Luxottica going to hourly wage?

[Eyedoc1999]

Then those PP docs are also low exam fee guys. I don't care if you are in private practice or commercial. If your fees are low, you are part of the problem. My fees are $265 for a comprehensive exam and I give a 20% discount for day of service which brings it down to $212. The way I look at it, I am the least expensive ophthalmologist in my area, but you can be sure I am the most expensive optometrist. Now do you see why I consider you a low exam fee guy?

You're also the lowest paid stock car driver and NFL quarterback (I only throw that out because you're not one of those either).

Before you break your arm patting yourself on the back I will remind you of the concept of "local economy." To give you some perspective, I called to schedule a visit with my retinal surgeon for a private pay patient and the fee was $225...that's for a very busy retinal surgeon. So the point being, you could come down here and charge $265 and within a month you'd be calling me to do some fill-in work because of your light schedule.

Also, it really doesn't matter what you charge...what matters is what you collect. What do you actually get paid on those exams? I'll bet your insurance panels aren't paying you $265 and I'll also bet that 3rd party constitutes the bulk of your patient base. So what actually hits your pocket for an annual eye exam?

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[Ben Chudner]

You're also the lowest paid stock car driver and NFL quarterback (I only throw that out because you're not one of those either).

Not sure what you mean here, but in my area I really am the least expensive ophthalmologist and the most expensive optometrist. I guess I should type larger for you in the future.

Before you break your arm patting yourself on the back I will remind you of the concept of "local economy." To give you some perspective, I called to schedule a visit with my retinal surgeon for a private pay patient and the fee was $225...that's for a very busy retinal surgeon. So the point being, you could come down here and charge $265 and within a month you'd be calling me to do some fill-in work because of your light schedule.

Also, it really doesn't matter what you charge...what matters is what you collect. What do you actually get paid on those exams? I'll bet your insurance panels aren't paying you $265 and I'll also bet that 3rd party constitutes the bulk of your patient base. So what actually hits your pocket for an annual eye exam?

So now you want to change the rules. You asked me what I charge and when it is significantly more than you thought it would be, it no longer matters or it is only possible in my area. You just don't understand the arguement. The point is that the retinal surgeon has decided that his exam is worth $225, yet you continue to charge less than half of that.

You are correct in that I don't get that much from insurance patients, and they represent the majority of my patients. What you fail to see is that I, like the retinal surgeon (who by the way is not collecting $225 from the majority of his patients either), are educating patients that eye exams are worth that much, whereas you and all of those docs like you (PP and commercial) are conditioning patients to believe a haircut should cost more than an eye exam.

For the record, I know that because my fees are so high, I am reimbursed the maximum amount by all of the 3rd party payors I deal with. You can't make that same claim which means you are leaving money on the table. Impressive. As for what hits my pocket for an annual eye exam, I have no idea. In private practice, it's not as simple to calculate. I can tell you that the I collect approximately $379 for every exam I perform. That of course includes optical and contact lens sales.

 

[Eyedoc1999]

Not sure what you mean here, but in my area I really am the least expensive ophthalmologist and the most expensive optometrist. I guess I should type larger for you in the future.So now you want to change the rules. You asked me what I charge and when it is significantly more than you thought it would be, it no longer matters or it is only possible in my area. You just don't understand the arguement. The point is that the retinal surgeon has decided that his exam is worth $225, yet you continue to charge less than half of that.

You are correct in that I don't get that much from insurance patients, and they represent the majority of my patients. What you fail to see is that I, like the retinal surgeon (who by the way is not collecting $225 from the majority of his patients either), are educating patients that eye exams are worth that much, whereas you and all of those docs like you (PP and commercial) are conditioning patients to believe a haircut should cost more than an eye exam.

For the record, I know that because my fees are so high, I am reimbursed the maximum amount by all of the 3rd party payors I deal with. You can't make that same claim which means you are leaving money on the table. Impressive. As for what hits my pocket for an annual eye exam, I have no idea. In private practice, it's not as simple to calculate. I can tell you that the I collect approximately $379 for every exam I perform. That of course includes optical and contact lens sales.

I was making that joke because you're not an ophthalmologist either...the type size is fine, I'll try to make my jokes more obvious. Sorry about that.

While I agree that my fees could be a little higher, I don't think it's fair to lump me in with folks that charge $40. That being said, my egos not so fragile that it bothers me all that much. I've said several times (and you have read it several times, but just for fun I say it again). When I charge $100 for an exam...I get paid $100. I don't worry about upcharging for 3rd party purposes because I'm 98% private pay, so I'm not leaving anything on the table. I'm in the process of credentialing a few medical plans and I will have to change my fee structure a bit, but that's why I charge what I do and I don't think it's changing the rules to say we get paid very similar for the same service (of course, minus the optical but I hate that anyway so no big loss). My point is that who cares if you charge $500 for an eye exam if you really get paid $100.

FWIW, I hate when we compare our services to others because it's just stupid. My wife had her hair done today and it cost slightly more than your eye exam (yes, I'm a little pissed). Are you going to raise your fees now out of shame? Should a haircut cost more than an eye exam? How about a brake job? How about a month of tanning? How about a set of snow tires? How about landscaping? Where do we draw the line?

As far as conditioning patients, how helpful is it when PP advertise 2 pairs of specs for $99 (exam included) which happens here all the time. This is an epidemic problem and I'll pat myself on the back for a minute and give the credit you won't by saying that if people were conditioned to my exam fees here, that wouldn't be a bad thing.

 

[Ben Chudner]

I was making that joke because you're not an ophthalmologist either...the type size is fine, I'll try to make my jokes more obvious. Sorry about that.

I get it now. Maybe you need to write larger for me.

My point is that who cares if you charge $500 for an eye exam if you really get paid $100.

Ok, your point is valid, and in fact I made that point on ODwire several moths back. But FWIW, if you exclude VSP which I consider charity work (and only represents 25% of my patients), the lowest amount I get paid is from Medicare. Even that lousy plan pays me over $150 when you include the refraction fee paid by the patient. That's still almost 2x what you charge and collect on the day of service. Every other third party plan pays more than that with one approaching $190.

FWIW, I hate when we compare our services to others because it's just stupid. My wife had her hair done today and it cost slightly more than your eye exam (yes, I'm a little pissed). Are you going to raise your fees now out of shame?

No, not out of shame but I might out of spite.

As far as conditioning patients, how helpful is it when PP advertise 2 pairs of specs for $99 (exam included) which happens here all the time. This is an epidemic problem and I'll pat myself on the back for a minute and give the credit you won't by saying that if people were conditioned to my exam fees here, that wouldn't be a bad thing.

You are right about the 2 pairs, but I refuse to accept that conditioning patients to your exam fees wouldn't be a bad thing just because you are at the top of the bottom.

 

[Eyedoc1999]

I get it now. Maybe you need to write larger for me.

Ok, your point is valid, and in fact I made that point on ODwire several moths back. But FWIW, if you exclude VSP which I consider charity work (and only represents 25% of my patients), the lowest amount I get paid is from Medicare. Even that lousy plan pays me over $150 when you include the refraction fee paid by the patient. That's still almost 2x what you charge and collect on the day of service. Every other third party plan pays more than that with one approaching $190.No, not out of shame but I might out of spite.You are right about the 2 pairs, but I refuse to accept that conditioning patients to your exam fees wouldn't be a bad thing just because you are at the top of the bottom.

Once again, I'm not at the top of the bottom. I'm slightly above the middle here probably including OMDs. I've not called them, but I would bet that the average exam fee quoted over the phone would be somewhere around $150 (yes, I do realize that it's considerably more than I charge). Don't forget that medicare only pays $119 here so even that's $50 less than your neck of the woods. I will be adjusting my fees when 3rd party becomes more of a norm for me, but my fees have always been directed to private pay. I suspect that when I get on a few more medical plans and it becomes a larger pt volume my fees will increase to the $150 range plus refraction, but we'll see. Things are going so well right now, it's hard to find a good reason to rock the boat!

 

[Ben Chudner]

Don't forget that medicare only pays $119 here so even that's $50 less than your neck of the woods.

Just to clarify, you need to add your refraction charge to that amount. So if you charge $36 on the day of service for a refraction (like I do), you would actually collect $155 from your medicare patients.

 

[Eyedoc1999]

Just to clarify, you need to add your refraction charge to that amount. So if you charge $36 on the day of service for a refraction (like I do), you would actually collect $155 from your medicare patients.

True...of course, I charge $25 for refraction, but that's splitting hairs so I'll concede your point. There is always the point to be made of how long it takes to collect that and how much effort with respect to man hours and the cost associated with that so it hasn't really been worth it thus far, but again it's only a small portion of my patients.

 

[m3unsure]

i personally know some of the higher ups in lux. they are planning on knocking down the pay of a doc to 50,000 or less over a transition period. It was all in a meeting they recently had. This was a proposition made by one of the main doctors who work for them (I believe he graduated from ICO a few years back). By making this transition, the doc that created this idea (I will keep him nameless) will get a bonus of 200,000, and every other doc will reduce their paycheck to 50,000 in a series of transition periods. The first being the change to hourly.
They are making it so that the doctor needs to work nearly 15-20 hours a day, 5 days a week to keep their current pay.

I'm just glad I knew about lux long ago from my buddies there.

Hey, us MDs face this kinda stuff too. Just remember, if our pay drops for all the schooling we do, so will yours.

No professionals are left to regulate their own career unless you are some bastard lawyers.

If some doc works 60-70 hours a week and makes like 125K in metro areas, don't expect your life to get better. You are employees of big business as well.

Well, that's what everyone gets with not supporting Ron Paul.

 

[still_confused]

Well, that's what everyone gets with not supporting Ron Paul.

I supproted him, he was going to save healthcare, but now we are doomed, national health insurance means we wont be able to pay for our mercedes, sigh.

 

[Eyedoc1999]

Well, that's what everyone gets with not supporting Ron Paul.

I just couldn't get past the whiney tantrums.