Medical Retina Salary

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OphthoMD

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I'm an ophthalmology resident in an East Coast program and just wanted to reach out to any PGY4 or recent residency graduates for their perspective.

I am debating heavily between medical vs surgical retina right now. I understand the differences in training and scope of practice, but cannot seem to find much reliable salary information on Medical Retina. Understanding that the salaries will dramatically differ from region to region and urban vs. rural, could someone provide some context on Medical Retina salaries in comparison to Surgical Retina?

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You will always do better being surgically trained.


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Just went through this . I have to say that most private practices, you will probably do equally well or better than your surgical counterparts if you can manage a busy clinic unless the surgical guys are doing like 10-15 peels a week and working ridiculous hours
The job market is a bit more limited because a lot of retina practices still see medical retina as a privelege earned by the senior docs after putting in their long hours on call, but honestly speaking the demand is so high that there's plenty of pathology to go around and it will only increase in the coming years.
A lot of your income depends on how much retina vs comp you want to do
 
Just went through this . I have to say that most private practices, you will probably do equally well or better than your surgical counterparts if you can manage a busy clinic unless the surgical guys are doing like 10-15 peels a week and working ridiculous hours
The job market is a bit more limited because a lot of retina practices still see medical retina as a privelege earned by the senior docs after putting in their long hours on call, but honestly speaking the demand is so high that there's plenty of pathology to go around and it will only increase in the coming years.
A lot of your income depends on how much retina vs comp you want to do


Can you elaborate on the "how much retina vs comp" you wanna do? Like if you're willing to do less retina you will make more or ?



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Actually it's the opposite. Retina clinic visits generate a lot more revenue than comprehensive ones. Most practices I talked to wanted to keep the incoming medical retina person in clinic because they were much more profitable for the practice there. Unless you are doing 30+ routine cataracts a week or having a booming premium IOL practice, u will generate a lot more as a medical retina specialist.
The catch 22 of being a medical retina specialist however, is that a lot of your revenue depends on procedure fees for injections and imaging fees. If these get a dramatic cut in the future, you are kind of handicapped in terms of an income source (of course, this could be offset by increasing your volume but who really wants to see 100 pts a day?). This is why the medical retina people I know choose to continue comprehensive and cataract surgery.
If you decide you want to do both, then joining a large multispeciality group as a 'comp plus' is your best bet...u are marketed as comprehensive with a focus in medical retina to the community and basically handle all the practice's internal med ret, that way you are not cutting off your referral sources. You have to make sure to always send the cataracts back to the referring doctor if they sent the patient to you for a med ret issue. Once you get a reputation for poaching, it's hard to shake.
If you chose not to do comp, then definitely a good idea to join a retina only practice
 
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What about if you have uveitis and retina ? I suspect I will be limited to academic Centers if I want to practice uveitis


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What about if you have uveitis and retina ? I suspect I will be limited to academic Centers if I want to practice uveitis


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actually, a lot of large reputable private practices want in-house uveitis so they can be truly multispecialty. Also many retina practices would be glad to have an in-house uveitis person Uveitis jobs aren't advertised heavily except for the academic ones so the process would be more that you figure out where you want to be location wise and have you or your mentor cold call places to see what their needs are.
The thing to realize about uveitis visits is that they are very time consuming, do not generate a lot of procedures as a whole and many people find the patients draining. This is the reason why many physicians will be more than happy to refer their uveitis pts to you. If you are one of the people that can handle the patient population it can be incredibly rewarding and interesting as a profession.
Uveitis reimbursements as you probably know, are traditionally lower. Many people also practice comprehensive ophthalmology and do routine cataracts to supplement their income. Adding medical retina to your uveitis training will allow you to very feasibly split your time between your clinics how you choose and adjust according to what you would like to generate and what type of practice you want to build
 
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Would anyone mind sharing their personal experiences or ideas of contracts they have heard in different regions of the country? Online surveys are incredibly unreliable in my experience, so any examples from people going through this would be very helpful!
 
actually, a lot of large reputable private practices want in-house uveitis so they can be truly multispecialty. Also many retina practices would be glad to have an in-house uveitis person Uveitis jobs aren't advertised heavily except for the academic ones so the process would be more that you figure out where you want to be location wise and have you or your mentor cold call places to see what their needs are.
The thing to realize about uveitis visits is that they are very time consuming, do not generate a lot of procedures as a whole and many people find the patients draining. This is the reason why many physicians will be more than happy to refer their uveitis pts to you. If you are one of the people that can handle the patient population it can be incredibly rewarding and interesting as a profession.
Uveitis reimbursements as you probably know, are traditionally lower. Many people also practice comprehensive ophthalmology and do routine cataracts to supplement their income. Adding medical retina to your uveitis training will allow you to very feasibly split your time between your clinics how you choose and adjust according to what you would like to generate and what type of practice you want to build

I understand all of this, but if the practice is so desperate to have multispecialty - why not carry the uveitis specialist financially to some degree... instead of pushing him into a corner pressuring high billing and reimbursements ...from what I have heard, once you force the uveitis specialist to supplement medical retina and comprehensive, only 10% of their time becomes uveitis. Just seems counterproductive to the original goal.

Thoughts ?


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Most of us can take care of 80-90% of uveitis relatively easily and it is the rare/complex stuff that is much more time consuming and challenging that presents an issue. From a financial standpoint, I don't think that many multi-specialty groups truly want to care for these patients. They usually go to a university. I think the uveitis/retina person is kind of like the neuro/plastics person, they realize that per unit time the generate several x more revenue doing either retina or plastics and thus gravitate in that direction.

In regard to the original post, I would really recommend anyone with interest in retina do surgical. As a medical retina specialist, you will be somewhat confined to jobs at a multi-speciality group that wants to keep injections in house. This will typically prevent you from being sent many/any outside referrals and you are completely dependent on your practice to feed you. If you do cataracts as well, some of the general ophthalmologists in the practice may have an issue. Practices may overestimate how busy they will be able to get you. It typically takes quite a few referring providers to support a single medical retina specialist. What happens when the younger associates/partners that did injections in residency want to treat their own wet AMD, DME, BRVOs? You won't have any outside optometrists referring to you since your practice has their own optical and likely competing optometrists. Outside optometrists will refer to the surgical retina person that is not a threat, takes care of everything, and always sends the patient back to them. I think you may potentially limit yourself quite a bit and I know people who have had this scenario unfold. If you want to do academics, then I think medical retina is potentially a good option.
 
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