Feeling like a PROSTITUTE

[Tasteestuff]

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Woww. Unbelievable...

I have a close friend who is an Ophthalmology resident and he once told me that he needed some extra income and decided to moonlight at Walmart and PearleVision. (He was paid $600 at Walmart and $550 at Pearle)

He came back from those offices and complained to me that he felt like a 'Prostitute'. I could not believe what he was saying since I have many friends (from my class) who are currently working for those commercial stores. I thought he was disrespecting our profession and I serioulsy felt upset about it until......

I filled in for a friend at Walmart and Sam's Club. Wow.. What an experience.. I did feel like I was a 'PROSTITUTE'. That is not what my profession was supposed to be. Patients attitude said it all. They came in with the same attitude as entering the Nail/Hair Salon next door. Their attitude was "Can you quickly rotate some dials and give me a new pair of glasses??" Holy $$$hhhiiiittt.. 😡 Dammmnn it..

Please.. Let's not lower the standard of our profession any more.. Please don't take those idiotic positions. Let's go back to our roots and re-introduce what our profession was and what it is supposed to be: "A DOCTOR'S OFFICE"

If you want to be called a 'Doctor', please... work/live like one. You will never see a MD, DO, DDS setting up an office at Walmart, what the hell are we doing?

In addition to "Free exam with purchase of glasses", "$19.99 for an eye exam if you purchase glasses." WTF !!! While Medicare reimburses roughly $130 for comprehensive eye exam, some loser/Bozo fuc#$%ing idiot charges $20 if you purchase glasses from him..

I am just getting so 'mad' with where our profession is going. How do you call yourself a doctor if 'my medical/optometric exam is free if you buy glasses from me'. What a *****..

Sorry for my crazy RANT

 

[f_w]

I guess for $19.90 per pop, that would be a low-end prostitute.

 

[71263]

I feel like a prostitute too. I dunno what it is. Maybe all the sex for money ive been having lately...

 

[ddown]

Have you seen the latest America's Best commercial?? Not sure if it's only local, but can you make our profession seem any more worthless? The whole commercial has this Old Navy commercial feel to it and the doctor is portrayed as some wobble-headish idiot as they advertise free eye exams. Oh, and if you join their eyewear "club", its free eye exams for THREE years! Whippeee!

 

[Tasteestuff]

Have you seen the latest America's Best commercial?? Not sure if it's only local, but can you make our profession seem any more worthless? The whole commercial has this Old Navy commercial feel to it and the doctor is portrayed as some wobble-headish idiot as they advertise free eye exams. Oh, and if you join their eyewear "club", its free eye exams for THREE years! Whippeee!

Oh.. Please tell me you are joking. What the F#$%. That is simply DEPRESSING. !! 🙁

 

[xmattODx]

Oh.. Please tell me you are joking. What the F#$%. That is simply DEPRESSING. !! 🙁

Dude, please don't be so full of yourself. Have you walked a mile in my shoes? Do you know why I work at a place that does $29 eye exams? I am just the same OD as you. I'm licensed in two countries. I graduated with distinction. I won scholastic awards in OD school. Is working at a commercial practice where I thought I'd be? No. Has it paid my bills for the last three years? Yes. Is it allowing me to care for people to the best of my ability? Yes. Am I underpaid for my services? Yes, but am I destroying optometry? No. It was destroyed far before I graduated.

 

[KHE]

I filled in for a friend at Walmart and Sam's Club. Wow.. They came in with the same attitude as entering the Nail/Hair Salon next door. Their attitude was "Can you quickly rotate some dials and give me a new pair of glasses??" Holy $$$hhhiiiittt.. 😡 Dammmnn it..

I hate to burst your bubble my friend, but in the real world, that's exactly what 95% of the patients you see will be looking for whether you are in private practice or working in a commercial location.

Please.. Let's not lower the standard of our profession any more.. Please don't take those idiotic positions. Let's go back to our roots and re-introduce what our profession was and what it is supposed to be: "A DOCTOR'S OFFICE"

When you're working one day a week in a private office for $35 an hour as an independant contractor, and the only other gig around is a commercial location, and you have a wife, kid, mortgage, and a $100k student loan payment..... well

If you want to be called a 'Doctor', please... work/live like one. You will never see a MD, DO, DDS setting up an office at Walmart, what the hell are we doing?

That's because in 99% of optometry offices out there, the bulk of money comes from the retailing of glasses and contact lenses. When you are essentially the retailer of a product like glasses and contact lenses, you are pretty much open to being taken over by commercial locations.

In addition to "Free exam with purchase of glasses", "$19.99 for an eye exam if you purchase glasses." WTF !!! While Medicare reimburses roughly $130 for comprehensive eye exam, some loser/Bozo fuc#$%ing idiot charges $20 if you purchase glasses from him..

Again, it's nice to stand on principal, but when that's the only opportunity available in your area....

I am just getting so 'mad' with where our profession is going. How do you call yourself a doctor if 'my medical/optometric exam is free if you buy glasses from me'. What a *****..

You have a lot to learn. The "profession" has been going this way for years and years. In fact, as another poster pointed out, it was private doctors who did this for years and years. That's precisely the reason why commercial optometry came into being in the first place.

 

[odstudent]

after reading this thread, i feel depressed now 🙁

 

[stompy]

The truth is out...

 

[ddown]

It is disheartening. After spending time on this, and other opt forums, I often find myself wondering if I made the right choice!? As a third year student I'm pretty much in it for the long haul at this point so I hope to make the very best of the situation.

So all of you practicing in the real world can you enlighten us? What advice do you have? What are some pitfalls to avoid? Is specialization the answer? Is there some grass-roots activism that we can be a part of (because it seems the mighty AOA is well, impotent when it comes to trumping the cause of the common OD)?

All I ever read is negativity. Are there any solutions?

 

[Ben Chudner]

Dude, please don't be so full of yourself. Have you walked a mile in my shoes? Do you know why I work at a place that does $29 eye exams? I am just the same OD as you. I'm licensed in two countries. I graduated with distinction. I won scholastic awards in OD school. Is working at a commercial practice where I thought I'd be? No. Has it paid my bills for the last three years? Yes. Is it allowing me to care for people to the best of my ability? Yes. Am I underpaid for my services? Yes, but am I destroying optometry? No. It was destroyed far before I graduated.

Absolutely correct. It's not where you practice, it's how you practice. There are excellent doctors that work in corporate settings, just as there are some real hacks working in private practice. The problem is not the doctors.

 

[Tasteestuff]

Dude, please don't be so full of yourself. Have you walked a mile in my shoes? Do you know why I work at a place that does $29 eye exams? I am just the same OD as you. I'm licensed in two countries. I graduated with distinction. I won scholastic awards in OD school.

Don't want to sound too harsh but YOU are NOT the same OD as I. I picked a different path to walk compared to you. And, Good for you!! So your grades did really prepare you for your current profession. $29/exam 🙄

Is working at a commercial practice where I thought I'd be? No.

Then, get out. No one is putting a gun to your head. I had choices, I had loans, I was married and I had a wife and child to provide for... So don't give me that crap about choices..

Has it paid my bills for the last three years? Yes.

If paying bills was your primary goal in becoming an OD, there are lots of jobs out there that could help you pay bills.

Is it allowing me to care for people to the best of my ability? Yes. Am I underpaid for my services? Yes

No, I think you are overpaid if you provide the same quality of care that is provided at MOST Walmarts. Not all but MOST

but am I destroying optometry? No. It was destroyed far before I graduated.

I disagree, you ARE destroying optometry.. With your attitude... Rather than attempting to make it better, you think that there is no better way.

Just 7years ago (last time I shaddowed my OD). He always set his professional fees high and sold glasses cheap. He used to say, 'I am a doctor, my patients are here to obtain my medical/optometric care which I will provide with my continuous education (but does not come cheap)

That was just 7 yrs ago.. (and this is not some rural city, it is in a large city with over 4 million)
So, I ask.. What the hell happened? There has to be a way for us to rebuild this profession. Don't you think? Any ideas?? If new OD grads stopped going to commercial stores, they simply couldn't survive. An optical shop is ineffective without a doctor on site.

Let's take back our profession from these corporations and let us decide on the fate of Optometry. Please don't consider these idiotic commercial stores as your path to practice Optometry.

 

[KHE]

Don't want to sound too harsh but YOU are NOT the same OD as I. I picked a different path to walk compared to you. And, Good for you!! So your grades did really prepare you for your current profession. $29/exam 🙄


Then, get out. No one is putting a gun to your head. I had choices, I had loans, I was married and I had a wife and child to provide for... So don't give me that crap about choices..

If paying bills was your primary goal in becoming an OD, there are lots of jobs out there that could help you pay bills.


No, I think you are overpaid if you provide the same quality of care that is provided at MOST Walmarts. Not all but MOST



I disagree, you ARE destroying optometry.. With your attitude... Rather than attempting to make it better, you think that there is no better way.

Just 7years ago (last time I shaddowed my OD). He always set his professional fees high and sold glasses cheap. He used to say, 'I am a doctor, my patients are here to obtain my medical/optometric care which I will provide with my continuous education (but does not come cheap)

That was just 7 yrs ago.. (and this is not some rural city, it is in a large city with over 4 million)
So, I ask.. What the hell happened? There has to be a way for us to rebuild this profession. Don't you think? Any ideas?? If new OD grads stopped going to commercial stores, they simply couldn't survive. An optical shop is ineffective without a doctor on site.

Let's take back our profession from these corporations and let us decide on the fate of Optometry. Please don't consider these idiotic commercial stores as your path to practice Optometry.

I don't understand this post at all. From your original post, you make it sound like the fill in day you did for your friend was your first experience in this environment, yet later on you make a sweeping generalization about the care provided at "MOST Walmarts. Not ALL, but MOST" In what way are you in any position to judge the care given at MOST Walmarts? Because you have a number of "friends" who work there? Are you impeaching the motives and skills of your friends?

Commercial practice did not destroy optometry. Private practice did.

Historically, private practice doctors were the ones who charged next to nothing OR nothing for their exam yet selling glasses for $500 per pair. It didn't take too long for corporations to look at the profit margins on frames and lenses and say to themselves "HEY! We're getting in on this act!" It's the exact same reason why you see less and less independant funeral homes. More and more funeral homes are being taken over by corporate entities because for years, funeral directors charged next to nothing for professional services, but gouged the public with over priced caskets. And that's the reason why you don't see MDs, DDSs, etc. etc. working in places like that because those groups of professionals don't sell products. Or at the very least, very little of their money comes from the sale of product. However, in optometry more than 85% of private offices get the majority of their revenue from their dispensaries.

And it's probably only a matter of time anyway. We already see tax professionals working at H&R Block in the back of Sears. We see veterinarians working in Petco. Just wait until Walmart or Costco starts selling low cost health insurance. There will be little clinics next to or inside all the Walmarts in America. Won't that be nice?? Get your physical, and your blood work done while you're waiting for your new tires to get put on!

Rest assured, I am no fan of commercial practice. But private practitioners really need to stop the sanctimony. When I practiced, I had the opportunity to work in a number of different offices, both private and commercial on both the east and west coast. The notion of private practice doctors as fine, upstanding, compasionate, benevolent people while commercial doctors are evil, money grubbing, corporate feeding hacks is a non-starter.

You're mostly right about the perception issue. But from a care/ethics standpoint, I saw much more unethical behavior in private offices. I saw much more "7 and 4 and out the door" in private offices. I saw much more badgering of little old ladies with mac degen to get AR coated progressive polycarbonate lenses in private offices. I saw much more use of so called "private lable" contact lenses in private offices. I saw much more BIOs covered in dust, and bottles of tropicamide that expired in 1994 in private offices.

Also, the notion that commercial practice would just "go away" if docs stopped working there is also a non-starter. If that happened, you would see "refracting optician" legislation passed in all 50 states within a matter of weeks. Also, if you check out the optcom listings, or the vast majority of the trade publications, you will see that optometric career positions have a commercial/private ration of about 5:1. Even the AOAs student matching service has a disproportionate number of commercial positions available. So the schools are simply producing far too many graduates for the number of private practices out there. Where are these people supposed to go? There are only so many VA positions out there. Sad fact is, in my class, more than 50% of them are working full time in commercial locations and more than 75% of them are working at least part time there. A collegue of mine who graduated 3 years prior to me reports similar figures for his class.

Remember that old joke they used to do in universities where they would take the incoming freshman and line them up and say "look to your left, and look to your right. One of these people won't be here in 4 years." Same thing here. All you prospective students and current students, look to your left and look to your right. One of these people will be working in a commercial environment when you're done.

 

[HOLLYWOOD]

Don't want to sound too harsh but YOU are NOT the same OD as I. I picked a different path to walk compared to you. And, Good for you!! So your grades did really prepare you for your current profession. $29/exam 🙄


Then, get out. No one is putting a gun to your head. I had choices, I had loans, I was married and I had a wife and child to provide for... So don't give me that crap about choices..

If paying bills was your primary goal in becoming an OD, there are lots of jobs out there that could help you pay bills.


No, I think you are overpaid if you provide the same quality of care that is provided at MOST Walmarts. Not all but MOST



I disagree, you ARE destroying optometry.. With your attitude... Rather than attempting to make it better, you think that there is no better way.

Just 7years ago (last time I shaddowed my OD). He always set his professional fees high and sold glasses cheap. He used to say, 'I am a doctor, my patients are here to obtain my medical/optometric care which I will provide with my continuous education (but does not come cheap)

That was just 7 yrs ago.. (and this is not some rural city, it is in a large city with over 4 million)
So, I ask.. What the hell happened? There has to be a way for us to rebuild this profession. Don't you think? Any ideas?? If new OD grads stopped going to commercial stores, they simply couldn't survive. An optical shop is ineffective without a doctor on site.

Let's take back our profession from these corporations and let us decide on the fate of Optometry. Please don't consider these idiotic commercial stores as your path to practice Optometry.

lenscrafters does 1.1 billion dollars in sales that does not include eye exams, where do you think the money comes from?

 

[cpw]

I'm suprised these places are getting away with advertising free exams with purchase.. that's illegal in most states.

lenscrafters does 1.1 billion in sales of glasses because it doesn't own the ODs. The ODs run their own independent offices... again, a legal situation. ODs are NOT allowed to be employed or controlled by corporate entities.

If you are considering going commercial new grads (especially at Wally World) make sure you have a lawyer who KNOWS Optometry go over your contract. I'm seeing more and more practicioners getting penalized cuz their practice contracts/situations are illegal in their states !!

The biggest one I can think of are some of the new supercenters. In Texas, the OD must be wholy independant and the optical is not allowed to be directly connected to the ODs office. The OD must have a seperate entrance either next to the optical or from the outside of the building. Most of the new super centers in Texas are not doing this... and if someone agrees work there they're breaking state law.

I'm not saying don't work for wal-mart. Just REALLY know what your state laws are and what you're getting into.

 

[futuredoctorOD]

👎

Woww. Unbelievable...

I have a close friend who is an Ophthalmology resident and he once told me that he needed some extra income and decided to moonlight at Walmart and PearleVision. (He was paid $600 at Walmart and $550 at Pearle)

He came back from those offices and complained to me that he felt like a 'Prostitute'. I could not believe what he was saying since I have many friends (from my class) who are currently working for those commercial stores. I thought he was disrespecting our profession and I serioulsy felt upset about it until......

I filled in for a friend at Walmart and Sam's Club. Wow.. What an experience.. I did feel like I was a 'PROSTITUTE'. That is not what my profession was supposed to be. Patients attitude said it all. They came in with the same attitude as entering the Nail/Hair Salon next door. Their attitude was "Can you quickly rotate some dials and give me a new pair of glasses??" Holy $$$hhhiiiittt.. 😡 Dammmnn it..

Please.. Let's not lower the standard of our profession any more.. Please don't take those idiotic positions. Let's go back to our roots and re-introduce what our profession was and what it is supposed to be: "A DOCTOR'S OFFICE"

If you want to be called a 'Doctor', please... work/live like one. You will never see a MD, DO, DDS setting up an office at Walmart, what the hell are we doing?

In addition to "Free exam with purchase of glasses", "$19.99 for an eye exam if you purchase glasses." WTF !!! While Medicare reimburses roughly $130 for comprehensive eye exam, some loser/Bozo fuc#$%ing idiot charges $20 if you purchase glasses from him..

I am just getting so 'mad' with where our profession is going. How do you call yourself a doctor if 'my medical/optometric exam is free if you buy glasses from me'. What a *****..

Sorry for my crazy RANT

You make some valid points here.....I have shadowed OD's in private practice, hospital, surgical, and yes---the commercial setting. I have made these realizations.

1. Optometry needs to move MORE in the direction of medical management of eye disease (they seem to be but more work needs to be done.)

2. Many of the docs in private practice, VA settings, etc....look at the Walmarts and Four Eyes places with chagrin. 👎

3. The commercial setting is a fast food restaurant that is hurting private practice Optometry.

4. It devalues a profession when you offer a "free eye exam"! You don't see "free Pap Smear" at the local OB! lol

5. The next generation of doctors in this profession need to take the initiative----not practice in these horrid McDonalds Eyeglass factories but instead put OD's in private and state hospitals (not just the VA), rebuild the private practice sector which has been severely damaged by the Costco, Walmart, and Pearle fast food restaurants of eye care.

6. I would rather make $85K a year working in the VA than $250K working in Sears or Costco or Walmart.....It is about respect and being a doctor....not a glasswear salesperson. 😕

 

[xmattODx]

Don't want to sound too harsh but YOU are NOT the same OD as I. I picked a different path to walk compared to you. And, Good for you!! So your grades did really prepare you for your current profession. $29/exam 🙄

And how is your "different" path any better than mine? I have worked private practice. In fact I drove for two hours one way one day a week just so that I could get into a private practice. Do you know what I did there? I refracted and I refered. His practice was built on material sales. As was the private practice I filled in at for three months while the OD was on maternity leave. Her practice was built on VSP and materials.

Then, get out. No one is putting a gun to your head. I had choices, I had loans, I was married and I had a wife and child to provide for... So don't give me that crap about choices..

Congratulations on your family. I am sure it made some choices more difficult for you. I am glad that you've found a way to support them and meet your financial needs while working in private practice. While no one is holding a gun to my head; I started my career four months behind the rest of my graduating class as I sat waiting for my green card. That delay and the overly saturated market I lived in drove me into commercial practice from day one. Move? Impossible. Go to a rural area and open a practice? What rural area can support two brand new OD's? (My wife, fortunately is wonderful and beautiful, but unfortunately is an OD as well.)

If paying bills was your primary goal in becoming an OD, there are lots of jobs out there that could help you pay bills.

This sentence summarizes the problem I have with your condemnation of your optometric brethern who work in commercial practice. You know nothing about us. I have bills to pay BECAUSE I'm an OD. $100,000 in student loans and thats it.

No, I think you are overpaid if you provide the same quality of care that is provided at MOST Walmarts. Not all but MOST

I disagree, you ARE destroying optometry.. With your attitude... Rather than attempting to make it better, you think that there is no better way.

Just 7years ago (last time I shaddowed my OD). He always set his professional fees high and sold glasses cheap. He used to say, 'I am a doctor, my patients are here to obtain my medical/optometric care which I will provide with my continuous education (but does not come cheap)

That was just 7 yrs ago.. (and this is not some rural city, it is in a large city with over 4 million)
So, I ask.. What the hell happened? There has to be a way for us to rebuild this profession. Don't you think? Any ideas?? If new OD grads stopped going to commercial stores, they simply couldn't survive. An optical shop is ineffective without a doctor on site.

With all due respect, my experience must be completely opposite to yours. All of the commercial practices provided equally good or better care than the private practitioners. All of the private practices I've worked in have made their money on materials which I think is the norm for private practice. The only difference between the private practices and the commercial practices I've worked at is what their usual and customary fee is. It is higher in private but they sell their souls to managed care. It is lower at commercial and they sell their souls to outside control and a lack of respect from their colleagues.

If I stopped working my job tomorrow someone would fill my spot the next day. In my experience private practice may be the ideal but in reality it is either not an option or it is exactly the same as a commercial practice; it just charges more for its refraction. This is not to say that I'm happy where I am. I come home many days feeling drained and dismayed. Will I be here in three years. No. I'm paying my loans down and I'm paying for tuition as I finish my M.P.H. Full time school and full time work at a commercial practice is a lot of fun!

 

[PublicHealth]

Doctors -- be they MDs, DOs, ODs, DPMs, DCs, PhDs, PsyDs, etc. -- are the "front-line infantry" of the insurance industry. Going into doctoral programs, I'm sure everyone has dreams of the nice house, BMW, trophy spouse, etc. Reality is that doctoral healthcare professionals are being squeezed to the limit in order to benefit insurance company CEOs who want to pick up a longer yacht this year. Capitalized medicine, my friends, get used to it.

 

[Eyegirl2k7]

I'd like to work in a private practice. But honestly, with about $200K Us in loans and no family in this country and no attachments...and needing the city like air...it's probably not going to happen.

Lucky me.

Eyegirl.

Back to studying for contact lens.

 

[rpames]

I'd like to work in a private practice. But honestly, with about $200K Us in loans and no family in this country and no attachments...

Having no familial obligations, ie. not having to support them, makes private practice more of an option...at least the way I look at it.

It is funny, early in this thread people used HAVING a family is why it is hard to have a private practice, and now NOT HAVING a family is why it is hard.

Let's de honest everyone, we will all find reasons not to do things when there is an easier way. I always think back to the speakers who come to the school to talk about private practice. I always look around and make a mental note of who is there. Then at the next one I do the same thing. There are always the same faces. These students don't sit an say how impossible it is b/c they have taken the time to learn how to do it from those who have. The people I don't see at those speaker are the ones who always say, "It is impossible, I want to do, but you just can't anymore!" They have given up before they every even tried to learn about.

I'm not saying you should never have to work at a chain, but keep it to a minimum. No one is fooled when others say, "I'm on they 5 year plan." Bull, they are on the, "Optometry sucks, I can't get a decent job plan." What you need to do is, work for a corporate entity (or private) PART TIME for a year or 1.5 years as you develop your practice. As far as not being able to do it in a city...as long as you are on there insurance provider card, they will come. It does not matter if there is a practice next door, if you are on the card and they are not, they will come into your door. Hell, if you both are on the card, make sure your office has the curb appeal. If your office looks like a doctors office and your neighbors has neon signs in the window (like a strip joint), they will come into your door...at least the patient type you want will.

People always say, "There are no private practice jobs out there." That may be true, so MAKE YOUR OWN JOB!

 

[ddown]

I have had the "how to stay out of corporate optometry" discussion with a friend of mine who is a residency trained recent grad. According to her, many of her classmates said they would work corporate for "a couple of years" to pay loans down and then get out. What really happened is that these people started basing their lives around that salary and essentially became trapped. A new car, a new house, a new baby, etc.

It seems that if you could live like a student for a few more years, and use that extra income to pay down debt and/or invest it. Then when the time came to look for more fitting position you would have the freedom to do so. Any thoughts?

 

[KHE]

Let's de honest everyone, we will all find reasons not to do things when there is an easier way. I always think back to the speakers who come to the school to talk about private practice. I always look around and make a mental note of who is there. Then at the next one I do the same thing. There are always the same faces. These students don't sit an say how impossible it is b/c they have taken the time to learn how to do it from those who have. The people I don't see at those speaker are the ones who always say, "It is impossible, I want to do, but you just can't anymore!" They have given up before they every even tried to learn about.

I'm not saying you should never have to work at a chain, but keep it to a minimum. No one is fooled when others say, "I'm on they 5 year plan." Bull, they are on the, "Optometry sucks, I can't get a decent job plan." What you need to do is, work for a corporate entity (or private) PART TIME for a year or 1.5 years as you develop your practice. As far as not being able to do it in a city...as long as you are on there insurance provider card, they will come. It does not matter if there is a practice next door, if you are on the card and they are not, they will come into your door. Hell, if you both are on the card, make sure your office has the curb appeal. If your office looks like a doctors office and your neighbors has neon signs in the window (like a strip joint), they will come into your door...at least the patient type you want will.

People always say, "There are no private practice jobs out there." That may be true, so MAKE YOUR OWN JOB!

Yes, yes. Make your own job. You CAN do that. However, you are going to have to come to grips with the fact that the bulk of your revenue is going to come from material sales. That's just the way it is in our field for the time being, and for the foreseeable future. And as long as you are making the bulk of your money from retailing a product, you are essentially going to be competeing with Walmart and Lenscrafters.

I know, I know. You are all sitting there saying to yourself "THAT WON'T BE ME! I PLAN TO HAVE A HIGH END GUGGENHEIM TYPE OFFICE WITH $500 DESIGNER FRAMES. AND I'M GOING TO BE A NICE DOCTOR WHO DOES 'THOROUGH' EXAMS, INCLUDING LOTS OF EXTRA TESTS TO IMPRESS MY PATIENTS" I sat in the same practice management classes as you, and had the same thoughts. I was awarded a scholarship at graduation for "commitment to enter private practice." Well, I hate to tell you all this, but the vast majority of private practices out there are essentially optical shops with exam lanes in the back. The vast majority of private practices out there are essentially sucking off the tit of VSP and Eyemed. The vast majority of patients do not WANT a lot of extra tests. They want to be in and out of your office as quickly as possible and they want "whatever my plan covers."

I have had that experience working in commercial offices, and I have definately had that experience working in private offices. I worked in some real dumpy private offices but I have also had the opportunity to work in some real upscale offices that grossed into the millions. They were essentially large optical stores instead of small ones. That brings in a good buck, to be sure, but sooner or later as managed vision care becomes more and more pervasive, VSP is going to cut exam fees by 30% and then the vast majority of private practices will be decimated.

For those docs that like to do all kinds of fancy GDxs, HRTs, OCTs, Pachymeter readings, photos etc. etc. (for those lucky enough to be admitted to managed care panels) and charge their patients insurance hundreds of dollars, its only a matter of time before managed care plans bundle all those services together into a "glaucoma evaluation" for which they will pay $150. Won't that be nice? One of the major carriers in my area is already looking at that.

Think that "any willing provider" legislation will help? It might help you get on a managed care plans, which is great in the short term, but sooner or later, VSP is going to have to open its panel to commercial locations, which will further decimate private offices since most of them are hanging on by a thread because of VSP anyway.

Don't let my negativity get you down. You CAN make a good living in this field. But you all better pay real close attention in your dispensing clinics.....
If I were talking to students who are interested in this field, I would suggest becoming an optician in a state where they are licensed. "Refracting Opticians" are only a matter of time. And you might as well take a two year tech course after high school instead of 4 years of college and 4 years of optometry school and $100k-$200k in debt because the sad fact is, 97% of the "pathology" knowledge you accumulate will not be used.

 

[rpames]

It really is surprising to me how nearly every older OD I speak to loves their jobs and say they would do it again. Then I come here and nearly every young OD says how horrible the job market is and it is going no where but down hill and you are really nothing more than a frame salesmen.

Why is selling frames so bad? I will treat every ocular disease I can and practice full scope, but I will also sell those patients frames. Are orthodontist ashamed of selling braces? They always offer the new "clear" braces. Sure they cost more, but they make you look better. Well so do nice frames. And here is the really amazing part...THEY ARE BOTH MEDICAL APPLIANCES! I was watching a plastic surgery tv show last night and the surgeon was selling "add-on" like you would not believe. The patient came in to get some live removed from her neck and the MD said, "That would be great, but I think you should also get a chin implant here...a little face lift here...yea, that would be really great for you." He was not ashamed for selling things. Why the hell are we?

Our profession is based of glasses, if "selling frames" is a four letter word to you, GET OUT. This is not the career for you. Yes, you will be treating disease, you will find diabetes, HTN, pituitary tumors...it will be great, but the time in between these cases, you will be selling frames! If every patient who walked in my door had some strange pathology, I think I would just cry. How is this different from most any other healthcare professional? Do you have any idea how many normal physicals a pediatrician has to give before they find something that makes their heart beat faster? I don't either, but I bet they wish they had something to sell to help offset the crappy reimbursement they get from the HMO the kid is on.

I do hate corporate b/c of the image they put on our profession, but I don't hate them b/c of they sell frames. Of course the amount they mark them up is ridiculous. As long as you do a comprehensive eye exam (not a 15 minute one), you can feel just fine about selling that person a frame. But, if you use the exam as a means-to-an-end, that end being selling a frame marked up 500%, you should feel dirt, ashamed, and down right guilty for being such a disgraceful human being. Ok, maybe that is a little extreme, but you get my point. If you give a good exam, and the patient need a correcting, sell them a frame.

 

[KHE]

It really is surprising to me how nearly every older OD I speak to loves their jobs and say they would do it again. Then I come here and nearly every young OD says how horrible the job market is and it is going no where but down hill and you are really nothing more than a frame salesmen.

Why is selling frames so bad? I will treat every ocular disease I can and practice full scope, but I will also sell those patients frames. Are orthodontist ashamed of selling braces? They always offer the new "clear" braces. Sure they cost more, but they make you look better. Well so do nice frames. And here is the really amazing part...THEY ARE BOTH MEDICAL APPLIANCES! I was watching a plastic surgery tv show last night and the surgeon was selling "add-on" like you would not believe. The patient came in to get some live removed from her neck and the MD said, "That would be great, but I think you should also get a chin implant here...a little face lift here...yea, that would be really great for you." He was not ashamed for selling things. Why the hell are we?

Our profession is based of glasses, if "selling frames" is a four letter word to you, GET OUT. This is not the career for you. Yes, you will be treating disease, you will find diabetes, HTN, pituitary tumors...it will be great, but the time in between these cases, you will be selling frames! If every patient who walked in my door had some strange pathology, I think I would just cry. How is this different from most any other healthcare professional? Do you have any idea how many normal physicals a pediatrician has to give before they find something that makes their heart beat faster? I don't either, but I bet they wish they had something to sell to help offset the crappy reimbursement they get from the HMO the kid is on.

I do hate corporate b/c of the image they put on our profession, but I don't hate them b/c of they sell frames. Of course the amount they mark them up is ridiculous. As long as you do a comprehensive eye exam (not a 15 minute one), you can feel just fine about selling that person a frame. But, if you use the exam as a means-to-an-end, that end being selling a frame marked up 500%, you should feel dirt, ashamed, and down right guilty for being such a disgraceful human being. Ok, maybe that is a little extreme, but you get my point. If you give a good exam, and the patient need a correcting, sell them a frame.

Ahhhhh yes. I remember being just like you. lol

I have gotten out. I got out a while ago. And it was the best thing I did for myself. I'm down about 20 pounds since I did.

I would suggest that the reason most old docs are thrilled and most young ones aren't is because most old docs were able to get away with selling patients a $400 per eye set of contact lenses or a $400 pair of +2.00 readers back in the day when you couldn't get them OTC on every corner and they could get away with seeing 8 patients a day and spending an hour with each one. Unfortunately, the days of being able to get away with that are OVER.

Also, most old docs graduated with student loan debt in the hundreds, not the hundreds of thousands. I recall attending a CE lecture where an old doctor sat with me at a lunch and we got talking. He told me how when he started, he used to see 5 patients when he opened his office cold in 1974. 5 patients a day, I asked? No. 5 patients per week! And, he told me that while he wasn't living like a king, he made enough money simply seeing those 5 patients a week where he could keep his office running and he didn't have to have his wife work.

I'd like to see any doctor open an office anywhere in the country and make it on seeing an average of one patient per day when you have thousands of dollars in student loan debt. (never mind thousands of dollars in "new practice debt.)

You will treat every ocular disease you can, IF you can get on the patients insurance panel. If you can not, which is more common than most people realize, you will be refering every pink eye to their family doctor, and every other eye problem to your friendly neighborhood ophthalmologist.

 

[xmattODx]

I'd like to thank KHE for his posts. They are very well written and enlightening. My reality has been similar to his. Optometry is a profession I love. I like to see patients. I like to help them see with a simple refraction. I like to do VT. I love low vision. I like treating disease. All of these things are great, BUT people don't want to pay more than their insurance covers. I can't treat disease because I can't bill for it. I can't justify charging someone hundreds of dollars when they can see an OMD for a copayment.

This thread started by calling me a prostitute because I work commercial. It really isn't an ideal place to be but neither were the private practices I worked at. My main argument is that we get no-where by belittling our colleagues in commercial practice. Commercial is a reality. Our commercial brothers and sisters sat beside us at school and offer the same services as the private folks - they just do so for the benfit of corporate America. Students - don't be ashamed if you end up in commercial. Just treat your patients to the best of your ability take your pay cheque, use it to pay your loans and enjoy life.

 

[truckibear]

Take it from someone who's been involved with the pharmacy business.... just be thankful that optometries do not have drive-thrus!! Patients drop off their prescriptions and want it done in 3 min. like a McDonalds 😡 Also, from a patient POV, I've been seeing optometrists since I was in second grade and all I have to say is, I really appreciate doctors who take their time with me. No matter what field you're coming from, there are always going to be a few bad apples. But I hope that there will always be patients out there that remind you why you're in the business in the first place. Stay optimistic and don't let yourself become apathetic to problems. I feel that if we spent less time letting these things get us down, and more time working to create positive change, maybe we'd get somewhere. I hope no one takes offense, just sharing my thoughts. Of course, it's always relieving to vent 🙂

 

[rpames]

You will treat every ocular disease you can, IF you can get on the patients insurance panel. If you can not, which is more common than most people realize, you will be refering every pink eye to their family doctor, and every other eye problem to your friendly neighborhood ophthalmologist.

It is strange how different the insurance plans are across the country, in Wisconsin billing medically is not really much of a problem. By that I mean, being a medical insurance plan does not seem to a huge problem. I hope our lobbyist can make this better around the US.

 

[hoosier1]

Thanks Tasteestuff for your post!! I think it's a very good representation on how optometry as a career is going down. I don't know what's goign to happen in the future, but it will probably be worst. I read somewhere that the United States is already 7,000 OD's over what is necessary is this true?

I think all the students in optometry school think they will be able to get into private practice or work full time jobs but those opportunities are REALLY hard to come by. Finding mutliple part time jobs is nearly impossible because working on Saturdays is always required at a clinic. This is absolutely ridiculous. I also have the same question as you: WTF is going on??

Should people be happy about getting into optometry school? I dont get it anymore.

 

[novacek88]

I agree with the OP's message. I respect optometrists and when I see their offices in Wal-Marts and other places offer free eye exams, I lose respect for the field. I don't want to lose respect for optometrists. When I was a teenager, optometrists worked out of doctor's offices. I considered them the equivalent of a physician. And financially, these optometrists did quite well. The level of respect payed toward them was nearly equivalent of a physician back then. I don't mean to disrespect the profession but the reality is that when people see these types of offices in Wal-Marts trying to pimp free eye exams, the prestige level of optometrists has fallen considerably. I don't know how all of you do it. I couldn't work that hard and be willing to sit in a Wal-Mart and be spat on by some patient who thinks I'm filling his prescription.

But to be objective and fair, this isn't only happening to optometry. There is a thread in the family practice forum entitled "Minute Clinics". It's only a matter of time before you see a family practice physician opening his office in a Wal-Mart with signs entitled "No Copay with first visit."

 

[cpw]

I think everybody needs to take a deep breath. I've never seen anyone at a county OD meeting treat the commercial docs any different than their private colleagues.

Yes, I just graduated... and yes, I'm probably going to have to go commercial at least part time. But, I found a commercial doc who I really respect who she is and her practice philosophy.. we agree. She works in a situation where she only sees 20 patients a day (plus contact checks). She won't see more... she likes spending time with them. And yes, she just happens to be next to a Lenscrafters. She's an amazing doctor and I and her patients have nothing but respect for her.

You do have to do something to make ends meet and pay your bills. The choices you make are personal. For this point in my life yes I have bills to pay, loans to pay and eventually in the next year or so I have wedding to plan.

I'm going to spend some time in private practice and some in commercial. The docs I externed with did offer me a job and I love them to death (they have the most successful practice I've ever been in with the happiest office staff). I LOVE going to work there everyday.. BUT they don't need a full time associate. The husband and wife only need me on Fridays. So, I will be working there on Fridays. I can pay my student loan payment working just one day a week (but what about my credit cards, car payment, mortgage,etc ??)

Before you judge your colleagues put yourself in their shoes. Not everyone has the drive to start their own ofifice. Not everyone WANTS their own office. Let them be the best doctors they can be no matter what they decide. Support them.. don't belittle them.

Eventually yes I do want my own office... it's just not practical right now for me. I can't even find my way to the north side of town yet.. how am I going to know where's a good practice location? So, I'm going to do what I have to do.. for now.

 

[KHE]

I think everybody needs to take a deep breath. I've never seen anyone at a county OD meeting treat the commercial docs any different than their private colleagues. .

I've been on both sides of this fence. Unfortunately, they just say it behind your back.

Yes, I just graduated... and yes, I'm probably going to have to go commercial at least part time. But, I found a commercial doc who I really respect who she is and her practice philosophy.. we agree. She works in a situation where she only sees 20 patients a day (plus contact checks). She won't see more... she likes spending time with them. And yes, she just happens to be next to a Lenscrafters. She's an amazing doctor and I and her patients have nothing but respect for her.

You do have to do something to make ends meet and pay your bills. The choices you make are personal. For this point in my life yes I have bills to pay, loans to pay and eventually in the next year or so I have wedding to plan.

I'm going to spend some time in private practice and some in commercial. The docs I externed with did offer me a job and I love them to death (they have the most successful practice I've ever been in with the happiest office staff). I LOVE going to work there everyday.. BUT they don't need a full time associate. The husband and wife only need me on Fridays. So, I will be working there on Fridays. I can pay my student loan payment working just one day a week (but what about my credit cards, car payment, mortgage,etc ??).

I know you are still in the process of getting your license. But maybe you could share some things with everyone: Since you are graduating and in the process of being licensed, students and prospective students could probably learn from your experience.

1) How did you decide on the area where you are practicing?
2) How did you go about looking for a position? What made you decide on this particular commercial location? Have you researched and/or applied at other commercial or private locations?
3) You don't have to be specific. But would you care to share how much you are going to be paid for your services? Are you eligible for fringe benefits? Are your employers going to pay you as a regular employee or as an independant contractor?
4) How does the pay compare between the private location and the commercial locations?

Are you hoping to one day make partner at this office that you are working at one day a week? If you are, I would be very cautious. I had some experience working with father/son and husband/wife teams. Rest assured that you will NEVER be an equal partner.

 

[cpw]

1) How did you decide on the area where you are practicing?

In the list of towns available for my fiance and myself to transfer to... Tampa topped the list. There were positions availble for me, there was warm weather, a beach, friendly people, and a good job for him.

2) How did you go about looking for a position? What made you decide on this particular commercial location? Have you researched and/or applied at other commercial or private locations?

I went through the docs I externed with... I searched lists at NOVA, UHCO, and SECO. I emailed people, made phone calls... and went to county meetings. I interviewed with three major commercial practices and couldn't find ANY docs in Tampa looking for a full-time private practice associate. They might be out there, but being new to the area I couldn't find them.

One of the commercial offices I interviewed at gave me the creeps. They made me go through a recruiter, wouldn't let me meet the docs (although I found one anyway), worked you 7 days a week unless you arranged for your own relief work, and made ya see almost 50 patients a day. I would NOT have been happy there and honestly the whole thing gave me a very skeevy feeling. Yes, I would have made a TON of money there.... the take home was amazing... but that's not what makes me happy when I have to kill myself working 7 days a week to get it.

3) You don't have to be specific. But would you care to share how much you are going to be paid for your services? Are you eligible for fringe benefits? Are your employers going to pay you as a regular employee or as an independant contractor?

No, I won't tell you what I'm going to be making. But, the daily rate in this area is higher than all of Texas. There are incentives.. and I'll be paid independent. (and yes, i'm aware of the tax implications)

4) How does the pay compare between the private location and the commercial locations?

commercial offers more incentives at first... but since I know the private OD better I can negotiate more with him (we've not finalized anything)

Are you hoping to one day make partner at this office that you are working at one day a week? If you are, I would be very cautious. I had some experience working with father/son and husband/wife teams. Rest assured that you will NEVER be an equal partner.

No, i'm not trying to make partner in their office. I like their office. That's all. I'm not trying to be an equal partner. I'm going to work with them to continue having them as mentors to learn to run my own office some day. So, yes, I might make a little less one day a week.. but i'm going to be learning enough about my future to more than make up for it..


That's all. I'm kinda sick of all the negativity around here lately... optometry is what you put into it.. i've said this NUMEROUS times. If you're not happy you CAN change your situation. No, it might not be easy... but nothing in life worth working for ever is.

 

[KHE]

I went through the docs I externed with... I searched lists at NOVA, UHCO, and SECO. I emailed people, made phone calls... and went to county meetings. I interviewed with three major commercial practices and couldn't find ANY docs in Tampa looking for a full-time private practice associate. They might be out there, but being new to the area I couldn't find them.

No, I won't tell you what I'm going to be making. But, the daily rate in this area is higher than all of Texas. There are incentives.. and I'll be paid independent. (and yes, i'm aware of the tax implications)
.

Did your potential employers give you any reason why you are being paid as an independant rather than as a regular employee?

commercial offers more incentives at first... but since I know the private OD better I can negotiate more with him (we've not finalized anything)
.

When you are done negotiating, you should post what you learned for the benefit of other students who will be going through the same things soon.

So, yes, I might make a little less one day a week.. but i'm going to be learning enough about my future to more than make up for it..

... optometry is what you put into it.. No, it might not be easy... but nothing in life worth working for ever is.

How cute. I remember I used to think the exact same way.

 

[cpw]

How cute. I remember I used to think the exact same way.

I'm not going to contribute my experience if you belittle me..... I'm sorry you're jaded.

 

[KHE]

I'm not going to contribute my experience if you belittle me..... I'm sorry you're jaded.

You're right. Please accept my apologies. I shouldn't have responded in that way.

Rest assured, I'm not jaded. I've long since left and it's worked out well for me.

But I do think that far too many students have the notion that if they simply "work hard" then they will find themselves in a rewarding situation, and I am suggesting that there are all kinds of things that no one every tells you about while you're in school, which unfortunately you have absolutely NO control over which will directly affect your ability to achieve satisfaction in this field. There are so many things that I wished I had known before I entered school, and before I graduated.

Please continue to share your experiences. They are helpful learning tools for future students.

 

[Ben Chudner]

You're right. Please accept my apologies. I shouldn't have responded in that way.

Rest assured, I'm not jaded. I've long since left and it's worked out well for me.

But I do think that far too many students have the notion that if they simply "work hard" then they will find themselves in a rewarding situation, and I am suggesting that there are all kinds of things that no one every tells you about while you're in school, which unfortunately you have absolutely NO control over which will directly affect your ability to achieve satisfaction in this field. There are so many things that I wished I had known before I entered school, and before I graduated.

Please continue to share your experiences. They are helpful learning tools for future students.

KHE,

Is it safe to assume you are the same person on seniordoc.org that left optometry to become a teacher? I am trying to understand your motivation for these posts, since you are no longer in the profession. If it is to let the students know that optometry life wasn't that great for you, I think it is important to emphasize that it wasn't that great for YOU. I have read a lot of posts, especially in this thread, that cast a negative light on this profession. Am I truely in the minority because I enjoy what I do, and I make a pretty good living? Am I in the minority because I can give you a list of 20 docs that feel the same way as I do? (It seems that all the unhappy docs have nothing but unhappy OD friends) I realize there are those that have had a bad experience, and they typically are the most vocal. Let me be the vocal happy optometrist who owns a private practice.

What I am interested in are your questions to CPW about what we can tell the students to prepare them. I am in the unique position in that I will be lecturing to students at each of the schools over the course of the next 12 months for one of the major companies within optometry. I would love to talk about these very issues to better prepare them for what to expect from optometry. Therefore, I'll open the question to students and docs. What would you like to know about practicing in the real world, or for the docs, what do you wish you had been told in school?

 

[Dr.wannabe]

Thank you ben chudner for a breath of positive fresh air. I am attending as a first year in Aug. I have two job opportunities just from private practice OD's that have befriended me while shadowing as an undergrad. Alot of these posts are making me think very seriously about a naval position.

 

[SoxTown]

KHE,

It is safe to assume you are the same person on seniordoc.org that left optometry to become a teacher? I am trying to understand your motivation for these posts, since you are no longer in the profession. If it is to let the students know that optometry life wasn't that great for you, I think it is important to emphasize that it wasn't that great for YOU. I have read a lot of posts, especially in this thread, that cast a negative light on this profession. Am I truely in the minority because I enjoy what I do, and I make a pretty good living? Am I in the minority because I can give you a list of 20 docs that feel the same way as I do? (It seems that all the unhappy docs have nothing but unhappy OD friends) I realize there are those that have had a bad experience, and they typically are the most vocal. Let me be the vocal happy optometrist.

What I am interested in are your questions to CPW about what we can tell the students to prepare them. I am in the unique position in that I will be lecturing to students at each of the schools over the course of the next 12 months for one of the major companies within optometry. I would love to talk about these very issues to better prepare them for what to expect from optometry. Therefore, I'll open the question to students and docs. What would you like to know about practicing in the real world, or for the docs, what do you wish you had been told in school?

I am very new to optometry, I'm starting school this fall at ICO, and
I've been reading this web board and seniordoc quite a bit lately. One of the messages I've gotten from practicing optometrists is that one important factor to acheiving success as an optometrist is location. Location because of competition, but also because of accesibility to insurance panels. It seems that accessibility of OD's to insurance panels varies from state-to-state, but I'm not really certain of that. Could you address the issue of insurance panels, how to get on them, which states allow OD's on their plans and which don't. Is there a centralized resource that compiles this information? Thanks for any light you can shed on this issue!

 

[Divineimpetus]

I was going into Optometry until I talk to an Optometrist and he set me straight.

Optometry is still a great career but you have to want to work in a clean environment, like eyeballs, go through 4 years of education and not work for yourself.

 

[KHE]

KHE,

It is safe to assume you are the same person on seniordoc.org that left optometry to become a teacher? I am trying to understand your motivation for these posts, since you are no longer in the profession. If it is to let the students know that optometry life wasn't that great for you, I think it is important to emphasize that it wasn't that great for YOU. I have read a lot of posts, especially in this thread, that cast a negative light on this profession. Am I truely in the minority because I enjoy what I do, and I make a pretty good living? Am I in the minority because I can give you a list of 20 docs that feel the same way as I do? (It seems that all the unhappy docs have nothing but unhappy OD friends) I realize there are those that have had a bad experience, and they typically are the most vocal. Let me be the vocal happy optometrist who owns a private practice.

Ben, yes that is me. I did not want to come on here. But someone about 6 months ago encouraged me to post my story on the "optometrysucks" board on yahoo. Reluctantly I did. I really wanted to leave well enough alone, because as you said, I rarely practice any more. I was flooded with emails from people who had similar experiences to mine and I also received a number of emails from someone who wanted to post my story on here, and kept badgering me to do so. I was unfamiliar with this forum until I poked around a little bit. I posted a link to my story but I tried to emphasize that I did NOT think that optometry "sucked" just that people could learn from a few of the mistakes and misconceptions that I had. Unfortunately, many of the students and prospective students on here have the exact same attitude that I did when I was in school, and in the early years when I finished. That attitude was "if I work hard, and perservere, and don't spend all of my money on a big screen TV or a fancy car, I can have a satisfying career." That was where my unfortunate comment to cpw came from. I regret posting that in the fashion that I did, but I have a bad feeling that she's potentially in for a rude awakening.

I learned very quickly that that was not going to be the case. Unfortunately, many of my collegues have found out the same thing. I did not intend to come accross as overly negative, but in retrospect, I'm sure I did. I just don't want to see students making the same mistakes, or having the same misconceptions that I did. And I feel that I did a LOT of research in this area before I graduated. In fact, I was awarded a scholarship at graduation for commitment to enter private practice. Unfortunately, I asked a lot of questions, but I didnt' ask the right ones.

What I am interested in are your questions to CPW about what we can tell the students to prepare them. I am in the unique position in that I will be lecturing to students at each of the schools over the course of the next 12 months for one of the major companies within optometry. I would love to talk about these very issues to better prepare them for what to expect from optometry. Therefore, I'll open the question to students and docs. What would you like to know about practicing in the real world, or for the docs, what do you wish you had been told in school?

I wish I had been told of a few things....

#1) That acceptance onto insurance panels is critical. I know I have harped on this continuously, and I know it comes as a surprise to many ODs who practice in areas where they are welcomed onto panels that there are areas of the country where ODs are excluded in their entirety.

#2) That the number of older doctors who would gladly screw over a new one is astronomical. This was a HUGE shock to me. Like most people, I sort of had the notion that when I graduated, I would be able to join in with an older doc who would be somewhat benevolent, learn the ropes a bit, and gradually take over an office. What I encountered was a large number of docs that wanted to sell their offices outright for half a million on a Friday, while I start on Monday and the old guy retires to Boca. Obviously that isn't going to work. Especially if half of that purchase price is for "good will."

One doctor tried to sell me an office in a strip mall for $400000. There was a large construction project at the end of the mall. I asked what was being built. He said "I think it's a grocery store." Just the fact that he said "I think" made me uneasy. Some simple checking revealed that it was going to be a new Walmart complete with optical. This guy was trying to foist his decaying practice on me at an over inflated price. Nice.

Another one tried to sell me an office that grossed $45000 per year for $135000 because it had "potential." Ummmmmm, yeah. What he forgot to tell me was that the lease on his space was expiring in 6 months and the landlord wanted to double the rent. How convenient that he forgot to mention that. These are just a couple of many instances of this that I encountered, but those were the most ridiculous.

#3) That virtually every private practice doc out there will try to hose you by paying you as an independant contractor when you are clearly an employee.

#4) That while your instructors and private practice docs may speak ill of commercial locations and the docs who practice in them (and rest assured, I'm no fan of commercial practice) there is just as much unethical behavior and shoddy care, IF NOT MORE in private offices than in commercial ones.

#5) Just how much income in private practice comes from material sales and how much internet sales and commercial venues cut into this, and how its just going to get worse as Eyemed and Walmart takes over more and more of the marketplace.

#6) When I talked to instructors about my concern regarding my student debt load, and the effect that it would on my ability to get financing for a practice, they all laughed and patted me on the back and said "HEY! You're going to be an EYE DOCTOR! Banks will throw money at you." Sorry to say, 7 SBA lenders and 4 banks later, I was still being told the same thing: "You have excellent credit. You have too much debt. We can't help you." In this day and age of heavy collateralization of loans, the notion that a bank is going to loan you a pile of money based on your optometric skills alone is wishful thinking. Every OD I know who tried this, had the same result. Perhaps it would be different now that I am more than a few years out, and have more experience in the field. It's possible that they were worried that I didn't have enough experience in the field. But that didn't matter. That left me working nights and weekends at Lenscrafters because no private docs were looking for anyone, even 1 day a week, and no bank would loan me any money to start up my own.

 

[KHE]

I am very new to optometry, I'm starting school this fall at ICO, and
I've been reading this web board and seniordoc quite a bit lately. One of the messages I've gotten from practicing optometrists is that one important factor to acheiving success as an optometrist is location. Location because of competition, but also because of accesibility to insurance panels. It seems that accessibility of OD's to insurance panels varies from state-to-state, but I'm not really certain of that. Could you address the issue of insurance panels, how to get on them, which states allow OD's on their plans and which don't. Is there a centralized resource that compiles this information? Thanks for any light you can shed on this issue!

This isn't a state by state issue. It can vary from region to region within a state.

I know of no centralized resource on this. The only thing you can really do is to find out who the major carriers are in the areas that you want to practice in, and then phone them up and find out if they are accepting new ODs. If they aren't, then you might want to think of practicing somewhere else.

 

[cpw]

That was where my unfortunate comment to cpw came from. I regret posting that in the fashion that I did, but I have a bad feeling that she's potentially in for a rude awakening.

I'm 30 years old. I've worked in pharmacy, biotechnology and optometry. I found something I'm good at and love. I worked in it for a year and a half before going to OD school. I know EXACTLY what I'm getting into... I put myself through school and worked my ass off. I have great mentors both OD and OMD. I'll be fine... I spent a year running a front desk and coding insurance. I know how to bill .. and I know what they pay. I also know which plans are le poo.

Don't worry about cpw... she can take care of herself.

 

[Ben Chudner]

I wish I had been told of a few things....

#1) That acceptance onto insurance panels is critical. I know I have harped on this continuously, and I know it comes as a surprise to many ODs who practice in areas where they are welcomed onto panels that there are areas of the country where ODs are excluded in their entirety.

#2) That the number of older doctors who would gladly screw over a new one is astronomical. This was a HUGE shock to me. Like most people, I sort of had the notion that when I graduated, I would be able to join in with an older doc who would be somewhat benevolent, learn the ropes a bit, and gradually take over an office. What I encountered was a large number of docs that wanted to sell their offices outright for half a million on a Friday, while I start on Monday and the old guy retires to Boca. Obviously that isn't going to work. Especially if half of that purchase price is for "good will."

One doctor tried to sell me an office in a strip mall for $400000. There was a large construction project at the end of the mall. I asked what was being built. He said "I think it's a grocery store." Just the fact that he said "I think" made me uneasy. Some simple checking revealed that it was going to be a new Walmart complete with optical. This guy was trying to foist his decaying practice on me at an over inflated price. Nice.

Another one tried to sell me an office that grossed $45000 per year for $135000 because it had "potential." Ummmmmm, yeah. What he forgot to tell me was that the lease on his space was expiring in 6 months and the landlord wanted to double the rent. How convenient that he forgot to mention that. These are just a couple of many instances of this that I encountered, but those were the most ridiculous.

#3) That virtually every private practice doc out there will try to hose you by paying you as an independant contractor when you are clearly an employee.

#4) That while your instructors and private practice docs may speak ill of commercial locations and the docs who practice in them (and rest assured, I'm no fan of commercial practice) there is just as much unethical behavior and shoddy care, IF NOT MORE in private offices than in commercial ones.

#5) Just how much income in private practice comes from material sales and how much internet sales and commercial venues cut into this, and how its just going to get worse as Eyemed and Walmart takes over more and more of the marketplace.

#6) When I talked to instructors about my concern regarding my student debt load, and the effect that it would on my ability to get financing for a practice, they all laughed and patted me on the back and said "HEY! You're going to be an EYE DOCTOR! Banks will throw money at you." Sorry to say, 7 SBA lenders and 4 banks later, I was still being told the same thing: "You have excellent credit. You have too much debt. We can't help you." In this day and age of heavy collateralization of loans, the notion that a bank is going to loan you a pile of money based on your optometric skills alone is wishful thinking. Every OD I know who tried this, had the same result. Perhaps it would be different now that I am more than a few years out, and have more experience in the field. It's possible that they were worried that I didn't have enough experience in the field. But that didn't matter. That left me working nights and weekends at Lenscrafters because no private docs were looking for anyone, even 1 day a week, and no bank would loan me any money to start up my own.

Ken,

Thanks for the post. I think these issues are very important to students, as well as practicing docs. As you and I have discussed before, my path was quite a bit different than yours. Maybe I had the advantage of not practicing in an area like Los Angeles or New York. I have, however, seen older docs try to screw younger ones. Not just OD's, but OMD's do the same thing. As for the OD's, it's the ones that complain about corporate optometry that either refuse or are unable to offer a new grad a position that would keep them in private practice. In some of my upcomming talks, there will be both OD's and students. Hopefully, I can make the OD's realize that corporate will continue to get new grads as long as they continue the same tactics.

That being said, let me once again tell my story so that the other side is presented. After graduating from Berkeley, I did a residency in ocular disease at Bascom Palmer. After a year in Miami, my wife was ready to leave so we headed back to the west coast. We were both able to find jobs in Washington State so that's where we moved. I worked for an OMD practice for three years, before I realized I couldn't be an equal partner (not because I was an OD, but because I couldn't produce as much as a surgeon on the medical side). An opportunity came up to purchase an optometry practice sight unseen, meaning I had never worked there before. I knew the doctor and the reputation of the clinic, so that made things easier. I was able to secure financing from the SBA very easily because the doctor was goining to stay on as an employee and he was willing to carry a note for 20% of the purchase price. I bought the practice in August of 2001. The seller retired in August of 2004. I have just brought on another doctor part-time. I knew that I wasn't ready for a full-time employee (she is paid as an employee), so I contacted another doctor in the area that I knew was looking for a part-time doctor and we share her. This way both clinics have fulfilled a need for a part-time doc, and she works full-time between the two. By the way, we have no trouble getting on insurance panels, which I agree is the key to success for the future. Optical sales only represents about 30% of my revenue, with the majority comming from the medical side.

The morale of the story - there are some of us private docs that are willing to be fair to new grads.

 

[housecleaning]

i know you guys spend 4 yrs learning all about anatomy & ocular pharmacology from fellow optos, and i'm not sure if this helps, but as a non-opto & non-opto wannabe, here's what i'm thinking when i go to the costco eye guy before i grab a $1.50 slice & soda:
give me some new contacts that work exactly as good as the ones i have on & don't waste too much of my time with the whole "is this better or worse/better or worse/better or worse crap." just read the numbers off the machine that i looked into when i walked into this little pathetic "office." and don't **** it up too much 'cause i don't want to waste 10 minutes fixing this the next time i stop by when i need another huge pack of chicken wings.

if i thought i had any sort of real eye problem, i'd go to my gp & tell them to refer me to an ophthamologist. just spreading the truth. don't hate the messenger.

 

[KHE]

i know you guys spend 4 yrs learning all about anatomy & ocular pharmacology from fellow optos, and i'm not sure if this helps, but as a non-opto & non-opto wannabe, here's what i'm thinking when i go to the costco eye guy before i grab a $1.50 slice & soda:
give me some new contacts that work exactly as good as the ones i have on & don't waste too much of my time with the whole "is this better or worse/better or worse/better or worse crap." just read the numbers off the machine that i looked into when i walked into this little pathetic "office." and don't **** it up too much 'cause i don't want to waste 10 minutes fixing this the next time i stop by when i need another huge pack of chicken wings.

if i thought i had any sort of real eye problem, i'd go to my gp & tell them to refer me to an ophthamologist. just spreading the truth. don't hate the messenger.

Fair enough, but I guess it begs the questions of why you go to the doc at costco in the first place if that's your feeling about them?

I'm also not sure how you expect the person to "not "*** it up too much" if you don't want them to "waste too much time with the whole is this better or worse crap"

 

[cpw]

i know you guys spend 4 yrs learning all about anatomy & ocular pharmacology from fellow optos, and i'm not sure if this helps, but as a non-opto & non-opto wannabe, here's what i'm thinking when i go to the costco eye guy before i grab a $1.50 slice & soda:
give me some new contacts that work exactly as good as the ones i have on & don't waste too much of my time with the whole "is this better or worse/better or worse/better or worse crap." just read the numbers off the machine that i looked into when i walked into this little pathetic "office." and don't **** it up too much 'cause i don't want to waste 10 minutes fixing this the next time i stop by when i need another huge pack of chicken wings.

if i thought i had any sort of real eye problem, i'd go to my gp & tell them to refer me to an ophthamologist. just spreading the truth. don't hate the messenger.

Hate to break it to ya.. but that "little machine you look into" is what's ****ing up your Rx. The "which is better crap" is what's really refining your Rx.

 

[rpames]

give me some new contacts that work exactly as good as the ones i have on & don't waste too much of my time with the whole "is this better or worse/better or worse/better or worse crap." just read the numbers off the machine that i looked into when i walked into this little pathetic "office."

This is my favorite comment of patients. They think it is our fault when the Rx is not perfect, sometimes it could be, but most of the time it is them who gave us crappy responses.

We can't see through your eyes, that is why we have to waste your time with all those "****ing questions." By the way, OMDs do it the same way.

But, what this poster does bring up is that image an optical located in a place that has an echo, is not a very favorable one. I would bet that if this poster were to go to clinic at ICO, he would think a little differently.

 

[aphistis]

I went to the optometrist yesterday for an exam & to get my Rx updated. Rachel & have only moved here relatively recently, and I typically go to Wal-Mart for most of my vision stuff. The one I went to had friendly people, and got things right as far as I could tell.

Yesterday I went to an independent chain (Eyeglass World is the name, I believe), and since I didn't have any referral sources I basically went based on a newspaper flyer a couple weeks back. I was *very* surprised at how unhappy everybody in the office appeared. My wife was in there last Friday, and she reported the same experience. The exam was $45--which then, it turns out, comes right back to me as a credit if I get my glasses there--and the sales staff were very high-pressure. It wasn't a pleasant experience, and I'm not going back.

One unfortunate trend from all three optometrists I've seen since starting dental school, is that when I answer them about what I do, they've all been very complimentary--I would almost say wistful--about dentistry and what a great field it is, despite not having much to say about their own field when I asked them about it. I usually change the subject since I'm never really sure how to respond to that, but I feel bad when that happens since I get the impression they're not especially satisfied with their careers, especially since I respect what they know and appreciate the help they're giving me (I'd be functionally blind without them!).

Now, I fully recognize my n of 3 means absolutely nothing, and maybe it really is just the corporate thing I'm seeing since I've never been to private practice, but that's my non-inflation-adjusted $0.02.

 

[KHE]

I went to the optometrist yesterday for an exam & to get my Rx updated. Rachel & have only moved here relatively recently, and I typically go to Wal-Mart for most of my vision stuff. The one I went to had friendly people, and got things right as far as I could tell.

Yesterday I went to an independent chain (Eyeglass World is the name, I believe), and since I didn't have any referral sources I basically went based on a newspaper flyer a couple weeks back. I was *very* surprised at how unhappy everybody in the office appeared. My wife was in there last Friday, and she reported the same experience. The exam was $45--which then, it turns out, comes right back to me as a credit if I get my glasses there--and the sales staff were very high-pressure. It wasn't a pleasant experience, and I'm not going back.

One unfortunate trend from all three optometrists I've seen since starting dental school, is that when I answer them about what I do, they've all been very complimentary--I would almost say wistful--about dentistry and what a great field it is, despite not having much to say about their own field when I asked them about it. I usually change the subject since I'm never really sure how to respond to that, but I feel bad when that happens since I get the impression they're not especially satisfied with their careers, especially since I respect what they know and appreciate the help they're giving me (I'd be functionally blind without them!).

Eyeglass World is the absolute POND SCUM of our field. They make Walmart look like the Mayo Clinic. I wouldn't go in there for anything, and I wouldn't work there for all the tea in China. I don't care how much student loan debt, or anything I had. Swear to God, I'd rather work at Arby's.

You should consider giving a private practice doctor a shot.

 

[aphistis]

Eyeglass World is the absolute POND SCUM of our field. They make Walmart look like the Mayo Clinic. I wouldn't go in there for anything, and I wouldn't work there for all the tea in China. I don't care how much student loan debt, or anything I had. Swear to God, I'd rather work at Arby's.

You should consider giving a private practice doctor a shot.

I might. I'm definitely not going back to EW (appropriate acronym, nein?). If private practice is going to cost more, though, I'd want some sort of referral before I just ring somebody out of the Yellow Pages.