Eye to the Future: Predicting 2017's Ophthalmology Compensation Trends

John Watson

December 23, 2016

In This Article

Demographics Behind the Salary Boost

With a new political administration set to overhaul, if not completely repeal, the Affordable Care Act (ACA), 2017 is likely to be an anxious, uncertain year for the US healthcare system. However, in ophthalmology at least, there is one clear trend that practitioners can depend on: A continued surge of patients will counteract reduced reimbursement, helping increase ophthalmologists' salaries. But those financial gains are likely to come at the personal cost of ever-rising dissatisfaction, according to an analysis of national polling of ophthalmologists.

Ophthalmologists are firmly in the middle tier when it comes to compensation, with an average self-reported annual salary of $309,000 that ranks 12th among the 26 specialties listed in the 2016 Medscape Ophthalmology Compensation Report. This represents a 5% increase over the average $292,000 salary reported in last year's survey.

The field is undoubtedly benefiting from an outpouring of older adults seeking treatment for eye conditions, a phenomenon recently dubbed "the senior tsunami."[1] Every day in the United States, 10,000 people turn 65, an age associated with 10 times the rate of eye care as those younger than 65.[1] Chief among age-related conditions are cataracts, followed in some order by other prominent disorders, such as glaucoma, ocular surface diseases, and diabetic retinopathy.[1] These patients also may be more motivated, and financially able, to seek treatments for these conditions regardless of their insurance.

"People are doing more activities that are not insurance-paid, mainly premium lenses, which a lot of the cataract surgeries are done with now," Christopher J. Rapuano, MD, chief of cornea services at the Wills Eye Hospital in Philadelphia, Pennsylvania. "Refractive surgery is making a little bit of a comeback over the past couple years as the economy improves. Then, practitioners, I think, are finding other things in their offices that can be paid for out-of-pocket, such as treatments for dry eye or blepharitis. For example, there's the LipiFlow procedure that people pay cash for; it is not insurance-covered. That's where I think [the salary increase] is coming from, because certainly the reimbursements are down each year."

Only 5% of ophthalmologists participating in this year's compensation poll reported operating cash-only practices, a 1% increase from the previous year. In addition, 77% and 87% of self-employed and employed ophthalmologists reported that they were taking on new and current Medicare/Medicaid patients, a notable increase from the numbers in last year's report (65% and 79%, respectively).

According to Shuchi B. Patel, MD, staff physician and director of glaucoma in the department of ophthalmology and surgery service at the West Palm Beach VA Medical Center in Florida, this patient boom has forced notions of patient turnover to evolve as well, with quicker testing and more patients seen daily. "There's an increased demand, along with, to some degree, an increase in efficiency. If there's an increase in salary, then I think it's more due to increased volume for both those reasons."

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