who was one of the most miserable doctors that I knew because he was an amateur pilot and he couldn't do enough LASIK to satisfy his desire for more and more jets. I'm lucky enough to live in a fairly affluent town and my financial planner has told me countless of stories of people (physicans and non-physicians) who are going broke because even though they make $350k per year, they (or their wife) SPENDS $375k per year.

Fact is, that unless you're Bill Gates, someone is always going to have or make more money than you. While I certainly would never advocate that someone take a vow of poverty, to get so fixated on your income is only going to cause you ulcers. Time and time again, studies have shown that you only need to make about $40k per year to be happy. After that, there is no correlation between income and happiness or contentment. Do what you love and you'll never work a day in your life.

 

[fizzbot]

I would be interested to know about the various aspects of sub-specialties, this could be a great thread.

As much as I hate to talk about it salaries are probably a good place to start, anyone know how much on average the various ophtho subspecialties make?

 

[Mirror Form]

Time and time again, studies have shown that you only need to make about $40k per year to be happy. After that, there is no correlation between income and happiness or contentment.

Actually, the only study I've seen on how content physicians are showed a direct correlation b/w income and job satisfaction (only doctors were polled). Is that b/c we're greedy? No, but medicine is a very demanding, time consuming, and above all, stressful, field. If you don't get paid well for your efforts you're not going to be as as happy as if you did.

I guarantee you that if doctor salaries were cut to 40k per year, every doctor would be absolutely miserable. As would most future doctors. There is noway anyone should go through all the work we have to just to earn them same salary as a HS teacher.

Should salary come before patient care? Hell no, but to pretend that "oh, all doctors are going to be rich and just shouldn't even worry about money" is naive. It's also the attitude that has allowed physician salaries to continue to be cut. BTW, what point are you in training? In my experience, most people who say income doesn't matter are the people who haven't started paying off their med school loans yet.

 

[VA Hopeful Dr]

Actually, the only study I've seen on how content physicians are showed a direct correlation b/w income and job satisfaction (only doctors were polled). Is that b/c we're greedy? No, but medicine is a very demanding, time consuming, and above all, stressful, field. If you don't get paid well for your efforts you're not going to be as as happy as if you did.

I guarantee you that if doctor salaries were cut to 40k per year, every doctor would be absolutely miserable. As would most future doctors. There is noway anyone should go through all the work we have to just to earn them same salary as a HS teacher.

Should salary come before patient care? Hell no, but to pretend that "oh, all doctors are going to be rich and just shouldn't even worry about money" is naive. It's also the attitude that has allowed physician salaries to continue to be cut. BTW, what point are you in training? In my experience, most people who say income doesn't matter are the people who haven't started paying off their med school loans yet.

There is much truth to what you say. However, I see this particular debate in a slightly different light. Let's say that peds optho folks make around 200k. Let's then assume that general optho's make more like 250-275k. If you really like working with kids' eyes, then the 50k pay cut is probably worth it. Or, conversely, the extra 50-75k might not be enough to justify doing something you don't enjoy as much as the other option.

 

[fizzbot]

how about some of the other ophtho sub-specialties? Anyone have a link perhaps? Just wondering.

 

[DrEyeBall]

I guarantee you that if doctor salaries were cut to 40k per year, every doctor would be absolutely miserable. As would most future doctors. There is noway anyone should go through all the work we have to just to earn them same salary as a HS teacher.

They do not make a whole more than that in England and people are still becoming doctors. If taking a pay cut would change your outlook that much, medicine may not be your calling.

Doctors in the US are now used to making a good living. The happiest doctors are those who enjoy doing what they are doing and feel lucky to get paid alot to do it. Altough we work hard, don't try to sell "we work so hard we deserve the money" to the average person. They won't buy it. There are alot of people working hard out there.

 

[Mirror Form]

There is much truth to what you say. However, I see this particular debate in a slightly different light. Let's say that peds optho folks make around 200k. Let's then assume that general optho's make more like 250-275k. If you really like working with kids' eyes, then the 50k pay cut is probably worth it. Or, conversely, the extra 50-75k might not be enough to justify doing something you don't enjoy as much as the other option.

I completely agree with you there. I just get annoyed when overly idealistic people get on their naive moral high horse about how money isn't even a consideration.

 

[Mirror Form]

They do not make a whole more than that in England and people are still becoming doctors. If taking a pay cut would change your outlook that much, medicine may not be your calling.

Actually they do make more than that in England, especially the 50% who don't work for the government. They don't make as much as over here of course, but they don't work anywhere near as hard as we do to 1. get into med school and 2. to get through medical training, 3. to continually worry about avoiding career ruining lawsuits.

Doctors in the US are now used to making a good living. The happiest doctors are those who enjoy doing what they are doing and feel lucky to get paid alot to do it. Altough we work hard, don't try to sell "we work so hard we deserve the money" to the average person. They won't buy it. There are alot of people working hard out there.

Ofcourse they won't buy it, they've never had to deal with the pain of getting through residency.

 

[KHE]

I completely agree with you there. I just get annoyed when overly idealistic people get on their naive moral high horse about how money isn't even a consideration.

VA Hopefull made the point I was trying to make much better than I did.

Obviously, very few people would practice medicine if the payscale was only $40k because very few people would be willing to invest the time and energy and endure the suffering needed to complete the training if the reward at the end of that road was $40k.

But the reason I brought up the studies showing that once income rises about 40k, there is no correlation between income and happiness was to show that it is unwise to make compensation the primary decision maker when choosing your medical specialty. I know dozens of high school teachers who love their jobs and are content with their lifestyles. I know dozens of physicians who hate their jobs and are always whining about their incomes even though they make 200, 300, 400 even 500 thousand dollars a year. They could make 20 million a year and they would whine because someone else makes 20.1 million. I have taught high school chemistry and we had a large number of former doctors, lawyers and business executives who made career changes because their work was not fulfilling even though they make a fraction of what they used to make.

If you truly have an interest in pediatric ophthalmology and enjoy working with kids then that's the route you should take. Yeah, you could probably make twice as much being a retinal surgeon but you better enjoy working with old people. If you don't, that extra salary isn't going to even be CLOSE to enough to make you happy.

 

[orbitsurgMD]

Hello!
I would like to start a discussion on the differnt subspecialties of ophthalmology. I will start my PGY 2 in July and as it approaches I am already thinking about the fellowships. Unfortunately with medicine being as it is today it will be difficult for a general ophthalmologist to practice the full scope of ophthalmology, therefore subspecialization seems necessary in order to be competitive in the job market.
So far I find all the the main subspecialties appealing, but pediatric ophthalmology sounds more exciting to me. I like dealing with children and their parents. Strabismus surgery is exciting and gratifying. I also feel that it will add a different population to my pracice which will bring in variety and excitement. I get very discouraged though when I see the pathetic compensation that peds. ophthalmologis get . For me money it is not the first thing when I look at what i want to do with my life but honestly it is not too far down the list either. I would appreciate your input in the future of pediatric ophthalmology as a career.

I would also appreciate your comments in other fields. Which field would allow me to be a more comprehensive ophthalmologists (i.e. to be able to do cataracts, strabismus surgery, simple plastics, basic glaucoma and basic retina procedures).
Thank you for your input

In peds ophth, you won't have the procedural income of a busy retina surgeon, but you won't have the hours and worries of one either.

You will likely have more business than you can handle, and more trouble dealing with the volume of referrals and the problems of dealing with lousy insurers and Medicaid than you will having to fill your schedule. The only two downsides in peds I can see (as a non-peds subspecialist) is the constant need to deal with difficult parents and the fact that there is a high Medicaid load in pediatrics practice.

The happiest peds people are the naturals--those who don't want to do anything else--and if you are one of them then that is what you should do.

I would not worry about being busy. You will be busy for sure.

 

[DrEyeBall]

Another piece of misinformation abotu peds is that the biggest reason people do it is because they love workign with children. That may certainly play a role and it is why many people initially look at it. The reality is that many people who choose peds do so because they enjoy strabismus and the thinking that is required for it. They also enjoy getting to do many different types of procedures. It is still a place where you can be a "comprehensive" ophthalmologist and do cataratcs, glaucoma, plastics, etc

 

[Jake the Snake]

Can one finish a peds fellowship and then go on to practice not only peds ophtho, but also general ophtho (adult cataracts, glaucoma, lasik)? Or is the volume associated with peds ophtho too much to include anything else?

 

[MedEye]

Can one finish a peds fellowship and then go on to practice not only peds ophtho, but also general ophtho (adult cataracts, glaucoma, lasik)? Or is the volume associated with peds ophtho too much to include anything else?

Same question as above but for retina specialists instead of peds.
Can a retinal specialist still practice general ophthalmology, or people will stop referring pts to him since he/she is stealing their cases?

 

[7ontheline]

Certainly it is possible to do peds as well as general. It can be difficult if there are not enough peds/strabismus docs around, because your schedule will tend to fill up with those patients but it's still possible.

Retina I believe is a little trickier, because of the referrals. No one is going to refer a patient for a laser if they don't get the patient back when they need a cataract removal. This may be different in smaller areas, where the doctors are more likely to do a lot of different types of procedures. However, in cities and other well-served areas, it's definitely tougher to do retina in addition to general.

 

[Eyescan]

I worked with one LASIK cowboy who was one of the most miserable doctors that I knew because he was an amateur pilot and he couldn't do enough LASIK to satisfy his desire for more and more jets.

The cowboy should have worked for the airlines. The air force has higher performance jets but the number of flying hours is much less. If he gets cracking, he could fly business jets. Have a dual flying/ophthalmology career is difficult unless you could start a local air taxi company, fly part time as part owner of the company, and do locums work.

 

[Eyescan]

Another piece of misinformation abotu peds is that the biggest reason people do it is because they love workign with children.

I know one peds faculty member that hates children. That faculty member has the worst attitude that I've ever seen in medical school or residency. That person needs to be locked up in a psychiatric ward. I heard of another one at a different program that tells kids to shut up!

 

[OMD]

As far as subspecialists doing general work, it would be easier if you are willing to work in an underserved area where there aren't many other ophthos. If you are in a bigger city, most peoplee would rather have a trab or cataract done by someone who does several per week rather than one every few weeks and referrals will likely reflect that. However, no one can keep you from doing a procedure who shows up in your office and needs the procedure.
As far as money goes, one reason Dr's deserve some of the compensation they get is not just because of the hours they work or time they've put in. Lots of people in this world work hard and don't get paid $100,000's. But very few people work day in, day out with the risk that their livelihood could be severely damaged by 12 people who didn't graduate from high school who don't understand enough to know if there was fault but feel sorry for someone who had a complication, whether you were negligent or not. The closer I get to the real world of medicine and the more stories I hear, the scarier a jury pool sounds.

 

[Nauss99]

Or is this just tacking on extra training and ultimately just a waste?

Bletharoplasty could add a lot of income... althout I imagine that its debatable whether or not its ethical to have that procedure done for children

 

[7ontheline]

Or is this just tacking on extra training and ultimately just a waste?

I would say it's definitely overkill.