Eyeworld

22 Ophthalmology Business • July 2016 by Liz Hillman, Staff Writer But even practices in the major cities are dishing out unprecedented salaries. It's a trend Ms. Simon has no- ticed happening for the last couple of years, but most significantly this year. It's also a trend that she cautions job seekers to be wary of. To explain why, Ms. Simon of- fered this example: Let's say a practice offered a base salary of $200,000 and agreed to give the physician 30% over 3 times their base. This means that anything they collect over $600,000, they could keep 30% of that while the rest would go to practice overhead, partner compensation, etc. With even higher salaries though, physicians would need to collect up to $1 mil- lion to get a bonus. "More importantly," Ms. Simon said, "they would have to collect at least double that to cover their own salary. Between overhead and bene- fits and their own salary, in order for a practice to break even, they have to collect that much money to cover themselves." Thus, she offers caution to those attracted to high salaries in primary markets. Those in secondary markets might have an easier time though. "The good news about that is once you go outside of a larger com- munity, you're able to produce more. You're not in such a competitive atmosphere. There is something to be said for that," she said, noting the additional quality of life benefits in secondary markets, such as not need- ing to focus on marketing to build a patient base as in metropolitan mar- kets. "The patients are more readily available [in secondary markets.]" Ms. Simon also tells hirees to consider earning potential over the long term, such as considering bonus with job search companies like The Eye Group. "In hindsight, this was the best decision I made because I learned that not all employers post their positions online." Shortage drives higher salaries Ms. Simon said the "biggest change" driving the market at the moment is a "serious lack" of ophthalmologists. She said residency programs, which have decreased acceptance rates by a slot of 2, have not adequately pre- pared for the large generation of baby boomers who need eyecare; they are also leaving ophthalmology practices without a successor. Although slight, this has made a difference in a market that needed an increase in ophthalmologists, not a decrease. Plus, more and more train- ees are women, and balancing fami- lies and career can sometimes result in them reducing their workload to part time, which has an impact on a field that already has a shortage, Ms. Simon said. Overall, it is a generation of men and women who have a work- life balance priority. "The salaries have increased significantly because even in the popular markets … there are a lot of openings," she said. "The second- ary markets and more rural areas are having an even harder time because it's harder to move doctors outside of major metropolitan areas as they have so many choices." As Ms. Simon put it, how is a practice in Springfield, Massachusetts, for example, going to attract a physi- cian who has 5 other opportunities in Boston? "They're going to pay $350,000 and attract the candidate based on salary," she said. Higher starting salaries and trouble selling solo practices characterize the market T he hiring market in ophthalmology within the last 2 to 5 years has changed. Base salaries for physicians just out of residency are higher. Competitive metropolitan markets have more openings. Residents are starting their job search earlier and earlier. And those on the flip side looking to retire or sell their solo practice are having a harder time finding interested buyers as group practices gain more popular- ity. There are many factors playing into this change in the ophthalmol- ogy hiring atmosphere, according to Lauren Simon, an ophthalmology recruiter with The Eye Group, Boca Raton, Florida. And it's a world that Josh Zaffos, MD, who is completing his fellow- ship in cornea, external disease, and refractive surgery at the Gavin Herbert Eye Institute, University of Califor- nia, Irvine, said was a "black box" to him when he neared the end of his residency at the Krieger Eye Institute, Sinai Hospital, Baltimore. "I knew very little about the job search process: how it worked, the process, interviewing, contracts— these were all topics that I heard little about during my training," he said, explaining that while some informa- tion about the process is posted on- line, most of what he knew he learned from his peers. This led him to work Buying and hiring trends in ophthalmology today

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