Retina Salary Surveys; Billing to Bonus Ratio

[umsami]

I have something from 2014, but I'm wondering if anybody has anything more recent for vitreoretinal salaries--ideally from ASRS or AAO.

I know that many practice owners easily clear $1 million, and that starting salaries are usually in the $350-$400k range--but am looking for something verified/more official.

Also, if anybody knows anything about a typical billing to bonus ratio, that would be great.

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[PLA2]

Post this question in the general forum. I'd also like to know this information. We also need data on what private equity is paying people

 

[mjohnsonets]

I'd say your estimate of $350K-400K is a fair average for private practices. I do see some dipping to $300K depending on the area and other things like a defined or low-cost buy-in. Salaries can go higher than $400K if you go out to a rural location or sometimes in private equity-backed practices.

As for bonus %, I see anywhere from 30-40% typically but have seen as high as 45% for an associate. Typically the lower % is in multi-spec practices and the higher in retina-only groups. While the numbers are obvious some of what you need to assess is surgery center ownership when comparing. Retina docs can buy into surgery centers they operate at but I can't remember a retina-only group that has their own. Many multi-spec practices have their own surgery centers. Some practices will allow you to buy into the real estate as well - this comes with unique tax advantages and income opportunities.

Retina partners in multi-spec or retina-only groups regularly reach 7 figures.

 

[LightBox]

PE is paying around 10-12x EBIDTA on the upper end. It's getting lower now as borrowing costs are increasing.

 

[PLA2]

PE is paying around 10-12x EBIDTA on the upper end. It's getting lower now as borrowing costs are increasing.

What do these numbers end up looking like for the first couple years of practice?

 

[mjohnsonets]

PE is paying around 10-12x EBIDTA on the upper end. It's getting lower now as borrowing costs are increasing.

I have heard 10x for a platform practice. Have you seen these multiples for bolt-on practices before?

I've heard what I thought were crazy numbers for some bolt ons but could never confirm what I heard from more than one source.

 

[RetinaDude]

If you are thinking long term, PE is not where you will generate the huge income eventually. It’s with private practice with no PE owners involved. If you are thinking short term, a PE owned practice may give you the best deal…….a physician owned group will likely start you at $250-$400k, whereas a PE owned group may start you higher. But, it’s highly unlikely any new retina docs, employed by PE, will ever reach those seven figure incomes that are common among private practice retina partners. On the other hand, the senior partners, of the recently purchased PE groups are probably making out like bandits. The new, associate docs….not so much

 

[PLA2]

@RetinaDude Should I go into retina if everything is going to be owned by private equity by the time I get out of fellowship in 2026

 

[dantt]

If you are thinking long term, PE is not where you will generate the huge income eventually. It’s with private practice with no PE owners involved. If you are thinking short term, a PE owned practice may give you the best deal…….a physician owned group will likely start you at $250-$400k, whereas a PE owned group may start you higher. But, it’s highly unlikely any new retina docs, employed by PE, will ever reach those seven figure incomes that are common among private practice retina partners. On the other hand, the senior partners, of the recently purchased PE groups are probably making out like bandits. The new, associate docs….not so much

On the other hand, the physician owned group may sell to private equity anyway before you make partner, have an absurd decades long buy in, or churn you like they churned the last 10 associates.

 

[RetinaDude]

@RetinaDude Should I go into retina if everything is going to be owned by private equity by the time I get out of fellowship in 2026

There’s still A LOT of us private docs who have zero desire to ever be owned by PE. And I don’t see that changing anytime soon. So, absolutely 100% do retina if that’s what you desire.