- Joined
- May 10, 2014
- Messages
- 3
- Reaction score
- 0
Last edited:
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.
Good for you. One hour from major city is a s***t hole in my book. Life's too short. Sorry.
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!
This is prime entertainment
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!
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.
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!!!
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.
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 agree but what planet are you living on where high six figures is chump change?
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.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.
Listen to above. He is exactly right. To me, life's too short to spend it in a small southern city.
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.
Because the competition is already so great, they figure no one in their right mind would actual stay there to practice.Not in So Cal.
"...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?"...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.
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 $$$. Administration has been trying to eliminate this forever. What I hear is that they finally succeeded.
At SCPMG, cataract surgeons are required to do a certain number of cataracts per unit time. If they do more, they get extra $$$. Administration has been trying to eliminate this forever. What I hear is that they finally succeeded.
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.
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 reason to start one's own practice Gotta have the gonads though first.
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.
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".