Disease Residency and Employment Query

[GDR]

Fellow OD's! If you're willing to answer any or all of these questions I will be grateful. I am trying to decide what residency would be best given the possibility of pursuing different employment options.

1) Ought students take residencies that focus on ocular disease when, in the scope of practice, this might mean they're playing second fiddle to ophthalmologists?

2) If one is overtly ethically-minded, will commercial optometry be upsetting? If one is seeking autonomy, will one find bureaucratic institutions (VA's) too confining? If one is seeking freedom to raise a family, will private practice be too demanding? What have your experiences been?

3) If one is able to begin a private practice partnership straight-away with funding from a non-financial institution, is it wise to do so if one has not worked in an office to learn billing/coding/management?

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[drumstix]

Fellow OD's! If you're willing to answer any or all of these questions I will be grateful. I am trying to decide what residency would be best given the possibility of pursuing different employment options.

1) Ought students take residencies that focus on ocular disease when, in the scope of practice, this might mean they're playing second fiddle to ophthalmologists?

2) If one is overtly ethically-minded, will commercial optometry be upsetting? If one is seeking autonomy, will one find bureaucratic institutions (VA's) too confining? If one is seeking freedom to raise a family, will private practice be too demanding? What have your experiences been?

3) If one is able to begin a private practice partnership straight-away with funding from a non-financial institution, is it wise to do so if one has not worked in an office to learn billing/coding/management?

I guess a followup remark to your last question could be:
3) If one is able to begin a private practice partnership straight-away with funding from a non-financial institution, is it wise to do so if one has not worked in an office to learn billing/coding/management, and how difficult is it to "pick up" on those things through exposure through time?

 

[PBEA]

Fellow OD's! If you're willing to answer any or all of these questions I will be grateful. I am trying to decide what residency would be best given the possibility of pursuing different employment options.

1) Ought students take residencies that focus on ocular disease when, in the scope of practice, this might mean they're playing second fiddle to ophthalmologists?

2) If one is overtly ethically-minded, will commercial optometry be upsetting? If one is seeking autonomy, will one find bureaucratic institutions (VA's) too confining? If one is seeking freedom to raise a family, will private practice be too demanding? What have your experiences been?

3) If one is able to begin a private practice partnership straight-away with funding from a non-financial institution, is it wise to do so if one has not worked in an office to learn billing/coding/management?

1) what?

2) yes, yes, and no, in my experience

3) regardless of what you do, you will have to learn those things yourself.

 

[GDR]

Thanks for your reply, PBEA!

1) what?

As I've read elsewhere, is it prudent to do a residency that is primarily concerned with ocular disease rather than providing education in a variety of sub-specialties (contacts, low vision, VT, etc.) considering that an optometrist who specializes in disease is generally considered to be second to ophthalmologist's skill in disease.

2) yes, yes, and no, in my experience

Can you give a some reasons why?

3) regardless of what you do, you will have to learn those things yourself.

My worry was "straight-away" - I know that it will be necessary eventually, but I fear beginning a private practice without this experience maybe disadvantageous at best if not dangerous. Should one work for someone and learn it before working for oneself and teaching oneself at the same time?

Thanks again!

 

[PBEA]

Thanks for your reply, PBEA!



As I've read elsewhere, is it prudent to do a residency that is primarily concerned with ocular disease rather than providing education in a variety of sub-specialties (contacts, low vision, VT, etc.) considering that an optometrist who specializes in disease is generally considered to be second to ophthalmologist's skill in disease.



Can you give a some reasons why?



My worry was "straight-away" - I know that it will be necessary eventually, but I fear beginning a private practice without this experience maybe disadvantageous at best if not dangerous. Should one work for someone and learn it before working for oneself and teaching oneself at the same time?

Thanks again!

1) OD's don't learn about disease to compete with MDs, OD's learn about disease to better help pts. That an MD may or may not be better at something is completely irrelevent.

2) no, they are self explanatory

3) That's a valid concern, just not one that I think is necessarily addressed by working for "someone else". In fact if you go work at the mall or some shlock optical you aren't going to learn squat about billing/coding. Not to mention that you can learn all kinds of bad habits from anybody that wants to "show you the ropes". Better to learn CPT and ICD in it's unadulterated form. Will you make mistakes? yup

 

[20DOC20]

1) Medical Optometry is the future of optometry. But ... if you were REALLY GOOD at vision therapy and working with children as young as infants and are really smart, you should pursue FCOVD training and learn behavioral optometry / neurorehab optometry. They're in demand because it takes a very particular personality and temperament in addition to the clinical skills to do it successfully. I don't know if I'd focus on any other area other than those two. And playing second fiddle to the local OMD is just the way it is.

2). Corporate optometry is tolerable in Costco, some Wal-Marts. I can't think of anyone else that's worthy of my services. Steer clear of any company associated with National Vision. They are abusive. (i.e. Vista Optical and America's Best).

3). I've been practicing for years and I'm still learning billing and coding. I don't understand first half of the question. How would you get funding from a non-financial institution??? You mean a grant? You're dreaming. But ... you could try MegaBucks.

Best!

 

[epalacios]

Fellow OD's! If you're willing to answer any or all of these questions I will be grateful. I am trying to decide what residency would be best given the possibility of pursuing different employment options.

1) Ought students take residencies that focus on ocular disease when, in the scope of practice, this might mean they're playing second fiddle to ophthalmologists?

2) If one is overtly ethically-minded, will commercial optometry be upsetting? If one is seeking autonomy, will one find bureaucratic institutions (VA's) too confining? If one is seeking freedom to raise a family, will private practice be too demanding? What have your experiences been?

3) If one is able to begin a private practice partnership straight-away with funding from a non-financial institution, is it wise to do so if one has not worked in an office to learn billing/coding/management?

Great questions, and ones that I've pondered myself.
In regards to number 1, I think that ocular disease is important in the evolving scope of practice for optometry. Certainly, if you are interested in ocular disease, a good residency would be very useful. Rather than "playing second fiddle," I look at it more in a co-managing perspective. I plan to manage glaucoma, diabetes, ARMD, and other diseases as a primary eyecare specialist, and refer to my MD retinal specialists in the event that treatment progresses outside of my scope of practice (Avastin/Lucentis injections, etc.) This could be in a private practice setting, or at a referral center--both of which are options I'm interested in pursuing. Here in Memphis, we see a lot of diabetes and glaucoma. I'm still interested in pursuing a disease residency, just to make sure I've gotten the maximum exposure I can before setting out on my own.
In regards to number, I think it depends on your personality. Each of those settings has the potential to be a good setting, based on diverse patient populations. It's the doc that makes a good practice, not the practice setting. I've worked as an optician for Walmart over 7 years, and have seen some very successful OD's in that mode of practice....as well as some very bad ones. The difference each time was how the doc percieved themselves in that practice. Whether or not they would admit it, you could tell that the bad ones viewed their practice as "second rate" because of the corporate setting and that affected their success.
As for the last question, if you're interested in going independent private practice and have the funds--go for it. Here at SCO they teach us everything we need to get going, and provide tremendous resources after graduation. If I had a chance to make a go of it without having to borrow money, I'd jump all over it. And make phone calls if I needed to to get out of a jam! That's what mentors are for, just a phone call or a text (or a Skype!) away. Don't shy away from opportunity.

 

[zuojiachezi]

good,I can't think of anyone else that's worthy of my services. Steer clear of any company associated with National Vision. They are abusive.thanks

 

[KHE]

Your "employability" will be determined by your ability to make money for the people you work for. Think about that......what can I do to make these people money?

 

[20DOC20]

Oh, a warning to be aware of -- some Wal-Mart Vision Centers are still run by National Vision. They're becoming less and less as Walmart Corporate is taking back those leases from National Vision. You need to ask lots of questions when working at a Wal-Mart, for that reason.

Working for Wal-Mart Corporate isn't too bad. They do treat their staff fairly, and the OD's are treated fairly well. Not as well as they should be, but as well as one can expect from a corporate entity.

There is nothing good about National Vision. I worked at several of their locations over a number of years, sometimes as leasing doctor, and sometimes as Independent Contract. I remember their billing department used to "lose" about 15% of my insurance claims, and no amount of complaining about missing payments got that department to fix errors. Every so often, I'd get paid for another doctor's work and I tried reconciling the claim with their billing department, the payment was never reversed and reapplied to the appropriate doctor. I couldn't bill for my missing claims myself because someone else got paid for them. It was a mystery. I was guaranteed a fixed amount per month from them anyway and after a while, I just gave up and cashed my checks.

The people at the top of the food chain at National Vision are the same STUPID people that have been there for years. They ALL should be replaced.

National Vision is owned by Warren Buffett, who is an unconscionable, greedy, living version of Mr. Scrooge, only without a repentant heart. His company is run with the same unloving spirit of greed, greed and more greed.

I won't even do fill-in work as an independent contractor (when employed by their leasing doctor) at one of their locations because they are so awful that I don't think I could stand being in one of their stores again for one single day. If there were a hell for optometrists, working in one of their America's Bests or Vista Opticals would be it.

They're really nice to you (and even kiss your behind) UNTIL you sign their contract and it's only after you sign it you realize you've signed a Faustian contract. After you sign they start barring teeth!

You can look on their website. I think they own more than some Wal-Marts, Vista Opticals and America's Bests. There are some smaller chains here and there and it varies from state-to-state.

Also, they're disguising themselves these days under the name of Doctor's Exchange of ____ (state), and have hired OD's as doctor recruiters. If you check the email address of the contact it says [email protected]. So ... just a heads-up there.

Unfortunately, you can't trust the word of an OD hired by them. Optometrists eat their young (and each other). Never forget that!

 

[20DOC20]

I'm so sorry I veered off-topic. Anyway, Disease Residencies = Best employment prospects.