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Should I become an Optometrist?

Discussion in 'Optometry' started by Roger Schmidt, Feb 19, 2012.

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  1. Roger Schmidt

    Roger Schmidt

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    Hello, this is my first post on SDN. I was originally going to post this under Pre-Med, but I need some advice from you senior guys. I've been an Engineering major for the past 2.5 years, but recently I've come to doubt my major. The main reason is that being an engineer, I will most likely be working for the government or some really big company, and the idea of being self-employed and having that independence really appeals to me. The field of Optometry has always been something that I've thought about, and it has come to appeal to me recently, however, I haven't had any biology and very little chemistry, so I'd likely end up being a 5th or 6th year senior if I tried to get all the requirements for getting into Optometry School.

    My question is this: is Optometry a good field for one who wishes to be self-employed, like in a rural practice maybe? (I grew up in the country and have no real interest in setting up in a big city) How difficult is it to set up / buy your practice these days? Is an Optometrist really as low stress as people make it out to be?
  2. q1we3

    q1we3

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    Please check out other similar topics on the forums. There is plenty on future of Optometry.
  3. thecgrblue

    thecgrblue Enjoyin' the journey

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    After my prep and eventual acceptance to an OD program I decided to apply to medical school and will be starting this fall.

    PM me if you want to know why I personally decided to change. Welcome to SDN!
  4. rodomon

    rodomon

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    I'd say yes. A fairly rural setting is often more profitable for an optometrist than an urban one. Also, it's probably much harder to own your own practice as an MD in a rural area, at least in my experience. It's generally lower-stress than an MD job as well, although there are some patients you will worry about when you go to bed. Also, if you own your own practice, that has a fair amount of stress simply in being a small business owner. But worth it if that's what you want. I actually switched from medicine to optometry, after being accepted to med school, for a variety of reasons, including some of the above, near the end of undergrad.

    However, I'd say the future is a little less certain for ODs than MDs, especially with potential changes to health care and insurances. I think they'll still be needed, but exactly how they operate is more likely to possibly change than how MDs operate. I don't foresee any huge developments, but they're possible, so it's a bit more risky; becoming an MD would be an easier path, stability-wise. Although if you want to own your own business, you should already be in the mindset of taking more risks.

    On the other hand, very few new optometric offices fail; compared to many other new business types, such as restaurants, it's much less risky.

    You have to decide what you want out of life and find a career that best fits those goals while considering potential changes in the next 40 years. For me, optometry was more aligned to my life goals than medicine.
  5. CL Doc

    CL Doc

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    In an ideal world we'd all have jobs we really enjoy and of course be decently compensated for our efforts. What a lot of pre ODs on this site fail to recognize is the impact that student loans can have on your life. If you do go to optometry school and end up with an average debt (about $200k) will you be happy carrying this debt for 30 years?

    Self employment can be great, but you will start with little income and the first few years will be tough. Rural doesn't guarantee success, but it less crowded. I know, I've practiced rural optometry.

    None of us know what is in store for this profession, so that creates a certain risk in itself. If you choose this profession plan on working a long time. With the current economics there is no early retirement.
  6. Shnurek

    Shnurek

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    :thumbup: Well said. Loans are the biggest hurdle my generation will have. Thankfully my father taught me how to be frugal and financially savvy along with influences from my friend that works at Wall Street lol.
  7. Roger Schmidt

    Roger Schmidt

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    Thank you all for your responses. I've been doing a lot of reading here on SDN about the future of Optometry. While most of what I read seems to be positive, their are a few out there (Jason K is a good example on this site) who say that the golden age of Optometry is coming to an end. While it may seem disheartening, I am glad that there are people willing to present that side of it. I honestly don't know who to believe. I suppose that since no one is looking into a crystal ball, nobody really knows for sure.

    BTW, does anyone know of a site where you can look up stats on Optometry (like rural salaries, % self employed, ect.) ? I looked on BLS.gov but couldn't find what I was looking for.
  8. Roger Schmidt

    Roger Schmidt

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    Thank you very much for your reply. If you don't mind my asking, exactly how did you get into rural Optometry, and how was it?
  9. Dr Colin K Chan

    Dr Colin K Chan Toronto Optometrist

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    in general, rural settings are good for this field. and yes, autonomy is one of the perks.
  10. Shnurek

    Shnurek

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    You can work as an associate in a rural setting and get to know the people. Have a buy-in clause in your contract so you can partner in later if the doctor and the people like you. Not only is rural more profitable and you get more autonomy but in general the optometry laws allow you to do much more in more rural states such as to give injections and/or even laser surgery (2 states). Also, from seeing and talking to my fellow classmates a lot of them want to stay in big cities, that means less competition for you :)
  11. Roger Schmidt

    Roger Schmidt

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    Thank you for your response. Is there any website or resource where one can see statistics on rural Optometry in different areas (salaries, % self-employed, failure rates, etc.)?
  12. Shnurek

    Shnurek

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    Some random stuff I found using google:
    http://grandrounds4ods.wordpress.co...-1-tips4eyedocs-weekend-28-29-jan-2012-no-38/
    http://www.marco.com/brochures/epic_ad8.pdf

    These maps might be helpful a bit:
    http://www.bls.gov/oes/current/oes291041.htm
    https://www.aoa.org/Images/Injectables-12-2011.gif

    "3. Optometry faces a "maldistribution" problem. The majority of optometry school graduates choose to
    practice in suburban or urban areas rather than in rural and other underserved areas. Although
    Californians may not feel the consequences of a maldistribution of optometrists as intensely as those
    involving physicians and other providers of urgent care services, shortage areas exist throughout the
    state."
    (http://www.ucop.edu/hss/documents/optometry.pdf)
  13. mclem222

    mclem222

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    Optometry is great. I just hired two associates.. One is getting about 60K/year with bonus incentives. The other is part time and getting a percentage. I think being an OD is a great field if you know what you are getting. Don't think you are going to be an OMD etc.. in terms of salary, pride etc.. Love optometry for what it is. A great field with great potential. I also work partime at a multispecialty OMD practice but I plan on stopping that soon.
  14. q1we3

    q1we3

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    60k and you wonder why commercial optometry is taking over. How many glasses does this person have to sell to get that coveted bonus incentive?
  15. Jason K

    Jason K

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    Oh my god.....it's even worse than I thought. :laugh:....."About" 60K? Does that mean a little more or a little less?......:eek:

    I mean you no offense at all, but when it's possible to come on here and brag about FT base salaries in the 60K range, I think my point has been made.
  16. CL Doc

    CL Doc

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    I don't think any of us who have been in practice "wonder" why commercial optometry is becoming the norm. What new grads have to realize is that they need to pay their own way in a private practice. Why should I give up some of my income just to keep you out of commercial optometry? No one did it for me when I started up.
  17. q1we3

    q1we3

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    Of course, since there is an oversupply of graduates anyways why not low ball them, if one doesn't bite someone else sure will. It might be unethical but makes perfect business sense. Please don't compare yourself to what future grads will be going through, times have certainly changed for the worst. In 5 years from now ODs will be offering 40k and telling new grads that they are doing them a favor. As I said before it makes perfect business sense but doesn't mean it's right.
  18. Jason K

    Jason K

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    I don't think any OD on here would disagree with you on that point. The problem is just that, however. Many private offices don't have the luxury of adding a new doctor for a fair wage or any other. The problem is, there's just not enough in the way of patients to support another doc even if the additional doc were there. Add in the fact that new ODs leave school with absolutely no idea how to code properly or how to actually make money for a practice and it's a losing battle for new ODs. Corporate entities like PV, LC, and America's Best don't have to worry about as much about patient numbers and until recently, they didn't even care about coding - the front desk girls did that. If there's a doc in the box, patients will come. They can and do pay a little more to new grads because they have to do something to attract them....at least they did in the past. As the private side of the profession becomes less and less able to support the thousands upon thousands of excess OD weight being added into the system every year, corporations will realize they don't need to provide incentives anymore since there's nothing to attract new grads away from. They're all that will be left - take it or leave it. Get ready for the 55K/year starting salary with Lenscrafters.....it's on its way.
  19. SilhouetteSight

    SilhouetteSight

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    Roger,

    SDN is a great site for varying viewpoints from established OD's. My advice is also to shadow many docs in a variety of settings to get their opinion as well. Optometry has many challenges and it is imperative you understand these before you choose this profession.
  20. CL Doc

    CL Doc

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    Not sure why it's unethical to pay someone a market rate for their work. What do you think an ethical salary is?
  21. Shnurek

    Shnurek

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    You should see how this discussion mirrors discussions in the pharmacy forums about paying new graduates 80k in california. I agree, free market economy is best. I'm getting my OD but that does not mean that I can't be a coal miner for 200k: http://online.wsj.com/article/SB10001424052970204621904577016172350869312.html

    lols seems like everybody wants an office job so the physical labor jobs are skyrocketing in salary. Why optometry? you should ask why college? lol
  22. dinkus

    dinkus

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    Free market blah blah blah, except it's not that simple. What's unethical is the false information propagated by optometry schools and associations in order to lure students in at ridiculously high tuition rates. What ends up happening is, once they graduate, optometrists no longer work for themselves, but rather for schools and banks. So the dissension isn't with the "market rate," it's with the potential alienation of an entire profession from its work.
  23. mclem222

    mclem222

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    Well...they are going to get 60K base and then once they make 180K in collections they get to keep 30% of what they make. This does not include glasses sales etc.. After two years they will be offered a buy in...I am not going to just give someone a salary of 120K when they haven't seen a patient etc..They need to build something etc.. I am outside Philly so it is pretty saturated.
    The partner I took on told me they got offers in private practice from 50K to about 90K.

    The other doc gets 20% of all collections that they bill etc.. They only work 1/2 day a week. For example last friday she saw 6 patients in the morning...collected about $750 from refraction fees and insurance and will take home $150 from that day. If you extrapolate that to a week it would be 1.5K a week or 75K a year...There are some weeks she seens only 2 people though..

    I am not sure what people expect from optometry but I do agree that 130K salaries are not realistic unless you want to be part of corporate. I did some corporate until 6 months ago to pay some bills and it was fine. I tried to convince some of those patients to see me in private practice but I don't sell TVs and bulk chicken breasts so they didn't really follow me.

    In the future who knows what will happen. I read online of an Iphone app that does an autorefraction. Combine that with a optician who does a PD and who knows what will happen. I don't think ODs are going to be fabously wealthy in 20 years but will make a good middle class income. In a rural area you could kill it and make about 150K I think if you hada a lot of volume.
    Last edited: Mar 2, 2012
  24. Visionary

    Visionary Medical Retinologist

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    Now, there's an idea. :idea:
  25. CL Doc

    CL Doc

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    Yes, it really is that simple. You'll get paid the market rate unless you want to take the risk of self employment. I can't base what I pay an associate on what the schools say you will earn.
  26. dinkus

    dinkus

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    You're dense. Nobody suggested you do that. I'm merely explaining why some posters scoffed at the 60k figure within the larger framework of the profession.
  27. Shnurek

    Shnurek

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    Totally agree. If you don't want to get 60k then go elsewhere. Simple. Grow a pair. I got offered $12 by an OD to work during school. I said hell no, I got paid $19 by an OMD. There's this thing called negotiation.
  28. Jason K

    Jason K

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    I can't wait until you get out of school and start "negotiating." You have so much to learn.

    You're going to be hearing a lot of "What's that? You want more money? Why don't you turn around and look at the other 40 better-qualified ODs behind you that will take the offer on the table?" Oversupply doesn't affect all fields equally, Shnurek. You seem to fail to understand that little factoid.
  29. Shnurek

    Shnurek

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    Yes, I understand that. You do what you have to do. When I was shadowing the opto at the VA told me there were 20 ODs interviewing for one position in Westchester, NY for example. Glamour vs. money. I'm sure if I did Podiatry or Dentistry there would be less competition. Ever wonder why Urology pays so obscenely well in Medicine?
  30. The Doctor

    The Doctor EMH Mark I

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    Urology pays well because it is highly procedurally based (TURPs for BPH, prostatectomies, ECL for kidney stones, etc) and surgical. Kind of similar to ophthalmology in some regards. Urologists are actually pretty well respected, and the rotation I did in it was pretty cool.
  31. thecgrblue

    thecgrblue Enjoyin' the journey

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    Huh?
  32. CL Doc

    CL Doc

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    I'm dense?

    I've been successful in this business for 25 years. And your experience in optometry is???

    I know more about this business than you ever will.

    Good luck paying your education off with today's starting salaries.
  33. q1we3

    q1we3

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    It was completely unnecessary and rude of dinkus to call you dense, no arguments there. But moving on to the salary debate, in most cases when you see numbers like 50-60k thrown around it is because there is not enough of a patient load to support the new doc. This poor graduate is just soon to be failed experiment who is fooled into believing that practice has great potential and will make so much more when he/she generates some unreasonable amount of revenue for your clinic. If your clinic doesn't have the patient volume to support a new OD do not try to hire anyone with 50k salary.
    On the other hand if you clinic with optical is actually busy and the new OD seeing around 20 patients per day but you can't pay more than 60k then there is something obviously wrong there. You are trying to underpay him/her for their work based on the fact that there is an oversupply and most prefer to work PP than commercial.
  34. Shnurek

    Shnurek

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    Podiatry, Dentistry and Urology are less glamorous fields because they are not as clean as optometry and you don't help people see. People want to be eye doctors so there is more competition and therefore less salary both on the part of the optometrists and ophthalmologists. Both fields pay less than they should because you have the privilege of working on the part of the body that is innately interesting. Again, glamour vs. $$$.
  35. dinkus

    dinkus

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    Oh look, a red herring. I don't really care how successful you are, though it speaks to how fragile your ego is that you would bring it up when called out on the non sequitur in your last post.
  36. Tippytoe

    Tippytoe

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    No, his point is that you have no idea what you are talking about. How could you? It's no different than if you went onto an engineering website and started tell them everything about their profession. Would you do that? It's what you are doing here.
  37. Jason K

    Jason K

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    Shnurek, your level of delusion about what optometry is, in comparison to other medical fields, is absolutely baffling. I don't know where you come up with this stuff.

    "Glamour????" Really? I don't know a single OD who considers what he/she does to be "glamourous." I also don't know any surgeons, urologists, or otherwise, who go around saying "geeez, I wish I had a little more glamour in my life.....I should have been an OD...." :laugh:
    Last edited: Mar 4, 2012
  38. dinkus

    dinkus

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    Except I didn't say anything that anyone else couldn't see at a cursory glance. I've never pretended to know more than an optometrist when it comes to the details of optometry. Given that, being an optometrist doesn't give you free reign to use logical fallacies whenever you're challenged. What does his success as an optometrist have to do with the posts I've made? Nothing. Similarly, the non sequitur in his first reply indicated a level of comprehension far below that required to have meaningful discussions. If indeed I have "no idea what [I am] talking about," comment on the post(s) which led you to that conclusion. If you do that, we might get a result that somewhat resembles meaningful discussion, instead of the irrelevant nonsense that details how amazing you are.
  39. The Doctor

    The Doctor EMH Mark I

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    I can see what you're saying about the desirability of the fields influencing competition and salary. Maybe you meant "lifestyle desirability" when you talked about glamor - I think a lot of people in medicine might consider a cardiovascular surgeon or a neurosurgeon to have a "glamorous" career even though the lifestyle is decidedly pretty sucky. Desirability has less of an impact on medical specialties than on other allied health providers' salaries. Our residency slots are frequently tightly controlled based on funding from medicare, availability at academic departments, and our governing specialty associations. This keeps demand and patient volumes relatively high. Salary is more closely related to the volume of your practice, ratio of overhead to reimbursement, and the reimbursement model in medicine which favors procedures. Dermatologists can remove moles, perform biopsies, evaluate path slides and so they can bill highly for these procedures and they make a good salary. Same thing with urologists. Urology is actually tremendously competitive to get into and only the students with good grades and high board scores typically apply. It's considered a surgical subspecialty, so you can be a surgeon but with a better lifestyle (although there are still many difficulty cases involving kidney pathology).

    I can also understand what you are saying about the eyes being cool. I appreciate that about our common fields and am looking forward to working with eye health, but I think a lot of other fields in medicine are also appreciated and this doesn't factor much into salaries. For example, old men with BPH are very happy when they can pee again with a urologist's help. You are right that ophthalmology is more competitive because it can have a good lifestyle and we get to do cool interventions, but I don't think that is the reason salaries are lower. The median ophtho salary is 340k which is fine compared to other medical specialties. The starting salaries are very low and especially so when you look at big cities. That's because you compete to build up a patient base and have to invest a lot in equipment at first for setting up a practice or buying into a practice since ophtho requires specialized tools. General ophtho salaries are also lower because cataract reimbursement has been continuously squeezed and cut as the procedure has become quicker and faster, and over the years CMS and the government has a growing inability to pay for free healthcare for everyone (I believe more total money has to be paid out for cataract surgery than any other surgery due to the sheer volume of procedures). Subspecialties pay more -> retina specialists make 570k median which is in the top 5 of all medical specialties, and I think they get to work with the coolest procedures and diseases (but I think this is due to procedures, billing for injections and diagnostic tests, lasering, surgeries not directly related to their tougher lifestyle or because of a perceived "coolness" factor that makes people want to go into the field).
  40. Shnurek

    Shnurek

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    Is this accurate?

    I've seen numbers such as $248,500: http://www.medscape.com/features/slideshow/compensation/2011/ophthalmology

    Or ~$145,000 starting: http://chws.albany.edu/download.php?f=c0ba310079a3be6678fd7e0e2af71e0c

    Also is retina still really that high? Even with OCT cuts by 50%+ and intravitreal injections cut like 25%?

    I agree with basically everything else you said about specialty lifestyle and you put it in better words than I did. But again, dentistry has a great lifestyle but its not glamorous and therefore there is less competition in that field.
  41. Jason K

    Jason K

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    Dude, you need to put down the Glamour magazines or Vogue or whatever you've been reading. Where do you keep getting these "glamour" references from? Urology and dentistry are less "glamorous" than optometry? What on earth does that even mean? Do you think optometry is "glamorous?" .....Really?

    Also, with your references to reimbursement cuts, you do realize that those cuts affect ODs as well, I hope? Except that for us, those procedures are a much larger percentage of our bottom line since we don't bill for surgical procedures.

    We're all getting screwed, Shnurek. MDs, ODs, DPMs, anyone who bills Medicare is getting the shaft. We just start out a lot lower on the totem pole than just about anyone else. Ok, we've got a leg up on the chiropractors - woohoo. That's great, we're one step above the peopel that the rest of the medical community considers to be witch doctors.

    Like it or not, the public expects our services free since we've given them away for so long. No one goes to a urologist and expects a free penis exam. I think you're under the mistaken impression that all "doctors" are created equal in the eyes of the medical reimbursement system. They're not.
  42. Shnurek

    Shnurek

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    "With immediate cuts averted, optometrists are now on track to see even higher Medicare payments in 2012. While most physicians will continue to receive 2011 rates through 2012, many ODs will see a roughly two percent increase in reimbursements in 2012."

    http://newsfromaoa.org/2012/02/17/congress-approves-measure-to-avert-massive-medicare-pay-cut/
  43. Jason K

    Jason K

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    You're so lost, dude....so lost. You have so much to learn, it's scary.

    Excerpt from AOA News 2/12/12:

    "As a result of this latest deal, under Medicare's sustainable growth rate formula (SGR), a nearly 30 percent cut is now scheduled for Jan. 1, 2013."

    You see, as a member of the "doctor" class, you're going to be "rich," Shnurek. You could work 4 PT jobs making a total of 58K, but you'll still be "rich." Think the general public feels sorry for doctors getting pay cuts?

    Unlike your physician colleagues, unfortunately, you won't have the bank account to pay for all the costs that these cuts will incur on you. Mortgages aren't getting cut back, car payments aren't getting reduced, taxes aren't going down, gas isn't getting cheaper, but rest assured, at some point in the near future, Medicare will cut physician reimbursements by the full 27.4%. It is going to happen.

    Wanna see what happens during an extreme leftist liberal president's second term? Well, for one thing, spending cut aversions will be tossed out like a bag of 3-day-old donuts from the back door of a Krispy Kreme. Thanks to the outlandish spending on both sides of the political aisle, the money has run out. There's just no way to pay for everything when you spend more than you have. If we thought Bush was a big spender, Obama makes him look like a miser. The cuts are coming. That they were temporarily "averted" means nothing in the long term.
    Last edited: Mar 4, 2012
  44. Satstill

    Satstill

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    Guys, take a break please. It's Sunday!! Go out have some fun!
  45. The Doctor

    The Doctor EMH Mark I

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    I suspect you are right that the retina cuts have made a difference. The number I quoted was based off of the 2010 MGMA private practice survey based on 2009 data which is supposedly the standard benchmark used for negotiationg with new hires or setting salaries in a non-academic setting. The AAO provides this median data quoted from MGMA since 2006 (297k), 2007 (316k), 2008 (214k), 2009 (338k) and 2010 (331k) for general ophtho. Retina median fell from 575k in 2009 to 558k for the 2011 report based on 2010 data.

    I agree, however, that it's very difficult to come to a consensus as to what a standard salary is in any field. There are so many variables which influence this and what are considered other compensation benefits. While I was aware of salary when choosing a field, I'm trying not to focus on this because I know that major changes are coming to the healthcare system and chances are we will be making much less than current practitioners. One thing I've learned over the past several years is that we are most disappointed when expectation fails to meet reality, so I'm doing my best to be mindful and grateful for what I have and to not dwell over what I can't personally change. We are fortunate to be well educated professionals in America and with careful financial planning neither we nor our families will ever be hungry or in great need.
  46. q1we3

    q1we3

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    SDN 2+ Year Member
    Tell that to the pharmacist who can't find work, optometrist who can't find enough patients, dentist who can't pay back 400k loan.
  47. Shnurek

    Shnurek

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    This is a good philosophy and yes we are very fortunate. Honestly, I am a minimalist and I do not require an extravagant mansion or Armani suits and I value experiences over material goods. I always strove to be above-average but not at the top. The higher you go the more you stray from normalcy and this may be good or bad depending on your preference. Also, my family was never in debt and I hope never will be. Such is my philosophy.
  48. mclem222

    mclem222

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    I don't think there is one urologist in America thinking "Hmm...if only I had been an optometrist, then I would be cool". My brother is an OMD and in med school there are tons of people who want to do urology but just can't get into the specialty. If you are in our profession for the sex appeal or glamour you've lost your mind and are in for a really big wake up call.

    And remember guys the average income in the US is around 45K. So if you are making 90K you make DOUBLE what an average joe makes..So as far as lay people are concerned you are rich, a baller etc..Now I know that living in Philly, NY, SF, Denver, Dallas 90K doesn't take you that far but remember 1/8 of the US population (or something like that) is on federal assistance. As far as they are concerned you are whining if you make only "90" grand or even "60" grand for that matter.
  49. mclem222

    mclem222

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    Just so you know the inflation rate increased from 2011 to 2012 is 3% and increase in the CPI index is about 3.2%. Thus a 2% increase in reimbursement is still a pay decline. It just isn't as bad as what MDs are getting
  50. hello07

    hello07

    Joined:
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    Optometrist
    SDN 5+ Year Member
    Schnurek, when you come out of your bubble- reality will hit you hard. You have absolutely no clue what you are talking about. I've been out almost 20 years from OD school and I can sincerely tell you the heydays of making money as an OD even a an employee are far gone. Salaries have plateau aand actuall gone done. Opticians, businessmen who own optical stores in big cities no longer cater or give a crap about OD's. Even our own colleagues, who might employee you in private or retail setting will have the edge over you as a worker. You better wake up or you'll be on the streets homeless soon after graduation............................wake up man.

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