Leslie Kane, MA
Editorial Director
Medscape Business of Medicine
Wednesday, May 31, 2023
Leslie Kane, MA
Editorial Director
Medscape Business of Medicine
• Survey fielded to 455,000 U.S. physicians
• Total respondents*: 15,794 U.S. physicians across 22 specialty areas
• Fieldwork conducted by Medscape from 2/2/11 to 3/30/11
• Data collected via third-party online survey collection site
*Respondents were entered into a sweepstakes to win a $50 American Express gift card - issued to 100 physicians. Demographic/attitudinal weighting not applied to tabulation
Despite declining reimbursements, ophthalmology is among the better-paid specialties. Medscape's survey indicates that the median 2010 compensation for ophthalmologists, $248,500, is higher than median earnings for 10 other specialties. What's more, according to the US Bureau of Labor Statistics, as baby boomers age and require treatment for cataracts, glaucoma, and other eye conditions, employment opportunities in ophthalmology are expected to grow 11%-14% during the next few years. As with most medical careers, pay for ophthalmologists increases with experience. Specialization counts, too. Ophthalmologists who specialize in retinal diseases, for example, typically earn more than other ophthalmologists.
For employed ophthalmologists, compensation covers salary, bonus, and profit-sharing contributions. For partners, compensation includes earnings after tax-deductible business expenses but before income tax. Compensation excludes non-patient-related activities (eg, expert witness, speaking engagements, and product sales).
Ophthalmologists who realized pay increases from 2009 to 2010 far outnumbered those who earned less. About 44% of ophthalmologists surveyed saw little or no change in their earnings from the prior year. However, close to one third of respondents noted that their earnings increased. About half of those who saw an increase reported compensation boosts of 10% or less; the others saw higher increases. Of the 21% of ophthalmologists who reported decreased earnings, almost one half saw their income drop by more than 10%.
Although increasing number of women are entering the medical profession, men continue to earn more, generally because many women will look for fewer work hours in order to make time for family commitments. The income for male ophthalmologists was a median of $285,000, compared to the median compensation of $200,000 reported by women. Among respondents as a whole, median earnings for male doctors ($225,000) exceeded median earnings for female doctors ($160,000).
Physicians overall fared best in small towns and rural areas with populations less than 25,000, where salaries are higher in an effort to attract qualified physicians. For ophthalmologists, those in small cities reported the highest median earnings, $330,000, followed by ophthalmologists in suburban areas. Ophthalmologists in major metropolitan areas, like physicians overall, reported the lowest median earnings.
Ophthalmologists in single-specialty group practices and those who are partners in a private practice reported the highest earnings, with medians in excess of $300,000. Solo practitioners fared less well, as did employees. Among employed ophthalmologists, healthcare organizations and hospitals were the most profitable venues; ophthalmologists who worked in these settings earned $30,000 more, on average, than private practice employees and employees of academic, research, and government establishments.
Employed ophthalmologists, whose pay is generally lower than that of ophthalmologists in private practice, were more likely to say that they were dissatisfied financially. Overall, almost 55% of ophthalmologists believe that they are fairly compensated, a number that puts them a bit above the midpoint among the specialties surveyed.
More than 27% of ophthalmologists indicate that they have invested in surgery or clinical procedure centers, a percentage exceeded only by orthopedic surgeons, plastic surgeons, general surgeons, and gastroenterologists. Another 9% of ophthalmologists reported that they were considering such an investment.
Because ophthalmologists do many surgical procedures, why haven't more opened their own ambulatory centers? According to ophthalmologist David Brown, MD, it's because "the rules regarding insurance reimbursement and Medicare are always changing. Unless a doctor is high-volume, many are unwilling to take the risk." C. Robert Bernardino, MD, an ophthalmologist in California, also isn't surprised by the numbers. He notes, "Practices run with significant overhead and in this economic environment, investing a surgery center may seem risky. However, over time I think this is a risk that more ophthalmologists will be willing to take."
Among ophthalmologists who are in private practice, 75% said that they did not reduce office operating costs, either because they felt that cuts were unnecessary or because cost-reduction efforts -- always a difficult process -- were unsuccessful. Most of the reported expense cutbacks were modest, but a few private-practice ophthalmologists managed to trim office expenses by 10% or more.
Although ophthalmologists are most likely to see patients from 30 to 40 hours weekly, almost 14% see patients for fewer than 30 hours each week. Compared with HIV/infectious disease doctors, of whom 15% report seeing patients for more than 60 hours per week, only 3% of ophthalmologists devote that much time to direct patient care.
Employed ophthalmologists were slightly more likely than those in private practice to see patients for fewer than 30 hours per week, and private practitioners were more likely to spend 46 hours or more each week seeing patients. About 44% of employees and an equal percentage of partners see patients for 30-40 hours per week. Correspondingly, 21% of employees and 22% of private practitioners are with patients 41-45 hours per week.
Close to 25% of ophthalmologists sees 100-124 patients per week, and 39% see more patients than that. Moreover, almost 14% of ophthalmologists report seeing from 175 to more than 200 patients. In contrast, only 2% of anesthesiologists, 3% of gastroenterologists, and 4% of urologists report seeing that many patients in a 1-week period.
In line with the relatively high patient volumes in ophthalmology, the specialty is not characterized by long patient visits. Almost 58% of ophthalmologists report that they spend fewer than 13 minutes with each patient. Just over 35% report average 13-20 minutes per patient visit, and only 7% report visits of 21 minutes or more.
Even if they don't spend as much time with patients than some other specialists, few ophthalmologists are getting out of the office early. Some 55% of employed ophthalmologists and 59% of private practitioners report that they devote 5-14 hours per week to activities other than patient care, including paperwork, participation in professional organizations, clinical reading, supervisory work, and administrative/managerial work. Employed ophthalmologists were slightly more likely than private practitioners to work on non-patient-care tasks for 15 hours or more weekly.
"The rewarding personal aspects of ophthalmology in terms of grateful patients, reasonable work hours, etc, seems to be keeping ophthalmologists happy despite all the governmental and insurance issues that are affecting physicians," says David Brown, MD. Two out of 3 ophthalmologists would once again opt for a medical career. About 19% are on the fence, with only 15% indicating that they'd take another career route if given the chance. Almost 80% of ophthalmologists said they would choose the same specialty. A mere 8% would definitely choose another specialty, and the remainder were undecided.
Ophthalmologists, like most other physicians, are less certain as to whether they would again elect to practice in the same setting. Here, 54% of respondents would choose the same setting; 27% were uncertain, and 19% would look for a different locale.
Among respondents in private practice, 25% are soloists, but the largest contingent (37%) work in practices of 3 to 9 physicians. MDs outnumbered DOs 96% to 4%. New physicians outnumbered long-time practitioners; 25% have been practicing between 1 and 4 years, and slightly less than 8% have been practicing 30 years or more.
The survey's collection timeline spanned from February 2, 2011, through February 17, 2011. Demographic/attitudinal weighting was not applied to tabulation as the survey was sent to physicians with a similar demographic profile. In some cases, small sample size may skew data results. However, the overall number of responses by specialty mirror AMA breakdown. Note that compensation data is represented by the median reported figures.
