Is optometry becoming saturated?

[TheWeeIceMan]

The 6-figure number should be your net income.

People seem to be mixing up gross and net income. A gross income of 150K would would likely result in a net income that's less than 100K. That's certainly doable as a starting salary.

You think new grads are getting offers for 150k and above? Do they also have to sell drugs on the side?

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[Studenttosee]

Many people on here are quoting that new grads are getting 100k or above... Don't expect that in California. Anywhere near San Francisco or Los Angeles you're probably looking at 70-90k. That is before taxes and usually piecing together many part-time positions. It is rare to find a full time in private practice in these areas.

That being said, Optometry is viable. And you can do very well if you avoid all the nice places to live. I hear 120k in Alaska for new grads.

It is what you make it, if you go out into Nebraska or Wyoming etc... You can do very well starting cold. You have to go into it realizing if you want to be in Southern California you are not going to be rich.

 

[310]

Many people on here are quoting that new grads are getting 100k or above... Don't expect that in California. Anywhere near San Francisco or Los Angeles you're probably looking at 70-90k. That is before taxes and usually piecing together many part-time positions. It is rare to find a full time in private practice in these areas.

That being said, Optometry is viable. And you can do very well if you avoid all the nice places to live. I hear 120k in Alaska for new grads.

It is what you make it, if you go out into Nebraska or Wyoming etc... You can do very well starting cold. You have to go into it realizing if you want to be in Southern California you are not going to be rich.

There are plenty of ways to break 120k in certain big cities. If it's in CA, it might take some thinking outside the box and maybe 6 days per week but I don't want to say it's completely impossible. But I agree, CA sucks for making money.


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[EyeCaptain]

It is what you make it, if you go out into Nebraska or Wyoming etc... You can do very well starting cold. You have to go into it realizing if you want to be in Southern California you are not going to be rich.

To some people, anything outside of California might as well be Nebraska or Wyoming. Fortunately, for the rest of us there are options.

 

[Tippytoe]

The original title of this tread is "Is Optometry Becoming Saturated?" This question should have been asked 30 years ago. It's not "is it become saturated?", it's "how saturated is it?' 30 years ago the mantra was, 'Go to a small town and you'll make a lot of money'. The big cities were saturated so new ODs took the advice and moved to Mayberry , NC and Wankers, Ohio and Jetmore, Kansas. This train left the station long ago. Just as the "wait until all the babyboomers need glasses--We will all be swamped with business" train.

There is virtually no town with a population of 5,000 or above in the U.S. that does not have an OD or five in the area. In my own 'little' city of 150,000 people, we have 51 ODs and 15 OMDs with TWO new ODs coming to the area EVERY YEAR since 2005. This is not a joke. We have 1 OD or OMD for every 2,238 people!! And my city is not unique. It is like this in most every big city to the smallest 'one-stoplight' town.

Forvever it has been said the ideal OD : population ratio was 1 : 10,000. This is the number given by many optometry practice experts including Irving Bennett in his excellent book, Optometry Practice Management.

With ratios like this, we were all told to "go medical". This was supposed to even us out from the oversupply of ODs, commercial proliferation and now on-line competition. For a few of the 'big time' ODs that were able to build large practices back in the 'hey-day' of Optometry (in the 1980's) from selling $500 glasses and $400 contact lenses, they were able to make the transition to medical fairly easily (able to buy the $50,000 OCTs and $20,000 corneal topographers, etc.....).

For the bread and butter eyeglass salesman ODs, they either sold out or just closed their 'mom-n-pop' office down. For those of us that graduated after 1990, we have had to manage on optical scraps and medical eye care scraps left over by OMDs, doc-in-the-boxes, family docs, peds, nurses, FNP,PA's, etc...and probably soon to be prescribing pharmacists.).

It's simply a different Optometric world since the 1990's. And its going to continue to get harder for us because there is no more "untapped" markets unless, perhaps, you swallow your morals and try to sucker soccer moms out of a few hundred dollars to treat little Johnny's convergence insufficiency with 45 weekly office visits (rolleyes and throw up a little in mouth simultaneously).

 

[Dorian1982]

damn....

 

[DocJL]

I'm not your bro, bro. You undermine too many things. Not everyone has everything spoon fed to them financially. What 23 year old has enough money saved up to put a nice dent on their loans? Yes we had a few people like that but Optometry was a second career for them and they were much older than the average matriculating student. Work study might pay for food--maybe gas--for the month if you're lucky? I worked 8-12 hrs/wk during the first two years, didn't have a car my first year, never paid more than $635/mo in rent and I still ended up just shy of $200k before interest from OD school alone. Most students can't or won't work that much. I didn't eat like Ghandi but I didn't eat like Chris Christie either. Most of us were fairly money contentious. Some weren't--a few in my class hit $300k. They hit the town every weekend, drove expensive cars and lived in better apartments.

If you do not believe that $250k is a realistic number then you are either:

a. Really, really, ridiculously delusional.
b. A trust fund baby who suckled the swollen bosom of your guardians.
c. An administrator at one of the schools--probably one of the newer, ironically--expensive, schools.
d. An OD who graduated before Y2K.
e. Choices a, b and d.
f. All of the above.

More importantly you're lying to potential students about realistic debt coming out of OD school. Go on any other OD forum and see what recent grads have to pay back.

This.

So how do we fix the problem?
Close 1/2 the OD schools or decrease the number of matriculants by 1/2.
Stop taking Davis, Eyemed, Spectera, et al.
Stop allowing 2 for 1's w/ free exams.
Take control of our profession.

As far as the whole bro thing--it's cool--I like to play hard to get.

Great posts above.


As a dentist, I totally felt your post about school costs, debt, etc.

I slummed it through college and dental school and thanks to close to 100k from the military (for which I gave them exactly 10 years of my life, counting pre-college, and post-dental school) I was able to graduate owing under 50k, but this was over 15 years ago.

There were MANY in my class whose father's were MD's or DDS's, and were able to drive a new sportscar and live in a luxury apartment during dental school.

We in dentistry are also facing the problem with MANY new dental schools opening.

Because we have been a lucrative profession, applicants are lining up out of sight to pay 50,60,70k per year in tuition alone for the many new private-for-profit schools popping up everywhere.

I take some comfort in knowing that mine isn't the only profession being hosed in this manner.

Stay strong.

 

[EyeCaptain]

No no no, you see Dentistry doesn't have problems. Just ask some of the posters on this forum.

 

[Salmon]

My brother is a recent graduate from dental school. He is in an obscene amount of debt (+450k from UoP). In the central valley he was able to find a full time job in California first at Western Dental (terrible place to work for... think America's Best), then in a private practice for ~120k/yr (this was all in the span of about two years). This is just an anecdote, but if you graduate right now from dental school finding full time work shouldn't be too hard. But that debt... my god.

 

[DocJL]

UoP, IMO is a really good school - I worked with several UoP grads in the Navy, and they were all very well trained.
Even better that they can train them that well in a 3-year curriculum.

I know SF is expensive to live in, but $450k?????

Did he also go to an expensive undergrad private school????


Your brother would do well to consider leaving California. He will be a slave to that debt for half of his career, if he stays in CA.

I know it's a beautiful state, and I spend over a month a year there in vacations and/or long weekends taking the kids to Disneyland, Magic Mountain, Laguna Beach, etc, but they are WAY oversaturated with dentists.

 

[310]

My brother is a recent graduate from dental school. He is in an obscene amount of debt (+450k from UoP). In the central valley he was able to find a full time job in California first at Western Dental (terrible place to work for... think America's Best), then in a private practice for ~120k/yr (this was all in the span of about two years). This is just an anecdote, but if you graduate right now from dental school finding full time work shouldn't be too hard. But that debt... my god.

120k per year isn't worth 450k in debt.

 

[Salmon]

He is planning on leaving California to a state where he can make more money (he is applying for a license to another state right now). Believe it or not, that debt was all UoP! Check it out: http://www.dental.pacific.edu/Acade...nd_Fees/Estimating_Your_Attendance_Costs.html

I couldn't believe it when he told me. Too bad he didn't join the military to have that debt taken care of. Hopefully he finds a job in an area with a low cost of living and amazing pay.

 

[DocJL]

Holy **** on that tuition!!!

It's always been an expensive school but I thought tuition was in the 50-60k per year range, on par with schools like USC (wonder if that has gone up too).

yah he would have been better off taking the military full ride. He could have gotten out in 3-4 years with his clinical skills and speed and NO debt, and bought a practice immediately.

 

[EyeCaptain]

Holy **** on that tuition!!!

It's always been an expensive school but I thought tuition was in the 50-60k per year range, on par with schools like USC (wonder if that has gone up too).

yah he would have been better off taking the military full ride. He could have gotten out in 3-4 years with his clinical skills and speed and NO debt, and bought a practice immediately.

You don't just "take the military full ride", you have to apply, and I'm betting it's fairly competitive for Dental.

 

[DocJL]

You don't just "take the military full ride", you have to apply, and I'm betting it's fairly competitive for Dental.

Perhaps you haven't read any of my posts, I spent 10 years in the active duty military including 4 years as a Navy dentist, including a Navy GPR, and including a scholarship.

If you think you know more about the military, dentistry, and/or military dentistry than I do, please enlighten me.

 

[EyeCaptain]

Perhaps you haven't read any of my posts, I spent 10 years in the active duty military including 4 years as a Navy dentist, including a Navy GPR, and including a scholarship.

If you think you know more about the military, dentistry, and/or military dentistry than I do, please enlighten me.

I never said anything about you or your experience. My remarks are true, and nothing you've said has changed that.

 

[DocJL]

see post #64.

You certainly chimed in as though you were an authority on the subject, while quoting my statement.

Your remarks are guesses, as you know next to nothing about the military. Or dentistry. Or military dentistry.


But then again, as you have earlier presumed to know more than practicing doctors of optometry (in this very thread). Perhaps you should take a step back and just absorb the comments from those who have actually experienced the things being discussed, or if not, refrain from posting with a condescending "I got it all figured out" attitude. Or not.

 

[Screwtape]

Just for anyone that cares… $450k is very much the highest end for dental school costs. Most people that go to their state school will be in the $200-300k range. I go to a state school and am expecting to be in ~$225k. The $400-500k cost is way over represented on this forum. There are so many more state schools than the USCs, NYUs, UOPs, etc. DocJL, HPSP has changed a lot since you've been out.

 

[DocJL]

Just for anyone that cares… $450k is very much the highest end for dental school costs. Most people that go to their state school will be in the $200-300k range. I go to a state school and am expecting to be in ~$225k. The $400-500k cost is way over represented on this forum. There are so many more state schools than the USCs, NYUs, UOPs, etc. DocJL, HPSP has changed a lot since you've been out.

My kids are considering dentistry, so I have followed tuition increases over the last decade, and been frankly shocked and dismayed at the rate of increases! Even state schools are shockingly expensive!

Not sure why you think HPSP has changed a lot since I've been out? I am well aware of the needs of the military driving number of scholarships, etc.

I also keep in touch with those who came in when I did, and those who stayed in are now high ranking officers of the rank/grade/experience level that decides who gets scholarhips.

It actually works on a sliding scale, with many factors.

When I got my scholarship, the military was flush with dentists, and just started offering 1, 2 and a handful of 3 year rides (the AF and Navy had NONE, and the Army offered about a half dozen 3 year rides). Scholarships were very few, with the year I got mine the Navy offering about a dozen, 2-year rides, and NO 3 or 4 year rides. Because of this, they were VERY competitive, with most recipients being near the top of their class (I was ranked in the top 10% of my class at dental school), and most of the scholarship recipients I met while on active duty were also near the tops of their classes.

Because of the decade of war, the military has needed more dentists to replace the ones leaving, and thus the 4 year full scholarships being offered. I'm sure a few years ago they offered more than now, as the military is once again in drawdown (it's like an accordion, same thing happened after first Gulf war). But I would also surmise that because anybody applying for a scholarship knew they would likely serve in a war zone, that may have prevented many from applying.

In short, I'm sure the one constant has been that most who received scholarships were near the tops of their classes, with those receiving full rides having been top undergrad students.

 

[EyeCaptain]

see post #64.

You certainly chimed in as though you were an authority on the subject, while quoting my statement.

Your remarks are guesses, as you know next to nothing about the military. Or dentistry. Or military dentistry.


But then again, as you have earlier presumed to know more than practicing doctors of optometry (in this very thread). Perhaps you should take a step back and just absorb the comments from those who have actually experienced the things being discussed, or if not, refrain from posting with a condescending "I got it all figured out" attitude. Or not.

Was I wrong? I believe I stayed well within the bounds of my authority. Your feathers are ruffled because you have spent time in the military as a dentist, and you assumed I knew that from your previous posts. Unfortunately I don't read your posts unless they pop up on a thread I care about.

I gladly absorb all of the things I read here and elsewhere. However, taking information for what it's worth, instead of accepting anecdotes at face value and spreading them over the face of an entire profession is different than presuming to know more than practicing doctors of Optometry. When I find out I'm wrong, I gladly change my view. If I've said something false, you are welcome to correct it.

 

[DocJL]

Was I wrong? I believe I stayed well within the bounds of my authority. Your feathers are ruffled because you have spent time in the military as a dentist, and you assumed I knew that from your previous posts. Unfortunately I don't read your posts unless they pop up on a thread I care about.

I gladly absorb all of the things I read here and elsewhere. However, taking information for what it's worth, instead of accepting anecdotes at face value and spreading them over the face of an entire profession is different than presuming to know more than practicing doctors of Optometry. When I find out I'm wrong, I gladly change my view. If I've said something false, you are welcome to correct it.

See my post #57, which you obviously read, as you commented snidely on it in post #58.

And as a former enlisted infantryman, and as a former commissioned dental officer, I DO find your know-it-all attitude concerning the military, and dentistry, and military dentistry annoying.

Obviously I am not the only one, as one only needs to read the posts from the doctor of optometry who put you in your place in this very thread.

Are you even IN an OD program? Or let me guess, you are about to start? And because you got decent undergrad grades you assume you are going to just absolutely KILL the curriculum, and in a few years be making a 6-figure salary with little to no effort? or just because you have a few pre-professional classes under your belt you assume you know as much as those who have earned a doctorate (not to mention having served in the military, or started and run a business/ private practice, or even those who have ANY experience in the working world of corporate healthcare.)

 

[EyeCaptain]

See my post #57, which you obviously read, as you commented snidely on it in post #58.

And as a former enlisted infantryman, and as a former commissioned dental officer, I DO find your know-it-all attitude concerning the military, and dentistry, and military dentistry annoying.

Obviously I am not the only one, as one only needs to read the posts from the doctor of optometry who put you in your place in this very thread.

Are you even IN an OD program? Or let me guess, you are about to start? And because you got decent undergrad grades you assume you are going to just absolutely KILL the curriculum, and in a few years be making a 6-figure salary with little to no effort? or just because you have a few pre-professional classes under your belt you assume you know as much as those who have earned a doctorate (not to mention having served in the military, or started and run a business/ private practice, or even those who have ANY experience in the working world of corporate healthcare.)

Oh that's true, it looks like I did respond to you twice. I apologize, for being both snide and unproductive with those commments. They were as pointless as our current conversation. You're right, I was put in my place by DrVinz earlier about student loans. Now I know that those levels of debt after school can be common. Although I am a little flattered that you cared enough about my comment to respond with personal insults.

I will let you guess anything you want about me. As a matter of fact I am about to start Optometry school, and I did get decent grades during my undergrad. The rest of your paragraph is false, because you left out the part about me having an immensely successful practice handed to me with little to no effort. That is the way it works, isn't it?

I'm sorry that you see my comments as presuming to know more than practicing ODs. In the interest of anyone trying to find useful information from this thread, feel free to correct anything false I may have said. I look forward to your future comments.

 

[DocJL]

I look forward to the beating that optometry school, and the real world of practice promises to one with such a smug cocky attitude- despite being so devoid of life accomplishments.

Cheers!

 

[DrVinzKlortho]

Man I missed some juicy stuff here.


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[EyeCaptain]

I look forward to the beating that optometry school, and the real world of practice promises to one with such a smug cocky attitude- despite being so devoid of life accomplishments.

Cheers!

I'll be sure to let you know how it goes

 

[DocJL]

I'll be sure to let you know how it goes

No need!

I'm sure you will cruise through the curriculum with little effort, and your faculty will absolutely love the fact that you are so wise beyond your years and experience, and so will any future prospective employers.

 

[Silent Cool]

My kids are considering dentistry, so I have followed tuition increases over the last decade, and been frankly shocked and dismayed at the rate of increases! Even state schools are shockingly expensive!

Not sure why you think HPSP has changed a lot since I've been out? I am well aware of the needs of the military driving number of scholarships, etc.

I also keep in touch with those who came in when I did, and those who stayed in are now high ranking officers of the rank/grade/experience level that decides who gets scholarhips.

It actually works on a sliding scale, with many factors.

When I got my scholarship, the military was flush with dentists, and just started offering 1, 2 and a handful of 3 year rides (the AF and Navy had NONE, and the Army offered about a half dozen 3 year rides). Scholarships were very few, with the year I got mine the Navy offering about a dozen, 2-year rides, and NO 3 or 4 year rides. Because of this, they were VERY competitive, with most recipients being near the top of their class (I was ranked in the top 10% of my class at dental school), and most of the scholarship recipients I met while on active duty were also near the tops of their classes.

Because of the decade of war, the military has needed more dentists to replace the ones leaving, and thus the 4 year full scholarships being offered. I'm sure a few years ago they offered more than now, as the military is once again in drawdown (it's like an accordion, same thing happened after first Gulf war). But I would also surmise that because anybody applying for a scholarship knew they would likely serve in a war zone, that may have prevented many from applying.

In short, I'm sure the one constant has been that most who received scholarships were near the tops of their classes, with those receiving full rides having been top undergrad students.

DocJL,
What would you say most private practice generalists are taking home?
Also, there is a thread on dentaltown right now about owing ~500K for dental school:

http://www.dentaltown.com/MessageBoard/thread.aspxs=2&f=2656&t=230828&pg=1

Also, I would say that just about all private schools these days will take students to 450K-500K of debt.

Is it worth it?

 

[DocJL]

deleted, copied and pasted in appropriate thread.

 

[Silent Cool]

Silent,

There is much info on dentist incomes on the internet, much of it nothing but guesswork, and even the various salary websites which represent themselves as authorities are all over the map.

The best info I have seen is the ADA surveys of dentist income. They send out surveys to their members every few years, and then place the info into several reports, general dentists and specialists, various specialties, practice owner vs. employee, part time vs full time et cetera.

Here is a link to the 2010 report, based on 2009 survey.
I would think current income levels would not be much changed, as the economy has just plodded along, and any improvement would be offset by MORE DENTISTS, as older dentists NOT retiring as their portfolios took a beating, and MORE graduates every year.

When you read through the data, understand that MEAN is much more representative than AVERAGE, and a practice owner would make much more than an associate, obviously. I think this is represented in the data that breaks down income by provider AGE, as most younger dentists are not yet owners.

While we do fairly well, the astronomical debt loads I am seeing which approach 500k are a concern.

It basically means that a new graduate with that kind of debt would have to make some lifestyle sacrifices, especially in terms of where they live and work. IMO the ONLY way to put a dent in that type of educational debt would be to go to an underserved area, which by definition would be a less desireable place to live for most. I look at it this way. Even living in a podunk small town where you are bored to death is not that much different than being in the military where you are subject to being sent to live in a podunk small town outside a military base in the middle of nowhere. The difference is you won't be owned by the military, and will be able to make 3-4 times what Uncle Sam pays. That said, the 4-year full rides are a great deal, unless you are really not cut out for the military. Not everyone is.

While I think it is worth it still, and I will support my kids if they decide to become dentists (they are also considering medicine, but my friends who are MD's seem to think I have it better, lol, the grass is always greener). However, I would probably tell them to specialize. Over the course of a career most specialists will make anywhere from 1 to 4 million or more than the average general dentist. There is a reason most of the kids in my class who's dad's were dentists, went into specialties. I'm sure their father's told them they didn't want to spend their lives working as hard as them, lol, (even those without top grades did 1 year externships or GPR's or AEGD's and then again applied to specialty training, and this got them in. I understand why now. General dentistry is HARD work. (not that specialty work isn't, but it pays better). Look at it this way. All day long I do procedures that generate between $100 and $800 on average. A specialist (perio doing osseious surgery or implants or os doing 3rd or implants) will spend much of their day doing procedures from $800 to $3000 or more.

Hope this helps:

http://www.ada.org/~/media/ADA/Science and Research/HPI/Files/10_sdpi.ashx
III. Income from the Private Practice of Dentistry
A. Independent Dentists
An independent dentist is a sole proprietor or partner who owns or shares in the ownership of an incorporated or
unincorporated dental practice. Sole proprietors or partners in incorporated practices are also referred to as
shareholders. Independent dentists accounted for 85.4% of all dentists in private practice as either a primary or
secondary occupation. Among dentists in private practice as a primary occupation, 86.1% were independent
dentists.
A 1. Net Income by Type of Dentist
As shown in Table 2, the average net income from the primary private practice for all independent dentists in 2009
was $212,830. Average net income decreased 7.8% from $230,920 in 2008. Primary practice earnings were
98.2% of total dental income.
Independent general practitioners’ average net income decreased by 7.0% from $207,210 in 2008 to $192,680 in
2009. Primary practice
earnings were 98.5% of independent general
practitioners’ total net income from dentistry.
Independent specialists’ average net income decreased by 10.6% from $342,270 in 2008 to $305,820 in 2009.
Independent specialists earned 97.1% of their total dental income from their primary private practice.
Table 2: Net Income from the Primary Private Practice of Independent Dentists, 2009

General Practitioners
Unincorporated $172,870 $ 98,000 $156,450 $225,000 $ 99,970 331
Incorporated 207,650 124,000 186,000 255,000 118,160 438
All Independent 192,680 110,000 175,000 247,000 112,030 769
Specialists (Weighted)
Unincorporated 284,530 145,000 250,000 400,000 192,210 418
Incorporated 313,040 170,000 260,000 400,000 205,980 1,170
All Independent 305,820 160,000 251,000 400,000 202,960 1,588
All Independent (Weighted)
Unincorporated 185,510 100,000 165,340 230,600 119,560 749
Incorporated 230,970 130,000 200,000 290,000 148,910 1,608
All Independent 212,830 115,000 186,000 270,000 139,740 2,357
Source: American Dental Association, Survey Center, 2010
Survey of Dental Practice
.
All
new independent dentists
(who graduated from dental school in the last ten years) had an average net income
from their primary private practice of $186,140 in 2009. New independent dentists averaged $187,990 in
incorporated practices. The number of new independent dentists in unincorporated practices was too low to allow
reliable statistical analysis.
New independent general practitioners earned $178,550 in 2009. The average net income for new independent
general practitioners in incorporated practices was $180,530. The number of new independent general
practitioners in unincorporated practices was too low to allow reliable statistical analysis.
New independent specialists had an average net income of $243,370. The average net income for new
independent specialists in incorporated practices was $238,36

Doc,

Thanks for your detailed post. I've seen the numbers before, but I was curious what your personal experience is as it relates to averages, etc..

Also, it seems that a new grad these days will have 500K of student loans and 500K of practice loans. How long do you think it will to pay that back? Also, would you pay for specialist training?

 

[DocJL]

Ditto.

 

[KHE]

When did this turn into the dental forum?

 

[DocJL]

When did this turn into the dental forum?

ooops you're right.

Sorry was replying to a question without realizing was in the optometry thread (been in a similiar discussion in a dental thread).

My apologies.

 

[Mr.MG]

Is the Georgia Optometry market also saturated?
Is there any place to see what starting salaries are like for optometrists?

 

[20DOC20]

Question: Are the larger chains (lens crafters, walmart...etc) hurting smaller private practices?

Yes. To a point. There is a certain patient demographic who will never frequent such an establishment.

PPs then compete with MD's for those patients.

But more than that, the biggest ouch factor to a PP is managed care and reimbursements so low that it can often be hard to make payroll. So, you have to minimize staff, maximize their roles and pump as many patients thru per hour as possible.

Example. MediCal pays around 40 per exam. Eyewear, if they have the benefit, is reimbursed at wholesale. They have state-run prison labs. Practitioner supplies a frame. That means you get 40 per patient. The doctor's salary is usually at least 50 per hour.

In PP practice where I work, a self-pay patient would pay $135 dollars. It takes over 3 Medical patients to equal a self-pay. And here's the ouch: the self-pay patients go to the chains, obviously, because they're cheaper.

VSP pays around 80 an exam. You might get 50% over your wholesale price for hardware. Again, the doctor's salary is 50 of all that. Davis vision pays around 60 per exam. Hardware is reimbursed on the frame only and you might get 50% over wholesale price. Like the frame benefit may be 115. Your frame may cost 30-55 wholesale. The exam is usually capped at 60. So your profit on Davis might be like 112 dollars. And that's with the good plans. On some Davis discount plans, you have to be careful because the discounts can go below your wholesale price (when not using Davis lab).

So ... you really need to do at least 2 exams an hour in PP to make it. Ideally, 2 exams and a recheck. Even better if you can do 2.5 exams an hour and minimize your rechecks to 4 per day. Make sure schedule is full and staffing matches the schedule. There is no reason for 3 staff members to be present on a non-doctor day. And you'll need a p-t job somewhere else to supplement income.

And you have to train staff to do EVERYTHING but the refraction and health check. It's really great if you can train a tech also to fit ctls for you and you just follow-up.

PP needs to be well-oiled these days or you'll go bankrupt.

 

[310]

Question: Are the larger chains (lens crafters, walmart...etc) hurting smaller private practices?

Yes. To a point. There is a certain patient demographic who will never frequent such an establishment.

PPs then compete with MD's for those patients.

But more than that, the biggest ouch factor to a PP is managed care and reimbursements so low that it can often be hard to make payroll. So, you have to minimize staff, maximize their roles and pump as many patients thru per hour as possible.

Example. MediCal pays around 40 per exam. Eyewear, if they have the benefit, is reimbursed at wholesale. They have state-run prison labs. Practitioner supplies a frame. That means you get 40 per patient. The doctor's salary is usually at least 50 per hour.

In PP practice where I work, a self-pay patient would pay $135 dollars. It takes over 3 Medical patients to equal a self-pay. And here's the ouch: the self-pay patients go to the chains, obviously, because they're cheaper.

VSP pays around 80 an exam. You might get 50% over your wholesale price for hardware. Again, the doctor's salary is 50 of all that. Davis vision pays around 60 per exam. Hardware is reimbursed on the frame only and you might get 50% over wholesale price. Like the frame benefit may be 115. Your frame may cost 30-55 wholesale. The exam is usually capped at 60. So your profit on Davis might be like 112 dollars. And that's with the good plans. On some Davis discount plans, you have to be careful because the discounts can go below your wholesale price (when not using Davis lab).

So ... you really need to do at least 2 exams an hour in PP to make it. Ideally, 2 exams and a recheck. Even better if you can do 2.5 exams an hour and minimize your rechecks to 4 per day. Make sure schedule is full and staffing matches the schedule. There is no reason for 3 staff members to be present on a non-doctor day. And you'll need a p-t job somewhere else to supplement income.

And you have to train staff to do EVERYTHING but the refraction and health check. It's really great if you can train a tech also to fit ctls for you and you just follow-up.

PP needs to be well-oiled these days or you'll go bankrupt.

Do you not understand medical billing? Seriously, a glc suspect can be $250-300 deep in exam fees on a single visit. (Yes, I understand that CA sucks for this.) if you don't have any special equipment, you can still get $100-200 in exam fees depending on what you do.

Why would you have one recheck per hour? I go through an absurd patient volume and end up with one or two rechecks per month.


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[Meibomian SxN]

Is the field of Optometry saturated, yes. Is it worth the amount of debt in the end, majority would say no. But in comparison to many other job fields (health and non-health fields) taking out those loans may just be worth it to them. End of discussion, lol.