Recently matched to Ophtho

[jacksroy]

Dear Ophtho forum,

Thank you for your time. I have recently matched ophtho. In making the decision to do ophtho, I was trying to learn about the field, the exams, the surgeries, and the different subspecialties of ophtho- to help me decide.

I never actually got any info on the income to expect when you are done w/ residency, or the hours worked which go along with these incomes.

I just have a mind that is curious about this & I like to study economics.

Could anyone offer experience w/ this. I reviewed some adds for general ophtho jobs, finding often beginning salaries of 150-200K. I know it varies, but if some people could offer their knowledge or experience, much appreciated. I have googled and researched on line, but I am lacking in any first hand knowledge. Thank you!

-does the income go up after 3 yrs? If so, is it by 10K, or is it by 50K? How about 5 & 10 yrs? I have no idea.

-Also, is this 150-200K the typical starting income, or is it more based on bonuses?

-Or are there other major expenses (insurance, fees) which would considerably lower this 150-200K value?

-are these incomes for ophthalmologist who work 65 hr work week, or is it typically a 40 hour work week (excluding call)?

-if one specializes in cornea, plastics, lasix, or retina, does the income go up? Or is it just the same, about 200K, and you do half plastics and half cataracts (for ex)?

-It seems I have heard that retina pays quite well, perhaps starting at 300K. At this point, it's not my main area of interest. I may be more interested in general, plastics, cornea/refraction. Any info on the incomes of these fields?

Again, I am just trying to become educated on all aspects of the field. Thank you for your time.

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[orbitsurgMD]

Dear Ophtho forum,

Thank you for your time. I have recently matched ophtho. In making the decision to do ophtho, I was trying to learn about the field, the exams, the surgeries, and the different subspecialties of ophtho- to help me decide.

I never actually got any info on the income to expect when you are done w/ residency, or the hours worked which go along with these incomes.

I just have a mind that is curious about this & I like to study economics.

Could anyone offer experience w/ this. I reviewed some adds for general ophtho jobs, finding often beginning salaries of 150-200K. I know it varies, but if some people could offer their knowledge or experience, much appreciated. I have googled and researched on line, but I am lacking in any first hand knowledge. Thank you!

-does the income go up after 3 yrs? If so, is it by 10K, or is it by 50K? How about 5 & 10 yrs? I have no idea.

-Also, is this 150-200K the typical starting income, or is it more based on bonuses?

-Or are there other major expenses (insurance, fees) which would considerably lower this 150-200K value?

-are these incomes for ophthalmologist who work 65 hr work week, or is it typically a 40 hour work week (excluding call)?

-if one specializes in cornea, plastics, lasix, or retina, does the income go up? Or is it just the same, about 200K, and you do half plastics and half cataracts (for ex)?

-It seems I have heard that retina pays quite well, perhaps starting at 300K. At this point, it's not my main area of interest. I may be more interested in general, plastics, cornea/refraction. Any info on the incomes of these fields?

Again, I am just trying to become educated on all aspects of the field. Thank you for your time.

Income in four or five years' time is hard to predict. I don't think anyone here can accurately say what you should expect.

There are some things you should consider:

Most general ophthalmology practice is skewed toward middle-aged patients and the elderly. Exceptions to this are pediatrics, of course, and refractive-only practices.

There is considerable pressure on the government to find a way to accommodate the available tax revenues for Medicare-eligible patients to the number of eligible beneficiaries. For more than ten years, the trend has been to reduce payments per CPT code and to find ways to bundle related groups of procedures so that only one of the procedures is eligible to be paid for for a given surgical treatment. In the future, this pressure will become ever greater as the post WWII baby boom generation becomes eligible for benefits and the relative number of contributing workers per retiree declines. Look to see wholesale cutting of Medicare rates, possibly enough to make Medicare an unsustainable option for many practices under the commonly accepted "Medicare-allowable" terms. There is no clear solution, but among the proposals is to make Medicare a defined contribution scheme rather than a defined benefit scheme, at least for some codes. That may change the way practices do business and thus indirectly what doctors can expect to earn.

Right now, starting salaries are pretty much related to local supply of doctors, and only secondarily to local economic conditions. High-cost but desirable areas often pay worse than lower-cost but less desirable areas.

Refractive practice is very dependent on local economic conditions and prevailing sense of optimism about the economy. LASIK consumption fell significantly after the dot-com bubble burst. Recessions hit luxury consumption hard, and for most, LASIK is a luxury.

Pediatric ophthalmology is heavily subscribed by various state-funded assistance programs for children through Medicaid. That is not generally a very good thing in areas where the rate of enrollment is higher than average or in states where the Medicaid agency is underfunded or neglectfully managed.

Income can vary significantly by all the usual factors: ease of recruitment, costs of practice locally, general fairness of the contract (i.e. not excessively padding overhead), ease of practice building and the referral climate in the community. Your income should rise as you build your practice, but so many factors come into play that you cannot make meaningful estimates as to how much that will be.

Retina typically does pay better than general ophthalmology, but starting salaries at $300K are not common. That is usually a sign that the area or practice has difficulty attracting or retaining people. You should always want to know why that might be the case.

 

[jacksroy]

Thank you, Orbitsurg MD, for the insightful post. I had not been well educated on these issues, particularly the medicare challenges ahead. Thanks again for taking the time to share some of your experiences learned along the way and things to be aware of. Very interesting and helpful.

Thanks.