What is the typical career track for an Ophthalmologist?

[Pre-Medguy1995]

Hey, I was hoping some experienced ophthalmologists could answer a couple of questions on what a typical career track looks like.

Do most people start employed by a hospital or private practice? What causes people to lean one way or the other and what's the difference in compensation?

How long does it take to become a partner if you do go into private practice?

If you join a hospital as an employee, is there any scope for advancement to a higher position down the line?

Why are the starting salaries reportedly so low but the median compensation so high? Is there a dramatic jump that happens in your career in terms of compensation? If so, when and why?

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[yerfdog]

Ophthalmology remains largely private practice based...there are plenty employed by hospitals outside of academics, but much less than most specialties. Depends on what's available in your region of choice, what your goals are, do you like teaching, do you want to get your hands messy in managing a practice, etc.

Most private practices set a 1-3 year partnership track. Can't comment on hospital employed situations.

It takes a while to ramp up production early on, unlike a specialty such as anesthesia or EM where the patient populations are "built in."

 

[mjohnsonets]

Ophthalmology recruiter here

In the ophthalmology market you can go the following:
Private practice - partnership track
Private practice - employed track
Hospital employed
Academic

There are a select few practices in the country that I would call a hybrid private practice/academic and many obviously with fellows.

To your compensation question; I am not sure which sub-specialty you mean so I will just state it as a comprehensive ophthalmologist. Much of the base salary for private practices will depend on the geography and typically does not follow the cost of living standards many enjoy with their careers - it can in fact be the opposite in many situations given there are more docs wanting into areas like Denver, Austin, SF, etc.

Numbers reflect starting base salary out of residency, most practice will also offer production bonuses. Keep in mind there are always some outliers as well:

Private practice - $200,000-$300,000 with $225,000 being a fair median
Hospital-based - $325,000-$450,000
Academic I have less handle on.

In most private practice settings you will end up making more than hospital colleagues but it will take a couple of years. There is also less bureaucracy in private practice.

 

[ColorblindBat]

Ophthalmology recruiter here

In the ophthalmology market you can go the following:
Private practice - partnership track
Private practice - employed track
Hospital employed
Academic

There are a select few practices in the country that I would call a hybrid private practice/academic and many obviously with fellows.

To your compensation question; I am not sure which sub-specialty you mean so I will just state it as a comprehensive ophthalmologist. Much of the base salary for private practices will depend on the geography and typically does not follow the cost of living standards many enjoy with their careers - it can in fact be the opposite in many situations given there are more docs wanting into areas like Denver, Austin, SF, etc.

Numbers reflect starting base salary out of residency, most practice will also offer production bonuses. Keep in mind there are always some outliers as well:

Private practice - $200,000-$300,000 with $225,000 being a fair median
Hospital-based - $325,000-$450,000
Academic I have less handle on.

In most private practice settings you will end up making more than hospital colleagues but it will take a couple of years. There is also less bureaucracy in private practice.

How do these hospital-based practices work? In my (very limited) experience, ophtho is very much an outpatient, clinic-based specialty that operates in FSCs. Is this like a clinic that the hospital owns but you staff? Do they provide patients for you? Are you operating in main OR's or does the hospital own FSC's as well?

 

[mjohnsonets]

How do these hospital-based practices work? In my (very limited) experience, ophtho is very much an outpatient, clinic-based specialty that operates in FSCs. Is this like a clinic that the hospital owns but you staff? Do they provide patients for you? Are you operating in main OR's or does the hospital own FSC's as well?

Employed hospital positions can vary almost as greatly as private practices do. I have worked with ones that:
- Have a separate outpatient clinic where patients seen
- Have patients seens in a clinic set up in the main hospital building
- Have separate outpatient surgery centers
- Have hospital OR's that are used

Obviously, in the stand-alone clinic and the outpatient surgery centers more patients and cases are able to be seen and done in a single day.

 

[Pre-Medguy1995]

Employed hospital positions can vary almost as greatly as private practices do. I have worked with ones that:
- Have a separate outpatient clinic where patients seen
- Have patients seens in a clinic set up in the main hospital building
- Have separate outpatient surgery centers
- Have hospital OR's that are used

Obviously, in the stand-alone clinic and the outpatient surgery centers more patients and cases are able to be seen and done in a single day.

Thank you SO much for replying!!! It's very hard to gather this type of information and even more so to get it from a legit source like a recruiter.

The salaries you listed are coming straight out of residency but you also say that private practice has the potential to earn more depending on years spent, etc. Does that same potential apply to hospital-based physicians or is there's more of a fixed salary.

You also provided numbers for a comprehensive optho (which I wanted, so thank you again!) but what about for the surgical/operation heavy subspecialties like vitreoretinal or LASIK?

Thank you again lol. I have literally spent months of life reaching out to people and trying to accrue this information.

 

[mjohnsonets]

Thank you SO much for replying!!! It's very hard to gather this type of information and even more so to get it from a legit source like a recruiter.

The salaries you listed are coming straight out of residency but you also say that private practice has the potential to earn more depending on years spent, etc. Does that same potential apply to hospital-based physicians or is there's more of a fixed salary.

You also provided numbers for a comprehensive optho (which I wanted, so thank you again!) but what about for the surgical/operation heavy subspecialties like vitreoretinal or LASIK?

Thank you again lol. I have literally spent months of life reaching out to people and trying to accrue this information.

Send me a message - happy to talk directly.

The short answer on hospitals, yes you can make more in production. They can be somewhat limited based on clinical and surgical efficiencies though. Example being little tech support, no scribe, or single OR to work out of. However, they can make large incomes too just need to be in a rural area typically.

I would call comprehensive ophthalmology fairly surgically heavy too. Retina reimbursement has shifted as such that while there is plenty of surgery to be done, most retina docs will tell you the clinic is where you make your money. Income in retina is the widest range - again depending on which city you look in it can vary but, as a graduating fellow, you will most typically find base salaries from $300,000-400,000 with a production bonus. There are experienced retina surgeons making $1mil+.

Refractive is a different ball game - if you're interested in refractive surgery you need to plug into the Refractive Surgery Alliance (http://www.refractivealliance.com/). There are some docs in that group that I've talked with that are pushing for refractive to be its own sub-specialty. It is a very different game than the rest of ophthalmology though as being a highly successful refractive surgeon takes a certain personality. Incomes here are harder to judge because many set up their own practices but there are some groups and generally, you can expect a base over $300,000.

 

[idkididk]

Refractive is a different ball game - if you're interested in refractive surgery you need to plug into the Refractive Surgery Alliance (http://www.refractivealliance.com/). There are some docs in that group that I've talked with that are pushing for refractive to be its own sub-specialty. It is a very different game than the rest of ophthalmology though as being a highly successful refractive surgeon takes a certain personality. Incomes here are harder to judge because many set up their own practices but there are some groups and generally, you can expect a base over $300,000.

Could you elaborate on what type of personality that is? The few refractive surgeons I've met would've easily fit into the businessmen/MBA grad/salesmen stereotype, is that what you mean?

 

[mjohnsonets]

Could you elaborate on what type of personality that is? The few refractive surgeons I've met would've easily fit into the businessmen/MBA grad/salesmen stereotype, is that what you mean?

They certainly could fit into that role but generally they are outgoing and very inviting personalities - seem like everyone's friend. My conversations with them generally leave me saying to myself "Man, that is just an awesome human being".

This makes sense though as a purely refractive focused practice that is 100% (or almost 100%) fee for service requires not only great clinical and surgical care but a truly great customer service experience from start to finish with the surgeon being the highlight.