Optometry School vs. Medical School

Medical school requires a lot of dedication. That can't be understated. Go to med school if you have an underlying, burning desire for the responsibility of being a physician. That dedication is what will help you persevere through what can be a fairly miserable four years. Of course, there are good times too, but you still must endure the bad. Go to medical school if you want complete medical responsibility for the patient-- if nothing less than that would satisfy you. If you don't mind the idea of having less responsibility, then perhaps a "peripheral" medical career would be a good match for you. Not quite as important, but still a major consideration, are your career prospects as an MD vs. and OD. Medical doctors have the freedom to enter any field, and several different modes of practice (clinical, research, business, law, etc), whereas, optometry is much more focused on clinical practice in primary eye care (yes, they can do research too.. but my point is that you have fewer options as an OD than as an MD). Of course, there is also the consideration of salary. Your top end is likely quite a bit higher as an MD. There are exceptions, but this is the generality. Finally, if you REALLY love the eye, you may want to keep open the possibility of becoming an ophthalmologist, which would allow you to practice surgery and have the final word on complicated referrals from optometrists.

My SO is an optometry student. She chose optometry over medical school so that she would have more time for family and travel, because if she entered medicine, she would have likely chose a field like pediatrics that can be somewhat limiting for these activities. I'm sure there are other optometry students in this forum who can help you with their own reasoning for entering optometry.

SilleAngyl said:

Thanks for the response, powermd. Does anyone else have any input? Specifically, how does schooling for an MD/DO differ from optometry? Also, do optometrists do procedures? How much diagnosing of eye disease do they do? Also, what other kind of treatments can they offer patients? What does the typical day consist of for an optometrist? Again, responses are much appreciated.

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As someone who has recently graduated from optometry school and is now attending medical school, I think I can offer some advice. In terms of schooling, the medical cirriculum is much more demanding, as it should be. The depth of the material can not even compare to optometry. However, that is not to say that the optometric cirriculum is not easy, because it was also very demanding. However, I can say that in medical school, I felt as though every free moment that I had outside of class, needed to be devoted to studying because the material was sooo voluminous. I never got that feeling in optometry school, even though the material was alot.
As for diagnosing, optometrists can pretty much diagnose any eye disease they wish, but the problem is this: you are often not exposed to the more complicated eye diseases as they are often referred to an ophthalmologist. Therefore, your management of these more complex cases often does not happen in optometry school. The way the rotations are set up during optometry training, you get really good at diagnosing the bread and butter cases (refractive errors, diabetic ret, etc) but you don't get good at handling the more complicated cases (like a systemic uveitis for example) because those cases are few and far between in opto trainining. That is not to say that you can't handle these cases after you're an OD, but that largely depends on the type of setting that you're in, and how comfortable you are at dealing with these cases. In terms of treatments, optometrists can rx glasses, provide as good array of eye meds to tx some eye diseases (like glaucoma), and do minor surgical procedures in some states. As an optometrist you're lifestyle will be better than a physicians for the most part. Lifestyle really depends on the setting that you're in but on average, optometrists work 40-45 hrs/week, compared to physicians who can sometimes work a great deal more. The pay isn't bad $80-120K is around average for opto. As an MD, especially is you want to be a LASIK MD, the sky is the limit for $$$$. The biggest problem I had with optometry is that it did get monotonous for me. Alot of presbyopes, SCL fits, and rx checks; I was expecting to see more pathology, but out of ten patients that you see in a day, 9 will be healthy and just looking for an update in their Rx. Again, the patients that you see will vary a great deal depending on the practice that you are in, but for the average private/commericial practice, this is what is going to happen. The patient interaction is great but the cases soon became somewhat monotonous, which is why I am now in medical school. Anyways, both professions are great, it just depends on what you find important in an occupation. hope this helps

Insightful posts.

vtrain said:

As someone who has recently graduated from optometry school and is now attending medical school, I think I can offer some advice. In terms of schooling, the medical cirriculum is much more demanding, as it should be. The depth of the material can not even compare to optometry. However, that is not to say that the optometric cirriculum is not easy, because it was also very demanding. However, I can say that in medical school, I felt as though every free moment that I had outside of class, needed to be devoted to studying because the material was sooo voluminous. I never got that feeling in optometry school, even though the material was alot.
As for diagnosing, optometrists can pretty much diagnose any eye disease they wish, but the problem is this: you are often not exposed to the more complicated eye diseases as they are often referred to an ophthalmologist. Therefore, your management of these more complex cases often does not happen in optometry school. The way the rotations are set up during optometry training, you get really good at diagnosing the bread and butter cases (refractive errors, diabetic ret, etc) but you don't get good at handling the more complicated cases (like a systemic uveitis for example) because those cases are few and far between in opto trainining. That is not to say that you can't handle these cases after you're an OD, but that largely depends on the type of setting that you're in, and how comfortable you are at dealing with these cases. In terms of treatments, optometrists can rx glasses, provide as good array of eye meds to tx some eye diseases (like glaucoma), and do minor surgical procedures in some states. As an optometrist you're lifestyle will be better than a physicians for the most part. Lifestyle really depends on the setting that you're in but on average, optometrists work 40-45 hrs/week, compared to physicians who can sometimes work a great deal more. The pay isn't bad $80-120K is around average for opto. As an MD, especially is you want to be a LASIK MD, the sky is the limit for $$$$. The biggest problem I had with optometry is that it did get monotonous for me. Alot of presbyopes, SCL fits, and rx checks; I was expecting to see more pathology, but out of ten patients that you see in a day, 9 will be healthy and just looking for an update in their Rx. Again, the patients that you see will vary a great deal depending on the practice that you are in, but for the average private/commericial practice, this is what is going to happen. The patient interaction is great but the cases soon became somewhat monotonous, which is why I am now in medical school. Anyways, both professions are great, it just depends on what you find important in an occupation. hope this helps

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I would be very interested to know why you just didn't go to medical school in the first place?? What were you expecting when you went to optometry school??

Jenny

JennyW said:

I would be very interested to know why you just didn't go to medical school in the first place?? What were you expecting when you went to optometry school??

Jenny

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Because I had wanted to become an optometrist since junior high school! In fact, I had no genuine intentions of entering medicine even in undergrad. The desire to enter medicine didn't surface until my 3rd/4th year of clerkships. I realized, that my interests had broadened considerably since entering optometry school. People just change, I guess. Case in point, I remember having a patient who I was suspected of having Stargardt's and feeling fustrated that I had to refer her just when the case got interesting. I wanted to run the additional diagnostic tests and make the diagnosis myself, but I knew that wouldn't be possible being a primary care eye doc (albeit, I'm sure there are ODs out there who diagnose Stargardt's but I knew my training wasn't sufficient to do so). This type of change is something that you can't predict but is an inevitable fact of life.

Let me make this clear as a physician. If you are pre med or pre opt or pre dental and you are considering what field to go into because one is "easier" or lifestyle is better etc.. I can tell you one thing...you will not make it through med school with that mentality. Med school is difficult enough that only the toughest can make it through. Anyone with that attitude should try something else.

thiaeyemd said:

Let me make this clear as a physician. If you are pre med or pre opt or pre dental and you are considering what field to go into because one is "easier" or lifestyle is better etc.. I can tell you one thing...you will not make it through med school with that mentality. Med school is difficult enough that only the toughest can make it through. Anyone with that attitude should try something else.

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Honestly, stop trolling and just shut up. Quit looking for the 6 year old posts to raise promote yourself on.

He's a newbie. He probably didn't check the date after performing a search, thought he had something useful to add, and posted it. Chill out. Happens all the time.

In fact, I think we should give him some sort of award for finding the search feature. So very few ever find it!

I can actually appreciate this 6 year old thread. This is something that I have wondered myself at times.

Very good insight.

vtrain said:

As someone who has recently graduated from optometry school and is now attending medical school, I think I can offer some advice. In terms of schooling, the medical cirriculum is much more demanding, as it should be. The depth of the material can not even compare to optometry. However, that is not to say that the optometric cirriculum is not easy, because it was also very demanding. However, I can say that in medical school, I felt as though every free moment that I had outside of class, needed to be devoted to studying because the material was sooo voluminous. I never got that feeling in optometry school, even though the material was alot.
As for diagnosing, optometrists can pretty much diagnose any eye disease they wish, but the problem is this: you are often not exposed to the more complicated eye diseases as they are often referred to an ophthalmologist. Therefore, your management of these more complex cases often does not happen in optometry school. The way the rotations are set up during optometry training, you get really good at diagnosing the bread and butter cases (refractive errors, diabetic ret, etc) but you don't get good at handling the more complicated cases (like a systemic uveitis for example) because those cases are few and far between in opto trainining. That is not to say that you can't handle these cases after you're an OD, but that largely depends on the type of setting that you're in, and how comfortable you are at dealing with these cases. In terms of treatments, optometrists can rx glasses, provide as good array of eye meds to tx some eye diseases (like glaucoma), and do minor surgical procedures in some states. As an optometrist you're lifestyle will be better than a physicians for the most part. Lifestyle really depends on the setting that you're in but on average, optometrists work 40-45 hrs/week, compared to physicians who can sometimes work a great deal more. The pay isn't bad $80-120K is around average for opto. As an MD, especially is you want to be a LASIK MD, the sky is the limit for $$$$. The biggest problem I had with optometry is that it did get monotonous for me. Alot of presbyopes, SCL fits, and rx checks; I was expecting to see more pathology, but out of ten patients that you see in a day, 9 will be healthy and just looking for an update in their Rx. Again, the patients that you see will vary a great deal depending on the practice that you are in, but for the average private/commericial practice, this is what is going to happen. The patient interaction is great but the cases soon became somewhat monotonous, which is why I am now in medical school. Anyways, both professions are great, it just depends on what you find important in an occupation. hope this helps

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Bertram Walz said:

Medical is most expensive, Optometry cheapest. Medical pays the most, I am not sure which two pay less, but I think Optometry. Dentist and Optometrists have the best hours, though if you are going to Ophthalmology it would depend on if you work in private or public practice and if you are involved in surgery etc.

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I would have to disagree here and say that medical school is pretty comparable to optometry school (in terms of tuition). In general, at least.

JMaui said:

I would have to disagree here and say that medical school is pretty comparable to optometry school (in terms of tuition). In general, at least.

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Concur. MANY more options for in-state tution. I could go to UWash for almost half any optometry tuition and my buddy at TX-Southwestern will have $10k/year for tuition. However, you can get some of those crazy ones up at $50k or even $60k/year

Bertram Walz said:

Medical is most expensive, Optometry cheapest. Medical pays the most, I am not sure which two pay less, but I think Optometry. Dentist and Optometrists have the best hours, though if you are going to Ophthalmology it would depend on if you work in private or public practice and if you are involved in surgery etc.

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Dental is most expensive.

most schools you have to buy your own dental instruments. I had to purchase almost 20k in dental instruments and that was over a decade ago. and that's on top of books, tuition etc.

DocJL said:

Dental is most expensive.

most schools you have to buy your own dental instruments. I had to purchase almost 20k in dental instruments and that was over a decade ago. and that's on top of books, tuition etc.

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Let me be the first to say Good Lord. I thought my $600 in medical instruments was bad.

Then again, 4 days/wk, making more money than I will, no rectums/vaginas....

VA Hopeful Dr said:

Let me be the first to say Good Lord. I thought my $600 in medical instruments was bad.

Then again, 4 days/wk, making more money than I will, no rectums/vaginas....

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we do have it pretty good, I gotta say, but then again, we have more than our share of difficult patients too.

there are days I envy you guys, physicians in the surgical fields get to work on their pts while they are completely out, and those in the non-surgical fields don't have to get as "down and dirty" as we do. I mean, what professional invades your personal space as close and as frequently as a dentist??? (and I don't even want to think about any exams involving rectums and vaginas, no sir....)

the grass is always greener eh?

DocJL said:

we do have it pretty good, I gotta say, but then again, we have more than our share of difficult patients too.

there are days I envy you guys, physicians in the surgical fields get to work on their pts while they are completely out, and those in the non-surgical fields don't have to get as "down and dirty" as we do. I mean, what professional invades your personal space as close and as frequently as a dentist??? (and I don't even want to think about any exams involving rectums and vaginas, no sir....)

the grass is always greener eh?

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Hmm, suppose I should have put one of those winking smiles at the end of my post. I'm happy where I am and wouldn't want your job, likely vice versa from your end.

Besides, what kind of doctor would I be if I didn't give a dentist a hard time about stuff like this?

VA Hopeful Dr said:

Let me be the first to say Good Lord. I thought my $600 in medical instruments was bad.

Then again, 4 days/wk, making more money than I will, no rectums/vaginas....

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How do you get away with only $600 in med instruments!?

ABaverage said:

How do you get away with only $600 in med instruments!?

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Stethoscope, scrubs and plenty of deodorant I guess.

ABaverage said:

How do you get away with only $600 in med instruments!?

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Stethoscope ($200), BP cuff ($150), ophthalmoscope/otoscope ($250). Of course this was 6 years ago so its probably more nowadays.

And honestly, most of us would argue about the need for the last 2 of those.

Good thread and comments (even if they are old). As a start I would like to mention that a good OD with today's training can diagnose and treat any eye condition that doesn't involve eye surgery. Over the last few months I have diagnosed and began treatment on many glaucoma patients, vasculitis, optic neuritis, and a brain tumor in a young girl that several other MDs and ODs missed. I have diagnosed and watched a Stargardt's patient. (There is no real treatment). I order my own CTs, MRIs, and blood work. I can Rx any topical or oral med to treat conditions of the eye and adnexa.

With that said I think the golden age of optometry has passed (even though new optometry grads are better trained than ever) and if I did it again I would choose dental or med school. With my post-doc training I have more years of education than a dentist but they easily earn twice as much and have much less professional, political, oversupply, and insurance issues. The major benefit of med school is nearly unlimited options after graduation.

In today's age I think the difficulty of the classwork is equal among the 3 professions. In fact in many of the schools the students take the same classes over the first couple of years. I graduated #1 in my undergrad pre-med class and many of those under me had no problems through medical or dental school. There is no doubt that some medical residencies will drain a bunch of your time.

So I guess my choice with what I know now would be dental school. Med school close behind.

IndianaOD said:

Good thread and comments (even if they are old). As a start I would like to mention that a good OD with today's training can diagnose and treat any eye condition that doesn't involve eye surgery. Over the last few months I have diagnosed and began treatment on many glaucoma patients, vasculitis, optic neuritis, and a brain tumor in a young girl that several other MDs and ODs missed. I have diagnosed and watched a Stargardt's patient. (There is no real treatment). I order my own CTs, MRIs, and blood work. I can Rx any topical or oral med to treat conditions of the eye and adnexa.

With that said I think the golden age of optometry has passed (even though new optometry grads are better trained than ever) and if I did it again I would choose dental or med school. With my post-doc training I have more years of education than a dentist but they easily earn twice as much and have much less professional, political, oversupply, and insurance issues. The major benefit of med school is nearly unlimited options after graduation.

In today's age I think the difficulty of the classwork is equal among the 3 professions. In fact in many of the schools the students take the same classes over the first couple of years. I graduated #1 in my undergrad pre-med class and many of those under me had no problems through medical or dental school. There is no doubt that some medical residencies will drain a bunch of your time.

So I guess my choice with what I know now would be dental school. Med school close behind.

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Are you saying you regret becoming an OD and you wished that you had become a DMD instead?

ABaverage said:

Are you saying you regret becoming an OD and you wished that you had become a DMD instead?

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That's the frustrated answer....how can an OD, who has never worked with teeth, want to all of a sudden? Money/lack of oversupply should not be the single reason.

I find too many people wanting something else, but they have yet to try it. Being a dentist is very different from being an optometrist, or an MD for that matter.

socal2014 said:

That's the frustrated answer....how can an OD, who has never worked with teeth, want to all of a sudden? Money/lack of oversupply should not be the single reason.

I find too many people wanting something else, but they have yet to try it. Being a dentist is very different from being an optometrist, or an MD for that matter.

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Although it may be politically incorrect to choose a profession or specialty based on financial remuneration, is is a large part of what may decide a student who is smart, hard-working, and qualified to go into any of a number of professions.

How many of us REALLY know what the day to day practice of any given profession entails, when we set our sights on that profession while (typically) only 20 years old and in college.

I do not believe that because somebody claims they chose a profession "because they love it and would do it regardless of salary"- yeah, right , automatically makes them a better practicioner than the person who chose the profession in large part due to earning potential.

We all have our own aptitudes, level of innate intelligence, work ethic, moral code, and a multitude of other factors which determine what type of practitioners we will ultimately become in our chosen fields.

And like it or not, money IS a huge factor later in your career when you have a family to support and provide for, and are thinking of retirement. This explains to me, at least, the OD's regrets with his professional choices. When you are 20 years old, although salary is a factor in your choice, almost ANY salary over 50K a year may SEEM like a fortune to a starving college student, but the reality is that even 2,3 or 4 times that amount will hardly make you a "rich doctor"

DocJL said:

Although it may be politically incorrect to choose a profession or specialty based on financial remuneration, is is a large part of what may decide a student who is smart, hard-working, and qualified to go into any of a number of professions.

How many of us REALLY know what the day to day practice of any given profession entails, when we set our sights on that profession while (typically) only 20 years old and in college.

I do not believe that because somebody claims they chose a profession "because they love it and would do it regardless of salary"- yeah, right , automatically makes them a better practicioner than the person who chose the profession in large part due to earning potential.

We all have our own aptitudes, level of innate intelligence, work ethic, moral code, and a multitude of other factors which determine what type of practitioners we will ultimately become in our chosen fields.

And like it or not, money IS a huge factor later in your career when you have a family to support and provide for, and are thinking of retirement. This explains to me, at least, the OD's regrets with his professional choices. When you are 20 years old, although salary is a factor in your choice, almost ANY salary over 50K a year may SEEM like a fortune to a starving college student, but the reality is that even 2,3 or 4 times that amount will hardly make you a "rich doctor"

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Gotta remember that 2,3 or x times 50k/year will never make you rich in any profession if you are terrible with money. You'd be amazed at the salaries of some people who declare bankruptcy.

DocJL said:

Although it may be politically incorrect to choose a profession or specialty based on financial remuneration, is is a large part of what may decide a student who is smart, hard-working, and qualified to go into any of a number of professions.

How many of us REALLY know what the day to day practice of any given profession entails, when we set our sights on that profession while (typically) only 20 years old and in college.

I do not believe that because somebody claims they chose a profession "because they love it and would do it regardless of salary"- yeah, right , automatically makes them a better practicioner than the person who chose the profession in large part due to earning potential.

We all have our own aptitudes, level of innate intelligence, work ethic, moral code, and a multitude of other factors which determine what type of practitioners we will ultimately become in our chosen fields.

And like it or not, money IS a huge factor later in your career when you have a family to support and provide for, and are thinking of retirement. This explains to me, at least, the OD's regrets with his professional choices. When you are 20 years old, although salary is a factor in your choice, almost ANY salary over 50K a year may SEEM like a fortune to a starving college student, but the reality is that even 2,3 or 4 times that amount will hardly make you a "rich doctor"

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So you are comfortable with your salary and have no regrets about going into dentistry? You don't ever feel like you could have gone into another field? What about the competition, do you ever feel that there is an oversupply of DMDs that is costing you patients?

ABaverage said:

So you are comfortable with your salary and have no regrets about going into dentistry? You don't ever feel like you could have gone into another field? What about the competition, do you ever feel that there is an oversupply of DMDs that is costing you patients?

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Honestly I consider myself very fortunate to have chosen dentistry, I enjoy my work (except for the occasional difficult patient) and I'm very good at it. I had actually strongly considered optometry when I was younger (I've worn glasses since I was 12), and my only real exposure to dentistry was annual checkups, a few fillings and 3 years of ortho. the books available 15-20 years ago were usually written even a few years before then, and at the time, the incomes of both professions were similar. I chose dentistry because I am very good with my hands, having always been good at drawing and building models, etc. and I could see that the profession involved working with your hands all day. Many of the dentists I've met who don't enjoy their jobs have confided that they are not "good with their hands".

I make more now than I ever would have thought when I was in college (and I made even more a few years ago before the recession hit, although I worked alot more), but as stated, once you start paying for private school for the kids, piano, karate and tennis lessons, etc etc and start taking nice vacations and driving nice cars, you really see that a 6 figure salary is hardly a fortune.

Obama likes to portray those with incomes over $250k as "rich". I beg to differ. Unless or until you have considerable assets saved, $250k for owning a private business is hardly rich, especially once you factor in paying down the debt on your business, and in most of our cases, the huge educational loans. The term I read in a magazine that fits best is I'm a HENRY. High Earner Not Rich Yet.

When I read IndianoOD's posts I have to admit I got a feeling of "glad I dodged that bullet", as I do not think I would be as happy as an OD (not at all trying to bash the profession here, I respect the level of training you guys have as eye doctors).

And yes I do see that the oversupply of dentists in my area has made it tougher for me. Just as dentists in California may only make 1/2 of what dentists living in Texas make, despite a higher cost of living, we are seeing the same trend here.

DocJL said:

Honestly I consider myself very fortunate to have chosen dentistry, I enjoy my work (except for the occasional difficult patient) and I'm very good at it. I had actually strongly considered optometry when I was younger (I've worn glasses since I was 12), and my only real exposure to dentistry was annual checkups, a few fillings and 3 years of ortho. the books available 15-20 years ago were usually written even a few years before then, and at the time, the incomes of both professions were similar. I chose dentistry because I am very good with my hands, having always been good at drawing and building models, etc. and I could see that the profession involved working with your hands all day. Many of the dentists I've met who don't enjoy their jobs have confided that they are not "good with their hands".

I make more now than I ever would have thought when I was in college (and I made even more a few years ago before the recession hit, although I worked alot more), but as stated, once you start paying for private school for the kids, piano, karate and tennis lessons, etc etc and start taking nice vacations and driving nice cars, you really see that a 6 figure salary is hardly a fortune.

Obama likes to portray those with incomes over $250k as "rich". I beg to differ. Unless or until you have considerable assets saved, $250k for owning a private business is hardly rich, especially once you factor in paying down the debt on your business, and in most of our cases, the huge educational loans. The term I read in a magazine that fits best is I'm a HENRY. High Earner Not Rich Yet.

When I read IndianoOD's posts I have to admit I got a feeling of "glad I dodged that bullet", as I do not think I would be as happy as an OD (not at all trying to bash the profession here, I respect the level of training you guys have as eye doctors).

And yes I do see that the oversupply of dentists in my area has made it tougher for me. Just as dentists in California may only make 1/2 of what dentists living in Texas make, despite a higher cost of living, we are seeing the same trend here.

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Our practice location is leased from a dentist and I have several dentist friends. I am a busy optometrist at a nice office. I do not make 6 figures and after you factor in time spent and loans I make less than many blue collar workers in town. Two dentists I know work between 3-4 days per week and more than double my income. No, it is not all about the money but knowing I could work half as many days for the same income is not comforting. That could be more time with my family and pursuing other interests.

In this area at least they are doing very well compared to the optometrists. Plus they don't have patients continually asking them for their Rx to go get their products online. I don't see internet order crowns or cavity fillings.

IndianaOD said:

Our practice location is leased from a dentist and I have several dentist friends. I am a busy optometrist at a nice office. I do not make 6 figures and after you factor in time spent and loans I make less than many blue collar workers in town. Two dentists I know work between 3-4 days per week and more than double my income. No, it is not all about the money but knowing I could work half as many days for the same income is not comforting. That could be more time with my family and pursuing other interests.

In this area at least they are doing very well compared to the optometrists. Plus they don't have patients continually asking them for their Rx to go get their products online. I don't see internet order crowns or cavity fillings.

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How long have u been in practice? Owning a practice and not making 6 figures is odd to me..... it would seem out of the norm for ODs at least.

Well, the choice really depends on you. If you really find optometry that interesting, then take it. Anyway, you will still be qualified for both courses.

ABaverage said:

How long have u been in practice? Owning a practice and not making 6 figures is odd to me..... it would seem out of the norm for ODs at least.

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4 years and I am a partner/practice owner. Costs are going up and insurances are paying us less and less. I only take the "better" vision insurance plans and they still pay crap. I recently had strep throat and my family doc spent 3 minutes with me. My bill was twice as much as I get paid for a 30 minute eye exam from vision plans. Review of Optometry had an article a couple months ago that the average optometrist has lost over $20,000 in annual income over the past 3 years. Optometry was the only medical profession with a loss.

There are some lucky and very successful ODs sill making big money but they are the vast minority. $350 per day was the average about 15 years ago and is staying true today.

IndianaOD said:

I only take the "better" vision insurance plans and they still pay crap.

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Are you unable to access medical plans? If so you are, are you unable to bill routine eye visits to those?

blackhole2 said:

Are you unable to access medical plans? If so you are, are you unable to bill routine eye visits to those?

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From my understanding, you can bill routine eye exams to medical insurance if there is a medical diagnosis. Anything but refractive errors, I suppose. Not sure on this one.

150 for a BP cuff? My friends and I got ours for 10 bucks on amazon. I wouldn't pay that much since your rotations and hospitals should have them. The stethoscope seems pricey for a med student/optometrist. Most of my classmates got their stethoscopes for about 150, I believe. The opthalmoscope/otoscope seems roughly in the ballpark range.

Its highly variable but I would say that you can/should spend about 300 dollars on the aforementioned supplies.

VA Hopeful Dr said:

Stethoscope ($200), BP cuff ($150), ophthalmoscope/otoscope ($250). Of course this was 6 years ago so its probably more nowadays.

And honestly, most of us would argue about the need for the last 2 of those.

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blackhole2 said:

Are you unable to access medical plans? If so you are, are you unable to bill routine eye visits to those?

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I am on every medical plan I can get on. The last few years the medical plans with "routine eye exams" have slashed their payments. Two years ago I got $96 from Anthem, now I get $70. I am not lying when I say optometrists in town take plans that pay $40 for an eye exam. Try paying your staff and overhead with that, especially when you patient goes to the internet for their glasses and contact lenses.

Patients used to have great medical plans that would pay for about anything. Now you charge a patient a reasonable fee for medical eye care and they haven't met their high deductible and you will never see them again. The schmuck OD down the road will do the works for $40.

Sorry guys, I am usually an optimist, but I just don't think there is much positive in this profession.

chinocochino said:

150 for a BP cuff? My friends and I got ours for 10 bucks on amazon. I wouldn't pay that much since your rotations and hospitals should have them. The stethoscope seems pricey for a med student/optometrist. Most of my classmates got their stethoscopes for about 150, I believe. The opthalmoscope/otoscope seems roughly in the ballpark range.

Its highly variable but I would say that you can/should spend about 300 dollars on the aforementioned supplies.

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Admittedly I wasn't a savvy consumer - bought the recommended stuff from the book store.

IndianaOD said:

Patients used to have great medical plans that would pay for about anything. Now you charge a patient a reasonable fee for medical eye care and they haven't met their high deductible and you will never see them again. The schmuck OD down the road will do the works for $40.

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Do u sell glasses or contact lenses?

IndianaOD said:

I am on every medical plan I can get on. The last few years the medical plans with "routine eye exams" have slashed their payments. Two years ago I got $96 from Anthem, now I get $70. I am not lying when I say optometrists in town take plans that pay $40 for an eye exam. Try paying your staff and overhead with that, especially when you patient goes to the internet for their glasses and contact lenses.

Patients used to have great medical plans that would pay for about anything. Now you charge a patient a reasonable fee for medical eye care and they haven't met their high deductible and you will never see them again. The schmuck OD down the road will do the works for $40.

Sorry guys, I am usually an optimist, but I just don't think there is much positive in this profession.

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As much as I hate to admit it, I'm guilty as charged.

I don't have insurance that covers optometric care (or eyeglasses or contacts) as I am self-employed and my insurance sucks. I typically pay $80-100 cash for my exams. Then I buy my glasses and contacts at Costco.
Last year I asked the front desk girl at my optometrist if he would be willing to sell me 12 boxes of Acuvue Oasys for the same price I get at Costco (I change lenses every 10 days so 12 boxes is a years supply), I told her to tell the office manager or OD (it's a group practice, privately owned as far as I can tell), that I was more than happy to support a fellow small business, and I would even pay in cash, but I couldn't see paying an extra $100 for exactly the same product. They declined my offer, and I bought my lenses from Costco.

DocJL said:

As much as I hate to admit it, I'm guilty as charged.

I don't have insurance that covers optometric care (or eyeglasses or contacts) as I am self-employed and my insurance sucks. I typically pay $80-100 cash for my exams. Then I buy my glasses and contacts at Costco.
Last year I asked the front desk girl at my optometrist if he would be willing to sell me 12 boxes of Acuvue Oasys for the same price I get at Costco (I change lenses every 10 days so 12 boxes is a years supply), I told her to tell the office manager or OD (it's a group practice, privately owned as far as I can tell), that I was more than happy to support a fellow small business, and I would even pay in cash, but I couldn't see paying an extra $100 for exactly the same product. They declined my offer, and I bought my lenses from Costco.

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Just think if all your patient's came to you for their routine exams and every time someone had a cavity, or needed a crown, or any other extra procedure they went to a dentist at Costco. How would you fare?

Ok, now lets say that almost all your patients have dental insurance that pays half of what you usually get per patient currently and there are no private pay patients because they all go to Costco. How are you doing now?

Oh crap, then you are living the optometric dream!

About 6 months ago I accidentally opened some mail that was addressed to the dentist in my building. It was payment for a routine exam and I was speechless. I couldn't believe how much it was. Very eye opening experience so to speak. Of course they charge close to $300 for a new patient exam and the local wally O.D. charges $46.

DocJL,

I'd love to hear your thoughts.

IndianaOD said:

Just think if all your patient's came to you for their routine exams and every time someone had a cavity, or needed a crown, or any other extra procedure they went to a dentist at Costco. How would you fare?

Ok, now lets say that almost all your patients have dental insurance that pays half of what you usually get per patient currently and there are no private pay patients because they all go to Costco. How are you doing now?

Oh crap, then you are living the optometric dream!

About 6 months ago I accidentally opened some mail that was addressed to the dentist in my building. It was payment for a routine exam and I was speechless. I couldn't believe how much it was. Very eye opening experience so to speak. Of course they charge close to $300 for a new patient exam and the local wally O.D. charges $46.

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Indiana,

I've read lots of interesting threads on this forum in the last couple of months. It seems like Optometry and Pharmacy practitioners are the most concerned about the future of their professions. On the medical side, only a few experienced providers seem to have posted about concerns of Obamacare ruining their profession, the students don't seem too concerned.

Dentistry seems to thus far have a good future, although my profession also has it's problems; there is currently a push for "mid-level" providers to be able to perform very basic dental procedures, basically there are legislators who want to turn our profession into the equivalent of a "trade" and the practitioners into "tradesman" like carpenters or plumbers. I daresay none of the legislators pushing for this legislation in several states would care to have anything less than a Doctor of Dentistry treating themselves or their family, but it usually is that way ("do as I say and not as I do"). Also, as Dentistry has grown more lucrative, there have been several new dental schools open in the past decade, with more planned. And the crappy economy has pushed back the retirement plans of thousands of older DDS's, creating oversupply in many more desireable-to-live-in urban areas.

I can see how the big box stores and especially online availability (contact lens express, etc.) have taken a huge chunk out of a typical OD's practice. Fortunately we make our living providing procedural services, and not goods. And although there are many corporate chain "mill" dental practices, I haven't heard of WalMart or Costco trying to open dental offices .

I had actually thought that with the advent and increased popularity of LASIK that many OD's would find their patient pools dwindling. Have you noticed that at all? (I also know some OD's have entered group practice with MD opthalmologists who offer LASIK). Literally half of my closer family friends have had LASIK, and they are pretty happy with not having to wear glasses. Myself I would probably only consider it when I retire (if I am still a candidate), as my career relies entirely on my ability to perform minute, detailed procedures with my eyes and hands, and I am not willing to take any risks that surgery would entail just to be free of contacts.

As far as the dentist payment you opened, I would have to see it to give you a complete explanation, but I will say I don't know ANY dentist who gets $300 for a routine exam. Maybe if it included a cone beam dental CT, and full mouth impressions/ study models for planning a complex restorative case, and/or also included hygiene services for the day, particularly if the patient has periodontal disease. My UCR fee for a complete set of digital radiographs and complete oral examination is probably close to $200, but I NEVER get that; like most practices who practice in saturated areas, I have largely a PPO practice, so a typical payment from insurance for this would be right around $100. Just as my full fee for a crown is about $1000, most of the plans I take pay me $600-$750 (I don't take the **** plans that I had to take when I worked at a corporate mill - those paid $400 per crown, and we used cheap materials, and had a very cheap lab - I made sure the crowns fit, and were clinically adequate, but they were hardly things of beauty.... I usually only get $1000 per restorative unit when I am doing a cosmetic case for a very discerning patient, and in this case I use a dental prosthetic laboratory that charges several hundred dollars a unit for high end esthetic work. Also, especially in this economy, I typically offer hefty discounts to pts who do not have insurance, with the exception being large cosmetic cases on patients who give me a vibe that they will be very difficult to please.... these PIA patients are quoted the full fee, take it or leave it....

I would also add that dentistry has amongst the highest overheads of the professions. I have a medium size practice, state of the art without being over the top fancy. The buildout on my leased office space cost close to $400k (dental equipment is UNGODLY expensive), my lowest paid employees make over $20/hour (and yes dental assistants are much more highly skilled than typical medical assistants, there is no comparison), and my highest paid employees (my RDH's) make between $40 and $50 per hour. So when they perform a routine prophylaxis on a typical PPO plan, it is basically a "break even" or "loss leader" for the practice. If I am not averaging over $250 to $300 per hour of production based on my costs and hours of practice, I am LOSING money. I could go on and on, but you get the idea....

Just curious, how much does it typically cost to set up an OD office? the size for a single office is usually probably half the size of a dental office wouldn't you say (for a sole proprietor)? But it seems many more OD's go into group practice, as the profession seems to lend itself to this practice model more so than dentistry. Any how many employees do you need? and how much are they paid?

Inquiring minds wanna know!

PS - would YOU have honored my request to match the price of contacts at Costco? (especially as I was completely up front about it, and offered to pay in full in CASH so there would be no credit fees, etc. involved for the OD office)

DocJL,

Your overhead is ridiculous! Is it true that malpractice insurance is quite expensive as well? Could you go about your daily work without the techs/other skilled employees besides the receptionist?

socal2014 said:

DocJL,

Your overhead is ridiculous! Is it true that malpractice insurance is quite expensive as well? Could you go about your daily work without the techs/other skilled employees besides the receptionist?

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Again....are you even IN optometry school or pursuing optometry as a career?

socal2014 said:

DocJL,

Your overhead is ridiculous! Is it true that malpractice insurance is quite expensive as well? Could you go about your daily work without the techs/other skilled employees besides the receptionist?

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overhead in dentistry IS ridiculously expensive, and although we do on average much better than OD's, my statement was to shed a little light on Indiana OD's interpretation of a dental bill/ statement he looked at.

absolutely could NOT do my work without my employees. only a nonbusy dentist performs his own prophies (cleanings) as it is hard to produce much more than $100/hour, which DOESN'T pay the overhead. Young dentists or dentists in SUPERsaturated areas might do their own hygiene, but it is a completely different practice model. If you are bogged down doing hygiene, you lose the opportunity to do productive high dollar work. when I am busy (which used to be every hour of every day, not so much now with the recession) I will do a minimum of say, simple restorative (fillings) which might produce $500/hour. a big cosmetic case might be $6-8k for 4 hours total work (preparation and seat). Also, working WITHOUT an assistant (ie - not using 4-handed dentistry) makes you very inefficient, and also (at least for me) forces me to bend over and twist around the patient, which is very hard on the back and neck.

malpractice isn't that bad (but then again my rates are better than most because I have extra training and I have never had a claim in over a decade of practice. I think I pay about 4 or 5k a year (but I honestly don't know for sure, my wife is my business manager and pays all the bills)

the BS fees do add up however. roughly $1500 a year for tripartite ADA membership (which I need to do because I get some of my insurance plans through the ADA), I think my annual state license is like $500, and I also have an assortment of other BS fees for my DEA license, licenses for my Xray units in my office, business licenses, etc etc and the list goes on... plus a requirement for CE, which is never cheap.....

I think I'm coughing up over 10g's a year for all of this.....

dbl post

Thread now transformed to "OD vs DDS"

I think that all pre-optometry students should read the conversation between IndianaOD and DocJL. So then, here is the fact: Optometry and dentistry schools are similar in terms of length and rigor. However, upon graduation, optometrists would be very, very lucky to make $100,000 while dentists 2 or 3 times more.

Knowing this, why do you wish to go into optometry instead of dentistry?

yushin said:

I think that all pre-optometry students should read the conversation between IndianaOD and DocJL. So then, here is the fact: Optometry and dentistry schools are similar in terms of length and rigor. However, upon graduation, optometrists would be very, very lucky to make $100,000 while dentists 2 or 3 times more.

Knowing this, why do you wish to go into optometry instead of dentistry?

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Easy answer, 1. because I do not want to work on teeth/be a dentist and 2. because money isn't everything.

Agree with most of Yushin's post, but, IMHO, I'm gonna say dental school might be more rigorous.

I've known 2 DDS's who were married to OD's (one was in my dental school class), these 2 couples had been together through their college and professional school years, and even the OD's agreed that their DDS spouses got put through the ringer to a worse degree in dental school....

Why is this? I will say that many of the instructors in Dental schools tend to be retired career military, and that may have something to do with the mindset. Also, in terms of academic rigor, I believe a dental degree is the only degree that is commonly used to get advanced standing in an MD program (ie - oral surgeons attending a dual degree program only go to med school for 2 years to obtain their MD, after completion of their DDS.) Also, there is just SO MUCH lab work that must be done, and dentistry is a profession that requires you to have, or develop good hand skills if you are ever going to be any good at it. Plus even in dental school you have to learn how to motivate pts to accept and pay for treatment (although it's cheap, the pts are usually poor), if you want to complete your clinical requirements.....

NOT trying to start a flame war, just some observations.

DocJL said:

Agree with most of Yushin's post, but, IMHO, I'm gonna say dental school might be more rigorous.

I've known 2 DDS's who were married to OD's (one was in my dental school class), these 2 couples had been together through their college and professional school years, and even the OD's agreed that their DDS spouses got put through the ringer to a worse degree in dental school....

Why is this? I will say that many of the instructors in Dental schools tend to be retired career military, and that may have something to do with the mindset. Also, in terms of academic rigor, I believe a dental degree is the only degree that is commonly used to get advanced standing in an MD program (ie - oral surgeons attending a dual degree program only go to med school for 2 years to obtain their MD, after completion of their DDS.) Also, there is just SO MUCH lab work that must be done, and dentistry is a profession that requires you to have, or develop good hand skills if you are ever going to be any good at it. Plus even in dental school you have to learn how to motivate pts to accept and pay for treatment (although it's cheap, the pts are usually poor), if you want to complete your clinical requirements.....

NOT trying to start a flame war, just some observations.

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Dr. JL,

I read somewhere that you are recuperating from an injury (Am I correct?). I hope you are getting better. I enjoy reading your posts because they are very informative. I hope that you would continue to share your insights even after you get back to work full-time.

I went to an optometry school (University of Alabama at Birmingham) where we took first 2 years of basic science courses with dental students, so I think that I can compare the rigor of the two schools slightly better than you. In all classes we took together (physiology, pharmacology, etc.), the average test scores of the optometry students were always 1-2 points higher than that of dental students, and I had an impression (observing the stress levels of the two groups of students) that optometry school was slightly more rigorous than dental school( in my school at least).

Having said that, I really do not have any idea about the 3rd and 4th years of dental school, even though one of my sisters is a dentist.

Are the 3rd and 4th years of dental school considerably more difficult than the 1st and 2nd years?