RETINA going down???

[billybud]

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Hello all,
uneducated MS3 wondering if avastin/anti-angiogenesis injections will ultimately reduce the bulk of retinal surgeries... I am concerned as ophtho is on my short list and am considering retina.

thanks for any info,
Billy

 

[JMK2005]

I think you can always find some negatives about every speciality. It's hard to really predict how any new treatment would affect the whole field. The effect is probably small enough that it should not be a major factor in deciding to pursue it.

Ophthalmology is great. If you think you'll really enjoy, nothing should stop you.

Personally, any new treatments that allows us to treat patients better and less invasively would make me want to do it more.

 

[orbitsurgMD]

Hello all,
uneducated MS3 wondering if avastin/anti-angiogenesis injections will ultimately reduce the bulk of retinal surgeries... I am concerned as ophtho is on my short list and am considering retina.

thanks for any info,
Billy

Don't make a decision like that based on some "breakthrough" medical treatment. By the time you are ready to practice, chances are many more things will have changed. You may find you like something besides retina even better.

Anti-angiogenic chemotherapy treatment has certainly changed retina--not much use for chromophore-targeting laser treatments now--but there is still plenty of business for retina-trained doctors, more than ever, if the doctors in my community are typical. Diabetes will still need evaluation and treatment, so will rhegmatogenous detachments, macular holes, epiretinal membranes and probably other things as well. Sticking needles into eyes for intravitreal injections has to be on a short list of procedures that need a less hazardous replacement, and someone will probably find one. Maybe you.

 

[qwopty99]

We aren't at a level of science where medicine is a cure-all.

The retina will continue to be diseased for the forseeable future.

 

[7ontheline]

I would be more concerned with how retinal injections affect reimbursement for retina/ophthalmology as a whole. There are so many now that they are taking up a bigger and bigger piece of a finite pie. Surgical procedures aren't going anywhere.

 

[Toadkiller Dog]

Retina reimbursement is going down for 2 reasons:

1. VEGF inhibitor injections are replacing much of the laser therapy that was done previously; lasers are the single most lucrative thing that retina specialists do. Injections do not pay nearly as well.
2. Reimbursement for vitreo-retinal surgery has been going down a lot in the past few years. Currently, you will make more per hour doing cataract surgery (which isn't that great) than you will doing VR surgery, by quite a ways. It's gotten to the point where many retina specialists have stopped operating and are doing medical only. Many others are considering it.

With that said, reimbursement in retina is still (for now) pretty good compared to most medical and surgical fields.

It's really a shame because we need good retina surgeons--the surgeries are very difficult and not just anybody can do them. I have seen some really sad botched ones, and it's scary. We can talk about altruism all day, but the fact is that when the reimbursement goes up or down in any medical field, it consequently becomes more or less competitive, and attracts or repels the good candidates.