Good, I don't really care about the optical industry. I'm not training here to be an optician. I will be writing out the scripts and the patients can figure out whether they want to buy them from luxotica or from China for $15.
Just for the record, you will not be the first to try a private OD practice without selling glasses. Others have tried. I tried years ago thinking (probably the same as you) that I will be the 'doctor of their eyes' and let someone else be their 'eyeglass' salesman'. Remember, historically ODs have sold glasses and CLs not necessarily because they like doing it. They did it because they HAD to do it, lest they don't eat.
Remember the average overhead for a medium size practice is about $25,000/month. That means you don't see a penny until you make the first $25,000 to pay everything and every one. So in essense, you are working 3 weeks out of the month just to pay the bills. Or put another way, you work from Jan to Sept to pay the overhead of your practice. You get the keep the money made from Oct, Nov and Dec. Without the ever-shrinking income from optical, I would never make any money. I'd be running the practice just to break even. Hardly the way a business can stay afloat.
I found 3 main problems with the, "I'm going to be a real doctor and not sell glasses" approach:
(1) About 60% of the patients were fine with this and actually wanted to take the Rx elsewhere (I am in a heavy commercial optometry area--as is most of the country). The problem is the other 40%. They were irritated that I couldn't offer "one-stop-shopping". They actually
want to buy from my office (or at least wanted to look in my optical and keep my employee busy for an hour while they write down the frame info they need to go home and order it on line). Many did
not come back (despite my sparkling personality, great staff and my personal good looks) so that was a very bad experiment.
(2). The Rx's you send out may be filled by just about anyone from a licensed optican to a guy that never got passed the 2nd grade somewhere in Mumbia, India. Some will be within ANSI specs and many won't be. Guess what the patient will do first and foremost. They will complain to you and demand to be seen and refracted again at NO COST. You'll be doing about 2 of these free 'exams' follow-ups per day. And you will have lost about $150 profit from each pair of glasses you lost. The 'free rechecks' used to be built in to the price of your glasses so now you will 'eat the cost'. And that little recheck will cost you. Rent, taxes, staff, equipment. It's take all off that even for the "free stuff" you will do day in and day out. Multiply 10 eyeglasses lost/day x 12 months and you just lost a LOT of money. ($20,000 net income a month you lost by everyone buying their glasses elsewhere). That's $240,000 of income over year you will be totally out of the running for.
(3) Which brings me to point # 3. The average income in optometry is said to be about $120,000 give or take. Historically, 60% was from glasses. This is not because ODs get a hard-on playing with glasses. It's because they MUST sell them to pay the bills. See, that's $72,000 out of your $120,000 income from glasses and contact lenses. Without them
you will be making $48,000 in income. Hardly enough to live on after loans and expenses. You will be making so little you might be eligible for food stamps (if you pop out a few kids).
Not to mention, many of the patients you do see will end up elswhere when they roam into the dollar optical and see that they can get a cheapo eye exam there in their closet too. Remember, people are lazy and almost always want the easy and the cheap way out. Put them both together and you have a winning combination, right (if you're a high volume warehouse store). But there is an old saying on a sign I read:
'You can have speed, accuracy or inexpensive but only 2 of those at a time.'
There is not enough eye exams and eye disease to make up for the loss of optical income. Plain and simple. I used to think there was just like you. I have all the fansy equipment to test for it. But they are not running 12 hours straight diagnosis all kinds of exotic diseases hour after hour.
You might can find a job in a non-dispensing OMD practice (which is getting rarer and rarer) but just know, no matter what, you will be his lacky. His clean up boy. Seeing post ops all day or being his refractor for $95,000 year. You will get burned out being treated like one of his techs. I've seen it happen more than a few times. Who knows, you might get lucky and 'partner' up with a good OMD but these situation are about as rare as a Roswell landing.