Compensation Transparency in Part-Time Ophthalmology

How production-based pay structures vary—and where we can do better

Authored and reviewed by the DIN team, June 2025

Executive Summary

This white paper presents a comparative analysis of part-time compensation models for comprehensive ophthalmologists in the United States, focusing on three common arrangements: private practice associate roles, locum tenens placements, and independent contractor setups. Each model varies in transparency, surgeon autonomy, and alignment of incentives. We synthesize common structures and identify prevailing compensation ranges to promote clarity around production-based pay. Our findings reveal wide variability in how collections are split and highlight opportunities for more consistent, equitable models—particularly in settings like rural hospitals where access to specialty care is often limited.

Overview

Physicians working part-time in ophthalmology encounter highly variable compensation structures, depending on practice setting. This white paper offers a comparative analysis of compensation models for part-time comprehensive ophthalmologists in the U.S., across three categories:

• Private practice associate roles

• Locum tenens arrangements via major staffing agencies

• Independent contractor (1099) models

Our goal is to improve transparency and support fair, sustainable compensation structures for rotating surgeons. This is particularly relevant for organizations like Doctors In Network (DIN), which emphasize flexibility, continuity, and empowerment for both surgeons and hospitals.

I. Private Practice Associate Models

Most private practices pay part-time associates using one of three frameworks:

• Base + Bonus: A base salary with a bonus of 25–30% of collections over a set threshold (typically 2.5–3x the base salary). These structures often exclude high-cost items such as injectable drugs or ancillary services (e.g., optical revenue or laser fees) from bonus calculations. (often 2.5x the base) (Ophthalmology Management, 2018). Practices keep 100% of revenue below that threshold.

• Straight Percentage: Surgeon receives ~30–35% of collections from the first dollar. Used more often in very part-time roles (Ophthalmology Management, 2018).

• Tiered Partnership Track: Bonus percentage increases gradually, starting around 28–30% and climbing to ~35% as a surgeon approaches partnership (Ophthalmology Management, 2018).

Key Factors:

• Percentages typically apply to professional fees only—facility, drug, and optical revenues are often excluded (Ophthalmology Management, 2018).

• In OR-heavy roles, surgeons may feel under-compensated if high-margin revenue streams aren’t shared.

II. Locum Tenens via Staffing Agencies

• Locum firms like CompHealth, VISTA, and Barton Associates offer:

• Fixed hourly/daily pay: Generally $175–$275/hour, or $1,400–$2,200/day, though rates can vary significantly based on geography and urgency. Rural or underserved areas often offer higher compensation to attract coverage., or $1,400–$2,200/day (CompHealth, 2024).

• No link to collections: Surgeon compensation is decoupled from billing volume (Physician Side Gigs, 2024).

• Agency margin: Firms retain 30–50% of the total paid by the client site. This margin covers malpractice insurance, credentialing, recruiter commissions, travel logistics, and company overhead, in addition to profit. of the total paid by the client site (Physician Side Gigs, 2024).

Key Tradeoffs:

• Surgeon income is stable, but in high-volume OR settings, the effective share of collections can drop to 1–5% (Student Doctor Network, 2024).

• Agencies typically cover malpractice and travel, reducing admin burden (VISTA Staffing, 2024).

III. Independent Contractor Arrangements

1099 models (direct contracts without a staffing agency) offer:

• Percentage-based splits: 50–70% of collections go to the surgeon. A 50% share is common when the host site covers all overhead and staff costs, while 60–70% may apply when the surgeon assumes more administrative burden or fills a high-demand niche.. Practices retain 30–50% to cover staff, supplies, and profit (White Coat Investor Forum, 2024).

• Fixed daily or per-case fees: Common in comanagement or high-variation settings. Simpler to administer.

• Fee-for-service variants: Some surgeons keep 100% of collections and pay a fixed service fee to the host facility (Cohen Healthcare Law Group, 2024).

Compliance Consideration: To avoid regulatory risk, compensation must reflect fair market value for services and infrastructure provided (Cohen Healthcare Law Group, 2024).