Best state to practice optometry?

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adenosine said:
I know it's probably been asked before, but given each state's unique laws, regulations, populations, and other important factors, I am curious: which state would be the best to start up a practice? Other docs I have spoken to say go for smaller towns and to avoid cali and utah. Any opinions out there?
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Choose your location on lifestyle setting. If you like mountains, beaches, urban/city etc; then choose accordingly. In this economy, smaller towns/rural areas would be your best bet in opening a new practice as opposed to an already saturated city.
 
Meibomian SxN said:
Choose your location on lifestyle setting. If you like mountains, beaches, urban/city etc; then choose accordingly. In this economy, smaller towns/rural areas would be your best bet in opening a new practice as opposed to an already saturated city.
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BBBBZZZZZZZZZZZZTTTTTTTTTTTTTTTT!!!!!!!!!!!!!!!!!!!

WRONG!!!!!!!!!!

Ok class.....who out there wants to tell this misguided soul what the number one factor in selecting a practice location should be??
 
KHE said:
BBBBZZZZZZZZZZZZTTTTTTTTTTTTTTTT!!!!!!!!!!!!!!!!!!!

WRONG!!!!!!!!!!

Ok class.....who out there wants to tell this misguided soul what the number one factor in selecting a practice location should be??
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Ability to get on vision plans! All future optometry students need to know how hard it is to get on vision plans, never allow yourself on a medical plan, those are for MDs and DOs and a trick for ODs, but make sure you try to get on vision plans, vision is an optometrists right line of work! If i was a OD and a medical plan called me to give me membership, Id hang up and call 1-800-Contacts for legal advice!
 
jupiterOD said:
Ability to get on vision plans! All future optometry students need to know how hard it is to get on vision plans, never allow yourself on a medical plan, those are for MDs and DOs and a trick for ODs, but make sure you try to get on vision plans, vision is an optometrists right line of work! If i was a OD and a medical plan called me to give me membership, Id hang up and call 1-800-Contacts for legal advice!
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:boom::boom::boom:
 
Logically it would be an area with the most demand, where you can make the most money.






(Exception: unless you choose Beverly Hills with the sole intention of attaining your own celebrity optometry reality TV series)
 
jymezg said:
Logically it would be an area with the most demand, where you can make the most money.

(Exception: unless you choose Beverly Hills with the sole intention of attaining your own celebrity optometry reality TV series)
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or maybe just access to medical panels...
 
or...come and practice in Canada, where you don't have to worry about manages care BS...at least not yet!😉
 
What is wrong with practicing in California and Utah?
 
Flanz said:
What is wrong with practicing in California and Utah?
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California is over saturated with OD's on every street and their laws prevent you from full scope Optometry with Lenscrafters and other big boxes hiring OD's keeping their pay low.
UTAH patients won't pay for high end. Too cheap, with so many Children and other forces taking their income. Church donations, Mission work, and being frugal.
 
KHE said:
BBBBZZZZZZZZZZZZTTTTTTTTTTTTTTTT!!!!!!!!!!!!!!!!!!!

WRONG!!!!!!!!!!

Ok class.....who out there wants to tell this misguided soul what the number one factor in selecting a practice location should be??
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Well class, as you can see this is an example of an unhappy doc who chose WRONG!!! Learn from his mistakes :laugh:

Imagine making lots of money and hating the place where you LIVE (What a life)! I know many ODs and MDs who went to a location that did not suit them but they got paid good. They never stay and are always scanning the classifieds for a way out!

If all you are going to accept is Vision plans, then you might as well go work for commercial because they are starting to be the default Vision Plan (AmBest, etc). You'll get a high starting salary and will not have to worry about insurance woes...

Research NOW and see what lifestyle/type of setting you like; and then look at things like state laws, population preferences etc. Mid-Westerners do not typically fit in NYC and SoHo docs definitely would not survive in the Mid-West. Red pill/Blue Pill :xf:
 
I've heard that Florida and OKlahoma are two good states to work in just because the scope of the practice is better there and u are allowed to do alot more? Not sure how true this is though..
 
Pre Opt Student said:
I've heard that Florida and OKlahoma are two good states to work in just because the scope of the practice is better there and u are allowed to do alot more? Not sure how true this is though..
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You are incorrect about Florida. Not the best scope there.
 
IndianaOD said:
You are incorrect about Florida. Not the best scope there.
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So true. They have one of the toughest state boards and you have to pass a practical exam!!! :scared: All that and you can't Rx orals...so hope you're good at selling shades 😎
 
California is very restrictive as far as TPA's- no such thing as a medical optometric practice. It is all refractive.
 
Tennessee and Oklahoma, I think have the widest scopes. Tennessee allows injectables so we learn all that in school here. I'm not sure, other than these two states if anyone else allows injectables. Anyone know?
 
Alabama is a great state to practice. We are looking at possibly getting injections in the near future. We can write appropriate orals including most narcotics. Most of us in urban areas have great relationships with the MDs who do Sx for our pts. Oklahoma has the best laws I believe, but I lived in Muskogee for a while and would rather slice my left arm off than move back. 🙂

Also, Alabama has a great variety of International populations and SES levels which gives you the opportunity to work with a variety of people in your career.
 
LionSight said:
Alabama is a great state to practice. We are looking at possibly getting injections in the near future. We can write appropriate orals including most narcotics. Most of us in urban areas have great relationships with the MDs who do Sx for our pts. Oklahoma has the best laws I believe, but I lived in Muskogee for a while and would rather slice my left arm off than move back. 🙂

Also, Alabama has a great variety of International populations and SES levels which gives you the opportunity to work with a variety of people in your career.
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Did you smoke marijuana?
 
😕 KHE, I know the post rambles a little but what do you mean by this ?


Also I am hearing about how NC keeps OD's numbers artificially low and has a very selective board...but is a very lucrative State to practice in,
with some nice areas to live in.
I'd like some feedback from anyone who has some experience there.
_
 
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JAZZEYE said:
😕


Also I am hearing about how NC keeps OD's numbers artificially low and has a very selective board...but is a very lucrative State to practice in,
with some nice areas to live in.
I'd like some feedback from anyone who has some experience there.
_
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What do you mean by this?
 
I don't think having a particular scope of practice necessarily makes a place great for optometric practice. A reasonable scope of practice is neccessary, but I would not base my criteria on where to practice based on seldom/never used procedures like injection.

Honsetly, a the best place to practice is where you will see lots and lots of patients and be compensated fairly for your professional services. No point in having injectables staring at an empty chair.
 
cloud99 said:
What do you mean by this?
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Thats my question ...what does this mean ?. I'm quoting a statement I came across browsing either the forum here or ODwire can't remember which. Sorry I couldn't recall the source and be more specific ...just made me curious myself :shrug:
 
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ICOnut said:
California is very restrictive as far as TPA's- no such thing as a medical optometric practice. It is all refractive.
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You are mistaken.

Recent graduates as of 2008 can now prescribe glaucoma medications. We can prescribe full scope of topical antibiotics, antivirals, steroids, NSAIDs, and anti allergy eye drops. We can prescribe oral antibiotics, antivirals, and pain meds (category 3).

This being said, there are not too many medical (optometric only) practices in California. I have heard of a few though. Most are refractive mainly, but do treat ocular pathology, unless of course you work with ophthalmology, which is the case with me. I do about 40% refractive and 60% medical on a 5 day work week basis.

As far as being the "best state to practice Optometry", I would agree that California is probably not the state with the most options. I have many colleagues and know many recent graduates trying to stay in CA that are having a tough time finding consistent work. Sad really, especially given the new optometry school that just opened in Pomona.

We're all promised abundant lucrative job offers after graduation, but the reality is that the good jobs may not be in an area you want to stay in.
 
JAZZEYE said:
😕 KHE, I know the post rambles a little but what do you mean by this ?


Also I am hearing about how NC keeps OD's numbers artificially low and has a very selective board...but is a very lucrative State to practice in,
with some nice areas to live in.
I'd like some feedback from anyone who has some experience there.
_
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I think the accusation that they keep the numbers artificially low is ridiculous. They do have a VERY intense state board set to pass, and they DO deny people that they feel would not meet their level of expectations. I know several doctors in NC and several students heading there. They feel it is worth the extra effort.
 
KHE said:
LMAO. Am I really that old? No one knows who Merle Haggard is?
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Hate to break it to you, but yup. My grandpa's a big fan, though 😉. Anyway, white lightnin's still the biggest thrill of all...:laugh:
 
yOyOYoo said:
You are mistaken.

Recent graduates as of 2008 can now prescribe glaucoma medications. We can prescribe full scope of topical antibiotics, antivirals, steroids, NSAIDs, and anti allergy eye drops. We can prescribe oral antibiotics, antivirals, and pain meds (category 3).

This being said, there are not too many medical (optometric only) practices in California. I have heard of a few though. Most are refractive mainly, but do treat ocular pathology, unless of course you work with ophthalmology, which is the case with me. I do about 40% refractive and 60% medical on a 5 day work week basis.
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Speaking to colleagues in California, the biggest issues are not the scope of practice per se, but the fact that comparatively few medical insurance panels will credential ODs. That of course, is the issue that I have harped on for years now, both on this forum and otherwise.

Stonegoat points out that there is no point in having a large scope of practice if you have no patients in your chair. That's true. I can't speak for Canada but here in the USA, the biggest factor in determining whether a patient will be in your chair or not is whether you as the provider are on their insurance plan.

So it doesn't make any difference if you are licensed to treat glaucoma because if you aren't on the patients insurance plan, you won't be treating them because they won't be in your chair unless you want to treat them for free under their VSP or other vision plan.
 
LionSight said:
I think the accusation that they keep the numbers artificially low is ridiculous. They do have a VERY intense state board set to pass, and they DO deny people that they feel would not meet their level of expectations. I know several doctors in NC and several students heading there. They feel it is worth the extra effort.
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What is the point of the "very intense" state board in this day and age other than to keep the number of ODs artificially low?

North Carolina at one point was at or near the forefront of TPA legislation. So at that time, it may have made sense to have that intense process so as to ensure that there wasn't a mass migration of under trained ODs.

However here in 2009, North Carolina's scope is no broader than the majority of states out there. So again, given modern optometric training and the NBEO sequence of exams, what is the point of that "intense process" other than to erect artificial barriers?
 
Hey can anyone create a table of a similar sort that the DPMs did in their forums about their scope of practice by state? (http://forums.studentdoctor.net/showthread.php?t=447651&highlight=scope+of+practice+by+state)

I know it is fun looking through ICO's links and reading the fine print about the scope of practice of optometry by state 😀

But yea it would really be awesome if something like this existed or someone would make it. It would clear up a lot of confusion. THANKS!
 
Great thread! I am also interested in this chart that Shnurek suggested. Is there a website that has all of this info but summarized?

Any thoughts about GA and TX scope of practice?
 
Here is the best thing I have found so far to show the scope of practice in the 50 states. Most of the images are from 2007 so it might be slightly different (less restricting) now.
 

Attachments

Some good info so far.
KHE's big point of emphasis is always the ability to get onto medical plans.

One thing I'd add is to find out what states have strong Any Willing Provider (AWP) legislation. The state mandates that any provider qualified to provide a medical service can (and often get paid the same for it as well).

A question to ask would be, "Can you sign up for Aetna w/o having to accept EyeMed/VSP or United Health Care w/o taking Spectera/Optimum?"

OK and the upper Midwest states are generally regarded as best optometric conditions.

TX has a restrictive glaucoma-treating policy, but the population shift and job prospects make it attractive yet.
 
I am entering my 31st year of practice, and having practiced in 3 states my feeling is there is not an ideal state to practice in versus any other; what is probably more important is your clinical skills, demeanor, and business savvy. Patients still want friendly, caring doctors who talk to them and not down at them and show they provide quality care. I think if anyone can practice this way they will be successful in any state they go to.
 
southwesternOD, thank you for your input. Is there anymore advice you can give a young shrimp like me? 😀 It is kind of rare, I think, to see someone with so many years under their belt as an optometrist on these forums.
 
Is there anyone willing to share their experiences practicing and/or becoming licensed in Oregon? I would love to end up back in the pacific northwest but I have yet to hear anything about the market there?
 
Salus2014 said:
Is there anyone willing to share their experiences practicing and/or becoming licensed in Oregon? I would love to end up back in the pacific northwest but I have yet to hear anything about the market there?
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I've heard good things about Oregon and Washington. I have plans on going back to Washington and they have AWP legislation so....yipee!
 
KHE said:
*AHEM!*

AWP legislation means ZERO if you can not be credentialled onto medical insurance plans.

Be sure that you can before you consider practicing there!
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Since I know about as much as a pre-schooler (not sarcastic) would you elaborate on your above statement?

I just learned about AWP about 19 hours ago and its not the most comprehensible thing (from online readings). Isn't the whole point of AWP make it so you can't be denied access to an insurance panel?

This came from a PM discussion I had with a SDN optometrist "Washington has what we call an "Any Willing Provider" law which makes it illegal for any plans to discriminate against optometrists" and is the current extent of my understanding on the topic.

p.s.- I hope to be KHE someday
 
thecgrblue said:
Since I know about as much as a pre-schooler (not sarcastic) would you elaborate on your above statement?

I just learned about AWP about 19 hours ago and its not the most comprehensible thing (from online readings). Isn't the whole point of AWP make it so you can't be denied access to an insurance panel?

This came from a PM discussion I had with a SDN optometrist "Washington has what we call an "Any Willing Provider" law which makes it illegal for any plans to discriminate against optometrists" and is the current extent of my understanding on the topic.

p.s.- I hope to be KHE someday
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I THINK - they can't deny you BECAUSE you're an optometrist - but medical plans close their panel when they have enough docs on it, which means they CAN deny you if there's no more room. (I also have a lot to learn about medical insurance so if KHE would like to elaborate or correct me I'd appreciate it)
 
I'm not good with googling legislative things such as scope of practice of a certain state. Honestly, I get lost in the bunch of words.

What does it take to get credentialed into med plans?
 
thecgrblue said:
Since I know about as much as a pre-schooler (not sarcastic) would you elaborate on your above statement?

I just learned about AWP about 19 hours ago and its not the most comprehensible thing (from online readings). Isn't the whole point of AWP make it so you can't be denied access to an insurance panel?

This came from a PM discussion I had with a SDN optometrist "Washington has what we call an "Any Willing Provider" law which makes it illegal for any plans to discriminate against optometrists" and is the current extent of my understanding on the topic.

p.s.- I hope to be KHE someday
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ARGH! You're right. I blew it. I don't know what the heck I was thinking. I was thinking in terms of broad scope of practice. THAT is what means nothing.

AWP in general DOES mean that a plan has to accept any provider willing to agree to the terms offered. So in that scenario, you should be able to access medical plans.

AWP legislation however does NOT prevent plans from paying optometrists on a different scale.
 
KHE said:
ARGH! You're right. I blew it. I don't know what the heck I was thinking. I was thinking in terms of broad scope of practice. THAT is what means nothing.

AWP in general DOES mean that a plan has to accept any provider willing to agree to the terms offered. So in that scenario, you should be able to access medical plans.

AWP legislation however does NOT prevent plans from paying optometrists on a different scale.
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Please excuse my ignorance, but by this do you mean the AWP legislation has no control over reimbursement?
 
KHE said:
ARGH! You're right. I blew it. I don't know what the heck I was thinking. I was thinking in terms of broad scope of practice. THAT is what means nothing.

AWP in general DOES mean that a plan has to accept any provider willing to agree to the terms offered. So in that scenario, you should be able to access medical plans.

AWP legislation however does NOT prevent plans from paying optometrists on a different scale.
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ERISA plans (employer self funded plans) also trump AWP laws. There are a lot of patients covered under ERISA plans so if the area you're practicing in has these you are still screwed.
 
That one would be quite difficult to answer, considering that there are several factors that you need to consider. Also, your preference will be taken into account for your choice.
 
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