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What are advantages and disadvantages of going into comprehensive ophthalmology? What are the advantages and disadvantages of pediatric ophthalmology? Would like to hear your thoughts.
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Pros and cons of ophtho subspecialties
- Thread starter eyemjustasking
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PEDS
Pros: Get to work with kids, varied pathology, Great Job Market and Job Security in otherwise ophtho-saturated areas, chance to be as comprehensive as you want (amblyopia, strabismus, ROP, cataracts, plastics, glaucoma, etc.).
Cons: Lower overall pay, liability issues of dealing with children (esp. ROP), screaming/uncooperative kids, the parents (sometimes), cool ophtho instruments/technology not quite as applicable.
COMP:
Pros: Don't have to work with kids, higher overall financial ceiling, lots of cool tech (cats, iols, lasers, etc.), probably more surgical time then Peds.
Cons: Have to work with adults, job market, competition, declining reimbursement.
The biggest difference is obviously the patient population. Like kids and can occasionally stand the poorly behaved one? Peds is a good choice. Don't like kids? Wouldn't think about Peds.
Pros: Get to work with kids, varied pathology, Great Job Market and Job Security in otherwise ophtho-saturated areas, chance to be as comprehensive as you want (amblyopia, strabismus, ROP, cataracts, plastics, glaucoma, etc.).
Cons: Lower overall pay, liability issues of dealing with children (esp. ROP), screaming/uncooperative kids, the parents (sometimes), cool ophtho instruments/technology not quite as applicable.
COMP:
Pros: Don't have to work with kids, higher overall financial ceiling, lots of cool tech (cats, iols, lasers, etc.), probably more surgical time then Peds.
Cons: Have to work with adults, job market, competition, declining reimbursement.
The biggest difference is obviously the patient population. Like kids and can occasionally stand the poorly behaved one? Peds is a good choice. Don't like kids? Wouldn't think about Peds.
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Thanks for your reply! I like kids and varied pathology, but it seems like all the other subspecialties are taking over the varied pathology (cataracts, glaucoma, ROP, even NLDO!) and only leaving the strabismus for the pediatric ophthalmologist! I also love adult cataract surgery, but hate the marketing aspect of it. Which leaves me with a few questions:
(1) It seems like the adult cataract surgery market is saturated in most mid-sized and large cities. How do you deal with this? How much time is spent marketing yourself if you are interested in adult cataracts? How do adult cataract surgeons network with optometrists?
(2) Is the pay for pediatric ophthalmologists really that much lower? If so, why is that? It seems like ROP pays well but comes with all that liability.
(3) How many strabismus surgeries does the average outpatient/non-academic pediatric ophthalmologist do nowadays?
(1) It seems like the adult cataract surgery market is saturated in most mid-sized and large cities. How do you deal with this? How much time is spent marketing yourself if you are interested in adult cataracts? How do adult cataract surgeons network with optometrists?
(2) Is the pay for pediatric ophthalmologists really that much lower? If so, why is that? It seems like ROP pays well but comes with all that liability.
(3) How many strabismus surgeries does the average outpatient/non-academic pediatric ophthalmologist do nowadays?
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Re: lower pay for pediatric ophthalmologists - I would say that yes, this is the truth. Now it's all relative. Like I said your ceiling is much lower, but to be perfectly frank my starting offers were more than those who were doing anterior segment. I realize though that my long-term earning potential is not nearly as high as a high volume cataract surgeon. That being said, a salary of 250-300k/year isn't anything to sneeze at. I think that this is a fair estimate (give or take) of what an established pediatric ophthalmologist makes. Do I wish I earned more? Sure I do, but not as a sacrifice for doing what I love to do (e.g. pediatric ophthalmology). As for why? I think it's multifactorial, but I feel it's mostly because our society seems to undervalue pediatric specialties in general. Across the board (pediatric ENT, pediatric ophthalmology, etc.) pediatric specialties make less than those who treat adults. I don't really understand why - it would seem to benefit society as a whole to put more into our children then our geriatric population. But that's not the nature of our healthcare system as a whole. Medical reimbursement is higher when you order more tests (more OCTs, more fundus photographs, more pachy's, more topographies). Older people require more tests, so the physicians who order these tests get reimbursed more. Personally I think it takes a lot more skill to perform an accurate refraction/retinoscopy on a screaming three year old, but I don't get any extra reimbursement for this.
As for scope of practice - it depends what you are trained to do and what you are comfortable with. I have plenty of strabismus, plus I do cataracts, dermoids, probes, chalazion, basic ptosis, ROP laser, etc. That's plenty of surgery for me and also enough variability. Other people just want to do strabismus, which is perfectly fine too.
Anyway, I could go on. I don't mean to offend anyone. I think we (as in all of ophthalmology) deserve to get payed more for what we do. P.M. me if you have questions about pediatric ophtho.
As for scope of practice - it depends what you are trained to do and what you are comfortable with. I have plenty of strabismus, plus I do cataracts, dermoids, probes, chalazion, basic ptosis, ROP laser, etc. That's plenty of surgery for me and also enough variability. Other people just want to do strabismus, which is perfectly fine too.
Anyway, I could go on. I don't mean to offend anyone. I think we (as in all of ophthalmology) deserve to get payed more for what we do. P.M. me if you have questions about pediatric ophtho.