Average ophtho salaries if you're interested...

[Eyefixer]

Visionary, I am very happy for you; sounds like you in a good situation. But please underdstand, YOU ARE IN MIDWEST! I don't think most people would consider that desirable or highly competative.

What Dusn, myself and others are describing is the situation in the costal/highly desirable areas. I am sorry but likely it is not where you are. Yes, I too get frequent calls from recruiters, etc.etc offering $400K to start for comp with 1 year partnership track in the Midwest, Southeast, etc.

I have been working in a one of those "desirable areas" for close 5 years now and I hate to tell you job situation is not getting any better and it will not get better anytime soon. ANYONE with a functioning practice knows very well they hold all the cards, as Dusn very well summarized. Case in point, there was a recent open comp position in Orange County on AAO website. I happen to know the owner. The guy got 60 resumes- residents, fellows, attendings, MD-PhDs, subspecialists, etc. He guy was actually overwhelmed as most these people were overqualified to work in his practice. Do you think this position come with may perks and high starting salary? I think not.

Yes, I know what your are going to say; "don't be geographically limited, etc. etc". Well, sometimes it's possible and sometimes it's not. But people going into ophtho should be aware of this situation and make necessary adjustments to their future plans.

No, I'm in a fair-sized midwestern/southeastern city. About 12 retina specialists in the area. I honestly think that the predatory practices are fairly few and far between nowadays. The folks I know who have left or are thinking about leaving their first jobs are doing so more because they aren't that happy with the area or feel that the volume isn't what they'd like. In one case, the senior doc was going to sell the practice to a local hospital system, and the junior doc didn't want to become a hospital employee. I think the key is to ask a lot of questions. If a practice is trying to hide information from you, that's a bad sign. Also look at recent hires. If a practice has had a lot of turnover, that's a bad sign.

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[Visionary]

Visionary, I am very happy for you; sounds like you in a good situation. But please underdstand, YOU ARE IN MIDWEST! I don't think most people would consider that desirable or highly competative.

What Dusn, myself and others are describing is the situation in the costal/highly desirable areas. I am sorry but likely it is not where you are. Yes, I too get frequent calls from recruiters, etc.etc offering $400K to start for comp with 1 year partnership track in the Midwest, Southeast, etc.

I have been working in a one of those "desirable areas" for close 5 years now and I hate to tell you job situation is not getting any better and it will not get better anytime soon. ANYONE with a functioning practice knows very well they hold all the cards, as Dusn very well summarized. Case in point, there was a recent open comp position in Orange County on AAO website. I happen to know the owner. The guy got 60 resumes- residents, fellows, attendings, MD-PhDs, subspecialists, etc. He guy was actually overwhelmed as most these people were overqualified to work in his practice. Do you think this position come with may perks and high starting salary? I think not.

Yes, I know what your are going to say; "don't be geographically limited, etc. etc". Well, sometimes it's possible and sometimes it's not. But people going into ophtho should be aware of this situation and make necessary adjustments to their future plans.

Hey, I've never misrepresented where I am. It is well-known that you'll struggle with any medical specialty in saturated areas. Nothing can be done about that, unfortunately. If you want/have to live in such an area, I feel for you...I honestly do. I'm just trying to share my experiences, as someone who lives in that vast land mass that is situated between the east/west coast of the US. Pardon, if I take offense to the bolded statement in your reply. Some people seem to think that being anyplace that is not on the east/west coast or within a huge metropolitan area is like being in the movie "Deliverance." I'm sorry, but there are plenty of places in this country that are "desirable" outside of the coasts. If you have family ties or what not that anchor you to an area, that's one thing. To say that everywhere that you aren't is going to be undesirable is ignorant.

 

[Eyefixer]

Hey, I've never misrepresented where I am. It is well-known that you'll struggle with any medical specialty in saturated areas. Nothing can be done about that, unfortunately. If you want/have to live in such an area, I feel for you...I honestly do. I'm just trying to share my experiences, as someone who lives in that vast land mass that is situated between the east/west coast of the US. Pardon, if I take offense to the bolded statement in your reply. Some people seem to think that being anyplace that is not on the east/west coast or within a huge metropolitan area is like being in the movie "Deliverance." I'm sorry, but there are plenty of places in this country that are "desirable" outside of the coasts. If you have family ties or what not that anchor you to an area, that's one thing. To say that everywhere that you aren't is going to be undesirable is ignorant.

Oh boy. Whenever a statement starts with "Some people..." you know it's not going to be good. Well, let me in turn disagree with your statement. Where I want to live, where I would like to raise my kids, etc. is my decision, is it not? Or should I simply come to midwest because its easier to get a job?

 

[Visionary]

Oh boy. Whenever a statement starts with "Some people..." you know it's not going to be good. Well, let me in turn disagree with your statement. Where I want to live, where I would like to raise my kids, etc. is my decision, is it not? Or should I simply come to midwest because its easier to get a job?

Hell, you should do whatever you want. It's your life. However, don't put a blanket statement out there implying where I live is undesirable.

Sent from my ADR6410LVW using SDN Mobile

 

[JBurns]

I think living in a coastal area for 150-200k/year is just plain dumb if you can make 500-700k in the MidWest. The differences in lifestyle are just too great between those two salary ranges. Living in Malibu won't matter if you can barely pay your mortgage! There is a lot of stress associated with struggling financially.

 

[KHE]

I get that I'm an optometrist but as a practice owner, I have some concerns with this posting.

Yes, those numbers are just starting salaries for an associate. You have to remember that as a starting associate, you basically are losing money for the practice initially since your patient load will be very low (if any). But as you build up your practice, you eventually will break even and generate a profit for the practice owner..

If an associate doctor loses money for a practice for than a month or two maximum, then that practice more than likely did not need the associate or the practice very poorly marketed and/or integrated the associate into the practice. And even that initial loss of money should come from delays in insurance payments.

I think it is perfectly reasonable for a practice owner to "profit" from their associate(s) for a few years after they are initially hired on. After all, the practice owners are typically the ones who took the large financial risk to start up the practice and deal with the administrative headaches that come with running a practice. Most newly-graduated residents and fellows have no clue what it takes to run a profitable practice especially in today's healthcare climate. But obviously, to retain quality physician-employees, owners usually have to offer some good financial incentives to stick around (e.g. share of equity or higher base salary/bonus).

This I agree with.

I think young Ophthalmologists (including myself) must remember that the employers are taking all of the financial risk in bringing a new associate on board. At the same time, employers should realize that no quality physician is going to stick around if they are getting a bum deal.

Again, there should be very limited "risk" in bringing on an associate.

 

[MullerCell]

It is very common for an associate to lose money for a practice in their 1st year (much more than 1-2 months). Startup costs can be high, especially if a new office is being opened and/or new equipment is being purchased. Additionally, the associate is possibly being paid a signing bonus/moving allowance, has initial costs of credentialing/licensure, there will be new staff hired, ect. The 1st few months of practice will likely be very slow and much time will be spent meeting with referring doctors. The associate may not break even the 1st year, but is likely performing many duties that the patners are happy to pass off (call, seeing uninsured/Medicaid patients, ect) that may not have a nominal value, but are certainly helpful to the owners.

 

[ophthope]

Some people seem to think that being anyplace that is not on the east/west coast or within a huge metropolitan area is like being in the movie "Deliverance." I'm sorry, but there are plenty of places in this country that are "desirable" outside of the coasts.

Please stop telling this to people. It is in our best interest to keep it a well-guarded secret! The southeast/midwest is my 'desirable' area and I would appreciate having less competition for jobs. California is the only good place to live and everyone should try to live either there or NYC. Please disregard Visionary's comments and continue on. Nothing to see here.

 

[kwel]

The starting salaries I've heard for general, cornea, glaucoma, neuro and uveitis on the east and west coasts are 100-170K. For retina: 160-220K. Often you can't be sure of making partner and the non-complete is a large area. This is actually much worse than most other fields in medicine. The average salaries you hear may apply more to the senior partners and few other fields have the same culture of predatory senior partners that ophtho has. Because market is fairly saturated on the coasts and the high cost of starting up on your own, ophtho senior partners can often get away with offering you a horrible deal. Try not to be geographically limited and be willing to look at rural positions in the middle of the country.

Visionary, are you working in a rural area? Your experience doesn't seem typical from what I've seen and I'd love to hear any advice you have about how to avoid the pitfalls I've mentioned above.

Do the opportunities you get and the chances of landing a good practice deal depend highly on where you went to residency (in other words, better residency = better practice), or is it still a game of knowing the right people?

 

[LightBox]

Do the opportunities you get and the chances of landing a good practice deal depend highly on where you went to residency (in other words, better residency = better practice), or is it still a game of knowing the right people?

No, in private practice, it doesn't depend highly at all.

They care more about: (1) if you have the personality and charm to bring in patients; (2) you possess or can easily learn the "business side" of running an Ophthalmology practice; (3) you are a good surgeon and are not an idiot clinically (so that you don't degrade the reputation of the practice); and most importantly of all (4) whether they actually like you on a personal level. If you are arrogant and/or a pain in the arse to work with, who would want to employ you and consider you for partnership?

Of course, it is considered a bonus if you went to a prestigious residency or fellowship, so that they can advertise that "Dr. X went to Harvard, etc". But to be honest, most patients don't really know the difference between training programs; but they will know if you are an unsympathetic doctor. And it is patient satisfaction that drives the success of a practice.

Many of our "prestigious" training programs are well-known because of their research reputation and less so on their clinical training. There are actually quite a few academic powerhouses that have terrible surgical training. Conversely, there are quite a few "unknown" programs where the residents are cutting up eyeballs left-and-right.

The same does not hold for academic positions where they care much more about your "pedigree" and your research potential than whether you can do a 4 minute cataract.

 

[LightBox]

Please stop telling this to people. It is in our best interest to keep it a well-guarded secret! The southeast/midwest is my 'desirable' area and I would appreciate having less competition for jobs. California is the only good place to live and everyone should try to live either there or NYC. Please disregard Visionary's comments and continue on. Nothing to see here.

I agree

Anywhere outside of the Bay Area/NYC metro area/LA/Orange County is absolutely terrible!! Full of rednecks and people who are married to their 1st degree relatives! It's an absolute terror to work in these areas! Stay away!!

 

[KHE]

It is very common for an associate to lose money for a practice in their 1st year (much more than 1-2 months). Startup costs can be high, especially if a new office is being opened and/or new equipment is being purchased. Additionally, the associate is possibly being paid a signing bonus/moving allowance, has initial costs of credentialing/licensure, there will be new staff hired, ect. The 1st few months of practice will likely be very slow and much time will be spent meeting with referring doctors. The associate may not break even the 1st year, but is likely performing many duties that the patners are happy to pass off (call, seeing uninsured/Medicaid patients, ect) that may not have a nominal value, but are certainly helpful to the owners.

A satelite office being opened is a completely different animal. A new office opening would lose money for the reasons you cited whether it was a new doctor being hired or one of the experienced parters taking over those hours.

I am referring to the scenario where a new doctor is added to an already existing practice. If that new hire can't pay for themselves quickly, then I would suggest that that office did not need another doctor, they simply needed more efficient delegation and/or use of the time of the doctors already there. In that scenario, staff wouldn't need to be hired either if a new hire was that slow. What do they need staff for? If their workload is small enough that they are losing money, you don't need to hire staff. The workload should be easily absorbed by existing staff.

 

[MullerCell]

A new physician will require at least 4 rooms (2 workup, 2 to see patients) as a bare minimum once they are moderately busy. This may take a few months, but there is really no point in not being able to allow for this from the beginning. Only a few staff may be needed at first, but it is better to be overstaffed when you aren't particularly busy so you have time to train the staff to function exactly the way you want before your schedule is too busy to allow this. In both instances where I have joined existing practices, a new buildout was required to add 4 lanes in 1 and a completely new office was acquired in another. Equipment other than outfitting exam rooms may not be required, but in both instances, I have needed a new laser, cryo, B scan that has to be available to travel with me. I can see how an optometric practice is likely quite different. There are major differences between adding an optometric associate who can essentially work out of 1 room and keep the overhead low by doing essentially everything alone vs. a subspecialist who is building a high volume practice that will need to be able to see 40-50+ patients/day within a 12-18 months. Paying for yourself immediately isn't as important as being able to ramp up once the practice is growing.

 

[Birdstrike]

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[Tomodachi123]

Bump.
2014 survey -
http://www.medscape.com/features/slideshow/compensation/2014/ophthalmology#1

http://www.medscape.com/viewarticle/831722

 

[DocDO2B]

Bump.
2014 survey -
http://www.medscape.com/features/slideshow/compensation/2014/ophthalmology#1

http://www.medscape.com/viewarticle/831722

If you look closely at the last page of the medscape survey it shows that only approx 480 ophthalmologists made up their information. With somewhere near 20,000 practicing ophthalmologists, this survey only makes up around 2% and really isn't accurate. The MDMA reports are made up of much more data points and probably much more accurate.

 

[DocDO2B]

If you look closely at the last page of the medscape survey it shows that only approx 480 ophthalmologists made up their information. With somewhere near 20,000 practicing ophthalmologists, this survey only makes up around 2% and really isn't accurate. The MDMA reports are made up of much more data points and probably much more accurate.

sorry meant MGMA not MDMA

 

[LightBox]

I chuckle every time I read these salary reports. I guarantee you that most ophthalmologist-owners are not earning only $291,000. At least, not from my experience. I bet you that most physician-owners do not have the time (or interest) to fill out these salary surveys, and they are filled out by young associates instead.

If some third-party asked me how much I was making, I would report a much-lower salary. I don't want the government thinking that we earn too much money!! The same thing goes for cataract surgery -- always emphasize the incredible amount of work it takes to perform one. Never minimize its worth!

 

[MullerCell]

Last I checked, the govt. gets our tax return and is very much aware of how much we each make.