Most ophthalmologists believe that owning a practice means being there 5 days a week, managing staff, handling billing disputes, and never really going home because the practice follows you there. That belief keeps talented physicians in employed positions earning less than they could, building zero equity, and depending on someone else's decisions about their professional future.
The belief is wrong. The economics of ophthalmology practice ownership work differently than most physicians assume, and the legal structure of physician owned professional corporations allows for models that employed physicians have never been exposed to.
Ophthalmology Leads All Specialties in Private Practice
The AMA's 2024 Physician Practice Benchmark Survey, published in May 2025, found that 70.4% of ophthalmologists work in private practice. That is the highest rate of any medical specialty surveyed. Orthopedic surgery comes in second at 54.0%. Across all physicians nationally, only 42.2% remain in private practice, down from 60.1% in 2012. And only 35.4% hold an ownership stake, down from 53.2% in 2012 and roughly 76% in the early 1980s.
Ophthalmology has resisted the consolidation trend longer than almost every other specialty. The AAO's 2021 Membership Survey found that the most common practice types were ophthalmic group practice at 45% and solo practice at 28%, with only 7% in PE owned practices at the time.
There's a reason for that. The economics of owning an ophthalmology practice are better than the economics of being employed in one.
The Ownership Premium Is 28%
Data from Physician Side Gigs, based on 87 verified compensation submissions from mid 2023 to mid 2024, shows that W-2 employed ophthalmologists average $476,000 in total compensation while partners and practice owners average $610,000. That's a 28% premium for ownership, and the owners reported working only about 5% more hours than employed physicians.
The Doximity 2025 Physician Compensation Report, based on over 37,000 physician surveys, places average ophthalmologist compensation at $477,232. MGMA's 2025 data for the Eastern U.S. puts the median at $495,301, with the 90th percentile reaching $1,081,229. The highest earning ophthalmologists are practice owners, not employed physicians.
The income difference becomes more pronounced by subspecialty. Retina specialists average $699,000 per year according to verified data, making it the highest paid ophthalmology subspecialty at 37% above the all-ophthalmology average. Comprehensive ophthalmology ranges from $400,000 to $700,000 for mid career owners. Cornea and refractive surgeons range from $350,000 to $700,000 or more depending on refractive volume. Glaucoma specialists range from $350,000 to $800,000.
The point isn't that ownership is guaranteed to pay more. The point is that the ceiling for an employed ophthalmologist is set by someone else's compensation formula. The ceiling for an owner is set by the practice's revenue and the owner's ability to grow it.
You Don't Have to Be There Every Day
Under the corporate practice of medicine laws that govern physician practice structures in 33 states, a licensed physician can own a professional corporation and employ other physicians to practice within it. The PC owner doesn't have to perform every procedure. They don't have to see every patient. They own the clinical entity and the revenue it generates.
This is how multi-location ophthalmology groups already operate. The physicians who own those groups aren't performing surgery at every location every day. They have employed ophthalmologists, optometrists, and support staff generating revenue across multiple sites while the owner practices at one location or manages the clinical operation from a leadership position.
A physician who owns two practices with a management services organization handling the non-clinical operations can practice retina surgery at one location 3 days a week and hire a comprehensive ophthalmologist to work at the second location full time. The second physician earns a W-2 salary. The PC generates revenue from their work. The owner keeps the profit above the employed physician's compensation without adding a single hour to their own schedule.
MGMA's 2025 report confirmed that physicians in physician owned practices posted higher total encounters and higher collections than counterparts in hospital or system owned practices. Ownership correlates with higher productivity because the incentive alignment is different. When the physician benefits directly from practice growth, the practice grows.
The MSO Makes It Operational
The reason most ophthalmologists can't realistically own multiple practices isn't legal. They're legally permitted to own as many PCs as they want. The barrier is operational. Running one practice is a full time job on top of a full time clinical schedule. Running two is physically impossible if the physician is also handling billing, staffing, marketing, compliance, credentialing, and every other non-clinical function.
A management services organization removes that barrier. The MSO handles every operational function across every location through a single management services agreement. The physician focuses on clinical care and clinical oversight. The staff at each location reports operationally to the MSO while working under the clinical direction of the PC.
The fixed monthly MSA fee covers everything non-clinical. It doesn't change based on revenue. It doesn't fluctuate with patient volume. The physician knows exactly what the management cost is and everything above that, after physician compensation and malpractice, is the owner's income.
This isn't a theoretical model. It's how thousands of ophthalmology practices already operate, just typically under PE ownership where the economic benefit flows to the fund instead of the physician. The structure works. The question is who sits on top of it.
Building Equity in Something You Own
An employed ophthalmologist builds equity in nothing. Their salary is their salary. When they leave, they leave with nothing except whatever they saved from their paycheck. The practice they helped grow, the patients they brought in, the reputation they built in the community, all of it stays with the employer.
A practice owner builds equity in the professional corporation every year. The patient base grows. The revenue increases. The reputation compounds. When the physician is ready to transition, they have an asset to sell, a practice with documented revenue, established referral relationships, trained staff, and a patient base that generates recurring visits. That asset has value. Employed positions don't.
The AMA's 2024 data shows that practice owners receive 35% of their income from salary with the remainder coming from productivity and performance incentives. Employed physicians receive 58.2% from salary. The compensation mix itself reflects the difference in upside. Owners have more variable income because more of their compensation is tied to practice performance, and practice performance is something they can influence.
Ownership isn't for every physician. Some ophthalmologists genuinely prefer employment and the predictability that comes with it. But for the physicians who want to build something, who want to control their schedule, their clinical decisions, and their financial future, the path to ownership doesn't require starting from scratch. It requires the right structure, the right operational partner, and a practice that's already generating revenue.
The practice exists. The patients are already there. The only missing piece is the physician willing to own it.
This article is for general educational purposes and is not legal or financial advice.
Verdira is a healthcare acquisition platform focused on ophthalmology practices. Physician ownership. Transparent structure. No volume quotas. If you're a physician who wants to own a practice without building one from scratch, we built this model for you.
Contact info@verdira.com | 307-381-3734 | verdira.com
