All optometry students read this

[KHE]

Here are three articles about opening a practice. I'm sure it won't take Jason K long to respond about unreasonable this is and how optometry is going down the tubes and blah blah blah but here's an article series from a well respected practitioner and consultant on opening cold. Take it for what it's worth.

http://www.optometric.com/mtotw/tip_new.asp?tip=502

http://www.optometric.com/mtotw/tip_new.asp?tip=503

http://www.optometric.com/mtotw/tip_new.asp?tip=504

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[Jason K]

Here are three articles about opening a practice. I'm sure it won't take Jason K long to respond about unreasonable this is and how optometry is going down the tubes and blah blah blah but here's an article series from a well respected practitioner and consultant on opening cold. Take it for what it's worth.

http://www.optometric.com/mtotw/tip_new.asp?tip=502

http://www.optometric.com/mtotw/tip_new.asp?tip=503

http://www.optometric.com/mtotw/tip_new.asp?tip=504

You're right, it didn't take me long to read this and post a response about how unreasonable this approach is, because it is. Dr Gailmard is a highly respected OD practitioner and paid consultant. He consults, for a substantial fee, with practitioners who want to start up cold, buy an office, run their office more efficiently, whatever.

This series amounts to what is effectively, an advertisement for his services. I enjoyed this plug at the end of each section:

"Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com."

He only stands to gain if 30 bright eyed, bushy tailed new grads show up with a desire to start up...."hot." Starting up cold right now, unless you find an isolated town of 15,000 people with an "OD wanted" sign, is crazy. I can see the logic behind buying an office that has an established cash flow. That might turn out to be a disastrous mistake in 10 or 15 years when optometry is fully sunk in its own waste, but starting up cold right now is nuts, and I think deep down you'd agree with me on that.

 

[blazenmadison]

Here is a blog about an ophthalmologist struggling to do a cold-start in California.
http://iballdoc.blogspot.com/2010/07/genesis.html

Very disheartening to read some of his blog entries. However, the same market principles apply to ophthalmology. Do not practice in a saturated market like California!

 

[Jason K]

Here is a blog about an ophthalmologist struggling to do a cold-start in California.
http://iballdoc.blogspot.com/2010/07/genesis.html

Very disheartening to read some of his blog entries. However, the same market principles apply to ophthalmology. Do not practice in a saturated market like California!

OMDs are certainly not immune to the effects of the changes that are taking place in optometry. Honestly, I'm not surprised that many ophthalmologists resent our profession. If we had not "moved into town," the commercial cancer that's spreading through the US would likely not be here at all, or at least it would not be so prevalent. It's a problem that we, as a profession, not only allowed, but actually fostered by pumping out thousands of unnecessary ODs with nowhere else to go, thus feeding an ever-growing animal that's now eating its owner. With no self control, we have effectively ruined our own profession and dragged down another.

I believe optometry is the primary reason that vision plans pay what they pay. It's because we jumped onto the materials train a long time ago, agreeing to essentially sacrifice service fees for selling glasses and contacts. When the "value" of an eye exam is deemed "free with a purchased pair of glasses," all eye care providers, MDs and ODs suffer the consequences.

If, as a profession, we had been smart, we'd have cut the oversupply problem off at the knees a long time ago. Had we done that, we would have never grown the commercial monster that has now overtaken our profession, and we'd have never devalued our own services. If we had never given in to the likes of Luxottica, National Vision, and the big box retailers, an eye exam would still be something that people would be willing to pay for. Now, it's largely something that's expected to be "free with any pair."

 

[KHE]

You're right, it didn't take me long to read this and post a response about how unreasonable this approach is, because it is. Dr Gailmard is a highly respected OD practitioner and paid consultant. He consults, for a substantial fee, with practitioners who want to start up cold, buy an office, run their office more efficiently, whatever.

This series amounts to what is effectively, an advertisement for his services. I enjoyed this plug at the end of each section:

"Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com."

He only stands to gain if 30 bright eyed, bushy tailed new grads show up with a desire to start up...."hot." Starting up cold right now, unless you find an isolated town of 15,000 people with an "OD wanted" sign, is crazy. I can see the logic behind buying an office that has an established cash flow. That might turn out to be a disastrous mistake in 10 or 15 years when optometry is fully sunk in its own waste, but starting up cold right now is nuts, and I think deep down you'd agree with me on that.

Each article was written one week apart. The fact that he puts at the very end (even below his tagline) that he offers consulting services hardly seems like some maniacal scheme to get "bright eyed bushy tailed new grads" to pay him. There's no advertising done within the body of any of the three articles.

But keep cursing the darkness, Jason. The end is nigh, right? Keep trying to save the souls of these poor unsuspecting sinners.

 

[KHE]

a

If, as a profession, we had been smart, we'd have cut the managed care problem off at the knees a long time ago. Had we done that, we would have never grown the managed care monster that has now overtaken our profession, and we'd have never devalued our own services. If we had never given in to the likes of Aetna, United, Cigna, and the big federal government, medical services would still be something that people would be willing to pay for. Now, it's largely something that's expected to be "free with any insurance."

No health profession is immune.

 

[Jason K]

Each article was written one week apart. The fact that he puts at the very end (even below his tagline) that he offers consulting services hardly seems like some maniacal scheme to get "bright eyed bushy tailed new grads" to pay him. There's no advertising done within the body of any of the three articles.

But keep cursing the darkness, Jason. The end is nigh, right? Keep trying to save the souls of these poor unsuspecting sinners.

I'm not saying he's sitting in his living room rubbing his hands together, waiting for prey to step in front of him, but his positions as a consultant places him squarely in a biased spot. He stands to gain if a few people read that article and decide to contact him. I'd love to know how many ODs out there would say this is a great time to fire up the engines on a cold start. I think we both know the answer to that question.

 

[Meibomian SxN]

Here is a blog about an ophthalmologist struggling to do a cold-start in California.
http://iballdoc.blogspot.com/2010/07/genesis.html

Very disheartening to read some of his blog entries. However, the same market principles apply to ophthalmology. Do not practice in a saturated market like California!

Excellent blog. I'm sure if he was an OD it be even MORE disheartening.

 

[Jason K]

a

No health profession is immune.

I never claimed we are unique in our place within the medical insurance realm. We are unique in the vision insurance realm (along with ophthalmology) and we ruined it. Did OMDs do it? Did they start flooding the US market with thousands of excess practitioners such that most of them had to find work in commercial because there was nowhere else to go? Did OMDs make flood into Walmarts, JCPenny's, Sam's, America's Worst, etc, etc, - giving away "free eye exams with any pair?" Have you ever heard of an OMD selling two pairs of PALs for $10.00 out of his optical? Did they grow the problem out of control? Nope - they had self-control when the time came. We did not. We did this to ourselves and that's the primary reason we get paid nothing for a vision-based eye exam.

No one can argue that the commercial disaster would have happened no matter what; ODs were the necessary link for the growth of that side of the industry and we supplied them thousands of clueless grads eager to get started spinning wheels for corporate slave-drivers. Without a steadily increasing crop of new ODs to feed the beast, the commercial explosion would have never happened. There might have been growth, but it would have been appropriate for its place in the industry, a small dark corner where the plaid-suit-wearing, greasy-haired OD might end up. Now, it's almost everyone.

We decided to allow ourselves to grow out of control and its driven down the value of both our degree and the services for which we bill. That problem is completely separate from the medical insurance issues we face.

 

[Meibomian SxN]

..........No one can argue that the commercial disaster would have happened no matter what; ODs were the necessary link for the growth of that side of the industry and we supplied them thousands of clueless grads eager to get started spinning wheels for corporate slave-drivers. Without a steadily increasing crop of new ODs to feed the beast, the commercial explosion would have never happened. There might have been growth, but it would have been appropriate for its place in the industry, a small dark corner where the plaid-suit-wearing, greasy-haired OD might end up. Now, it's almost everyone......

Exactly. Mostly everything is commercial now here in America, so its not just ODs. Look at pharmacy, mechanics, etc. The equivalent for MDs is called "hospital." Unfortunately, this profession of Optometry is just easily transformable into a corporate entity.

Recently I learned the founder of Pearle Vision passed away. Ask me if I felt any condolence......

http://www.pittsburghlive.com/x/pittsburghtrib/s_502442.html

 

[KHE]

Exactly. Mostly everything is commercial now here in America, so its not just ODs. Look at pharmacy, mechanics, etc. The equivalent for MDs is called "hospital." Unfortunately, this profession of Optometry is just easily transformable into a corporate entity.

Recently I learned the founder of Pearle Vision passed away. Ask me if I felt any condolence......

http://www.pittsburghlive.com/x/pittsburghtrib/s_502442.html

No one would argue that commercialism is good for the profession but lamenting it is a waste of stomach acid. Stanley Pearle let that horse out of the barn in 1961.

The fact that we even have a commercial side to the profession is a big PLUS. Every time I see my GP or talk to any medical specialist, they all talk about how they wish they had more things that they could sell from their offices.

 

[Jason K]

No one would argue that commercialism is good for the profession but lamenting it is a waste of stomach acid. Stanley Pearle let that horse out of the barn in 1961.

The fact that we even have a commercial side to the profession is a big PLUS. Every time I see my GP or talk to any medical specialist, they all talk about how they wish they had more things that they could sell from their offices.

Wait a minute - you say “No one would argue that commercialism is good for the profession...” and then in the next paragraph you say “...the commercial side to the profession is a big PLUS?” Are you serious?

Having a retail component to the profession was once an advantage, but when that component was hijacked by corporations looking to give away services for the benefit of sales, it ceased to be any advantage. Now it's just a giant lead weight that's dragging us further and further to the bottom of the ocean.

 

[optom123]

No one would argue that commercialism is good for the profession but lamenting it is a waste of stomach acid. Stanley Pearle let that horse out of the barn in 1961.

The fact that we even have a commercial side to the profession is a big PLUS. Every time I see my GP or talk to any medical specialist, they all talk about how they wish they had more things that they could sell from their offices.

That's one of the reasons why I prefer optometry over medicine, but, its not like the retail part of optometry (selling materials) is optional. Its probably necessary for you to do well since insurances reimburse way too little from what I've seen. In some of the more successful practices, don't material sales constitute like >60% of revenue?

I don't think an OD can survive without selling materials...unless its a VT practice?

 

[KHE]

Wait a minute - you say “No one would argue that commercialism is good for the profession...” and then in the next paragraph you say “...the commercial side to the profession is a big PLUS?” Are you serious?

Having a retail component to the profession was once an advantage, but when that component was hijacked by corporations looking to give away services for the benefit of sales, it ceased to be any advantage. Now it's just a giant lead weight that's dragging us further and further to the bottom of the ocean.

Ok....maybe I should not have used the word "commercial" twice since it implied the same meaning.

What i should have said that while commercialism is not good for the profession, having a retail component to it actually is a big plus.

 

[Jason K]

Ok....maybe I should not have used the word "commercial" twice since it implied the same meaning.

What i should have said that while commercialism is not good for the profession, having a retail component to it actually is a big plus.

I'd be inclined to agree with you if it were 1980, but it's 2011. The retail component of the profession is now a liability because of the commercial explosion which devalued not only the services for which we bill, but also the materials that we sell. It used to be an asset - it's not anymore. But we still have to keep moving materials - that's not going to change, we're just going to be paid less and less for them, just like services.

 

[syma]

We've always had a commercial side to the business.

Realistically that's how optometry started.

 

[Jason K]

We've always had a commercial side to the business.

Realistically that's how optometry started.

Not true. We've always had a retail side, that is how we started. The commercial side came later when corporations realized they could sell materials and use ODs as prescription factories. It was a tolerable, and some might say, necessary evil of the profession for a long time. When it grew out of control as a result of our unwillingness to keep our numbers under control, it then started to become a serious liability. Now, we've effectively sunk our own profession. The problems is, students don't see it yet because they look at the older, established OD in their town and think they can do the same thing. They can't. We all know it, but they just focus on what they want to see instead of what's really there. Every time a private practice closes its doors, we get one step closer to pharmacy. One step closer to an entirely commercially dominated profession. It's coming - it's not here yet, but it's on its way.

Other professions have retail components, just like ours, but none of them has been crushed by it. Optometry, as a collective, inanimate being, has behaved with incredible stupidity over the last 15-20 years. The future ODs, the ones on this forum, will be the ones bearing the brunt of those past, present, and future mistakes.