Optometry as a Career Choice

[Paul Farkas]

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Optometry as a Career Choice​

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You will graduate college this year. You have a high grade point average and are strong in sciences. You enjoy dealing with people and helping them. You decide to explore the health professions that lead to a doctorate.​

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Your GPA will allow you to consider Medicine, Dentistry, Podiatry or Optometry. You rule out medicine, because you do not wish to have the stress of life and death decisions combined with unpredictable hours. Dentistry is unappealing because you have never enjoyed working with your hands and suspect you are a bit clumsy.​

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That leaves Podiatry or Optometry. You learn that Podiatry has a low glamor rating but high income potential. Optometry has a median salary that is $88,000 versus Podiatry at $124,000. For more on glamor versus income visit ...http://netscape.salary.com/articles/body/atcl_careeradvice.asp?atc=544​

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You feel eyes and vision have a greater “glamor factor” than feet and ankles and are willing to sacrifice the potential income difference for what you perceive is a satisfying profession. What are your perceptions of optometry? You gain your knowledge from sources such as the Center for Advising and Student Achievement whose description...​

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The Perception of Optometry​

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“Optometrists are independent, primary health care providers who examine, diagnose and treat disease and disorders of the eye and visual system. This includes measurement and prescription for glasses and contacts, diagnosis and treatment of eye coordination and focusing issues, treatment of eye diseases such as glaucoma, and detection of systemic diseases such as diabetes and high blood pressure. Optometrist also perform non-invasive surgical procedures. Areas of sub-specialty include low vision rehabilitation, pediatric or geriatric eye care, vision therapy, sports vision, and ocular disease.”


It is an accurate description. You feel this is the right fit. You will sacrifice four difficult and expensive years of education and training to achieve a Doctor of Optometry (OD) degree. You perceive this will allow you to either open a new practice, become an associate leading to a partnership in an established practice or have other attractive opportunities if you do not wish to become self employed.


You could work for the government. Opportunities exist for a career in the military. This means being commissioned as captain in the army, air force or as a naval officer lieutenant in the Medical Service Corps. For those who enjoy rural locations, there are also opportunities in the Indian Health Service. Closer to home, you can be employed by the Veteran's Administration


What you really like best are these multiple choices, that would allow you to have very flexible hours, good income with enough free time to meet family obligations. Although tuition is extremely high there are generous student loans. Funding your professional education will not be a problem. These may be your perceptions for a rewarding future career in optometry. All based on solid research.


You decide on the appropriate optometry college... (http://www.aoa.org/x2664.xml). If you are a resident in one of the states with a college of optometry as part of the public university system, there is considerable tuition reduction, over private optometry colleges. All this is reviewed by visiting (http://www.opted.org/info_faq.cfm)

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The Reality of Optometry​

Optometric education and training is demanding and exciting. After one free summer between the first and second year, there is no free time. Outside employment to supplement income is out of the question for most. By the end of the fourth year student loan debt can range from a low of $100,000, to for many who graduate from private colleges $200,000. A formidable debt!​

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This not an impossible debt however, because of long term, low interest repayment provided there are professional opportunities with adequate remuneration. Some students delay loan repayment by electing to take a residency.(http://www.opted.org/residencies_faq.cfm) . They sacrifice a years higher earnings for proficiency and improved future hiring opportunities.​

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Now the problem...​

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There is an excess of optometric graduates. Optometry colleges have been unwilling to cut back on enrollment. As a result the vast number of graduates cannot be absorbed into private practice, as associates leading to partnerships. Those ODs who receive offers, do so at a lower salary than they expected. This makes paying off the student debt very difficult.​

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ODs who wish to open a new practice find receiving bank loans difficult to impossible because of their student debt and no financial track record. For many this closes the door to becoming their own boss.​

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Some recent graduates elect working for the government either in the military or Indian Health service if they don't mind being far from home or the Veteran's Administration when there are openings.​

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A lucky few, are hired as associates in an Ophthalmologic practice where they can utilize their training to the fullest extent and maintain doctor prestige and that “glamor factor”. Starting salaries in MD practices are better than in an optometric associate situation. The down side is that there is no equity in the practice. The OD will remain an employee, always subservient to the MD.
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The Commercial Alternative
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At present, the majority of optometric graduates are forced into situations that they did not expect when they selected optometry as a career choice. They are forced into commercial, corporate optometry. The pay scale is better but the “glamor factor” of optometry is gone. They may work in a mall with undesirable hours. That means possibly evenings and week ends. These ODs might receive a prestigious title, but make no mistake, they are employees of a corporation. Employees can be terminated at any time if the employer is displeased. Equity and patient loyalty cannot be built in that commercial environment.​

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The question to ask... Would working in Wal Mart or a similar company, in a small dark room eight hours or more each day, something that would be acceptable as a career? This may not happen, but it is a sad reality to many recent optometry graduates.​

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Optometry can be a rewarding and gratifying career. Be certain that you review your positive perceptions and that the optometry college admission committees will reinforce, but understand the realities. Certainly visiting with practicing optometrists in both professional and commercial locations will allow a well rounded picture for future career decision making.​

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If you decide on optometry and are accepted in an optometry college, our website welcomes you.

Paul Farkas,M.S.,O.D.,F.A.A.O.
Web site administrator
ODwire.org
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[Kenya Henderson]

another option

there is also chiropractic school.

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[Paul Farkas]

Not in the same category

there is also chiropractic school.

Visit the Chiropractic education web sites and you will see that Chiropractic School does not have the same requirements as medical,dental, podiatric or optometry school.

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[Quyen C. Nguyen]

You pretty much summed it up Paul. And you are correct.
I first started out to work for private OD as a recent grad. Unfortunately, I was being underpaid b/c I was a new rookie.
Worked for an OMD, but was overloaded with patients.
Worked for cooperate, but got screwed.
Worked for another private OD for 3 years, but was not offered an associate position. Seems that the person wants you to make money for them and not share.
Now, finally taking the risk and open your own business, but finding the right location is kind of tough. Too many OD's. Seems like they took all the hot spots.

 

[Paul Farkas]

Before opening cold...

Visit every OD in the area where you wish to practice. Inform them of your intention.

You might be surprised that some might reconsider and offer an association prior to purchase. Set the purchase price at the beginning of your association not a value after your skills have built the practice to a new level.

If you have a language skill other than English that is invaluable, if you can find opportunity in that ethnic community.

Good luck and good hunting!

 

[Ken Jeffers]

Accurate Assessment

Paul,
I believe your assessment is right on!
I think that Optometry is a great profession with some drawbacks. Is there any profession that doesn't have drawbacks?
Look on the bright side, we could be like the OB/GYN's who can't afford to practice anymore due to sky rocketing insurance rates. How's that for job security?

 

[Shaune Wallace]

Have we reached a saturation point with the optometric profession?

There was mention of over enrollment. I think that the demand for optometry should increase in coming years due the the aging of the baby boomer population. Still, it is a challenge and the way to overcome that issue is to find your niche. Corneal molding? Vision Therapy? Deluxe eyewear?

People have needs that are not being met. It's just a matter of finding out what those needs are and servicing them.

 

[James Schmitt]

Over Supply

Have we reached a saturation point with the optometric profession?

There was mention of over enrollment. I think that the demand for optometry should increase in coming years due the the aging of the baby boomer population. Still, it is a challenge and the way to overcome that issue is to find your niche. Corneal molding? Vision Therapy? Deluxe eyewear?

People have needs that are not being met. It's just a matter of finding out what those needs are and servicing them.

Needs being met . I've seen this in the magazines. It seems to be the new mantra meaning everyone who wants an eye exam as frequently as they wish at little cost to them. I'm more interested in our needs being met.

Several years ago the AOA commissioned a study of the supply of optometrists and the results showed that there was an excess. But that did not sit well with the powers that be, so ,by golly if we just do a little rejiggering of the results, why, actually there are too few because of all the baby boomers. Of course the undersupply assumed lots of insurance to supply many many patients for lots of optometrists who can supply lots of $40 eye exams.

There are no market forces at work in optometry in terms of supply and demand. Our leaders say the demand for services will drive the number of doctors. But that is not accurate because the schools have an inherent self interest in keeping the number of schools open and class sizes as large as possible. This circumvents the whole supply and demand process.

Supply and demand must be measured by the number of the highest caliber students seeking a seat. Years ago optometry accepted one in ten applicants. At its low a couple years ago they were accepting about one in three. I understand it is up a little now but certainly not like it was years ago.

The brightest college students see our income versus the cost of education and other professions and opt for other professions. When the supply of docs is more equitable, the insurers will have to provide better remuneration as doctors gradually pull out of the lousey plans, thus producing a more reasonable balance.

As long as too many doctors are being produced, that can't happen.

 

[Jonathan Warner]

Excellent article, Paul. I don't know how I missed it earlier.

 

[Paul Farkas]

Thanks for the complement...

Excellent article, Paul. I don't know how I missed it earlier.

The article was placed on the Public Forum to allow search engines to pick up the story. Potential optometry students who "Google" optometric career or something similar should find it.

The piece is important reading for the pre-optometry student members. I hope our professional members spend time being on line mentors at the pre-optometry forum for those interested in an optometric career.

 

[Mike Burley]

I love my career, but....

I have practiced optometry since I joined my father's practice in 1982. I love the work, but there's just not enough of it. A few years ago, my wife, who had been my office manager and optician for years, said that optometry looked like a lot of fun, and she might like to become an optometrist also. Then I said two words... "managed care". She now has one more year to go before finishing law school.

 

[Mike Burley]

Thank you, Bill.

Thank you for your insightful posting of your story. optometry, law, or any other career can be practiced with high ethical standards, or not. My wife has extremely high ethical/moral standards, so I am positive she will not go over to the "dark side". My being a doctor and her being a lawyer is sort of like diversifying our investments. If one profession falls onto hard times, the other may continue to do well. We still have three (of six) more children to get through school and hopefully into good careers, and I think we will make it. I love optometry, and having done some pinch-hitting in chain opticals, I have to say that you can do good eye care in a chain store, but it's not nearly as satisfying as private practice.

 

[Paul Farkas]

Point of information ...

Bill and Mike...

Great observations.

You want some interaction with pre-optometry students and possibly some optometry students as well visit out pre -optometry forum. the topic where you might wish to add comments...

http://www.odwire.org/forum/showthread.php?t=25810

Thank you for your input. This is a public forum. it is being picked up by the Internet search engines. Your comments are being highly publicized.

 

[Steven Nelson]

I would respectfully submit a few points in response to your article. The first is that I found it overwhelmingly biased against corporate practice. If one is going to write such an article, it would be nice to read something a bit more balanced. The second is that ANY employee can be fired at any time whether they be employed by a chain, ophthalmologist or even another optometrist. Nobody is sheltered from being fired for poor performance and private practice can support that performance far less than a corporate office. The final point I would like to bring out is that you've never practiced in any way, shape or form affiliated with corporate optometry so based on your lack of first-hand experience, one could argue that you know very little about the subject. The reality is that while a corporate environment can have questionable "security" (I would argue that given the number of private offices that are closing, that's somewhat of a misnomer), there are several advantages to this type of practice:

• Steady cash flow
• Flexibility in type of practice (most encourage as much medical care as you are able to do)
• Heavy initial income with no investment
• No legwork on the front end getting financed
• Reasonable rent and expenses
• Portability (I could decide I want to live anywhere in the country tomorrow and I'd have what is certain to be a well paying job before I ever left)
• Ability to build a patient base (if one wanted to practice in this environment prior to opening a private office)
• Opportunity to acquire advanced instrumentation while having guaranteed traffic to support the cost
• Hours (I work 5 days per week from 9-5...does that differ so much from other ODs? I'll grant that some chains attempt to force other hours, but at that point you either say no or hire someone to work the hours you don't want)

The point being that if potential students are going to read this, they need to get the complete picture because when they find out for themselves it makes your article seem more rhetorical than informational. I practice in commercial and I make more than most ODs, have equipment to rival 95% of OD offices out there, practice as medically as 95% of ODs, have a very good life and, based on my track record and merits, have as much job security as most ODs if not more so because I can always count on my bottom line being healthy. It's also allowed me to build a 5yr patient base so that if I ever DID feel the need to leave, I would have enough of a following that I could at least keep a new office running smoothly (as well as my own equipment, so much lower initial debt). Are there bad stories out there? Sure, but there are just as many stories about private offices abusing new ODs. There is an OD on here that went back and sued his old employer because he had been paying him incorrectly for years in order to skip out on employment taxes and gaffing them onto him.

With regard to oversupply, I think it's also important to point out that the concept of oversupply is largely geographical. The problem is what it's always been and that's that nobody wants to go to rural areas to practice and the more metropolitan areas are just pushed to the limits. When the AOA or any other entity puts out articles about a shortage of care, it's just as valid as the people that talk about oversupply from a certain perspective. I would encourage those potential students to simply do their homework on the front end. Don't consider areas that have large numbers of ODs where you'll be begging for scraps. It's simply supply and demand and we're no different than any other profession.

 

[Paul Farkas]

Valuable comments from the commercial side of optometry

Dr Steven Nelson practices in Texas at several Wal Mart locations. He wrote an extremely useful article on how to retain independence although working in a corporate environment...http://www.odwire.org/forum/showthread.php?t=20214.

His observations are based on corporate optometry in Texas with strict optometric regulations that control corporate influence. He practices as an Independent Contractor with a good degree of decision making freedom. In other states with lax optometry regulations, allow corporations to have greater control over employed ODs. Those employed optometrists might have a very different story to tell.

Those interested in an optometric career should get as much information as possible. What is most important is to speak to ODs in the states where you might wish to settle. Experiences will vary from OD to OD as well state to state.

 

[Steven Nelson]

In other states with lax optometry regulations, allow corporations to have greater control over employed ODs. Those employed optometrists might have a very different story to tell.

Those interested in an optometric career should get as much information as possible. What is most important is to speak to ODs in the states where you might wish to settle. Experiences will vary from OD to OD as well state to state.

I agree 100% with this. Where you decide to practice will determine a LOT of your professional satisfaction. For example, there are states whose therapeutic legislation would make me crazy regardless of my practice geography (although I'll admit that Texas has a LOT of work to do in this regard). I find it shameful that some state associations have allowed direct corporate employment of ODs by non-healthcare entities. It can lead to a less than desirable situation that just begs for the employee to be abused for the sake of profit, but that's employment in general.

 

[Mike Sandy]

The Commercial Alternative
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At present, the majority of optometric graduates are forced into situations that they did not expect when they selected optometry as a career choice. They are forced into commercial, corporate optometry. The pay scale is better but the “glamor factor” of optometry is gone. They may work in a mall with undesirable hours. That means possibly evenings and week ends. These ODs might receive a prestigious title, but make no mistake, they are employees of a corporation. Employees can be terminated at any time if the employer is displeased. Equity and patient loyalty cannot be built in that commercial environment.​

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The question to ask... Would working in Wal Mart or a similar company, in a small dark room eight hours or more each day, something that would be acceptable as a career? This may not happen, but it is a sad reality to many recent optometry graduates.​

Admittedly, I did not expect to work in commercial optometry when I graduated. It was a matter of timing, convenience, and financial evaluation. No one is really "forced" to do anything in this world so I'll move past that point. You noted the pay scale is better but also noted "the glamor factor is gone". It is awesome that somehow working between the nail salon and Qdoba across the street from the mall is somehow more glamorous than between the nail salon and Qdoba in the mall. Whether OD is a prestigious title or not, any employee can be fired at any time - period. You saying "Equity and patient loyalty cannot be built in that commercial environment." is pure garbage written by someone who simply doesn't know anything about that mode of practice.

"Would working in Wal Mart or a similar company, in a small dark room eight hours or more each day, something that would be acceptable as a career? This may not happen, but it is a sad reality to many recent optometry graduates."

OUR ENTIRE PROFESSION is based on sitting in a small, dark room eight hours a day whether you're at Hoosier Eye Doctor, Wal-Mart, or on a nuclear sub.

You can do this job for a little or you can do this job for a lot.

 

[Ken Elder]

Admittedly, I did not expect to work in commercial optometry when I graduated. It was a matter of timing, convenience, and financial evaluation. No one is really "forced" to do anything in this world so I'll move past that point. You noted the pay scale is better but also noted "the glamor factor is gone". It is awesome that somehow working between the nail salon and Qdoba across the street from the mall is somehow more glamorous than between the nail salon and Qdoba in the mall. Whether OD is a prestigious title or not, any employee can be fired at any time - period. You saying "Equity and patient loyalty cannot be built in that commercial environment." is pure garbage written by someone who simply doesn't know anything about that mode of practice.

"Would working in Wal Mart or a similar company, in a small dark room eight hours or more each day, something that would be acceptable as a career? This may not happen, but it is a sad reality to many recent optometry graduates."

OUR ENTIRE PROFESSION is based on sitting in a small, dark room eight hours a day whether you're at Hoosier Eye Doctor, Wal-Mart, or on a nuclear sub.

You can do this job for a little or you can do this job for a lot.

Any reference to doctors working between either a nail salon or a pizzeria violates my copyright on that phrase and I demand my royalty payment.

In the future, please do not use the terms "nail salon" or "pizzeria" when discussing practice locations.

$5 please.

 

[Mike Sandy]

$5 please.

Do you take Paypal?

 

[Jeffrey A. Wilson O.D.]

more op schools

Don't forget that 4 more optometry schools are opening in the next several years! Even more graduates to fight among the few jobs/opportunities!!!

I'd imagine most OD's could see a whole lot more people if they wanted to, so saying that there will be increased demand from baby boomers and what not doesn't justify the current number of graduates. OD's practice until they die in the chair-not enough income to retire? That wouldn't be a problem if there were fewer ODs.

Speaking of corporate optometry, I'd have to say that 2 pairs of glasses for $99 and a free eye exam does not add value or respect to the profession. Corporations have engineered eye care to be driven by the retail, not the healthcare side. Yes, some corporate docs have great practices, but if you think that most of your patients will follow you to your private practice to charge more $ than Walmart does, I'd challenge you to try it out! Good luck. Every patient I've had that came from Walmart doesn't even know the OD's name, they just went for the "cheap glasses" but they realized that that was exactly what they got.

I think corporate optometry has fragmented the profession and caused it to decline in respect and professionalism. Yes, it's the only option for a lot of graduates-but if docs didn't work there it wouldn't be an option and there would be more opportunity in private practices! For every doc that won't work at sprawl mart doc in a box, 10 are lined up ready to go. News flash: ODs make corporations (and their shareholders-who are their real boss) rich by working there, not themselves. The potential in private practice is 2, 3 or more times what the average corporate wage is. Just like pharmacists! Sure they make good money working for the man, but they used to make much more working for themselves-plus some control over their life/schedule and probably more respect. Optometry once again is its own worst enemy. I would highly caution people looking at optometry to do their homework first. By the way, I could have gone to dental school or medical school but chose optometry. I'm a private practicing solo doc who started cold 3 years ago and I am succeeding, but I wonder how much further ahead I'd be without corporate locations and an oversupply of O.D.'s....

 

[Steven Nelson]

Speaking of corporate optometry, I'd have to say that 2 pairs of glasses for $99 and a free eye exam does not add value or respect to the profession. Corporations have engineered eye care to be driven by the retail, not the healthcare side. Yes, some corporate docs have great practices, but if you think that most of your patients will follow you to your private practice to charge more $ than Walmart does, I'd challenge you to try it out! Good luck. Every patient I've had that came from Walmart doesn't even know the OD's name, they just went for the "cheap glasses" but they realized that that was exactly what they got.

I think corporate optometry has fragmented the profession and caused it to decline in respect and professionalism. Yes, it's the only option for a lot of graduates-but if docs didn't work there it wouldn't be an option and there would be more opportunity in private practices! For every doc that won't work at sprawl mart doc in a box, 10 are lined up ready to go. News flash: ODs make corporations (and their shareholders-who are their real boss) rich by working there, not themselves. The potential in private practice is 2, 3 or more times what the average corporate wage is. Just like pharmacists! Sure they make good money working for the man, but they used to make much more working for themselves-plus some control over their life/schedule and probably more respect. Optometry once again is its own worst enemy. I would highly caution people looking at optometry to do their homework first. By the way, I could have gone to dental school or medical school but chose optometry. I'm a private practicing solo doc who started cold 3 years ago and I am succeeding, but I wonder how much further ahead I'd be without corporate locations and an oversupply of O.D.'s....

I guess we can add your name to the list of folks that think this is exclusive to corporate practice. Let me take that illusion away with the following:

hoosiereyedoctor.com

Any doctor can make their practice anything they choose and I see plenty of private practices advertising "eye exam and 2 pairs of specs for $99". For that matter, in the State of Texas a corporation can't affiliate with an OD in any fashion so any implication or advertisement like that would be illegal.

I could have gone to medical school as well and went with my OD acceptance letter instead and I don't regret the decision one bit. This can be a frustrating profession, but it can also be a tremendously rewarding one both financially and personally. I'm a firm believer that those doctors with struggling practices would have the same problems in Medicine or Dentistry.

As for oversupply, it's a geographical problem. There isn't an oversupply, there is merely an oversaturation in certain areas. Large, metropolitan areas can only handle so many ODs yet that seems to attract us like moths to a flame. I don't support the decision to open more schools because I think they're not necessary, but our problem has nothing to do with too many ODs, it's got everything to do with the fact that they all want to live in one place. There are literally thousands of areas where there are no ODs. They might be rural areas, but there out there and this same problem exists for any business. It's simple economics.

 

[Matt Judd]

I was very naive before entering optometry school (97). My doctor growing up was in private practice, and the doctors I visited through college were in private offices. Even in school, commecial practice was never even mentioned. I recall a professor or two making jokes about it, but thats about it. On one occasion, a speaker asked the audience how many planned to work in a commercial environment. Not one hand went up (I'm sure, in retrospect, he had a chuckle inside).

I can say this without delay, and with absolute sincerity: had I known optometry was such a commercial being, I would never, ever have become an optometrist. Never.

 

[Steven Nelson]

I was very naive before entering optometry school (97). My doctor growing up was in private practice, and the doctors I visited through college were in private offices. Even in school, commecial practice was never even mentioned. I recall a professor or two making jokes about it, but thats about it. On one occasion, a speaker asked the audience how many planned to work in a commercial environment. Not one hand went up (I'm sure, in retrospect, he had a chuckle inside).

I can say this without delay, and with absolute sincerity: had I known optometry was such a commercial being, I would never, ever have become an optometrist. Never.

I find it very interesting that you grew up in an environment heavily dependent on retail sales, yet find commercialism such an affront to your sensibilities. The irony is not lost on me anyway.

Just so you know, if memory serves you were only a couple of years behind me at SCO so you still have plenty of time to do something else with your life.

 

[Matt Judd]

I remember having an exam in high school, where the exam was done, the results were discussed. I was then taken to a room full of frames, where a frame was selected for me, I was asked a series of questions 'do you want thinner lenses', etc etc. No prices were discussed. There were no prices on the frames. After essentially having the glasses ordered without even a question of whether I even wanted them, I went to the front and promptly paid a $435 bill.

That, my friend, is traditional optometry. Bad? Yes. Anything having to do with professionals working in a grocery store chain that also sells tires and cheap cosmetics? Absolutely not.

 

[Steven Nelson]

The difference between that exam and my exam is that your entire experience was focused around the profit made from the glasses. I'll bet the "results" you discussed had strictly to do with what was going to be required for your refraction. Maybe to you that's what optometry is all about, but for me it's a little more complex than that. I'll let you make your recommendations based on the net profit necessary to make your boat payment and I'll just focus on patient care.

You're a bad punchline if you're going to sit there as a salesman and try to cast aspersions on me when the only focus of my practice is professional services. Does my geography bother you? Good...because odds are all of your patients pass my office several times per week and eventually make it into my office where they have the refreshing experience of their examination being about THEM rather than what they're going to buy when they're done. Oh, and they probably wonder why my equipment is so much nicer than their last doctor.

For those that might read this article that might not be in the profession, there is a war of sorts that constantly wages between those in self-contained practice and those affiliated with corporate entities. It's never pretty and it's never solved so my apologies if this dialogue seems a little personal. There are lots of divisions within this profession where the "private" folks try to look down on the corporate ODs based on jealousy, antiquated notions and rhetoric with virtually NO basis in fact.

 

[Matt Judd]

Steven,
I have absolutely no idea where your last post even came from. What are you talking about? I can see you really have a personal issue with working at WM. And the post you deleted, very mature bringing my "dad" into this.

You working in a commercial practice has nothing to do with my opinion of you or anyone else in commercial practice. Having an anti-commercial bias is an issue of the profession itself, not a personal issue. You really can't see this, can you?

I'm starting to see that the person with the most problem in working at Wal-mart is you.

And don't worry, theres been an ODWire Aggrandizement issue here for a long time. It's difficult to control that new megaphone you got for Christmas. After a while, your new toy will grow old, and you'll realize you really by golly are a true blue professional (no pun intended).

 

[Steven Nelson]

Steven,
I have absolutely no idea where your last post even came from. What are you talking about? I can see you really have a personal issue with working at WM. And the post you deleted, very mature bringing my "dad" into this.

You working in a commercial practice has nothing to do with my opinion of you or anyone else in commercial practice. Having an anti-commercial bias is an issue of the profession itself, not a personal issue. You really can't see this, can you?

I'm starting to see that the person with the most problem in working at Wal-mart is you.

And don't worry, theres been an ODWire Aggrandizement issue here for a long time. It's difficult to control that new megaphone you got for Christmas. After a while, your new toy will grow old, and you'll realize you really by golly are a true blue professional (no pun intended).

I didn't "bring your dad into it", I misread your initial post and thought your dad was an OD. After re-reading it, my post didn't make sense so I deleted it.

I have no problem where I work. I've been in private, military and now corporate practice and I have to say that my current practice is the most profitable, medically oriented care I've been able to provide. My overhead has created a situation where I could acquire equipment to rival 99% of the optometry practices out there and the variability of my patients health profiles has made me more proficient in filing medical insurance than most ODs (and probably OMDs as well).

My biggest problem with people of your mindset is that you completely ignore our history. You want to throw some mantle of responsibility for creating a "retail image" of our profession because it offends the nature of your education. Since we had it at the same place at the same time, I can understand this because we were trained to be doctors but our forefathers were largely salesmen who did "exams" merely as a vehicle for selling materials. Our practice as actual doctors is a relatively new phenomenon and it takes time for that image to take root. Do you think the kids you see now will have the same adult image of ODs that your older patients now do?

I certainly don't want this to be personal, but this whiny "if I'd only known, sob sob sob" attitude just makes me crazy. The long and short of it is that optometry is a very rewarding profession that even in a reportedly dismal economy does someone make less than a very stable six figures.

 

[Matt Judd]

It is a great profession. However, theres a huge beast that will never go that may in fact be the reason BC is trying to be pushed through. Agree with me or not, but its the truth. Many academics and a % of those in PP absolutely despise commercial practice.

Have you forgotten it was illegal to advertise in the 80s? Have you forgotten that the OD boards used to censor routinely for reasons you couldn't comprehend today.

Retail profession or not, optometry was always a private profession until the 80s. Again, as everyone knows, the fact that we sell Glasses is not the same thing as commercial optometry.

 

[Jeffrey A. Wilson O.D.]

I guess we can add your name to the list of folks that think this is exclusive to corporate practice. Let me take that illusion away with the following:

hoosiereyedoctor.com

That is disturbing to see. I guess let me expand my definition of corporate practice: any practice that does that-promise to be low price, 2 for _$, the exam as a means to an end, etc. Yes, the product does drive the profession, I wish it was the professional side of things, but I would suggest that MOST corporate locations trivilaze the eye exam as an inconvenient end in order to buy the glasses for $X. America's Best bobble head doctor is a perfect example, why anyone would work at a place that does that is beyond me. Yes, there are very few private practices that stoop to compete such as the one referenced above, but I would be willing to bet plenty that they wouldn't if it wasn't for the corporate influence.

Just my 2,000,000 cents -adjusted for (soon to be) inflation.

 

[Steven Nelson]

It is a great profession. However, theres a huge beast that will never go that may in fact be the reason BC is trying to be pushed through. Agree with me or not, but its the truth. Many academics and a % of those in PP absolutely despise commercial practice.

Have you forgotten it was illegal to advertise in the 80s? Have you forgotten that the OD boards used to censor routinely for reasons you couldn't comprehend today.

Retail profession or not, optometry was always a private profession until the 80s. Again, as everyone knows, the fact that we sell Glasses is not the same thing as commercial optometry.

What I find somewhat interesting about this rhetorical argument about our "image" is that everyone always harkens back to the glorious days before corporations. It's always portrayed as back when we were more respected and professional, but it sort of rings falsely. We are at a point, despite any effect of corporation, where we have the largest scope of practice in history, have the highest reimbursements for professional services in history, have more access to medical plans than any time in history and provide actual "doctor" care more than we ever had. In those "golden" years, we were nothing but refractionists and doctors in much the same way as a PhD. I, for one, would have HATED practicing in those days.

You can say what you want about our "image", but the fact is that we are considered to be doctors a heck of a lot more than before corporations came to the market place (a model initiated by groups of ODs, by the way). So I think it could be fairly argued that corporations have had little affect on the progression of this profession.

I agree that there is a lot of hatred and resentment toward corporate affiliated ODs by a small population of small-minded ODs with no appreciation for the realities of the modern market. What those folks need to realize is that close to 50% of the practicing ODs out there are affiliated with corporate entities and that it's much more important to nurture our profession as a whole and protect it's integrity than holding on to misplaced nostalgia. It's the patient care that matters and our job is to make sure its always of the highest caliber regardless of where it's adminstered.

 

[Jeremy Ernstes]

Visionworks?

I've heard the stories about America's Best and the other corporate beasts..... I suppose Visionworks is the same? Anyone know anything about them? I'm a luxottica "bobble head" now, just wondering if the grass was any greener at the other box store.

 

[Joe DiGiorgio O.D.]

Steve,

You are a guy with a lot of experience, and seem to have a good perspective on the eyecare marketplace.

How could you see private O.D.s with decent practices, being able to make an effective opportunity for new grads, so that the grads would actually find this as an attractive option? Most O.D.s probably don't have the business savvy to do this effectively, yet they could have great single doctor practices which could be a great opportunity, perhaps initially on a part-time basis, for young docs to further develop a nice private practice opportunity.

You have said elsewhere in this topic, that some O.D.s may not be profitable no matter what occupation they had chosen to pursue. You, on the other hand, would probably be successful at whatever profession or location you were/are/will be involved with. You could probably be a great practice consultant.

So what could you, consultant Nelson, recommend for these new docs, if they want to try to get a private practice opportunity?

Sincerely,

Joe D.

 

[Mike Sandy]

So what could you, consultant Nelson, recommend for these new docs, if they want to try to get a private practice opportunity?

Great question. What Would Private Practice Steve Do?

 

[Steven Nelson]

Steve,

You are a guy with a lot of experience, and seem to have a good perspective on the eyecare marketplace.

How could you see private O.D.s with decent practices, being able to make an effective opportunity for new grads, so that the grads would actually find this as an attractive option? Most O.D.s probably don't have the business savvy to do this effectively, yet they could have great single doctor practices which could be a great opportunity, perhaps initially on a part-time basis, for young docs to further develop a nice private practice opportunity.

You have said elsewhere in this topic, that some O.D.s may not be profitable no matter what occupation they had chosen to pursue. You, on the other hand, would probably be successful at whatever profession or location you were/are/will be involved with. You could probably be a great practice consultant.

So what could you, consultant Nelson, recommend for these new docs, if they want to try to get a private practice opportunity?

Sincerely,

Joe D.

My ego thanks you and wishes it could say that it's owner didn't learn these lessons by screwing it up the first time.

In all seriousness, I think the biggest problem with ODs in general is that they don't really do their homework in terms of where to practice and a lot of things fall down from there. In order to be able to provide a competitive opportunity, you need to be in a practice that is growing beyond your ability to sustain alone. Many ODs try to expand in an effort to grow their practice, but that's sort of the backward approach. New people don't grow a practice and in most cases initially they merely take the heat off of the "main guy" so that they can continue to grow the practice by seeing and wowing those new patients with the same formula that built it to begin with. When you don't have that growth curve, you can't really offer a salary that can begin to compete with the other alternative.

I think that unless you're in an area with high demand, most practices would actually be best served by just one doctor and a highly trained optical staff. If I were back in private practice, I would focus largely on medical care and make sure that the word is out that my optical staff is unparalleled. I would also focus on more specialty services like specialty contacts etc. You need to be able to serve the masses, but really ANYONE can do that and it's hard to carve out a niche in "ordinary". A big boost to being able to absorb a future partner is having a high net per patient...I don't mean sticking it to anyone, but a little bit of fundus photo here, a little ortho-K there, a few keratoconus fits and you're doing something DIFFERENT.

You also need to decide up front what you're looking for. Do you want an employee or do you want a partner? I think that if someone is "buying in" to a practice, that's justification for a lower salary but what a lot of docs do is start off with that low salary to see how it goes and they string people along with unfulfilled promises. You might be able to get a really good OD for $40K, but there are only so many Scott Caughells to go around. I guess the best advice for a private OD is to make sure they're in an area that can support growth and aggressively grow it and be willing to pay someone what they're worth...either in terms of dollars or practice equity.

To be honest, I think that most practices that think they need to expand simply suffer from intractible inefficiency. A change to EMR, better tech usage and/or a second lane of equipment would actually do a hell of a lot more to grow a practice than a second doctor.

Just my two cents.

 

[Joe DiGiorgio O.D.]

Good reply Steve. "Lessons a big box doc learned at the school of hard knocks" A good title for for a practice management lecture, and perhaps the segway to a consulting practice.

Excellent point that the practice should services, staff, efficiency and excellence in service.

So if this doc has a great one-doctor practice, how could the savvy new-grad sell him/her self that he or she could add value to the senior doc, maybe at the 2 or 3 day per week level? And then possibly working in a 2nd practice, or OMD location for the balance of the week.

Do you think this could be an opportunity for young docs to incubate the practice management experience and entrepreneurial spirit, so that the exceptional young doc can become an owner either in the current practice, or eventually at another location? ( I am not advocating to cannibalize patients from the primary location--do no harm, and burn no bridges)?

"Nelson Consulting" that concept may have legs.

Sincerely,

Joe D.

 

[Steven Nelson]

If I were a new grad (oh...to know what I do now), I would try to find a practice that doesn't do what I have an interest in. If you're really into path, I would pitch to practices that either have a path volume that the current doctors have a hard time servicing OR EVEN BETTER pitch to a practice that's largely refractive so that you're bringing something to the table they currently DON'T do. If the latter is the case (really the best case scenario IMHO), make sure you know all aspects including demographic info for the area, how to bill, etc (it also wouldn't hurt to have the insurance credentialing process started before you go so that you can present yourself as truly being ready to go).

You really don't want to bring homework for the people you're trying to convince to hire you, so you really need to be able to present a "business plan" that shows real growth (I don't really mean "numbers" of patients as much as I do types and revenue generation as a result) as a direct result of you. The thing is that you really need to present yourself as an asset they would miss. If you're trying to just fit in with the norm, welcome to Ordinaryville population virtually everyone.

I would also like to take this opportunity to give advice to students that might read this...LEARN SOMETHING UNIQUE. One thing it took 10yrs of practice to learn is that there is a HUGE market in specialty contact fittings. What's better is that there's no competition from ophthalmology and no legislative restriction. Our main job and the main expectation from the public is to make them see. Yes, path is sexy but you'll never be the "main guy" unless you get absorbed into a mega practice and the future is in Optometry (medical care is an important aspect, but there's LOTS more to optometry than disease). There is almost no competition anywhere in areas like low vision, specialty fittings, binocular vision etc.

Let's say you CAN bring in a totally different population of patients, THAT'S a marketable aspect. Especially if you're bringing in things like $300 contact fittings and potential referrals from PCPs that don't currently consider it and even OMDs in certain cases.

Man, these posts really make it sound like I know what I'm doing.

 

[Jorge F PerezVelasco]

Great job Paul. Optometry is a good profession but I think Paul has highlighted the main problem with it being the difference between perception and reality. As long as you go in knowing what to expect then it is fine. Even corporate practice is fantastic if you know what to expect.

We are taught by practice management experts that as OD we should under promise and over deliver to our patients. Optometry as a profession does not do this but rather does the reverse. Optometry is not as glamorous, as lucrative or gives you as much independent and freedom as advertised. But then again it is all relative.

Unfortunately, most OD don't know what they have gotten themselves into until it is too late. The field is a major commitment in time, effort and money. Not something easily started nor easily dropped.

 

[Steve Howard]

I guess we can add your name to the list of folks that think this is exclusive to corporate practice. Let me take that illusion away with the following:

hoosiereyedoctor.com

Any doctor can make their practice anything they choose and I see plenty of private practices advertising "eye exam and 2 pairs of specs for $99". For that matter, in the State of Texas a corporation can't affiliate with an OD in any fashion so any implication or advertisement like that would be illegal.

I could have gone to medical school as well and went with my OD acceptance letter instead and I don't regret the decision one bit. This can be a frustrating profession, but it can also be a tremendously rewarding one both financially and personally. I'm a firm believer that those doctors with struggling practices would have the same problems in Medicine or Dentistry.

As for oversupply, it's a geographical problem. There isn't an oversupply, there is merely an oversaturation in certain areas. Large, metropolitan areas can only handle so many ODs yet that seems to attract us like moths to a flame. I don't support the decision to open more schools because I think they're not necessary, but our problem has nothing to do with too many ODs, it's got everything to do with the fact that they all want to live in one place. There are literally thousands of areas where there are no ODs. They might be rural areas, but there out there and this same problem exists for any business. It's simple economics.

Dr. Nelson, I respectfully disagree with the notion that there is no oversupply problem with optometry.

I agree there are certain rural areas where one could set up shop and do well but most of these are so remote and very undesirable by any healthcare practitioner. I grew up in the Texas panhandle, one of the least desirable places for new graduates unless one grew up there.

Both larger cities, Lubbock and Amarillo, are full of ODs and OMDs, and all the surrounding smaller towns with enough population are also well supplied. In comparing ODs to family docs or internists who are not in oversupply, they aren't encouraged to find some little nook and cranny location where there is room for another doc, whereas with optometry it is becoming a necessity.

Yea, here in Houston, there definitely is an oversupply. If 25% of ODs retired tomorrow, the healthcare industry wouldn't be effected at all. The OMDs in my area routinely see 70-100 patients/day.

There aren't many ODs seeing more than 40 patients/day. Many are seeing like 10 patients/day. There simply isn't enough patients seeking the help of ODs as supply would allow. With all the vision plans out there driving patients into OD practices, why don't we have individual ODs seeing 70-100 patients/day?

The answer is we have to share these patients with so many other ODs. This is an argument nobody will ever win, but I thought it would be fun to discuss.

 

[Paul Farkas]

To add to the optometric oversupply problem...

New optometry colleges are opening their doors this month in Arizona, California and Texas.

 

[Steven Nelson]

Dr. Nelson, I respectfully disagree with the notion that there is no oversupply problem with optometry.

I agree there are certain rural areas where one could set up shop and do well but most of these are so remote and very undesirable by any healthcare practitioner. I grew up in the Texas panhandle, one of the least desirable places for new graduates unless one grew up there.

Both larger cities, Lubbock and Amarillo, are full of ODs and OMDs, and all the surrounding smaller towns with enough population are also well supplied. In comparing ODs to family docs or internists who are not in oversupply, they aren't encouraged to find some little nook and cranny location where there is room for another doc, whereas with optometry it is becoming a necessity.

Yea, here in Houston, there definitely is an oversupply. If 25% of ODs retired tomorrow, the healthcare industry wouldn't be effected at all. The OMDs in my area routinely see 70-100 patients/day.

There aren't many ODs seeing more than 40 patients/day. Many are seeing like 10 patients/day. There simply isn't enough patients seeking the help of ODs as supply would allow. With all the vision plans out there driving patients into OD practices, why don't we have individual ODs seeing 70-100 patients/day?

The answer is we have to share these patients with so many other ODs. This is an argument nobody will ever win, but I thought it would be fun to discuss.

I think we're talking semantics. Any urban area will have a saturation problem and that applies to ANY profession whether it be optometry, medicine, dentistry or even retail oriented industries. I think you have to realize that supply and demand are REAL economic principles and just recognize that if you decide to set up shop in an area where there are already too many providers of your type, you'll be begging for scraps. The way around this is to find areas in demand and you don't have to go to "undesirable" areas to do it. I would think that one of the main characteristics of undesirable would be the inability to make a living. The other way around this is to do something outside of the norm. Specialty practices are hard to build, but they're about the only way to set yourself apart from the norm.

Don't get me wrong, I do not endorse in any, way, shape or form the opening of new schools. These were opened in response to what is perceived as a demand and if you factor in those rural areas, it's probably a valid analysis. The problem is that flooding the market with new graduates won't necessarily make ODs move there. It will only serve to further burden the already overpopulated areas. It will also serve to possibly lower admission standards (and subsequently produce less than qualified providers) because I've never read any stastic that suggests that there is a significant volume of QUALIFIED applicants being denied at our current institutions which in my mind is the only valid justification for opening a new school.