Recent residency grads with something positive to say?

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Lilbigfoot

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Most of my colleagues around here (comprehensive or retina), ~5 years out of fellowship, are making high-6 figures or 7 figures. So yes, there are some positive stories out there :)

And you have to remember: ALL fields of medicine will go through reimbursement cuts.

Lastly, these forums are definitely biased because usually the "venters" are the ones posting. The ones enjoying the fruit of their spoils are too busy vacationing in Monaco.
 
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Lightbox, you always come here with these "high 6, low 7 figure claims". Do you mind sharing what state you are in? I don't think we could figure out who you are for mentioning your state. I am in So Cal. The only way a general ophthalmologist can make 7 figures here is if they own a surgery center (or two) that is firing on all cylinders (busy 5 days/week) or employ another 2-3 MDs and pay them nothing. Looking forward to your reply.
 
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In cali retina people do make about that much doing tons of injections and vits without talking to the patients much. The generalists seem to make around half that.
 
Lightbox, you always come here with these "high 6, low 7 figure claims". Do you mind sharing what state you are in? I don't think we could figure out who you are for mentioning your state. I am in So Cal. The only way a general ophthalmologist can make 7 figures here is if they own a surgery center (or two) that is firing on all cylinders (busy 5 days/week) or employ another 2-3 MDs and pay them nothing. Looking forward to your reply.

Actually, I do mind sharing my location :) No, I'm not in Southern California. I practice in an area that is about 1 hour from a major city. And yes, we own our own ASC and opticals and have a bunch of optometrists working for us. But no, we are not operating 5 days a week, though we do perform alot of cases. It really is not that rare of a situation as you might think. I just want new grads out there to know that a diversity of work environments/potentials exist.
 
Good for you. One hour from major city is a s***t hole in my book. Life's too short. Sorry.
 
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Good for you. One hour from major city is a s***t hole in my book. Life's too short. Sorry.

So a place like Newport Beach (i.e. 45 minutes from LA) is a "s***hole"?!? To each his own Eyefixer...
 
I am willing to bet you are not in Newport Beach. More like one hour from Cleveland?
 
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Haha, ahhh, the sour grapes...
 
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There are gems of towns 30 minutes to an hour out from the nearest major city. Anywhere in New England, western Maryland, large swathes of Texas, etc. Don't speak in ignorance!
 
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Haha, ahhh, the sour grapes...

Not really. I am a partner in a group and make high 6 figures. And I live walking distance from Rodeo drive. But my situation is unique. Cheers!
 
Not really. I am a partner in a group and make high 6 figures. And I live walking distance from Rodeo drive. But my situation is unique. Cheers!

This is prime entertainment
 
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And the bro love between Zeke and fixer grows


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That's assuming you guys are Bros lol


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Any more contributions to the OP's question/concerns. I'm starting ophtho this year, and i'm also interested in getting more feedback form recent grads regarding
1. fellowship trained or not
2. ease of landing a job/how many offers did u get
3. starting salaries/benefits if you don't mind sharing (please post anonymously if concerned about ur privacy/identity)
4. location/practice settings
5. general advice for those in the pipeline regarding landing that first jeeerrrbb!! :)

thanks!!!
 
6. When to start looking for a job if your not planning to do a fellowship?

7. Aao job site worth anything?


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Not really. I am a partner in a group and make high 6 figures. And I live walking distance from Rodeo drive. But my situation is unique. Cheers!

Nice, good work! I guess I am confused about your line of questioning about how to make that level of compensation. You are experiencing it (in L.A. to boot), so you already know what it takes. Cheers.

So to reiterate to the new graduates: not everything is as dreary as it might seem from your mentors during med school or residency.
 
Thanks, but again my situation is unique. I am not in private practice, I don't own a surgery center nor do I employ "a bunch of optometrists". I do keep on top of various opportunities in my area and let me tell you to get into a partner situation around here is like hitting a lottery. Predatory practices with new graduate mills q2 years is more of a rule then an exception. I want new grads to be realistic. As reimbursements go down and HMOs take more hold, this will only get worse. But partner situations apparently are much more available "one hour from a major city ". So, if you don't mind the location, it's all good. Unfortunately, some folks do.
 
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Thanks, but again my situation is unique. I am not in private practice, I don't own a surgery center nor do I employ "a bunch of optometrists". I do keep on top of various opportunities in my area and let me tell you to get into a partner situation around here is like hitting a lottery. Predatory practices with new graduate mills q2 years is more of a rule then an exception. I want new grads to be realistic. As reimbursements go down and HMOs take more hold, this will only get worse. But partner situations apparently are much more available "one hour from a major city ". So, if you don't mind the location, it's all good. Unfortunately, some folks do.

So you are a partner in a group that is not a private practice? I don't understand what type of situation that is. Do you mean something like being part of a HMO like Kaiser?

Sure, everyone knows that partnership opportunities are harder to obtain in downtown Los Angeles or San Francisco. But they aren't nonexistent. In addition, nothing is stopping people from just starting their own practices in these type of locations. I know quite a few people who have done just that, and they seem to be doing okay.
 
Any more contributions to the OP's question/concerns. I'm starting ophtho this year, and i'm also interested in getting more feedback form recent grads regarding
1. fellowship trained or not
2. ease of landing a job/how many offers did u get
3. starting salaries/benefits if you don't mind sharing (please post anonymously if concerned about ur privacy/identity)
4. location/practice settings
5. general advice for those in the pipeline regarding landing that first jeeerrrbb!! :)

thanks!!!

- Fellowship training is not mandatory to doing well, but I personally feel that it helps ALOT. There are some surgical cases that you just will feel more comfortable doing if you are fellowship-trained.

- Most people I know just concentrated on being hired for one or two job prospects. They didn't have 10 job offers to choose from, because it required too much work to do due diligence on each of them.

- Most starting associate salaries will be from 150-200k plus bonus, CME travel, health benefits, etc. The bonus is typically calculated as a percentage of the revenue that you bring in after a certain threshold. For example "30% of collections after 3.5x your base salary". So if your starting salary is 200k, and you brought in 800k during one fiscal year, then your bonus would be = 0.3 * 800 - (3.5 *200) = 30k.

- There are a wide variety of practice locations from the middle of Manhattan to the island of Guam. Obviously, there is more saturation of providers in more "desirable" locations. The problem with saturation is that insurance companies aren't paying that much more for you to do a cataract in San Francisco compared to rural Arkansas. However, more affluent areas have more affluent clientele which can lead to a higher rate of cash services (e.g. higher premium lenses, LASIK, etc).

- General advice: do a lot of networking and don't piss anyone off. Ophtho is a very small world and a bad reputation will spread quickly. Also, drug/device reps can be a great source in finding employment opportunities since they travel around to all of the offices in an area. They are also a great source of gossip.

- If you know where you want to end up geographically, then the earlier you look for a job, the better. I know of one friend who started at the very beginning of residency for an employment opportunity in a very desirable area. It worked out for him well.

- The AAO job site has some good jobs posted on it. But it definitely is not the only source of info about jobs. Most great jobs go unadvertised at first, and are only discovered via word-of-mouth. Again, networking is important in this regard.
 
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How serious is OD encroachment? What are they encroaching on exactly at the moment? How far can they go in the future?
 
Something to keep in mind is that income is always relative to cost of living. Making high six figures in NYC or LA is chump change. You end up with much more disposable income in a smaller city (doesn't need to be some Podunk town either). It's all about your priorities.
 
Something to keep in mind is that income is always relative to cost of living. Making high six figures in NYC or LA is chump change. You end up with much more disposable income in a smaller city (doesn't need to be some Podunk town either). It's all about your priorities.

I agree but what planet are you living on where high six figures is chump change?
 
I agree but what planet are you living on where high six figures is chump change?
Heh, you're right. Not the best choice of words. No where is high six figures chump change. I was trying to get at the relative nature of the topic. The exaggeration was over the top.

I look at it this way. I spent a lot of blood, sweat, tears, and money to do what I do, and I want my compensation to reflect that. I'll provide an example.

Out of fellowship, I had a friend who went to California for a job, while I went to a smaller, southern city. I was married with two kids and a stay at home wife. He was married with a wife who works and plans to have their first child. My starting pay was significantly less (surgical vs medical). I moved into a 4 bedroom house on a golf course and put my kids in a great private school. He struggled to find a nice apartment.

Another friend lives in Seattle. A two bedroom condo there costs twice as much as a 4 bedroom house where I am.

Does that mean their lives suck, and mine doesn't? Of course not. It's about where your priorities are, though. If you absolutely have to be in a highly competitive area with a high cost of living, you're not going to do as well financially or you'll be working so hard that you won't be able to enjoy the fruits of your labor. You have to decide what you want.
 
Listen to above. He is exactly right. To me, life's too short to spend it in a small southern city.
 
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Listen to above. He is exactly right. To me, life's too short to spend it in a small southern city.
Lol, I know we've gone round and round about this before, Eyefixer, and I don't mind. It really is personal preference. Just to clarify, though, I said smaller, not small. The area I live in has a population of over 1.3 mil. It's not some one stop light town. Here's how I look at it, and again, it's personal preference. Say you take 4 weeks of vacation per year (I'm assuming you don't vacation at home). That leaves 48 work weeks in the area you live. During those weeks, you'll be at the office the majority of the day Monday through Friday. Personally, when I get home, it's family time. Kids' soccer, bike rides, pool, etc. followed by dinner together and getting the kids to bed. That's not likely to change, regardless of where I live. So, 70ish% of the week is effectively covered. The other 30ish%, the weekend, is what is open, and that's if I don't have call responsibilities locking me down. So, that means roughly 25% ([48 weeks * 2 days]/365 days) of my year max is what I'd be paying the premium of living in a highly competitive, high cost of living area. I'd rather just take the money I save by living where I do and take amazing vacations and weekend trips, live in a great house on a golf course, and retire early. But, that's me. Some folks, particularly single folks, wouldn't like that at all. One of my fellows is currently grappling with a job search. What he's looking for is very different from what I was looking for, and that's perfectly OK. I've tried to advise him as such.
 
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Lol, I know we've gone round and round about this before, Eyefixer, and I don't mind. It really is personal preference. Just to clarify, though, I said smaller, not small. The area I live in has a population of over 1.3 mil. It's not some one stop light town. Here's how I look at it, and again, it's personal preference. Say you take 4 weeks of vacation per year (I'm assuming you don't vacation at home). That leaves 48 work weeks in the area you live. During those weeks, you'll be at the office the majority of the day Monday through Friday. Personally, when I get home, it's family time. Kids' soccer, bike rides, pool, etc. followed by dinner together and getting the kids to bed. That's not likely to change, regardless of where I live. So, 70ish% of the week is effectively covered. The other 30ish%, the weekend, is what is open, and that's if I don't have call responsibilities locking me down. So, that means roughly 25% ([48 weeks * 2 days]/365 days) of my year max is what I'd be paying the premium of living in a highly competitive, high cost of living area. I'd rather just take the money I save by living where I do and take amazing vacations and weekend trips, live in a great house on a golf course, and retire early. But, that's me. Some folks, particularly single folks, wouldn't like that at all. One of my fellows is currently grappling with a job search. What he's looking for is very different from what I was looking for, and that's perfectly OK. I've tried to advise him as such.

This is a great thread. I've already set my heart on a few broad geographic regions and I don't think I'm willing to compromise. :) but I'm willing to go anywhere for the best fellowship training that I can get.
 
Listen to above. He is exactly right. To me, life's too short to spend it in a small southern city.

It may also be too short to be spent taking out people's cataracts, doing their LASIK, or managing their dry eye. But alas, we are all doing it instead of traveling the world as a pro surfer!
 
I have only heard positive things. I am not interested in making a ton of money, but do want to make an average wage and be busy. Glaucoma was a great fit for me, and recent grads in glaucoma from my program have ended up in great situations. Depends on the specialty you choose and where you are willing to live, but great opportunities abound everywhere!
 
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I have been in practice for 2 years now and have really enjoyed practicing ophthalmology. Restoring someone's vision is such as great experience to be part of. Also it provides a great life style so you can have a life outside of work (outpatient setting, Mon thru Friday job). In ophthalmology there is less headaches compare to some to the other specialties (don't have to admit anyone to the hospital, minimal or no inpatient consults, calls are home call and usually not heavy, etc).

I agree with the posts above that finding a job can be more difficulty if you restricted to a certain area esp in the big cities (LA, New York, Chicago, etc). But if you preserver and network well it is possible to find decent jobs in a tough market. Also consider doing your residency or fellowship in a location where you want to practice after you finish as it will be easier to network well. My wife really wanted to end up in california to be close to her family, so I ended up doing a fellowship in california (did my residency in the midwest). I was able to find a job in southern california (joined Kaiser) and really did help that my mentors knew lots of people in the area and help me network to land a job. Now I have job I enjoy and get paid decent money to support my family. I have a four day schedule so have plenty time to hang out with my family and enjoy my hobbies outside of work. Really glad that I chose ophthalmology as my career.
 
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"...consider doing your residency or fellowship in a location where you want to practice after you finish as it will be easier to network well."

This is a key point. I think this helps tremendously. Even if you come from a big name residency, unless you do academics where name means much, you will be at a disadvantage in a competitive area compared to folks who finished local residencies/fellowships. So pick a place you train at wisely.

"I was able to find a job in southern california (joined Kaiser) and really did help that my mentors knew lots of people in the area and help me network to land a job. Now I have job I enjoy and get paid decent money to support my family. I have a four day schedule so have plenty time to hang out with my family and enjoy my hobbies outside of work. Really glad that I chose ophthalmology as my career."

SCPMG has been extremely competitive in the last 15 years. Biggest positive has been pension. I'd advise you though as a new KP doc not to get too comfortable. I do think KP pension won't be there or will get significantly reduced (already has been reduced some) by the time you need it. SCPMG starts comp ophtho at around $200K; sub-specialists get ~$30K more; retina $300K. Not bad for start, but it does not go up much until partnership and even then maxes out quickly. Cataract incentive is nice and WILL go away soon. The more years you put in, the tighter "golden handcuffs" get, harder to leave... just my 0.02.
 
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As far as training where you want to practice, you need to be careful about some residencies and fellowships, as they can have non compete clauses. It's more common for fellowships, but some residencies also require them.
 
As far as training where you want to practice, you need to be careful about some residencies and fellowships, as they can have non compete clauses. It's more common for fellowships, but some residencies also require them.


Not in So Cal.
 
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"...consider doing your residency or fellowship in a location where you want to practice after you finish as it will be easier to network well."

This is a key point. I think this helps tremendously. Even if you come from a big name residency, unless you do academics where name means much, you will be at a disadvantage in a competitive area compared to folks who finished local residencies/fellowships. So pick a place you train at wisely.

"I was able to find a job in southern california (joined Kaiser) and really did help that my mentors knew lots of people in the area and help me network to land a job. Now I have job I enjoy and get paid decent money to support my family. I have a four day schedule so have plenty time to hang out with my family and enjoy my hobbies outside of work. Really glad that I chose ophthalmology as my career."

SCPMG has been extremely competitive in the last 15 years. Biggest positive has been pension. I'd advise you though as a new KP doc not to get too comfortable. I do think KP pension won't be there or will get significantly reduced (already has been reduced some) by the time you need it. SCPMG starts comp ophtho at around $200K; sub-specialists get ~$30K more; retina $300K. Not bad for start, but it does not go up much until partnership and even then maxes out quickly. Cataract incentive is nice and WILL go away soon. The more years you put in, the tighter "golden handcuffs" get, harder to leave... just my 0.02.

DC Kaiser starts Comprehensive = Cornea = Glaucoma at $273k base salary. Unsure about retina.
 
Nor Cal KP comp is $300k, retina $400. It's all based on how desirable the area is.
 
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By the way Mid Atlantic Kaiser is under control of TMPG (Robbie Pearl CEO of both). So salaries are similar.
 
"...consider doing your residency or fellowship in a location where you want to practice after you finish as it will be easier to network well."

This is a key point. I think this helps tremendously. Even if you come from a big name residency, unless you do academics where name means much, you will be at a disadvantage in a competitive area compared to folks who finished local residencies/fellowships. So pick a place you train at wisely.

"I was able to find a job in southern california (joined Kaiser) and really did help that my mentors knew lots of people in the area and help me network to land a job. Now I have job I enjoy and get paid decent money to support my family. I have a four day schedule so have plenty time to hang out with my family and enjoy my hobbies outside of work. Really glad that I chose ophthalmology as my career."

SCPMG has been extremely competitive in the last 15 years. Biggest positive has been pension. I'd advise you though as a new KP doc not to get too comfortable. I do think KP pension won't be there or will get significantly reduced (already has been reduced some) by the time you need it. SCPMG starts comp ophtho at around $200K; sub-specialists get ~$30K more; retina $300K. Not bad for start, but it does not go up much until partnership and even then maxes out quickly. Cataract incentive is nice and WILL go away soon. The more years you put in, the tighter "golden handcuffs" get, harder to leave... just my 0.02.
What is the cataract incentive?
 
Nor Cal KP comp is $300k, retina $400. It's all based on how desirable the area is.

That salary ain't half bad. I wonder what the salary averages after 10 years at Kaiser. Not a bad deal considering you don't have to deal with any of the administrative hassles of private practice. Also not bad considering that one has absolutely zero financial risk. I guess the only downside would be job security.
 
At SCPMG, cataract surgeons are required to do a certain number of cataracts per unit time. If they do more, they get extra $$$. Administration has been trying to eliminate this forever. What I hear is that they finally succeeded.
 
That salary ain't half bad. I wonder what the salary averages after 10 years at Kaiser. Not a bad deal considering you don't have to deal with any of the administrative hassles of private practice. Also not bad considering that one has absolutely zero financial risk. I guess the only downside would be job security.


Comp tops out at $400k after 10 years. Yes, not too bad for no financial/private practice risk. Problem is things constantly change and not for the better for physicians. Another advantage of SCPMG is that you start getting K1 instead of w2 after you become a shareholder.
 
At SCPMG, cataract surgeons are required to do a certain number of cataracts per unit time. If they do more, they get extra $$$. Administration has been trying to eliminate this forever. What I hear is that they finally succeeded.

Sounds like it's turning into the VA.
 
At SCPMG, cataract surgeons are required to do a certain number of cataracts per unit time. If they do more, they get extra $$$. Administration has been trying to eliminate this forever. What I hear is that they finally succeeded.

I don't think that is true unless eyefixer has some inside information about we Kaiser ophthalmologist don't know about.

Overall Kaiser is a decent job that gives you job security/stability and don't have to deal with running a business or practicing medicine by how you get paid. Yes our income potential is not high as the private sector, but as mentioned we carry less risk. Especially given how the healthcare is changed recently with decreasing in reimbursement and obamacare the future is uncertain. While every physician will be impacted by it, you have little more cushion in a big health care system like Kaiser. Kaiser is not perfect job but it is great fit for me.

All the new ophthalmologist we have hired in the last year have been all from private practice. They were getting tired of being used by practice (seeing 40 patients or more in a day) where they get paid lower salary for the promise of "partnership" that never happens.
 
All the new ophthalmologist we have hired in the last year have been all from private practice. They were getting tired of being used by practice (seeing 40 patients or more in a day) where they get paid lower salary for the promise of "partnership" that never happens.

All the reason to start one's own practice :) Gotta have the gonads though first.
 
I don't think that is true unless eyefixer has some inside information about we Kaiser ophthalmologist don't know about.

Overall Kaiser is a decent job that gives you job security/stability and don't have to deal with running a business or practicing medicine by how you get paid. Yes our income potential is not high as the private sector, but as mentioned we carry less risk. Especially given how the healthcare is changed recently with decreasing in reimbursement and obamacare the future is uncertain. While every physician will be impacted by it, you have little more cushion in a big health care system like Kaiser. Kaiser is not perfect job but it is great fit for me.

All the new ophthalmologist we have hired in the last year have been all from private practice. They were getting tired of being used by practice (seeing 40 patients or more in a day) where they get paid lower salary for the promise of "partnership" that never happens.

Let's see, shall we...

As you said, changes in healthcare will impact everyone. Private practitioners feel the impact sooner. It takes a while, but they will get to Kaiser as well, just as severe if not worse. Remember, as a Kaiser doc you have to pay for an ARMY of administrators whose sole purpose in life is to analyze and re-analyze every single part of your day/practice and make changes in order to cut costs. Changes to you daily practice happen all the time, most behind closed doors and as a Kaiser doc you have no control over anything. You know how now they decrease your pay when you don't meet a certain patient numbers target? They never used to do that. There was not even a requirement to supply billing codes by docs in recent past. Now they do make you bill, correct? I can go on and on.

It is possible that your specific department just happen to hire a few former private practitioners. Within the region though, vast majority positions go newly graduated residents and fellows (lots of glaucoma fellows and residents in LA area got KP jobs this year). They are perfect targets for "Kaiserization".

Lastly, you mentioned about seeing 40 patients per day. You have to understand that the patients you are seeing at Kaiser are not the same as others see. Your 24-25 patients per day are all sick (high IOP followed by vision loss, followed by hit in the eye, followed by acute diplopia, etc, etc.) and on and on every 15 minutes. All your glaucoma screenings are seen by optometry. All your DM screenings are done with a camera at PCP offices. On a flipside, my template is 34, most days I end up seeing 38 or so. I love seeing pathology interspersed with DM screenings, glaucoma screenings, mild issues. Your patients have been carefully selected to be as sick as they come. And don't get me started on patient emails. When I see Kasier billboards with "email your doctor anytime from your iphone", my heart skips a beat.

Look, I think it's a decent gig for what it is. Lots of positives, BUT lots of negatives to consider as well.
 
Let's see, shall we...

As you said, changes in healthcare will impact everyone. Private practitioners feel the impact sooner. It takes a while, but they will get to Kaiser as well, just as severe if not worse. Remember, as a Kaiser doc you have to pay for an ARMY of administrators whose sole purpose in life is to analyze and re-analyze every single part of your day/practice and make changes in order to cut costs. Changes to you daily practice happen all the time, most behind closed doors and as a Kaiser doc you have no control over anything. You know how now they decrease your pay when you don't meet a certain patient numbers target? They never used to do that. There was not even a requirement to supply billing codes by docs in recent past. Now they do make you bill, correct? I can go on and on.

It is possible that your specific department just happen to hire a few former private practitioners. Within the region though, vast majority positions go newly graduated residents and fellows (lots of glaucoma fellows and residents in LA area got KP jobs this year). They are perfect targets for "Kaiserization".

Lastly, you mentioned about seeing 40 patients per day. You have to understand that the patients you are seeing at Kaiser are not the same as others see. Your 24-25 patients per day are all sick (high IOP followed by vision loss, followed by hit in the eye, followed by acute diplopia, etc, etc.) and on and on every 15 minutes. All your glaucoma screenings are seen by optometry. All your DM screenings are done with a camera at PCP offices. On a flipside, my template is 34, most days I end up seeing 38 or so. I love seeing pathology interspersed with DM screenings, glaucoma screenings, mild issues. Your patients have been carefully selected to be as sick as they come. And don't get me started on patient emails. When I see Kasier billboards with "email your doctor anytime from your iphone", my heart skips a beat.

Look, I think it's a decent gig for what it is. Lots of positives, BUT lots of negatives to consider as well.

Eyefixer I agree with you there are positives and negatives for working at Kaiser. Also there are positives and negatives for any job position (solo/large group private practices, hosptial based, academics, VA, etc). It all depends on the each individual what they are looking for. Sounds like you are happy with your job position and I am happy with working at Kaiser.

Back to the original poster, as you can see there is no perfect jobs but overall I think we are pretty happy to be in the field of ophthalmology. Even if you restricted to geographic location that is highly competitive it is possible to find decent jobs and enjoy what you do.
 
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It is possible that your specific department just happen to hire a few former private practitioners. Within the region though, vast majority positions go newly graduated residents and fellows (lots of glaucoma fellows and residents in LA area got KP jobs this year). They are perfect targets for "Kaiserization".

There's a good reason for that. "Good" gigs are few and far between in the area. The only ones with decent gigs have a family connection or are long established.

I'm curious how many people leave Kaiser to join/start another practice. I bet it's rare.
 
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