There are roughly 18,000 practicing ophthalmologists in the United States. That number has barely moved in a decade, and it's about to go in the wrong direction.

The Health Resources and Services Administration projects a 12% decline in ophthalmology supply by 2035, while demand is expected to increase by 24%. That's a 30% workforce gap, making ophthalmology the second worst staffed specialty out of 38 studied. Between 2015 and 2022, the number of solo and two-physician ophthalmology practices dropped from 35% of the market to 28%. Practices are consolidating, physicians are aging out, and the pipeline of new graduates isn't close to keeping up.

About 500 new ophthalmology residents begin training each year. That number has been growing at 1 to 2% annually, which sounds fine until you realize that roughly 450 ophthalmologists leave the workforce every year through retirement, career changes, or death.

The net gain is somewhere around 50 to 70 physicians per year for the entire country, serving 330 million people. Every number in this article comes from federal workforce projections, CMS claims data, and residency match statistics published in peer-reviewed journals. They all point to the same place: there are not enough ophthalmologists to meet the demand that already exists and the gap is widening every year.

What This Means If You Built a Practice

If you're a solo ophthalmologist over 55, you've probably thought about what happens when you're ready to slow down. You might have talked about it with your spouse or accountant, or you might have avoided the conversation entirely because every time you start thinking about it, the same problem shows up. Who takes over?

Twenty years ago, the answer was straightforward. A younger surgeon would approach you, buy in over a few years, learn the patients, earn referrals, and eventually take the reins. That pathway barely exists anymore because the new graduates coming out of fellowship have six figures in student debt and no appetite for the financial risk of buying a practice. The few who do want to own something are getting recruited by hospital systems offering guaranteed salaries and signing bonuses that a solo practice can't match.

The rest are watching their colleagues get burned by PE groups and deciding that employment is safer than ownership. Meanwhile you keep working, another year then another, because leaving means the practice closes, staff lose their jobs, and your patients have to start over with someone new. They ask when you're going to retire and you don't have a good answer because the truth is you don't have a successor.

This is happening at thousands of practices across the country right now. Strong revenue, loyal patients, experienced staff, and no exit plan. The sense of obligation alone keeps people working years past when they wanted to stop.

What This Means If You're a Physician Looking to Own

If you're mid-career or finishing fellowship, the math is actually in your favor, but probably not the way most people are presenting it to you.

The shortage means you're in demand everywhere. Every hospital system, PE group, and independent practice in the country is trying to recruit ophthalmologists right now. You have options, but the real question is whether any of them actually give you what you went to medical school for.

A hospital system gives you a salary and a schedule.

You see the patients assigned to you, in the rooms they put you in and with the equipment they chose. You don't own anything, and if the system restructures or merges, your position gets evaluated like every other line item on the budget.

A PE group gives you a signing bonus and a promise of clinical autonomy. The autonomy narrows after the first few months, volume targets increase, and the contract you signed has a non-compete that makes leaving as expensive as staying.

Starting your own practice means two years of buildout, half a million in startup costs, and the reality that you'll spend more time on insurance credentialing and HR issues than on patient care during your first year.

Then there's a fourth option that most physicians never hear about. You walk into a practice that already exists with patients already booked, staff already trained, revenue already flowing, and you own the clinical entity from day one. You step into something that's already working and you make it yours.

That's the model we built. The practice is acquired and stabilized by an MSO that handles operations, billing, marketing, staffing, and compliance. The physician owns the PC, controls clinical decisions, sets the standard of care, and decides how patients are seen.

The MSA spells out every term before anyone signs, and if the physician wants to leave, the exit is defined and the non-compete is geographic and fixed rather than an expanding radius that follows the platform's acquisition map.

Why the Shortage Is Actually a Tailwind

The instinct when you hear "workforce shortage" is to think it's bad news. For a solo practitioner trying to find a successor on their own, it is. For the model we're describing, it's the opposite.

As the shortage grows, more practice founders need a structured transition because they can't find a buyer on their own, don't want to sell to PE, and don't want to close and walk away from what they built. They need someone who will acquire the practice, keep it running, protect the staff, and find the right physician to lead it going forward.

At the same time, the value proposition to the physician who steps in gets stronger every year. You're walking into a practice that has been generating revenue for 20 or 30 years with a community that already trusts it. The operational burden is handled, capital is provided, and you own the entity your license backs.

The result is more sellers need a real transition and more physicians benefit from real ownership, an advantage that only compounds over time.

The shortage created two problems at the same time. Founders who can't find the right buyer and physicians who can't find the right path to ownership. We exist to connect them.

Verdira is a healthcare acquisition platform focused on ophthalmology practices. Physician ownership. Transparent structure. No volume quotas. If you're looking for a different model, or you know a colleague who is, contact us today.