Question from a reader: Is Southern California Over Saturated with Ophthalmologists?

By Andrew Doan, MD, PhD

This was a question from one of our readers:

I am interested in working as an ophthalmologist in Southern California. Is Southern California over saturated with eye surgeons?

People want to live near large cities. Great restaurants, professional athletics, and culture are some benefits of living near a big city. However, young physicians will pay a price when seeking practice opportunities near large cities where there are established ophthalmology practices. In the San Diego area, for instance, ophthalmologists may perform 4 to 6 cataract surgeries a week. However, moving one hour away from San Diego in a growing city will allow you to perform 8 to 12 cataract surgeries a week. Although living in a growing city may not be ideal as you'll be farther away from city amenities, you'll make more money and the cost of living will also be significantly lower.

I've always encouraged residents to seek job opportunities in areas where other physicians do not want to live. The fastest growing and busiest practices are located in towns where there is a population of 100,000 people living in an area away from major cities. If you want to live in Southern California, then look for growing areas where people are forced to move because of rising housing costs.

However, you’ll have to determine if you’re willing to give up the conveniences of living near the city for increased practice volume. This is a personal question that only you can answer. Keep in mind that being financially strapped to live in a major city can be quite stressful and lower your quality of life. On the other hand, living further away from the city may result in a lower quality of life that money cannot compensate for.

Some job hunting and building a practice pearls:

1) Ask yourself if you want to work for a paycheck or be an entrepreneur in private practice. If the appeal of a stable paycheck is irresistible, then settle for lower income and work for a hospital, Kaiser, the military, or university hospital. However, if you want to maximize your income, then look for a private practice position where your income is dependent on how many patients you see and how many surgeries you do. Successful private practice ophthalmologists have entrepreneurial drive.

2) If your entrepreneurial drive is strong, then consider taking out a business loan and starting your private practice. Call existing practices and ask how long will your mother wait before she can have cataract surgery? If the doctor can see her in a few days, then don't consider practicing in the area. If there is a month wait, then open your practice across the street.

3) Research the demographics of the areas you're considering working as an ophthalmologist. Find out the number of patients over 65 years of age, the prevalence of specific diseases, such as diabetes, and the number of ophthalmologists serving these patients. Pick the areas with the highest patient to ophthalmologist ratio.

4) Get to know and contact the local pharmaceutical sales team, particularly the surgical representatives. They will have numbers on the volume of supplies used for different areas. They may have good advice on how to setup your practice as they have incentive to see you busy.

5) Build relationships with physicians and optometrists in the area. Assure optometrists that you'll return patients to them after surgery and let the optometrist prescribe the post-cataract surgery glasses. In medicine, remember to treat others the way you want to be treated.

6) Give local internal medicine and family practice doctors business cards to give to their diabetic patients for diabetic examinations.

7) Offer to take call for local hospitals.

8) Learn the billing requirements for insurance companies and setup accounts with the companies.

9) Learn coding, billing, and accounting. This will assure that you're paid for your services and keep you out of federal prison for fraud.

10) Ethics will keep you happy and your patients healthy and content. Do no harm, be honest, and practice impeccable ethics.

In summary, while there are many ophthalmologists working in Southern California, consider working outside of the major cities. There are rapidly growing areas with increased demand for ophthalmologists. These growing areas provide the best practice opportunities and income potential for young ophthalmologists in private practice. If city living is important to you, then be prepared to accept lower income to live in or near a city.