Attention, fellow middle-aged ophthalmologists: We are becoming the caretakers of our tremendous profession, the beneficiaries of all who came before us. We have overcome a fair share of obstacles over the past decade or two while gradually climbing the ladder and building our practices.

Now, the direction of the profession is our responsibility. We are no longer the young ophthalmologists — it is time we take on that mantle. As we do so, it is important to remember that those who are at the beginning of the journey face challenges unique to their generation.

FACING TODAY’S CHALLENGES

According to the Education Data Initiative, medical student debt has increased tenfold since the mid-1980s. Surgical reimbursement has contracted to about one-third of the rates in the 1990s, while overhead averages between 60% and 70%.¹

Many jobs for new graduates are inside private equity conglomerates, with reduced opportunity for autonomy. Starting a practice de novo has an unrealistic barrier to entry for most, given the cost of equipment, personal debt and low reimbursement.

With increased patient demands (especially among refractive corneal and cataract surgery patients who are just 0.25 D away from authoring a bad online review), the stress of board certification, the increased complexity in surgical decision-making and the severe risk of burnout syndrome, the pressures mount before practice even starts.

Further, freshly minted ophthalmologists endured training during the COVID-19 crisis and missed out on the economic boom of the past decade while entering the field during an ensuing recession with increased interest rates and inflated home prices.

BE THE SOLUTION

Despite these challenges, we emerging leaders have the power to help shape a brighter future for this new guard of ophthalmologists. What if we decided to empathize with their needs rather than complain that they want too much too soon? What if we respected them like partners from the day they joined the practice and didn’t dismiss their ideas as impractical fever dreams? What if we advocated for better pay and better work-life balance for them while they are starting out? How do we help give the next generation a hand up?

The most practical step should be to incentivize younger surgeons to be future practice owners by creating standardized norms or formulas for partnership tracks, surgery center ownership and timelines to reach these milestones. These formulas need to be distinctly separated from the private equity formulas that have become the norm for obvious reasons: financial buyers are purchasing a revenue stream, while our new associates are generating the revenue. Creating a partnership is more than a financial transaction; it is merging the culture and mission between physicians for the greater good of the patients, staff and ultimately the future of our profession.

IF YOU CHOOSE TO ACCEPT IT ...

My experiences have given me a unique perspective, so here is the mission as I see it: Be the senior partner your junior-partner self would have wanted to join. Be the leader you would have wanted to follow. Pay it forward to the next generation, and they will take this profession to heights we could have only imagined. OM

REFERENCE

1. Lichter PR. Payment data and the “me” in Medicare. Ophthalmology. 2014;121:1849-1851.

Gary Wörtz, MD is a board-certified ophthalmologist specializing in cataract and refractive surgery at Commonwealth Eye Surgery in Lexington, Ky. Dr. Wörtz revealed no relevant disclosures.