There’s a sequence early on in the classic adventure movie Raiders of the Lost Ark where the main character, intrepid archaelogist Indiana Jones, sprints through an ancient temple as a giant rolling stone ball threatens to crush him from behind. As he finally bursts through the exit to safety, Indy looks up to see a platoon of warriors aiming poison-tipped arrows at him: Out of the frying pan, into the fire.

Our country’s intrepid ophthalmologists find themselves in a similar situation, except now the giant stone ball is 2020—with the pandemic and the cascade of staff furloughs and decreased income—and the enemy warriors are the Centers for Medicare and Medicaid Services, armed with poison-tipped reimbursement cuts set to fire in 2022.

 As to what cuts are coming, the American Medical Group Association notes that physicians can expect as much as 10 percent worth of cuts, consisting of a 2-percent Medicare sequester cut, a 4-percent Medicare Pay-As-You-Go reduction and a 3.75-percent decrease in the Medicare conversion factor.1 

In a survey regarding the potential fallout from these cuts, the AMGA reports that 43 percent of doctors say they’ll have to institute hiring freezes or delays, 37 percent will begin eliminating services and 25 percent will furlough or lay off non-clinical staff.1

Physicians are also looking into “side hustles,” alternative ways to make income, as reimbursements shrink and the pandemic wreaks havoc with their traditional way of practicing and making a living. Medscape reports that nearly 40 percent of doctors now have a job in addition to their medical practice. And, of the doctors who started moonlighting in the past 12 months, 45 percent were driven to it by the pressures put on them by the pandemic.2 Most of these side jobs are in the medical field, consisting of such things as participating in clinical trials and teaching, but they also include such activities as real estate, playing music and making astrological charts. 

In ophthalmology, too, physicians are looking into alternative income, as illustrated by this month’s cover story (p. 30). Though not as high-falutin’ as crafting psychic star maps, the ideas the surgeons we spoke to can help you make up some of the income that was lost during the pandemic, or which may go away if the 2022 cuts go into effect.

Speaking of going away, one of the most sobering statistics from the AMGA physician survey was that  22 percent of the respondents say they’ll stop accepting new Medicare patients as a result of the cuts. This means that, if the government’s not careful, it may utimately hurt the people the Medicare program was designed to help in the first place: the patients.


— Walter Bethke
Editor in Chief

1. Medicare Cuts Threaten Pandemic Weary Healthcare Systems. Accessed October 26, 2021.

2. Side Gigs: A Growing Trend as Physicians Seek Extra Income. Accessed October 25, 2021.