Ophthalmologists fared relatively well in 2020 in terms of compensation, despite substantial practice changes during the COVID-19 pandemic. Earnings were nearly the same in 2020 as in 2019, according to the Medscape Ophthalmologist Compensation Report 2021.

Sixty-one percent of ophthalmologists reported experiencing some decline in compensation during the year; 96% attributed the decline in income to the COVID-19 pandemic. The average annual income nevertheless remained nearly the same, at $378,000, vs $379,000 in 2019.

That surprising consistency is reflected in changes in medical specialties overall ― income did not vary widely between 2019 and 2020, according to the survey of nearly 18,000 physicians in more than 29 specialties.

Among those ophthalmologists who did experience financial or practice-related effects stemming from the pandemic, 53% reported that they expected a return to pre-COVID-19 income levels within the next year; 37% said they believe it could take 2 to 3 years for income to recover.

“I think as the country starts to reopen, we’ll see more patients coming in, but we may still have issues with those patients who will delay coming into a doctor’s office for a while,” said Ravi Goel, MD, senior secretary for ophthalmic practice at the American Academy of Ophthalmology, in commenting on the report for Medscape Medical News.

Importantly, “those delays in receiving care could wind up affecting their quality of vision and quality of life,” he added.

The majority of physicians overall (83%) said they expect pre-COVID income levels to recover within a couple of years; 45% reported that they had experienced no financial or practice-related harm from the pandemic.

Of note, significant differences in earnings were reported according to employment status. Self-employed ophthalmologists reported higher annual earnings in 2020, at an average of $395,000, vs $361,000 among those who were employed.

That gap is even wider among physicians in general. The self-employed made an average of $352,000, whereas for those who were employed, it was $300,000.

Compensation Satisfaction?

Ophthalmologists’ views regarding the fairness of their compensation is a bit less optimistic, however. With only 55% feeling fairly compensated, they are fifth from the bottom of the list of specialists, which is topped by oncologists (79%). Infectious disease specialists came in last, with 44% — an understandable sentiment during a pandemic.

Despite their opinions about the compensation, however, ophthalmologists appear most enthusiastic about medicine, with 87% reporting that, if given a choice, they would choose medicine again, behind only oncology (88%) at the top of that list.

An even higher percentage — 94% — indicated that they would choose ophthalmology again if given a choice, which is also near the top of the list of specialties, behind only dermatology, orthopedics, and oncology (96% for all three).

“It’s encouraging to see those high numbers,” Goel commented. “I think it’s clear that medicine is still a calling, and this data shows that,” he said.

Workload in Context

When it comes to time spent on paperwork and administration, ophthalmologists appear be on the better end of the spectrum. They report spending an average of only 10.3 hours a week on medical-related work outside of patient visits, the second best of the specialties, above only anesthesiology, which reported only 10.1 hours per week. Infectious disease specialits, by contrast, reported spending 24.2 hours weekly on administrative tasks, perhaps not a surprise during the pandemic.

Overall, physicians reported working an average of 16.3 hours per week on tasks outside of patient visits.

The average number of work hours per week overall remained the same for ophthalmologists — 46 hours in both 2019 and 2020.

It’s no surprise that the specialists who reported increases in average number of work hours include intensivists, infectious disease physicians, and public health and preventive medicine physicians. They reported spending 6 to 7 hours more per week in 2020.

The average number of patients ophthalmologists saw per week declined from 132 in 2019 to 117 in 2020, owing to COVID-19-related medical office safety protocols and other factors, the report shows.

Although 36% of self-employed ophthalmologists reported no permanent reduction in patient volume, 55% said they had a 1% to 25% permanent reduction.

Goel himself observed an increase in early retirement among ophthalmologists under the strain of the pandemic.

He added, however, that “despite the challenges, I’m more excited about ophthalmology today than when I first matched 20 years ago.

“The profession continues to advance; there are new technologies and outpatient-based care, and artificial intelligence is going to revolutionize the practice for years to come,” he said.

“So I’m bullish on the potential for ophthalmologists to continue to help protect our patients’ sight and help empower their lives,” Goel said.

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