Naive OD Students

[IndianaOD]

Ok students, here is your annual dose of reality. Many think that a few of us practicing ODs are very negative towards optometry. Some may take it this way, but really its just our way of trying to improve a profession that we love. Over my short career I am seeing more and more negative trends developing in the profession.

Also, in the face of rumors, most of us are doing very well professionally. It could be much better though if some positive changes to the profession could take place.

I usually try to stick to facts if possible.

Fact #1: A survey by VSP showed that over 90% of first year OD students wanted to be a private practice OD. A survey of recent grads showed that less than half of these students were practicing in a private practice!

This is caused by the increasing pressure by commercial optometry who's only motivation is profits for the optical. No young grad NEEDS to go commercial. If no one did there would be plenty of private practice jobs.

Fact #2: It is easy to find a JOB in optometry, it is hard to find a CAREER. You need to start researching private practice from day one, otherwise you will panic during your 4th year and give your life away to walmart.

Fact #3: Commercial optometry projects a very negative image on the profession. Ask many of the current commercial ODs who are ashamed to say where they work during local society meetings. You will get very high level training during your schooling and should be able to handle everything short of surgery. Do you want to spend your day doing 5 minute exams and refer everything out to ophthalmology that comes up? (these pts should get referred to other ODs but they rarely are ). Don't forget the slushy machine 5 steps from your exam room! Do you think you can maintain your "doctor" skills if all you do is refractions all day?

Fact #4: We ARE in an oversupply situation. This is driving down insurance reimbursements and causing ODs to see each other more as competition than colleagues. This is not good!

Fact #5: Not really a fact, just a statement. You are trained like a doctor so act like one.

Take these challenges seriously. Many in my class were completely caught off guard by the current state of optometry. They did too little too late and are unhappily working for a optical manager instead of themselves. Please take the profession seriously. This is YOUR profession.

Stay active in the AOA and spend some time out in the real world. Become a member of www.odwire.org where you will learn a lot of usefull information.

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Members don't see this ad.

 

[xmattODx]

Dude,
give it a rest already. You are in no position to say what a particular individual "needs" to do (or not to do). Do you know all the reasons why one would go the commercial route? Have you been to the same "private 7 and 4 and out the door practices" that I have? Where everyone is a 0.3 c/d.

For someone with very little real life experience you sure do have a lot of attitude - unearned attitude at that. What have you done for optometry? I'm sitting at my commercial gig confident that my skills are as good as yours and that I've accomplished a lot more proffesionally than you. Yet I practice commercially more than in a private practice - EGADS!

Give these kids a break from your holier than thou atitude. Give advice but don't be so damned condescending.

 

[docwatson]

Ok students, here is your annual dose of reality. Many think that a few of us practicing ODs are very negative towards optometry. Some may take it this way, but really its just our way of trying to improve a profession that we love. Over my short career I am seeing more and more negative trends developing in the profession.

Also, in the face of rumors, most of us are doing very well professionally. It could be much better though if some positive changes to the profession could take place.

I usually try to stick to facts if possible.

Fact #1: A survey by VSP showed that over 90% of first year OD students wanted to be a private practice OD. A survey of recent grads showed that less than half of these students were practicing in a private practice!

This is caused by the increasing pressure by commercial optometry who's only motivation is profits for the optical. No young grad NEEDS to go commercial. If no one did there would be plenty of private practice jobs.

Fact #2: It is easy to find a JOB in optometry, it is hard to find a CAREER. You need to start researching private practice from day one, otherwise you will panic during your 4th year and give your life away to walmart.

Fact #3: Commercial optometry projects a very negative image on the profession. Ask many of the current commercial ODs who are ashamed to say where they work during local society meetings. You will get very high level training during your schooling and should be able to handle everything short of surgery. Do you want to spend your day doing 5 minute exams and refer everything out to ophthalmology that comes up? (these pts should get referred to other ODs but they rarely are ). Don't forget the slushy machine 5 steps from your exam room! Do you think you can maintain your "doctor" skills if all you do is refractions all day?

Fact #4: We ARE in an oversupply situation. This is driving down insurance reimbursements and causing ODs to see each other more as competition than colleagues. This is not good!

Fact #5: Not really a fact, just a statement. You are trained like a doctor so act like one.

Take these challenges seriously. Many in my class were completely caught off guard by the current state of optometry. They did too little too late and are unhappily working for a optical manager instead of themselves. Please take the profession seriously. This is YOUR profession.

Stay active in the AOA and spend some time out in the real world. Become a member of www.odwire.org where you will learn a lot of usefull information.

Could not agree more. Excellent post.

It is hard to be a good doctor and business owner but easy to be a good refractionist. It takes a lot of work and dedication to own your own private practice. Just because you worked hard in school doesn't mean that hard work ends there. To achieve your dreams sometimes means you have to go to hell and back. I know I did. I lived more than one nightmare after graduation. But, here I am, with a nice group practice and frankly, I think I deserve everything I have...

 

[IndianaOD]

Dude,
give it a rest already. You are in no position to say what a particular individual "needs" to do (or not to do). Do you know all the reasons why one would go the commercial route? Have you been to the same "private 7 and 4 and out the door practices" that I have? Where everyone is a 0.3 c/d.

For someone with very little real life experience you sure do have a lot of attitude - unearned attitude at that. What have you done for optometry? I'm sitting at my commercial gig confident that my skills are as good as yours and that I've accomplished a lot more proffesionally than you. Yet I practice commercially more than in a private practice - EGADS!

Give these kids a break from your holier than thou atitude. Give advice but don't be so damned condescending.

What am I supposed to do, say everything is wonderful? You are not a typical practicioner if I recall correctly and are not as invested in your local community per say. If optomerists were booked out and averaged 190k per year (per NYTimes article) like dentists there wouldn't be any condemnation to hand out.

A recent survery found out the average OD was at 57% of capacity. You COULD be a fantastic doctor at a commercial practice, but I just don't see it. As one commercial doc told me it doesn't pay to manage any disease when you could do twice as many refractions in that time. If you never treat any disease how could you be good at it?

Optometry could be a great profession, but when patients won't come to me for a red eye because ODs work at the mall and walmart why should I be happy about it? Why are dentists so opposed to commercial practice? How does it help optometry for ODs to take every low ball vision available? After 8+ years of eduacation should we charge less than a plumber?

Maybe I expect too much out of a doctoral level profession. I guess I shouldn't fight for a stronger profession. The students who care about the profession will come to understand what a lot of us are saying on here. These forums are so clueless sometimes that I usually on post in small bursts once in awhile.

 

[Ben Chudner]

Here we go again.

I usually try to stick to facts if possible.

When it's not possible, you fall back on how evil corporate optometry is.

Fact #1: A survey by VSP showed that over 90% of first year OD students wanted to be a private practice OD. A survey of recent grads showed that less than half of these students were practicing in a private practice!

This is caused by the increasing pressure by commercial optometry who's only motivation is profits for the optical. No young grad NEEDS to go commercial. If no one did there would be plenty of private practice jobs.

The first part of this is fact. VSP did put out a survey and found those results. The second part is your theory to explain those results. There are several reasons why someone chooses corporate optometry, and you have no clue as to what they may be. I also disagree that there would be more private practice jobs if no one went commercial. If corporate all disappeared instantly, then there should be more private practice jobs, if all those patients who do not have insurance would suddenly want to pay private practice fees. Not only will corporate not go away instantly, but many patients will just seek out those private practices in stip malls that advertise free eye exams with glasses purchase. Is that better for our profession?

Fact #2: It is easy to find a JOB in optometry, it is hard to find a CAREER. You need to start researching private practice from day one, otherwise you will panic during your 4th year and give your life away to walmart.

This is a fact.

Fact #3: Commercial optometry projects a very negative image on the profession. Ask many of the current commercial ODs who are ashamed to say where they work during local society meetings. You will get very high level training during your schooling and should be able to handle everything short of surgery. Do you want to spend your day doing 5 minute exams and refer everything out to ophthalmology that comes up? (these pts should get referred to other ODs but they rarely are ). Don't forget the slushy machine 5 steps from your exam room! Do you think you can maintain your "doctor" skills if all you do is refractions all day?

Commercial OD's are ashamed to say where they work because of OD's like you. Would you want to have to deal with someone who tells you how inferior you are because of your office location? Furthermore, there are plenty of private practice OD's that project a negative image on the profession.

Fact #4: We ARE in an oversupply situation. This is driving down insurance reimbursements and causing ODs to see each other more as competition than colleagues. This is not good!

Please provide your source for this fact. I am not saying that we need more OD's, or schools for that matter, but I would like to see the data that supports this. Most OD's that I know continue to do very well. There are those that do not, but in my experience of lecturing around the country on issues such as practice management, the OD's that are not successful would not be successful even if they were the only OD in a 500 mile radius. And although I respect KHE, I do not agree that just because you can get in to see an OD for a non-emerency appointment within 3 days, we have an oversupply issue. Most OD's that I know are booked a couple of weeks out, but there are always one or two spots open every day, and a morning rarely goes by where there isn't a patient message on the answering machine requesting to be rescheduled for that day. This is just the nature of the way we practice, and I don't think you can compare it to dentistry or even ophthalmology.

 

[xmattODx]

Look,
Its not what you post, its how you post it. This profession is what it is. These kids can use useful advice but to continually harp on oversupply and commerical optometry is not useful. There will always be commercial practice. There will probably always be oversupply. That is worth mentioning but I think its naive to think that going to a public university or a research institution will do anything for the profession. New schools will open if they want.

Much of what you say is just parroting other outspoken "internet ODs" and who really cares what they have to say? Not me. You can scream out against these things until your fingers fall off from all the typing but you're just yet another voice on the world wide waste of time. Do something.

Support the AOA? Ok. What else? You want to excert change give us steps to excert change rather than bitching and moaning about what others are doing to your beloved profession.

I did not hurt optometry by going to a private school. I have not hurt optometry by working commercial. I went to a private school because it was the best fit for me. I work(ed) commercial because it was the best fit for me.

Do I undercharge for my services? Probably. But so do a lot of your holy private practices. Do I set a bad image for optometry? Who knows. I seriously doubt my patients think about optometry before or after their exam. They just go to the place they buy glasses from. It will always be that way. You can be the glasses place or the commerical places I work can be the glasses place. What does it really matter?

You want one thing for optometry I want another. Am I wrong? Are you?

You have the chance to go from the very annoying voice on SDN to a guiding light.

You practice in a 3 OD private practice. How did you find the opportunity? How much VT are you doing? How are you getting reimbursed for these services? How much ocular disease are you able to treat? What type of equipment can a 3 OD private practice afford? Etc, etc.

Lead, dude.

Help.

Quit being annoying.

 

[IndianaOD]

You have to be annoying to get any debate going on these sites. A little bit of conflict is good if it makes people think. All I want to do is encourage OD students to think about their career before they panic during the last few months of their 4th year rotations. When I supervised 4th year case conf as a resident it was stunning to see how few of them had even looked into what they were doing after they got their degree.

Would as many students apply to OD school if private practice went extinct?

The VSP statistic was pretty accurate from the number or raised hands at a 3rd year dinner I attended as a resident. I remember there was 1 student in my class that wanted to go commercial.

My rhetoric may be annoying to some, but it got me at least 3 out of state job offers from posters on other sites who were appreciative of a young grad who gave a crap about the profession.

Looking into the crystal ball, once a lot of the older private practice docs retire I bet there will be an even greater difference in the amount of disease and BV issues treated by private ODs than commercial.

Truthfully what is annoying to me is why someone would spend 8+ years in school and basically work as a factory employee at an assembly line. Why wouldn't you want more for your profession for youself, other ODs, and your patients.

Why spend the time and money learning how to treat things if you never will. Better to go get an MBA and open up an optical. Heck you can still refract for your hired OD.

 

[Ben Chudner]

A recent survery found out the average OD was at 57% of capacity.

Let me clarify my position. I don't know if there is a major oversupply issue as of this moment. I am not saying there isn't a problem. I am just saying I don't know. When I see stats like the one above, I want to see the source because that number scares me. 57% capacity would imply that there are almost twice as many OD's as are needed. It could also mean that most OD's are inefficient and could actually see more patients in a day than they already are, but I don't know without seeing the source. I do think we are headed for an oversupply problem as we continue to open up more schools, and I believe we could do fine with a couple of the existing ones closed. But I also know that corporate optometry is here to stay and it's naive to believe that there is anything the AOA, ODWire, or the students on this forum can do about it. The only thing to do is to come down off your soapbox and adapt your practice so you will be successful. Anything short of that is simply tilting at windmills.

 

[prettygreeneyes]

IndianaOD,

To provide a frame of reference, can you tell us how long you have been in practice? ie When did you graduate from school? If I recall correctly from this and other online forums, you have not yet completed even one year in private practice. You were a resident until this summer, is that correct? If so, why the incredibly negative attitude towards students? You are far closer to us than you are to the "practicing ODs" you are trying to lump yourself in with

And in all honesty, I could really do without the "naive OD students" comments. Unless you know me and every other student, how do you know how knowledgable I am about the profession? You don't. Period. I spent a great deal of time before I ever applied researching this profession, on SDN, ODWire, and POP. Even after I was accepted, I did more research - even considering not attending optometry school at one point. I worked in a private practice for a year. Outside of being a paid employee, I have also observed 5 different doctors (more than 45 hours of observation) in different modes of practice, including one of SDN's own doctors who I had to drive almost 5 hours one way to see.

I attended one of the larger optometry conferences on the West coast (GWCO) just this past weekend, where I spent a great deal of time talking to practice doctors from all over the western US. Some of these doctors had been in practice for 5-10 years, and some for over 30. Not one of those doctors was as negative as you. Not one of those doctors felt it necessary to talk down to me, and tell me I didn't know what I was getting myself into. Why you and other doctors feel you have the right to do that here on SDN under the guise of our "annual dose of reality" is beyond me.

 

[IndianaOD]

Let me clarify my position. I don't know if there is a major oversupply issue as of this moment. I am not saying there isn't a problem. I am just saying I don't know. When I see stats like the one above, I want to see the source because that number scares me. 57% capacity would imply that there are almost twice as many OD's as are needed. It could also mean that most OD's are inefficient and could actually see more patients in a day than they already are, but I don't know without seeing the source. I do think we are headed for an oversupply problem as we continue to open up more schools, and I believe we could do fine with a couple of the existing ones closed. But I also know that corporate optometry is here to stay and it's naive to believe that there is anything the AOA, ODWire, or the students on this forum can do about it. The only thing to do is to come down off your soapbox and adapt your practice so you will be successful. Anything short of that is simply tilting at windmills.

Ben, I will make an effort to find the source. I believe it was quite reliable. Think about it though. There are a lot of older ODs still doing 8 full exams max per day. Nothing wrong with that at all. However, ODs efficiently using paraoptometrics and staff could easily see 20+ full exams per day.

 

[xmattODx]

My concern with your posts is that they have no substance. As they say put up or shut-up.

If you were truly here to help you would counter your attacks with a helping hand. Aside from most of your "facts" being complete conjecture your tone turns people off from your message.

Take 20 minutes to start a new thread that outlines your suggestions as to what a student should do to find themselves in private practice AND able to be paid for the services they render (VT, disease, etc.). Put in suggestions for pre-opt students and then 1-4 years.

You've made the leap from school to private practice. Surely you found your position through means other than your internet diatribes.

Educate.

Show us how to avoid the negatives of optometry rather than simply telling us what they are.

 

[Ben Chudner]

Ben, I will make an effort to find the source. I believe it was quite reliable. Think about it though. There are a lot of older ODs still doing 8 full exams max per day. Nothing wrong with that at all. However, ODs efficiently using paraoptometrics and staff could easily see 20+ full exams per day.

Thanks. You are right in that there are still docs seeing only 8 exams per day when an efficient office should be able to see 20+. That only helps to prove how inaccurate that survey was. There are several docs who I know personally that choose to see one patient per hour. Docs like this lower the capacity percentage, but they do it by choice. That is not an indication of oversupply. It's an indication of a different way to practice. Again, I am not saying there isn't an oversupply problem, only that I haven't seen any facts to support that statement.

 

[Ben Chudner]

including one of SDN's own doctors who I had to drive almost 5 hours one way to see.

But it was worth it

 

[IndianaOD]

IndianaOD,

To provide a frame of reference, can you tell us how long you have been in practice? ie When did you graduate from school? If I recall correctly from this and other online forums, you have not yet completed even one year in private practice. You were a resident until this summer, is that correct? If so, why the incredibly negative attitude towards students? You are far closer to us than you are to the "practicing ODs" you are trying to lump yourself in with

And in all honesty, I could really do without the "naive OD students" comments. Unless you know me and every other student, how do you know how knowledgable I am about the profession? You don't. Period. I spent a great deal of time before I ever applied researching this profession, on SDN, ODWire, and POP. Even after I was accepted, I did more research - even considering not attending optometry school at one point. I worked in a private practice for a year. Outside of being a paid employee, I have also observed 5 different doctors (more than 45 hours of observation) in different modes of practice, including one of SDN's own doctors who I had to drive almost 5 hours one way to see.

I attended one of the larger optometry conferences on the West coast (GWCO) just this past weekend, where I spent a great deal of time talking to practice doctors from all over the western US. Some of these doctors had been in practice for 5-10 years, and some for over 30. Not one of those doctors was as negative as you. Not one of those doctors felt it necessary to talk down to me, and tell me I didn't know what I was getting myself into. Why you and other doctors feel you have the right to do that here on SDN under the guise of our "annual dose of reality" is beyond me.

You are clearly more informed than most. There are the informed, the uninformed, and the hopeless.

I'm not talking down to students in general, but working with over 70 optometry students under my care opened my eyes.

I don't believe I singled anyone out, take a deep breath.

 

[IndianaOD]

My concern with your posts is that they have no substance. As they say put up or shut-up.

If you were truly here to help you would counter your attacks with a helping hand. Aside from most of your "facts" being complete conjecture your tone turns people off from your message.

Take 20 minutes to start a new thread that outlines your suggestions as to what a student should do to find themselves in private practice AND able to be paid for the services they render (VT, disease, etc.). Put in suggestions for pre-opt students and then 1-4 years.

You've made the leap from school to private practice. Surely you found your position through means other than your internet diatribes.

Educate.

Show us how to avoid the negatives of optometry rather than simply telling us what they are.

The internet diatribes were critical actually =)

 

[blazenmadison]

Every other thread on this site is about A)Oversupply B)OD students are naive and clueless C)AOA sucks D)Optometry Sucks E)I wish I went to med school



We know.

 

[JAZZEYE]

I have found SDN and ODWIRE to be somewhat informative.... definitely some food for thought. I am still curious as to why both of these forums have the same couple of dozen or so Docs and students who do most of the posting ( usually making the same point over and over ) with a few others chiming in here and there.This is hardly representative of the thousands of OD's and students out there

 

[IndianaOD]

Like I said, the apathy on this forum causes me to only be active once in awhile. If you check some other posts I attempt to help when useful.

I could give advice on how to look for a job etc, etc, but there would be 5 views and it would disappear from the forums.

If the students get uncomfortable about their future they will be more likely to get informed and be more successful.

I actually considered staying in academia because I love teaching the students. However, I was passionate about optometry and wanted to try private practice and work my way up the AOA structure or state politics. BTW my residency coordinator stated I was the best resident that he ever had, both in clinical and teaching terms.

It is my opinion that not enough ODs at the schools have real world practice experience. I wanted to experience it first.

The students can do whatever they want with my rantings. I believe my posts have a lot less fluff than 90% of the posts on here.

Oh an as for my part. I helped 2 OD students find private practice positions.

 

[xmattODx]

Those 2 thank you.

The rest?

Not so much.

 

[IndianaOD]

Thanks. You are right in that there are still docs seeing only 8 exams per day when an efficient office should be able to see 20+. That only helps to prove how inaccurate that survey was. There are several docs who I know personally that choose to see one patient per hour. Docs like this lower the capacity percentage, but they do it by choice. That is not an indication of oversupply. It's an indication of a different way to practice. Again, I am not saying there isn't an oversupply problem, only that I haven't seen any facts to support that statement.

Yup, that's right. I'm beating that thing to death. Ben, you must be in an area with a lower concentration of ODs. It is pacific NW? Here in the midwest we are surrounded by OD schools. With 3 more schools, the west will soon hit critical mass as well.

What else besides oversupply can explain the following:

1. Many ODs willing to charge $29 or worse FREE for an eye exam.
2. The rampant increase in low ball insurance plans. I would be shocked to see a dentist accept $30 for a comprehensive exam with the same "Dr" time as an OD.
3. The number of new grads going into commercial when most really want a private practice. Also considering the average income for a commercial doc is quite a bit lower than private.
4. ODs not getting accepted on medical plans, because the panel is full of ODs and OMDs
5. ODs needing to work at 3 offices just to survive.

I wouldn't discount the eas of being able to get a rountine exam within the same day in most cities/towns. I had to wait 3 weeks for a dental exam at an office that was less than a year old and had 2.5 dentists! It was the lowest wait time of the 3 offices I called.

If insurance keeps reimbursing less, there is no way an OD can survive with 8 patients per day. If we get dragged into socialized medicine it will be even more of a joke.

Out of around 700 ODs who voted on ODwire, oversupply was their # one concern.

Just food for thought.

 

[IndianaOD]

Those 2 thank you.

The rest?

Not so much.

Like you said I'm young. What may I ask are you doing for the future of American optometry?

 

[Ben Chudner]

Let the beatings continue, because I asked for facts and I am still waiting.

Ben, you must be in an area with a lower concentration of ODs. It is pacific NW? Here in the midwest we are surrounded by OD schools. With 3 more schools, the west will soon hit critical mass as well.

I am in the Pacific NW. I don't know what other areas are like, however I was just in Indianapolis and there is a large private practice out there that is about to open 6 more locations in the next six months. That's on top of the 11 locations (all high-end) he already has. Your little piece of the world may be saturated, but that is not proof of oversupply, just local saturation.

What else besides oversupply can explain the following:

Let's take each one individually.

1. Many ODs willing to charge $29 or worse FREE for an eye exam.

The mistaken belief that in order to compete with corporate optometry, you need to match price. Once again, not proof of oversupply, just proof that OD's are not necessarily the best business people.

2. The rampant increase in low ball insurance plans. I would be shocked to see a dentist accept $30 for a comprehensive exam with the same "Dr" time as an OD.

The rampant increase is a function of employers getting squeezed by the cost of providing insurance to employees. There is a market for these plans. The fact that OD's take these insurances is not proof of oversupply, but again proof that OD's are not good business people.

3. The number of new grads going into commercial when most really want a private practice. Also considering the average income for a commercial doc is quite a bit lower than private.

Until there are over 1300 legitimate opportunities a year in private practice, new grads will go into corporate. This is not proof of oversupply, it's proof that a large number of students don't feel they can pay back their student loans on $70,000 a year and they believe the recruiter that tells them they can make over $100,000 at Wal-mart.

4. ODs not getting accepted on medical plans, because the panel is full of ODs and OMDs

It is in the insurance companies interest to have as many providers as possible to offer it's subscribers more choices. The exclusion of OD's is not proof of oversupply, it's proof that there are some groups (MD's) that would prefer if patients could only see MD's.

5. ODs needing to work at 3 offices just to survive.

This seems to occur when a doc starts out cold and should be expected, or when a doc goes to work for a private practice that is just starting to get busy enough to hire a new OD. This is not proof of oversupply, it's proof that there are opportunities for OD's to find work and those opportunities are growing in number.

I wouldn't discount the eas of being able to get a rountine exam within the same day in most cities/towns. I had to wait 3 weeks for a dental exam at an office that was less than a year old and had 2.5 dentists! It was the lowest wait time of the 3 offices I called.

I don't think you can compare a dental office schedule to an optometric office, and I definitely don't think that is proof of optometric oversupply. It may be proof of a need for dentists, however.

If insurance keeps reimbursing less, there is no way an OD can survive with 8 patients per day. If we get dragged into socialized medicine it will be even more of a joke.

I agee with you on this, but I bet most of those patients seen in the 8 a day offices are cash paying patients.

Out of around 700 ODs who voted on ODwire, oversupply was their # one concern.

I can't believe you are quoting a survey from ODWire. The majority of OD's on that site are the biggest whiners I have ever met and are there because they believe there is an oversupply issue and corporate optometry is evil. With all due respect, their opinion carries little weight and, again, is not proof of oversupply.

If there is an oversupply issue right now, there must be some data you can show me. Not opinion, not theory, not situations like ones above which could be indications of other issues. I want to believe you since you are so passionate about this problem. Please find some real proof so I can get onboard with your fight.

 

[xmattODx]

Like you said I'm young. What may I ask are you doing for the future of American optometry?

Hey, I'm young too!

The answer to your question? Not a thing.

I'm published and pursuing a fellowship.

I'm not politically active because I don't agree with what the AOA is pursuing and I choose to be a-political in my life.

American optometry is not my passion. It is my living.

Where it ends up is apparently less of a concern for me than it is for you.

I'm still waiting for guidance from you.

In the meantime I've created a blog that will outline the next chapter in my families pursuit of the "optometric dream". I hope it will give guidance rather than continue to beat students down.

Where is your advice? You've found the dream. I'm merely pursuing it. Your advice is worth far more than mine.

My Latest Journey

 

[RichardOD]

These people from ODwire are just a bunch of paranoid O.D.'s who are looking out for their wallets and are trying to reduce the "future oversupply" of optometrists by discouraging future optometry students into other fields.

 

[IndianaOD]

Hey, I'm young too!

The answer to your question? Not a thing.

I'm published and pursuing a fellowship.

I'm not politically active because I don't agree with what the AOA is pursuing and I choose to be a-political in my life.

American optometry is not my passion. It is my living.

Where it ends up is apparently less of a concern for me than it is for you.

I'm still waiting for guidance from you.

In the meantime I've created a blog that will outline the next chapter in my families pursuit of the "optometric dream". I hope it will give guidance rather than continue to beat students down.

Where is your advice? You've found the dream. I'm merely pursuing it. Your advice is worth far more than mine.

My Latest Journey

Thanks for the honesty. If its just a job then you shouldn't care what people say about it.

 

[IndianaOD]

Ben,

The private practice you quote is not really a private practice. Most of their employees stay employees. They are brutally good business people, mostly concentrating on optical sales. That's great for the owners, but I've heard its not the best working environment in the long run.

Its an interesting question though, when does it become a corporate or retail practice? There is a similar thing happening in northern Indiana, but they are just buying up local pratices and merging them. These aren't really new private practices in my idea of the word.

I had some classmates go to Oregon and they are doing very well. They tell me its a much more open market there, far less saturated.

Obviously there are people on this board that don't want to consider what could be a reality.

Its also a completely wrong assumption that current ODs are just looking out for their wallets. Though if you want to work twice as hard and make half the money when supply far outpaces demand I hope you will still be happy.

Currently of the 4 year professions optometry averages near the bottom of income averages. When more than half of the graduates can't practice as they desire I call that a problem. Others may think that's fine. I guess we'll only see if it gets worse. The future is grand if you want to work for Lux or Wally world.

 

[IndianaOD]

These people from ODwire are just a bunch of paranoid O.D.'s who are looking out for their wallets and are trying to reduce the "future oversupply" of optometrists by discouraging future optometry students into other fields.

I rather have more qualified students and less spots. I'd like some capable colleagues. Your info says pre-op. You're an expert?

 

[Ben Chudner]

Ben,

The private practice you quote is not really a private practice. Most of their employees stay employees. They are brutally good business people, mostly concentrating on optical sales. That's great for the owners, but I've heard its not the best working environment in the long run.

I think this practice is a hybrid between corporate and private. There is one owner and he has no desire to let anyone buy into the practice. I think in the long run he will end up selling the whole thing to Lux. My point however, was that even in that area, he is planning to open 6 new offices in the next six months. I have been to some of the locations, and I can tell you they focus on medical care as well as optical sales. If there is an oversupply problem, it hasn't affected his plans to continue expanding his practice.

I had some classmates go to Oregon and they are doing very well. They tell me its a much more open market there, far less saturated.

This only helps prove the point that saturation is not the same as oversupply.

Obviously there are people on this board that don't want to consider what could be a reality.

I don't know who you are referring to here, but I want to consider what could be a reality. If oversupply is a reality TODAY, I want to know about it. I just haven't seen any proof other than the rantings of ODWire docs. I do believe we are heading towards an oversupply problem, and adding more schools will not help solve the problem.

Its also a completely wrong assumption that current ODs are just looking out for their wallets. Though if you want to work twice as hard and make half the money when supply far outpaces demand I hope you will still be happy.

This is a problem that faces us all in private practice. If we continue to increase the number of graduates per year, then I think supply will outpace demand. As long my practice continues to grow at 7-12% a year, I just don't see how we are there yet. Again, if there is conclusive data I want to hear about it.

Currently of the 4 year professions optometry averages near the bottom of income averages. When more than half of the graduates can't practice as they desire I call that a problem. Others may think that's fine. I guess we'll only see if it gets worse. The future is grand if you want to work for Lux or Wally world.

I don't think you can say that half of the graduates can't practice as they desire. I think it's accurate to say half change the way they desire to practice. We have a survey that says 90% of first years want to work in private practice, but we don't have a survery of 4th years. I have no evidence other than a study I conducted at nine schools of optometry that showed a significant number of 4th years wanted to work part-time for at least some of their career. It was thought this was due to a large number of women graduating that wanted to start a family. Corporate optometry is more suited for part time than private practice in most cases. This may be one reason why people change their mind about where they want to practice.

 

[RichardOD]

I'm tired of seeing the same stuff over and over. Even more so than the O.D. vs. _____ threads. What are you guys going to do about it besides posting on student forums?

 

[prettygreeneyes]

But it was worth it

Definitely!

 

[prettygreeneyes]

You are clearly more informed than most. There are the informed, the uninformed, and the hopeless.

I'm not talking down to students in general, but working with over 70 optometry students under my care opened my eyes.

I don't believe I singled anyone out, take a deep breath.

I don't believe you singled me out, but you have no qualms about lumping all students into the same category. My point is that we aren't all alike.

I appreciate your passion for optometry, but I believe that your posts do little other than discourage students. You failed to acknowledge that you do in fact have relatively little experience in the field. You have more than I do, but then again so does practically everybody. I absolutely recognize that I have a lot to learn, and that SDN is a great resource. Use this site as a tool to tell us HOW you have accomplished what you have, what you would do differently, etc. Your condescending tone makes it incredibly difficult to even read your posts - let alone glean useful information from them. View this as an opportunity to teach us students - not preach to us.

 

[docwatson]

I don't believe you singled me out, but you have no qualms about lumping all students into the same category. My point is that we aren't all alike.

I appreciate your passion for optometry, but I believe that your posts do little other than discourage students. You failed to acknowledge that you do in fact have relatively little experience in the field. You have more than I do, but then again so does practically everybody. I absolutely recognize that I have a lot to learn, and that SDN is a great resource. Use this site as a tool to tell us HOW you have accomplished what you have, what you would do differently, etc. Your condescending tone makes it incredibly difficult to even read your posts - let alone glean useful information from them. View this as an opportunity to teach us students - not preach to us.

Give me some questions and I'll be happy to answer them. But I will only share my opinions if I'm not attacked. I have my own opinions so you should treat them as such and try to learn from them. I believe this is the problem with the forums. Many people may say they want to be taught but what they really want is to argue their own position. I don't want to get into that game because you can't argue someone else's intractable opinion. I would rather be in a room of like-minded individuals who want to learn from each other than be in a room of hornets. These forums are like being a bible thumping conservative walking into a militant environmentalist convention.

This also partly explains why it's the same people over and over. Many people just don't have the time to post, they aren't opinionated enough or brash enough to share their position publicly, or they just do not want to argue. I really don't like to argue because most of the time it ends up a free-for-all between two diametrically opposed opinions. Like Bush and Gore would ever agree on anything...

A good example of an appropriate forum of like-minded individuals is your own optometry school. You paid to be there and you didn't attack the professor because you wanted the information--you were willing to listen.

I've been an optometrist who has been practicing since 1999. I've worked commercial, filled in for private and commercial, worked as an employee, been shafted by various doctors over the past 8 years, and I now own my own office that I purchased 3.5 years ago.

What do you want to know from my perspective? (I also don't want to get into anything personal--if you want to know that then send me a private PM).

Let's see what happens now...

 

[IndianaOD]

I'll say it again. If I start a thread that offers useful advice, no one would even care to look at it. Students don't tend to think about thier futures after school until its too late, then they end up accepting any job for better or worse.

Personally, there is way too much coddeling in optometry. We need to heap a lot more responsibilty and pressure on the students so they aren't likely to refer out the first red eye they see.

You don't need experience to realize there is oversupply and that commercial practice is bad for our profession. After you hear, "oh you're not a real doctor, you're an optometrist" a couple times it starts wearing on you. The public gets this perception for all the ODs that do nothing but peddle specs and contact lenses.

I could do everything in my power to make this profession better, but the second a patient goes to wally et al and gets referred out for any little medical condition we will always look like a spectacle peddler and not a real doctor. What would you think if every time a problem was found you always got sent to a "real" doctor?

What do I do for the profession?
I practice to the full scope allowed by law, treating everything except surgery, after which I demand to co-manage my patients.
I'm active and involved in my local optometric society.
I write a newspaper column to educate the public on all that we CAN do.
I send faxes and letters to all the new schools asking them to reconsider opening a unneccessary new school.
I'm currently using Indiana law to persuade a local medical ins co to credential ODs
I talk to local groups to educate them on eye care.
The few things I don't do like low vision I refer to another OD!
I've helped several students find jobs.
I don't accept any low ball vision insurances, even though they could help me build a patient base.
We set our fees at a reasonable level.

I would think that this is above and beyond 80% of ODs out there.

I am not joking when I say, we have a lot of walmart employees come to us for their eye care. The local walmart has a vision center!

I'm about to go a posting haitus again do to a busier schedule. So spew all you want, but just know there has to be truth to something that has so many ODs talking about it.

So why bother trying to talk students out of commercial practice?
BECAUSE THOSE CHOICES NEGATIVELY AFFECT US ALL!!!!!!!

Just try spending your time treating disease at a walmart. I'm betting you'll loose your lease real quick because you aren't selling glasses for walmart.

Oh an my #1 proof of over supply. The fact that ODs will stab each other in he back to keep from loosing a patient. They are afraid if they send you a patient they'll never see them again. They'll give away free exams and slander each other. Don't believe me, start calling around and see how many openings optometrists have compared to nearly all other medical professions. Heck hairstylists charge more and are booked out farther than ODs.

Okay, its time for all the future wally and luxottica employees to take the stage.

-and yes, if reasonable questions are asked and I'm on here, I'll try my best to help.

 

[xmattODx]

I'll say it again. If I start a thread that offers useful advice, no one would even care to look at it. Students don't tend to think about thier futures after school until its too late, then they end up accepting any job for better or worse.

Try. Try to offer positive advice.

Right now start a thread that says: "I'm a new graduate and I didn't ever set foot in a commercial practice. Here is how to do it."

Take the premise of that thread. The questions. The comments and turn the thread into a pamphlet. Send the pamphlet to all of the optometry schools.

Take the comments and questions. The rebukes and the mistakes, mature a little professionally and turn the pamphlet into a presentation. Offer your services to all of the optometry schools.

Take your presentation and your thread and your pamphlet and write a book.

All that you do now is make yourself look like an ass.

You try to spout statistics. You know that most of these students don't dream of Wal-Mart. (Do you shop at Wal-Mart? You probably shouldn't if you believe what you believe.) They dream of private practice. What changes? Help them recognize that nothing changes and that their dream can become a reality. You are an example of that!

Personally, there is way too much coddeling in optometry. We need to heap a lot more responsibilty and pressure on the students so they aren't likely to refer out the first red eye they see.

Where is your proof that everything is referred out? Does it happen more or less in private practice? Where is that proof? Is there a statistical difference in the age of the referring optometrist?

Do a study. Prove these things. Then develop a solution.

You don't need experience to realize there is oversupply and that commercial practice is bad for our profession. After you hear, "oh you're not a real doctor, you're an optometrist" a couple times it starts wearing on you. The public gets this perception for all the ODs that do nothing but peddle specs and contact lenses.

We're not real doctors in the public eye. Real doctors are physicians. I doubt that we will change that perception. Johnny Q. Public doesn't know what it takes to become a physician, an optometrist or a nurse for that matter. Who cares if they think of you as an optometrist? You are. Embrace it.

I could do everything in my power to make this profession better, but the second a patient goes to wally et al and gets referred out for any little medical condition we will always look like a spectacle peddler and not a real doctor. What would you think if every time a problem was found you always got sent to a "real" doctor?

How much does this happen? What is the public perception of optometry? Does that perception change after a visit to a private practice? Proof. Prove things. Show us these things. Offer us viable solutions.

What do I do for the profession?
I practice to the full scope allowed by law, treating everything except surgery, after which I demand to co-manage my patients.
I'm active and involved in my local optometric society.
I write a newspaper column to educate the public on all that we CAN do.
I send faxes and letters to all the new schools asking them to reconsider opening a unneccessary new school.
I'm currently using Indiana law to persuade a local medical ins co to credential ODs
I talk to local groups to educate them on eye care.
The few things I don't do like low vision I refer to another OD!
I've helped several students find jobs.
I don't accept any low ball vision insurances, even though they could help me build a patient base.
We set our fees at a reasonable level.

Thank you for all that you do. You are an example of a hard working, conscientious new grad. Lead us. Help us to follow your example. Be honest. How much control of your practice do you have? If the fees were lowered tomorrow could you do anything about it? Your fees are set high but what percentage of those fees do you typically get from the insurance companies. You don't accept low ball plans. What is a low ball plan? How do you avoid these plans and still draw in patients? Educate. Explain. Lead.

I'm about to go a posting haitus again do to a busier schedule. So spew all you want, but just know there has to be truth to something that has so many ODs talking about it.

This is reminiscent of a troll's behaviour. Spew out hatred and conjecture and then leave. Come daily for a few minutes to pick up the pieces. Why is your schedule changing? Are you full-time at your practice? Do you have to take on a second job?

So why bother trying to talk students out of commercial practice?
BECAUSE THOSE CHOICES NEGATIVELY AFFECT US ALL!!!!!!!

Where is the proof of this? Are you certain that the same patients that visit Wal-Mart think less of you? Do they think its a different kind of practitioner there? Do they care? Why do you? Are you equally angry about the private practice across the street from where I sit now offering free exams? How about the private practice where my wife works that accepts an insurance that only one commercial place will accept? ($15 for an exam)

Just try spending your time treating disease at a walmart. I'm betting you'll loose your lease real quick because you aren't selling glasses for walmart.

Have you even worked in a Wal-Mart? Do you have any real life experience or just the internet ramblings of others to rely on? I'm no fan of Wal-Mart but I am sure there are opportunities out there that will allow a long term relationship with Wal-Mart if so desired.

Why would optometrists desire this relationship? As a personal affront to you? Or could there be other reasons.

In public health school we were always told that it is very easy to tear a project or program down. It is much harder to offer viable solutions to reframe that project or program.

I issue that challenge to you. You see faults in optometry what can these students do to avoid the negatives? What can we do to find and succeed in private practice? What can we do to change the face of optometry? Don't tear things down unless you have a new foundation.

 

[CaribbeanEye]

First off I appreciate some of the points brought out by IndianaOD's post. It really is thought provoking and hopefully helps all lot of us out.

My personal background is in business, specifically in the areas of accounting and finance. After plenty of research I decided to make a career change into optometry. Why? Here are my top reasons:

1. Optometrists get the opportunity to help people daily. Something accountants rarely get to do.
2. There are plenty of opportunities available to optometrists compared to most other professions. Whether this means having a private practice or working commercial, jobs are out there.
3. Vision care is something that interests me a whole lot.

Needless to say I was taken back when I first found this forum and read some of the posts about optometry. If I may, I would like share some thoughts of my own and discuss some of IndianaOD's points.

Fact #1: A survey by VSP showed that over 90% of first year OD students wanted to be a private practice OD. A survey of recent grads showed that less than half of these students were practicing in a private practice!

This is caused by the increasing pressure by commercial optometry who's only motivation is profits for the optical. No young grad NEEDS to go commercial. If no one did there would be plenty of private practice jobs.

Very good point. This statistic is not surprising and can be said for every other profession out there as well. Everyone wants to own their own business, be their own boss and make more money. But how many people really go out and do it? Most people don't want to put forth the effort into starting their own business. That is what makes commercial optometry jobs so appealing. Very handsome salary without the headaches of a business.

Fact #2: It is easy to find a JOB in optometry, it is hard to find a CAREER. You need to start researching private practice from day one, otherwise you will panic during your 4th year and give your life away to walmart.

This is very good advice, if you plan to go the practice route. It is very important to start researching how you are going to accomplish your goals of setting up your optometry business as soon as you can. This involves gaining knowledge on how to run a business, doing research and writing a detailed business plan.

Fact #3: Commercial optometry projects a very negative image on the profession.

I guess the question is, From who's point of view? If you talk to someone who knows a lot about the profession I would heartily agree. On the other hand the average joe really doesn't know that there are more options than JCPenney out there. Or even the fact that eye exams with a competent OD can make a huge difference. I would say this falls into an overall lack of public awareness about the subject. I was very happy to hear some radio Ad's put out by the AOA. A lot more advertising and public awareness needs to be done. This is indeed an area for concern.

Fact #4: We ARE in an oversupply situation. This is driving down insurance reimbursements and causing ODs to see each other more as competition than colleagues. This is not good!

My question on this fact is, What is your definition of oversupply? Your Fact #2 clearly states that "it is easy to find a job in Optometry." In the business world job vacancies translate into labor demand. The US department of Labor also points out something very interesting:

Employment of optometrists is expected to grow faster than average for all occupations through 2014, in response to the vision care needs of a growing and aging population.

I think it is safe to say there is not an "oversupply" in the optometry profession. Now if you are worried about the prices OD's can charge for their services because of supply and demand, that is a valid point. So again some clarification would be appreciated.

Although I can see some need for concern, from a business standpoint Optometry is doing very well.

 

[KHE]

I issue that challenge to you. You see faults in optometry what can these students do to avoid the negatives? What can we do to find and succeed in private practice? What can we do to change the face of optometry? Don't tear things down unless you have a new foundation.

A few months ago, I posted a 3 part series called 'The Way It Is."

In that series and in many other of my postings on here, I have tried to outline my mistakes and how you can all go about not making the same ones I did. It has detailed suggestions on how to find and succeed in private practice. Feel free to search for those postings....

 

[Eye-Spy]

I find it interesting that a thread designed to educate "Naive OD students" turned into mostly a bickering match between current ODs. As a current "naive" OD student, all this thread has managed to do is scare me a little, not about the future state of optometry as a profession, but about the atmosphere that seems to exist here between collegues. It would be infintely more useful to me as a student if fellow ODs would simply add their input rather than nitpick at the details of each others posts.

That's all.

Peace.

 

[prettygreeneyes]

Give me some questions and I'll be happy to answer them. But I will only share my opinions if I'm not attacked. I have my own opinions so you should treat them as such and try to learn from them. I believe this is the problem with the forums. Many people may say they want to be taught but what they really want is to argue their own position. I don't want to get into that game because you can't argue someone else's intractable opinion. I would rather be in a room of like-minded individuals who want to learn from each other than be in a room of hornets. These forums are like being a bible thumping conservative walking into a militant environmentalist convention.

This also partly explains why it's the same people over and over. Many people just don't have the time to post, they aren't opinionated enough or brash enough to share their position publicly, or they just do not want to argue. I really don't like to argue because most of the time it ends up a free-for-all between two diametrically opposed opinions. Like Bush and Gore would ever agree on anything...

A good example of an appropriate forum of like-minded individuals is your own optometry school. You paid to be there and you didn't attack the professor because you wanted the information--you were willing to listen.

I've been an optometrist who has been practicing since 1999. I've worked commercial, filled in for private and commercial, worked as an employee, been shafted by various doctors over the past 8 years, and I now own my own office that I purchased 3.5 years ago.

What do you want to know from my perspective? (I also don't want to get into anything personal--if you want to know that then send me a private PM).

Let's see what happens now...

All of my questions have been answered by other doctors on this forum, including KHE, Ben Chudner, xmattodx, cpw, and others. I appreciate your offer and I'll let you know if I think of anything.

 

[IndianaOD]

A few months ago, I posted a 3 part series called 'The Way It Is."

In that series and in many other of my postings on here, I have tried to outline my mistakes and how you can all go about not making the same ones I did. It has detailed suggestions on how to find and succeed in private practice. Feel free to search for those postings....

I was looking for this thread, but unable to find it. Is it still around?

 

[prettygreeneyes]

I was looking for this thread, but unable to find it. Is it still around?

http://forums.studentdoctor.net/showthread.php?t=429718
http://forums.studentdoctor.net/showthread.php?t=427605
http://forums.studentdoctor.net/showthread.php?t=427182

 

[IndianaOD]

http://forums.studentdoctor.net/showthread.php?t=429718
http://forums.studentdoctor.net/showthread.php?t=427605
http://forums.studentdoctor.net/showthread.php?t=427182

Thanks,

Boy KHE your postings have changed a lot with the new job! You used to be a major source of doom and gloom.

A couple of points. I agree that it is a major problem that new grads sing and dance for commercial joints for $30 an exam. I do feel though that if you stay in commercial awhile you will dull your skills and fall into the mentality of 1 and 2 and out the door to collect your next $24. I work with a reformed "retailer" a couple days a week who stated that is almost always how it was.

When I was in school, the best lecture I ever heard was by a recent grad. His talk was titled "don't give away the keys to your ferrari". The "ferrari" being your OD degree. He thought he might HAVE to take a commercial job to feed his family after having a very hard time finding a good private practice position. He said the lowest point in his life was filling out a walmart application right next to the slushy machine. After a few minutes he ripped up the application, left and took an unmatched residency position.

The gist was don't give a commercial manager with no medical training control of your OD degree.

Happy ending, he finially found a private practice position he enjoyed.

These positions are difficult to find and usually do take sacrafice.

Yes, I have a family. I too had a great (so I thought) private practice job lined up after school. Similar to KHE I got hosed and luckily had the credentials to match at my first residency pick. Yes, at first one of the main reasons I took the residency was just to avoid commercial. It turned out to be one of the best possible choices because I learned a useful specialty. I also accepted a significantly lower salary at the private practice with the caveat that I have a guranteed offer to buy in. This is in writing as I think is critical!

Not only did I give up a lot of instant income to go this route I turned down a job offer with a very prestigeous OMD practice. If private practice is why you chose optometry then you should be willing to give up a little at first.

If you are crazy and think you will be happy working at a mall or wally then no one is going to stop you. Just don't forget your job is a major part of your time on this earth.

Sorry, had a school screening today so had some extra time.

My last thought of the night: A lot of the ODs that don't believe in oversupply and the problems with commercial are older doctors. You will hear some ODs talk about the golden years of optometry. Back awhile it appears it was much easier starting and growing a successful private practice. Vision insurance was less prevalent and there weren't nearly as many commercial competitors. IMHO these doctors don't have the feel for the current job market. My thoughts are largely based on the struggles of my close classmates, and the 70 4th year students who were under my watch.

This thread is racking up views at a record pace. I must not be that crazy.

 

[IndianaOD]

From another OD

Why in AOA's own salary survey do they report the average OD sees 1750 complete eye exams and 638 "other" encounters for a total of 2388 patient encounters per year? Also reported these "average ODs" would like to schedule 2 patients per hour, but see only 1.15/ hour on "average." The "average" OD also reportedly is available to see patients 2080 hours/year. This means there are 4160 appointments available (at 2 per hour) and these "average" ODs are at 57% capacity. This does not even consider what could happen if we truly delegated like we should and became more efficient than 1.15 patients per hour! There's no shortage!

 

[Ben Chudner]

A lot of the ODs that don't believe in oversupply and the problems with commercial are older doctors.

A lot maybe, but not all unless your cut off for older is 10 years of practice

 

[qwopty99]

great thread! really didn't want to get involved, but couldn't resist.

my personal thanks to all who have contributed. kudos Indiana, KHE, xMatt, Ben, et al.

my opinion on the subject somewhat mirrors that of Indiana, in that i foresee negative trends for optometry in the future. i think optometry will undergo/is undergoing a "pharmacy-ization", in which u will no longer ask a colleague, "where do u work", but rather, "do u work at WalMart, Lenscrafters, or Pearl?" once upon a time, a pharmacy grad would open their own pharmacy. now they are at london drugs, SDM, or target.

as for our situation, why a pharmacy-ization? the average PP OD has to pay for rent, hydro, secretary, equipment, staff, etc. and thus has to charge $89 for an exam, while the side-by-side doc has virtually no overhead, and hence can charge $29 an exam. u can argue about "value-added-whatever", but this price gap will soon cause problems for the PP OD who has to do more and more "selling of himself and his services", in order to convince patients that it is worth paying 3X more to see him.

of course... the guy in the 29 dollar joint will also be doing the an analogous selling, which in this case, is telling the patients that for 29 bucks, they are getting the "same thing" without all the bells and whistles of a private practice. PP ODs talk all the time about making patients understand the value-added they give. the thing is, WM ODs can do the same...

anyways, even if we JUST TALK ABOUT COST, the patient who walks in a mall will see Pearl on his right for $29, and Dr. Joe OD on his left for $89. he might also see a nice pair of shoes for $60. doing the quick mental calculation, he needs an eye exam, but if he goes to Pearl, he can also get that pair of shoes, for the cost it would be to see Dr. Joe OD. i think Dr Joe has a tough sell.

i believe in market forces, and honestly, no matter how hard "we try", i don't think optometry really can do anything about it.

anyhoos, it is my opinion the private-practice-optometry "business-model" will essentially become obsolete in URBAN centers in 15-20 years or so. it is already on record, in peer-reviewed journals, that more and more PP OD practices are simply closing - they are not sold. i.e. no buyers for PP OD practices. unless ur the only gig in town, maintaining a PP OD in a saturated urban center will just get harder and harder.

 

[qwopty99]

From Medline:

The future of optometric practice? The results of a survey of optometrists and optometry students.

Optometry. 2004 Oct;75(10):615-23.
Silverman MW, Woodruff C, Hardigan PC.

BACKGROUND: There is an apparent increase in the number of private optometry practices that are closing due to a lack of interested buyers. We examined some of the factors that influence the market for optometry practices in a survey of practicing optometrists and third- and fourth-year optometry students. METHODS: Optometrists in six states, and students at four schools and colleges of optometry, completed a mailed or faxed survey regarding attitudes toward optometric practice, including fair/reasonable compensation for a new optometrist, the value of optometric practices, and preferred mode of practice on graduation. RESULTS: Doctors and students differed significantly in the amount of money they reported as fair/reasonable compensation for a recently graduated optometrist joining a practice. Comparing students to doctors in specific categories of compensation, students chose a higher fair/reasonable compensation compared to doctors. Students were more likely than doctors to choose >$70,000 as fair/reasonable compensation, while doctors were more likely than students to choose $40,000 to $69,000. Doctors tended to overvalue their practices for the purpose of selling the practice when using percentage of gross income as a valuation method. Students' choices for mode of practice changed dramatically from their ideal when taking their current financial situation into consideration. Students were more likely to choose corporate practice as their preferred practice mode when considering their current financial situation than when not restricted. CONCLUSIONS: There are many factors that affect the value and marketability of an optometric practice. In order to sell a practice, the owner must consider the effects of the needs and desires of recently graduated optometrists.

 

[Ben Chudner]

From another OD

Why in AOA's own salary survey do they report the average OD sees 1750 complete eye exams and 638 "other" encounters for a total of 2388 patient encounters per year? Also reported these "average ODs" would like to schedule 2 patients per hour, but see only 1.15/ hour on "average." The "average" OD also reportedly is available to see patients 2080 hours/year. This means there are 4160 appointments available (at 2 per hour) and these "average" ODs are at 57% capacity. This does not even consider what could happen if we truly delegated like we should and became more efficient than 1.15 patients per hour! There's no shortage!

First of all, let me reiterate that I am not saying there is no oversupply and I am definitely not saying there is a shortage. I won't say there is an oversupply either. I have yet to see conclusive data to prove either position. I assume, Indiana, that this is where you got the 57%, and I appreciate you comming up with the source. Unfortunately, I believe you have misquoted the data from the AOA's salary survey. I also find it funny that those that feel there is an oversupply always say the salary data is skewed when someone talks about the increasing salary result (I believe DocWatson was the last one to make this claim), but it is totally accurate when it shows 57% capacity.

Here is the latest data that I could get from the AOA website, which you need a password to get. According to the report, in 2004 OD's worked on average 1,867 hours. This was down from 2010 hours in 1994. This may or may not be by choice and I don't think you can assume either way. Complete exams per year were 2,134, plus an additional 916 other exams for a total of 3,050 exams per year on average. This equals 1.63 patients per hour on average. Even if OD's would like to schedule 2 patients per hour, which by the way I could not find in the report, this would be 81.5% capacity. Does this still prove oversupply? I have no idea, mainly because I don't know how accurate the survery is.

In light of the potential accuracy problem, here are some other things to think about, not that I think they prove or disprove oversupply.

1) The number of hours OD's work per year on average is decreasing yet the average salary continues to rise
2) As stated on this site, and there is no evidence to the contrary, once you graduate from optometry school you WILL find a job, if not a career
3) Salaries continue to rise even with decreasing insurance reimbursements

As I said before, I have no idea if there is an oversupply at this moment. I am concerned for the future of the profession with additional schools comming online. I also agree with qwopty99 in that this profession will change in the future. I think the solo practice, especially those doing $500,000 and less will disappear. The large practices will take over some of these and you will end up with large multi-doctor, multi-location practices, and corporate practices. What does this all mean? I have no idea, except that I have would really like to see conclusive evidence regarding oversupply so we can put this to rest.

 

[hello07]

can someone explain to me what is all the fuss about if an additional Optometry school or two opens up in a few years? Whether it is in California or Texas why the negativity of opening another school and giving more potential applicants a chance? Will it really impact our current job market?
Please explain to me.

 

[IndianaOD]

can someone explain to me what is all the fuss about if an additional Optometry school or two opens up in a few years? Whether it is in California or Texas why the negativity of opening another school and giving more potential applicants a chance? Will it really impact our current job market?
Please explain to me.

Yes it can have a disaterous impact on the job market. The schools will easily increase the graduation rate 15% or more. It is easy supply and demand. The current trend is incresing supply and flat demand. More ODs equals less patients per OD. This causes ODs to accept less and less money for their services in order to attract the fewer patients and "steal" them away from other ODs.

This also leads indirectly to lower incomes wich leaves less money to invest in technology like OCT, GDx etc to better manage eye disease.

Furthermore, more schools means less qualified applicants have a chance to get in. Personally, I want to be surrounded by highly qualified colleagues who have the brains and drive to improve the image of optometry and actually practice how they were trained.

I know I say it all the time but look at dentristy. Most people agree the average OD makes around 90-100k. The average DDS/DMD is at 190k! Same schooling, twice the income and a good number of them only work 4 days a week in my experience. Here demand is outpacing supply. Therefore entrance to dental school in more keen and attracting smarter students. I have two good dentist friends who tell me there is a lot of pressure to keep commercial dentistry from growing and the students are made well aware of this.

 

[IndianaOD]

First of all, let me reiterate that I am not saying there is no oversupply and I am definitely not saying there is a shortage. I won't say there is an oversupply either. I have yet to see conclusive data to prove either position. I assume, Indiana, that this is where you got the 57%, and I appreciate you comming up with the source. Unfortunately, I believe you have misquoted the data from the AOA's salary survey. I also find it funny that those that feel there is an oversupply always say the salary data is skewed when someone talks about the increasing salary result (I believe DocWatson was the last one to make this claim), but it is totally accurate when it shows 57% capacity.

Here is the latest data that I could get from the AOA website, which you need a password to get. According to the report, in 2004 OD's worked on average 1,867 hours. This was down from 2010 hours in 1994. This may or may not be by choice and I don't think you can assume either way. Complete exams per year were 2,134, plus an additional 916 other exams for a total of 3,050 exams per year on average. This equals 1.63 patients per hour on average. Even if OD's would like to schedule 2 patients per hour, which by the way I could not find in the report, this would be 81.5% capacity. Does this still prove oversupply? I have no idea, mainly because I don't know how accurate the survery is.

In light of the potential accuracy problem, here are some other things to think about, not that I think they prove or disprove oversupply.

1) The number of hours OD's work per year on average is decreasing yet the average salary continues to rise
2) As stated on this site, and there is no evidence to the contrary, once you graduate from optometry school you WILL find a job, if not a career
3) Salaries continue to rise even with decreasing insurance reimbursements

As I said before, I have no idea if there is an oversupply at this moment. I am concerned for the future of the profession with additional schools comming online. I also agree with qwopty99 in that this profession will change in the future. I think the solo practice, especially those doing $500,000 and less will disappear. The large practices will take over some of these and you will end up with large multi-doctor, multi-location practices, and corporate practices. What does this all mean? I have no idea, except that I have would really like to see conclusive evidence regarding oversupply so we can put this to rest.

Here are some survey results from Review of optometry:

Then again, inflation rose a little more than 6% over the same period (based on the U.S. Consumer Price Index), so many self-employed optometrists have effectively lost net income since 2004. Actually, they’ve lost income since 2002, as median income has been flat between the 2002 and 2004 surveys.

 

[IndianaOD]

great thread! really didn't want to get involved, but couldn't resist.

my personal thanks to all who have contributed. kudos Indiana, KHE, xMatt, Ben, et al.

my opinion on the subject somewhat mirrors that of Indiana, in that i foresee negative trends for optometry in the future. i think optometry will undergo/is undergoing a "pharmacy-ization", in which u will no longer ask a colleague, "where do u work", but rather, "do u work at WalMart, Lenscrafters, or Pearl?" once upon a time, a pharmacy grad would open their own pharmacy. now they are at london drugs, SDM, or target.

as for our situation, why a pharmacy-ization? the average PP OD has to pay for rent, hydro, secretary, equipment, staff, etc. and thus has to charge $89 for an exam, while the side-by-side doc has virtually no overhead, and hence can charge $29 an exam. u can argue about "value-added-whatever", but this price gap will soon cause problems for the PP OD who has to do more and more "selling of himself and his services", in order to convince patients that it is worth paying 3X more to see him.

of course... the guy in the 29 dollar joint will also be doing the an analogous selling, which in this case, is telling the patients that for 29 bucks, they are getting the "same thing" without all the bells and whistles of a private practice. PP ODs talk all the time about making patients understand the value-added they give. the thing is, WM ODs can do the same...

anyways, even if we JUST TALK ABOUT COST, the patient who walks in a mall will see Pearl on his right for $29, and Dr. Joe OD on his left for $89. he might also see a nice pair of shoes for $60. doing the quick mental calculation, he needs an eye exam, but if he goes to Pearl, he can also get that pair of shoes, for the cost it would be to see Dr. Joe OD. i think Dr Joe has a tough sell.

i believe in market forces, and honestly, no matter how hard "we try", i don't think optometry really can do anything about it.

anyhoos, it is my opinion the private-practice-optometry "business-model" will essentially become obsolete in URBAN centers in 15-20 years or so. it is already on record, in peer-reviewed journals, that more and more PP OD practices are simply closing - they are not sold. i.e. no buyers for PP OD practices. unless ur the only gig in town, maintaining a PP OD in a saturated urban center will just get harder and harder.

Thanks for the post. I think private practices do add value. (Well many of them do, not all) I see quite a few patients who go to wally for glasses exams, but have shown up to see me when they got a red eye or their child is having some troubles. As one father put it "I'm not sure how good Johnny's exam was at walmart." It is important to note that while I harp on commercial here, I never talk badly about other ODs to patients. On average I think I tend to spend quite a bit more time with patients than the average commercial doc. I tend to do more prelims such as blood pressure, NPA, NPC, accom Lag etc.

Also very few commercial locations have instruments like the Gdx, retinal camera, visual fields etc. We can do these for the patient on the same day where a commercial doc would, sorry to say, send them to an ophthlmology practice. Why go through all that intesive ocular disease education if you aren't going to treat it?

I don't think the total demise of private practice is in the cards at this point. I really think its up to recent grads to make the hard decision to not empower the commercial entities. Lets be honest, if commercial was the only choice you had, how many would have gone to OD school? When I was younger I thought pharmacy would be cool. However one of my friend's dad was one who was very unsatisfied that his only real choice was commercial. PharmDs get great training that probably never gets used in the commercial setting.

Also you have to figure that most private docs are invested in their communities much more. Our money goes back into the local community, not some business executive 500 miles away.