Retina Workweek

[donvicious]

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Could someone explain why retina docs work so much more than other ophthalmologists? Is it just that there is more call? Is it possible to have a 40 hour workweek?

 

[rubensan]

macula on retinal detachments are not something that can wait until the next morning. if one of your patients has one at 200AM on saturday morning, guess what? you are repairing it that morning. if someone comes into your clinic at 530 PM with neovascularization of the angle, guess what? you are performing PRP that day. retina is a fascinating field, V-R surgeons make more than other ophthalmologists and and they earn every penny of it!

Could someone explain why retina docs work so much more than other ophthalmologists? Is it just that there is more call? Is it possible to have a 40 hour workweek?

 

[Olddog1]

Could someone explain why retina docs work so much more than other ophthalmologists? Is it just that there is more call? Is it possible to have a 40 hour workweek?

Don't forget all the referrals from anterior segment surgeons (typically at 5 pm on Friday) for their POD #3 endophthalmitis.

 

[orbitsurgMD]

Don't forget all the referrals from anterior segment surgeons (typically at 5 pm on Friday) for their POD #3 endophthalmitis.

An experienced retina surgeon under whom I trained said that the ratio of office appointments to operating room cases in a retina subspecialty practice was in the neighborhood of one hundred to one. That seemed a little high to me, but with postop checks, visits for retinal angiography, visits for laser photocoagulation and other in-office procedures, the number might be correct. It seemed to me that most busy retina surgeons operate in the evenings on more than just the urgent cases, as daytime practice activity had to be devoted to office appointments. Even when doing day surgery, many were always pressed to return to their offices. Surgical retina is not usually a 40-hour workweek lifestyle. It is closer to 60 hours, and call frequently requires surgery. Practice development requires availability to general ophthalmologists even when the retina surgeon is not properly on call, as the domain of vitreoretinal surgery remains exclusive to retina subspecialists in most places.

Medical retina could be a more predictable practice and closer to the regular 40-hour workweek you mention.

 

[Retinamark]

macula on retinal detachments are not something that can wait until the next morning. if one of your patients has one at 200AM on saturday morning, guess what? you are repairing it that morning. if someone comes into your clinic at 530 PM with neovascularization of the angle, guess what? you are performing PRP that day. retina is a fascinating field, V-R surgeons make more than other ophthalmologists and and they earn every penny of it!

This is not the case everywhere. I know at UCLA they operate a lot at night, but at many other programs around the country, a macula on retinal detachment would never be done after midnight.
There are many places where even if it came in at 7pm, it would be kept until the next morning.
It depends somewhat on many factors such as
- location of the detachment (inferior RD or nasal RD not as urgent)
- type of break, speed of progression
- OR availability (if the surgeon has no OR availability the next day then it might have to be done at night)
- nursing staff availability (better to do a Vx next day with eye nurses, than at midnight with the orthopedic nurses)

I'd be very interested to hear what people have seen around the country.

 

[JR]

At Wilmer:

Mac-on usually goes within 24 hrs; mac-off within 1 week.

Nothing at night, not even globes 🙂

 

[Andrew_Doan]

- OR availability (if the surgeon has no OR availability the next day then it might have to be done at night)

This is the main factor why surgeons may take cases in the middle of the night.

Retina is also busy by design. These surgeons need to see high volumes of patients to generate their surgical loads. Being busy isn't a bad thing because more surgery = higher compensation.

I know cataract surgeons who are as busy as retina surgeons. These cataract surgeons have an army of people setup so they can do 30-40 cataract surgeries weekly.

 

[ckyuen]

Called my boss mac off RD, says okay I'll take care of it tomorrow night. Most vits go at night b/c they are not as elective. and standard of care in my community is to do RD mac off even with in a day or 2. so therefore most go at night.