Optometry Mentoring Thread

KHE · May 30, 2007

Hello SDN users.

I am happy to volunteer my services as a mentor to pre, current, and post graduate optometry students. I am 7 years out of school, worked for a few years, took a couple of years off to pursue other interests and am now back in the game having recently purchased a practice.

I was asked to specify what questions I will and will not take. I will take ANY and ALL questions with the EXCEPTION of how much money I make. I know that salaries and income are always of great interests to students so I don't mind talking generalities in that area. I will say however that I make a lot more than the person serving you your Starbucks in the morning but I make a lot less than Shaquille O'Neill.

cpw · Jun 5, 2007

thanks for volunteering, KHE !!

KHE · Jun 8, 2007

es255305 said:
Hi, thank you for being a mentor!

I'm a 3rd year undergrad, and I was hoping to ask you about what it's like to be an optometrist. Did you always know you wanted to go into optometry? What is an average day like for you? Have you gotten to treat a wide variety of conditions and diagnoses in your practice? And finally, do you have any advice for an undergrad like me who is trying to choose between optometry and med school?

Thanks!

Being an optometrist is, for the most part very rewarding. At it's core, I get paid decent money to help people see better. Yes, there are daily struggles with insurance companies and rude/difficult patients but any health care provider deals with that. On the whole, it is good.

I decided I wanted to be an optometrist when I was 14. That is probably much younger than most people who don't have ODs in the family. The story of how I decided that is long and dull, but if anyone cares I will try to post it sometime.

I now get to see and treat a wide range of conditions. In the past, I was limited by access to medican insurance plans. That problem still exists, and exists substantially in some parts of the country but for me now, it has been much smoother.

The choice between optometry school and medical school is about as different as the choice between soup or salad. Even though both will lead to you becoming a "doctor" and both fields provide "health care" they are substantially different enough that I think you should proabably ask yourself what it is that is attracting you to either field and what you are looking for in a career. That might help focus your thoughts a bit better.

I will say that anyone who goes into any "non-MD" track profession such as an optometrist, dentist, podiatrist etc. etc. because they want to be a doctor but not go to medical school, or didn't get into medical school and the other choice is "good enough" is doomed to a lifetime of misery. You have to make sure that you enter a field that you want to particpate in. Don't enter a field because you think it's "good enough" or "close enough."

KHE · Jun 8, 2007

JeffChou said:
How does one go about opening a large multi-doctor clinic. I heard that the Dr. who owns the clinic must practice at least 50% of the hours in the clinic. It seems that an optometrist would be stretched rather thin if he had as many as two offices.

I'm also interested in what services are elicited from OMDs who work in optometry offices.

Thanks!

I have never heard of a doctor just opening a large multi doctor clinic. Those types of clinics are either bought into or grown over time.

The 50% rule you are referring to is something that varies state to state. In the past, some ODs "owned" multpile offices and just hired other doctors to work there while never actually practicing themselves. Some doctors also had arrangements with opticians to provide "prescriptions" without ever seeing the patient.

As far as services from OMDs, the optometrists offices that do this usually enter into an arrangement in which the ophthalmologist shows up once or twice a month to see patients of the optometrist in the opotmetrists office who are in need of ophthalmological consultation. It is exceedingly rare for ophthalmologists to be employed by optometrists. Most states have laws on the books that preclude physicians from accepting employment from non physician providers. In most states, there are loopholes that can be exploited but again, it's very rare.

KHE · Jun 8, 2007

**DISCLAIMER** THE QUESTIONS POSED ESSENTIALLY ASK FOR RESPONSES THAT ARE PERSONAL OPINIONS. I WILL TRY TO BE AS NON-BIASED AS POSSIBLE BUT THE RESPONSES ARE MY OPINION ONLY

JAZZYEYE said:
1. Is the field oversaturated as badly as the OD's on the internet say or not at all like the Schools and AOA say ?

It is my belief that the field is saturated. The schools and the AOA operate on a theoretical basis. If every single person in the USA got an eye exam each and every year, then you might be able to argue that there is an unmet need for optometrists. However, many people do not get yearly exams and many do not seek out optometrists when they need eye care. The AOA and the schools also seem to be of the opinion that an aging population will increase demand for eye care services. I remain skeptical of that claim because there is no real reason to think that these aging people are going to be, or able to seek out optometrists for that needed care.

That being said, you will never starve as an OD. You will not default on your student loans. You will always make a good living with salaries far above the national average.

JAZZYEYE said:
2. Will opticians get refracting rights in USA as in Canada ?

Probably but I think it will take a very long time. In some states, to become an optician requires fairly extensive training and licensure. In other states, there are no requirements at all. You can just open up a shop and call yourself an optician. I think that in the states where opticians are trained and licensed, it is more likely that you will see opticians independently refracting at some point in your life. In states where opticians are not licensed, I think you will never see it.

JAZZYEYE said:
3. Health care reform is inevitable ...what impact, good or bad will this have on Optometry ?

I'm going to go on the assumption that you are talking about "national health insurnace" or "socialized medicine." If you're not, please correct me.

I'm sorry to give a lawyerly answer but the answer is "it depends." To the extent that optometrists are able to participate in the system, I think it will be a good thing. To the extent that they are excluded, it will not be good.

JAZZYEYE said:
4. Lasiks seems more like a procedure than traditional cutting surgery , do you think Optemetry should have Lasiks procedures within its scope of practice ?

No...I don't think LASIK should be part of optometric scope of practice. LASIK is not a technically demanding surgery but dealing with complications of LASIK can be very demanding. Do or would optometrists have the skill to deal with a free cap or a buttonhole? Right now I don't think so.

Regarding optometrists performing "surgery...." I think it is not a good idea.

Yes, it is true that many other "non-MD" professions perform fairly invasive "surgical" procedures safely and effectively, and yes MDs sometimes run around acting as if they have been annointed with the sole right right to perform surgery by God herself, but it is my belief that current optometric training does not come close to preparing optometrists to perform the vast majority of surgical procedures out there. Could a program be set up to train optometrists to perform eye surgeries with 4 years of post graduatate training similar to dentistry and podiatry? Probably. But it's not happening right now and I think it makes very little economic or political sense to even try.

An example I have used many times before....

Lets say ODs were suddenly granted the right to perform LASIK. Even if only 10% of licensed ODs pursued those rights, you would essentially set up a situation where the demand for LASIK stays the same, but the supply of providers triples overnight. What do you think that is going to do to fees? In case you haven't noticed, LASIK fees are under severe pressure in most markets. Drive down the interstate in any large or even mid sized cities and I can bet you $100 that you will see at least 3 billboards advertising cheap LASIK. We don't need more ophthalmic surgeons, and I believe it is close to economic suicide for ODs to pursue that.

JAZZYEYE said:
5. What are the specialty areas and their advantages that you would reccommend to new student ?

The main optometric specialy areas are vision therapy, low vision, and contact lenses. They all have their advantages but there are very very few practices out there that practice exclusively those specialties. Most of the providers who provide those services are just interested in those areas and do it on the side.

KHE · Jun 12, 2007

Jay12 said:
Hi, I think its great your taking time out of your day to answer our questions...thank you..

I am an individual who values lifestyle over anything else (i.e. family time, time for vacations (rest), time for hobbies, hours of work,...more so than making large amounts of money)...

Can you tell me the type of lifestyle one may expect once becoming an optometrist? (I know that the question might be vague, so may you comment on the things aforementioned above?)

Thanking you in anticipation.

The question is vague because "lifestyle" means something different to every person. Some people are content to live a hermit's existence as long as they have enough free time to fingerpaint and make clay pots and others need/want all the outwardly flashy trappings of success.

Optometry is, like most professions one in which you can practice as much or as little as you like and you can generally make as much or as little as you like.

362.04 · Jun 14, 2007

I'm a new mentor in optometry. I practice mainly in a hospital setting in a large metropolitan population center.

I mainly cover the scope of practice of optometry in a interdisciplinary setting and novel ways for optometrists to practice outside of the traditional office-based practice.

KHE · Jun 14, 2007

Sight5 said:
Just have a few questions for you, thanks for being willing to mentor those interested in the field of optometry:

1. Where do you practice and how many hours a week do you work?

I practice in a small town in Connecticut. I see patients about 36 hours a week and I spend as much time as needed on administrative tasks in the office which usually tack on about 10-15 hours a week.

Sight5 said:
2. I live in Southern California and would prefer to stay here. Do you think the new Western optometry school will cause a highly saturated OD atmosphere? How is it (that is, the number of other optometrists/ophthalmologists) where you live?

I cant speak for southern California since I live on the opposite end of the country but the majority of my colleagues who live in southern California report that the area is saturated and the new school is expected to make that problem worse. If you live in that area, I would encourage you to visit a number of ODs in the area you are interested in practicing in and asking them their opinion. They will have a much better frame of reference to answer that question than I would.

Sight5 said:
3. I am unsure if you have any children yet. But say your son/daughter was an undergrad bio major and was talented/hardworking enough to pursue whatever he/she wanted, would you encourage him/her to pursue optometry? This is a somewhat open ended question but I would appreciate an honest answer besides the usual "I would encourage them to merely pursue whatever it is they are interested in." If you think you could turn back the hands of time 11 years knowing what you know now, would you still do it?

I do have a child and even though you asked me not to say it, Im going to anyways. I would encourage them to pursue a career path that they are interested in and that makes them happy. However, to answer your question about whether I would do it again, the answer is Yes.but. I WOULD do it again, but I would have done some things differently. I would have been more aware of insurance issues and how that affects where I would practice. I also would have probably tried to open a practice sooner because I feel that I spent a fair amount of time trying to find a practice to purchase and I found that to be difficult. Many of the offices that I found for sale were tired, old, and the owners wanted far too much money for them and I think I spent too much time dealing with small time thinkers. Obviously, there are plenty of pros and cons of opening an office cold AND of a practice purchase and we can discuss that on another thread if you wish.

Sight5 said:
4. What did you do in the couple of years to pursue other interests?

I wrote a book centered around some pictures I have taken over the years and I taught high school math and science.

Sight5 said:
5. Do you see yourself ever becoming bored with being an optometrist? Would you ever, knowing what you know now, consider being an ophthalmologist, why if so, and why not if not?

Unless you work in a tertiary referral center, or an urban clinic with a diverse patient population then I think that if you limit your career to just patient care, optometry can get boring after a while. There are only so many myopes you tweak glasses on and so many pink eyes you can give patanol to. I enjoy the challenges of running my own practice now. I will also say that it is more enjoyable seeing patients when they are your patients instead of the owner doctors patients. I also maintain a number of interests and hobbies outside the profession which I recommend for anyone in any field. It is easy to slip into a rut of just seeing patients and going home to flop on the couch. That is going to leave you unfulfilled after a while.

I would not consider becoming an ophthalmologist unless I became a pediatric one because a fair amount of ophthalmology centers around geriatric care and I prefer to work with children.

I hope that answers your questions.

362.04 · Jun 15, 2007

Sight5 said:

2. I live in Southern California and would prefer to stay here. Do you think the new Western optometry school will cause a highly saturated OD atmosphere? How is it (that is, the number of other optometrists/ophthalmologists) where you live?

Click to expand...

I practice in CA and can say that three optometry schools would crowd the market. Already, it is an employer's market. With the steady slowing of population growth in CA, there surely would be a huge overabundance of CA optometrists.

Ben Chudner · Jun 24, 2007

Hello All,

Well, taking KHE's lead, I have volunteered to become a mentor. Here is a little about me - I have been out of school for 10 years and currently own a private practice with one associate doctor. I have worked in a hospital setting (during my residency), as well as in a corporate setting (briefly, also during my residency) and in a group OD/MD practice. My rules regarding which questions I will answer are exactly the same as KHE. Anything is fair game with the exception of my personal salary.

362.04 · Jun 24, 2007

rallthenamesgon said:
362.04,

I have had experience shadowing ODs in the commercial, private and VA settings but none in the hospital setting. When I first starting researching the field I read that some ODs work in hospitals, but I didn't find any details about those who did. How is working in a hospital different from working in an office? Do you have a relationship with any other doctors in the hospital? Do you enjoy where you're at or would you rather work in a office? Thanks in advance.

There are several levels of participation for an optometrists (at least in my model).

1. Optometrists who are on staff in outpatient departments of HMOs who are closely managed by ophthalmologists. The scope of practice is narrow and usually just includes routine vision checks and contact lens fitting. The Kaiser HMO system is a good example of this. In some of the Kaiser facilities, though, there may be active refractive surgery practices where optometrists may comanage the pre and post operative patient

2. Optometrists on the staffs of departments of ophthalmology because of a specific skill. The most common are low vision, pediatric and contact lens optometric specialities. The optometrist may have a broader scope of practice becausse the incumbents of thes positions are usually some of the very best. Not too man slouches.

3. Finally, there are optometrists who are "attending" providers who have limited staff privileges in a hospital. Unlike the Kaiser OD, this third category of an optometrist may order imaging or laboratory studies, manage glaucoma and pre-surgical phase of diabetic retinopathy, and medically manage simple to moderately complex trauma and medically sick eyes (corneal ulcers, conjunctivitis, et.c)

The second and third categories of optometrists often have very good relationships with members within their own department or even with primary medicine providers. There may even be a protocol, where the optometrist might be the first to see a new patient who has been referred to the department but not to a specific physician. In many venues, the optometrists may completely manage the patient with some or little ophthalmologic co management or supervision.

Of course, I think 2,3 categories are the best, in my opinion.

362.04 · Jun 24, 2007

rallthenamesgon said:
36'....Do you have a relationship with any other doctors in the hospital? Do you enjoy where you're at or would you rather work in a office? Thanks in advance.

Part 2 of my answer,

I much prefer the hospital environment over a private office. I am able to use almost all of what I have learned on a regular basis. Often I will see 6-10 diabetics per day, about 3-4 glaucoma patients per day and 1 -3 corneal injuries or infections per day. You get to work on cases that you only read about.

I will say though, that the optometrist in the office-based environment is able to add to their income from the sale of ophthalmic goods while the hospital optometrists cannot. So the hospital environment, as it is structured today, may not be as renumerative as the office.

In the end, the intellectual stimulation is the big draw.

Ben Chudner · Jun 28, 2007

afweji said:
Hello Ben Chudner,

You said that you've worked for an OD/MD group practice in the past. What kind of interactions, if any, do you have with the MDs? Are you both constantly referring patients to one another when necessary or is it just two doctors that happen to practice under one roof? I've always wondered about any collaboration that exists between different professions. Thank you for your time!

I spent 3 years working in an OD/MD group immediately after I finished my residency training. As a disclaimer, any experience I had in that office is specific to that office. I cannot comment on what the norm is, only what happened where I was. In that practice we had 2 OD's, 2 cataract surgeons, 1 retina specialist, 1 glaucoma specialist, and 1 plastics specialist. We were one practice with multiple docs, so patients were referred back and forth all of the time. The 2 OD's saw most of the the primary care and all of the walk ins, and we had the benefit of sub-specialists backing us up. When cataract surgery was necessary, we would send to the surgeon and then we would perform the post-op. If an emergency patient had a retinal detachment, we sent them to the retina doc. If the retina doc felt one of his macular degeneration patients could benefit from low vision, he would send them to one of us. The OD's were treated as just another provider, no different then the MD's.

KHE · Jul 4, 2007

Jay12 said:
Hi, knowing what you do now, having gone through optometry school and working in your profession for a number of years, is there anything you would have done differently if you had the chance to do it all over again (i.e. open your own clinic sooner rather than later, avoided a particular specialty or went into a particular specialty)?

Thanks.

I hope that the other mentors will respond to this posting as well....

If I had to do it again these are the things I would have done differently:

1) I completed a residency at the school I attended. It was a fine residency but if I had to do it again, I would do one at a school other than the one I attended. I recommend that for anyone contemplating residencies....do them at schools OTHER than the one you attended.

2) I would have tried to open a practice much sooner on my own. Ultimately, I was able to find a wonderful practice to buy but I was INCREDIBLY lucky in that I found that opportunity at exactly the right time. Most of the practices that I looked to purchase were tired old practices in which the seller wanted far in excess of what they were worth. I think I spent far too much time dealing with small time thinkers and their tired old practices.

3) I can't recommend one specialty over the other. I have not really encountered a lot of situations that I felt I could not handle but would have been able to had I had some sort of optometric "specialty."

4) I wish I had been more aware of the issues surrounding access to medical insurance plans by non-physician providers. Had I known that, I would have chose where I practiced much more carefully. Ultimately, it worked out but again, only through a stroke of good luck. It can not be stressed enough that it is critical that you be able to become a provider for major medical insureres in the area you want to practice in.

Ben Chudner · Jul 5, 2007

KHE said:
I hope that the other mentors will respond to this posting as well....

I'll respond although I may no be much help on this subject. There is not much I would do differently, given the chance.

1) I completed a residency at the school I attended. It was a fine residency but if I had to do it again, I would do one at a school other than the one I attended. I recommend that for anyone contemplating residencies....do them at schools OTHER than the one you attended.

I couldn't agree more. Depending on the residency, staying at your school is not much different than a fifth year of optometry school. Residencies in low vision, binocular vision and pediatrics will give you more exposure than you got as a student simply because you will spend the entire year in those clinics instead of a short rotation, but there is value in getting a different prespective from new faculty when you go to a different school. For primary care, ocular disease, and contact lenses you should look at residencies that are not at schools, but at specialty clinics where you wll be exposed to much more. I did my residency at Bascom Palmer and do not regret it.

2) I would have tried to open a practice much sooner on my own. Ultimately, I was able to find a wonderful practice to buy but I was INCREDIBLY lucky in that I found that opportunity at exactly the right time. Most of the practices that I looked to purchase were tired old practices in which the seller wanted far in excess of what they were worth. I think I spent far too much time dealing with small time thinkers and their tired old practices.

In my opinion, you should try to work in prvate practice for a couple of years before going out on your own. This allows you to learn a lot about the business of eyecare before it's your butt on the line. I worked for 3 years before purchasing a practice. By having a good job, I had the time to search for the right opportunity. In the end, I got very lucky but I was also prepared for the situation when it presented itself. I don't know if there is a magic number of years. I suspect everyone has a different amount, but I think you will know when the time is right.

3) I can't recommend one specialty over the other. I have not really encountered a lot of situations that I felt I could not handle but would have been able to had I had some sort of optometric "specialty."

For me, I wanted to make sure I was comfortable handling anything that walked through the door so I did a disease residency. As for the other specialties, I feel competent in them, but I am willing to refer to other OD's to handle BV and LV. There is an OD in town that loves to see those patients, and I would rather not so it works out really well.

4) I wish I had been more aware of the issues surrounding access to medical insurance plans by non-physician providers. Had I known that, I would have chose where I practiced much more carefully. Ultimately, it worked out but again, only through a stroke of good luck. It can not be stressed enough that it is critical that you be able to become a provider for major medical insureres in the area you want to practice in.

This is where working in an area before you buy or start a practice has its advantages. If you are lucky enough to find a practice near where you are working, staying on panels is a lot easier than getting on them the first time. I had been working for an MD, so I was on all of the insurance panels when I bought my practice. All I had to do was change my practice information and I was good to go. Ken is exactly right on this issue. You need to be able to get on insurance panels if you want to be successful in private practice.

KHE · Jul 6, 2007

Sight5 said:
Can you name the most pivotal event that happened to optometry approximately 10 years ago that totally changed its position in the health care industry?

I can't think of anything that happened 10 years ago specifically. There have been "milestone" moments in the profession but there is nothing that comes to mind which occured 10 years ago.

I'll ask the other mentors to chip in with their suppositions....

Ben Chudner · Jul 6, 2007

KHE said:
I can't think of anything that happened 10 years ago specifically. There have been "milestone" moments in the profession but there is nothing that comes to mind which occured 10 years ago.

I'll ask the other mentors to chip in with their suppositions....

I became an OD 10 years ago!

Somehow I doubt that is the pivotal event you are asking about. I'm with Ken. I can't think of anything specific.

362.04 · Jul 6, 2007

I think one of the more difficult decisions I had to make was what to do after I graduated. I didn't know but looking back, the first thing I would have sat for 2 more state boards and held onto them for dear life.

Fortune has a funny sense of humor and several or even many years later, you might find yourself longing for a different part of the country. Taking the boards again or jumping the hoops when you've been out of school for 10 or 15 years is a bit more dicey than when you first come out.

The second thing I would do would be to do a residency. I immediately thought of private solo practice and did that for many years. When my interests waned, my options for alternate practice options were somewhat hampered by the lack of a residency. However, it is not impossible to land something you like that is exceptional and intellectually challenging if you don't have one, but it is extra work and an extra hurdle.

Lastly, I think I would have liked to do more in the way of pediatric vision. I have grown to appreciate the many rigors that children must go through to attain their full potential. This is a specialty that is definitely one that can make a lasting impact on patients.

KHE · Jul 9, 2007

Is there an area of the country that you think is not saturated with optometrists?

It depends on what your definition of "saturated" is but I would say that there is no part of the country in which you can not get an non-emergent optometric examination within 2 days and within a 2 hour drive.

So in my opinion, the answer is "no"

Other mentors please chime in.....

Ben Chudner · Jul 10, 2007

KHE said:
It depends on what your definition of "saturated" is but I would say that there is no part of the country in which you can not get an non-emergent optometric examination within 2 days and within a 2 hour drive.

So in my opinion, the answer is "no"

Other mentors please chime in.....

I am sure there are some areas where there is a dire need for new optometrists, but these would be areas that most people do not want to live. Demographic studies show the west will have a shortage of OD's within the next 15 years, but I find that hard to believe.

Ben Chudner · Jul 10, 2007

Caverject said:
Hello. First of all, I am from a different health field (pharmacy) and have no interest in becoming an OD. I do have a question though. Do you feel Wal-Mart has changed your profession for better or worse? They have had quite a negative impact on pharmacy in the past year or two and was curious if its the same for optometry. Thanks!

The answer of this question depends on who you ask. There are those that will say that Wal-Mart has destroyed the public's perception of optometrists. There are others that believe there are plenty of OD's that do a fine job of destroying the public's perception of optometrists all by themselves. What I believe Wal-Mart has done is make private practice OD's focus on other aspects of their practices. Offering more diagnostic tests, offering new services like corneal molding, etc. Either way, I do not believe Wal-Mart has had the same inpact on optometry as it has on pharmacy.

KHE · Jul 10, 2007

Originally Posted by Caverject
Hello. First of all, I am from a different health field (pharmacy) and have no interest in becoming an OD. I do have a question though. Do you feel Wal-Mart has changed your profession for better or worse? They have had quite a negative impact on pharmacy in the past year or two and was curious if its the same for optometry. Thanks!

I think it would be easier to answer this question if you could outline what in particular you think has been the negative impact on pharmacy by Walmart....PM me if you want your concerns to not be posted publicly.

But the short answer to your question is no....they have not had a positive effect.

Dr Gump · Jul 16, 2007

Hello All,

I am a new mentor. I hope I can help answer your questions or at least add to the knowledge base. Let me answer the standard beginning questions.

1. What do you enjoy most about your specialty? I enjoy the autonomy. Caring for patients takes a great deal of responsibility and it feels good to step up to the plate and do the right thing for a fellow human being. This is my second career. I did Radiation Therapy for 13 years, so I came into this vocation with a strong medical background.

2. Is there anything you dislike about your specialty? Yes, the "old school" mentality that "I am not worth the fees I charge". We all went to school for a long time and have mastered our craft....shouldn't we get paid??

3. How many years of post-graduate training does your specialty require? I think we all know this one.

4. What is a typical schedule like for your specialty? Are the hours/shifts
flexible? I am the boss so my hours are long and odd. I work evenings sometimes and even overnight - I also do corneal harvesting for the Texas Tissue Bank. Right now I work 4.5 days in my office. Planning to start working weekends again...but for a secondary Optometry endeavor.

5. Where do you see your specialty going in five years? I see it branching out into new and exciting ways.

If anyone would like to know more about my practice, please feel free to PM me or just add to this thread.

KHE · Jul 30, 2007

asmaka19 said:
I have a question for the mentors but FIRST I wanted to comment on the recurring question of oversupply/need of optometrists. I'm not an optometrist and I can't speak for the whole country but as a volunteer/shadower in various opto settings I can tell you there is a real need for optometrists in Louisiana. Many commercial optical places in Baton Rouge and New Orleans don't even have full-time optometrists working there, they're looking!

So now my question, are any of you in debt due to student loans? How long did it take you to pay them off and how much of a hardship did those loans prove to be when you graduated and got out into the real world?

I've gone to private undergrad and graduate schools but my parents paid; they're not going to pay for optometry school and I'm wondering if cost of school is something I should really worry about.

The fact that every commercial location doesn't have a full time OD does not in any way suggest that an area needs more ODs. Many commercial locations that want their ODs to work as independent contractors would GLADLY have an OD sit there full time whether there was the patient load to support a full time OD or not. Then the OD just spreads 3 days of patients out over 5. What good is that?

Regarding student loans...it never caused me hardship in terms of my monthly expenses. It caused me problems trying to get a practice loan from an SBA lender when I had been out about 18 months. In my opinion, the mistake was trying to go to the SBA in the first place. If I had to do it again, I would have used a lender that specializes in financing to doctors for practice startups or aquisitions.

Regarding your school...you should go to whatever school you are most comfortable with that is in whatever city you would like to live in for 4 years. Obviously if it comes down to a choice between two that are identical, then go with the cheap one but I would not go to a school I didn' really want to go to just on account of tuition.

Ben Chudner · Aug 9, 2007

KHE said:
The fact that every commercial location doesn't have a full time OD does not in any way suggest that an area needs more ODs. Many commercial locations that want their ODs to work as independent contractors would GLADLY have an OD sit there full time whether there was the patient load to support a full time OD or not. Then the OD just spreads 3 days of patients out over 5. What good is that?

I agree!

Regarding student loans...it never caused me hardship in terms of my monthly expenses. It caused me problems trying to get a practice loan from an SBA lender when I had been out about 18 months. In my opinion, the mistake was trying to go to the SBA in the first place. If I had to do it again, I would have used a lender that specializes in financing to doctors for practice startups or aquisitions.

Student loans are a necessary evil. I look at my student loan payment (12 more to go!) as an investment. I came out about $80K in debt. I realize that is a small amount compared to current students. I am not sure how much I will have paid once I am finished because my wife handles it (maybe $100K including interest), but I assure you that I made that money in salary within the first 1 to 2 years of practice. Now anything I make is pure profit on the the investment I made in purchasing my education. Sure I might have been able to spend less on my education and make more money but not only is that not guaranteed, it doesn't matter because this is the path I took. I have done pretty well in the stock market, but I could have bought Microsoft at its IPO and became a millionaire. There will always be better opportunities, but I prefer to look at how well the choices I made work out. At the end of my career I will have taken $100K and turned into $4 to $5MM. That is a conservative estimate and does not include profits from other investments that my salary allows me to purchase.

Regarding your school...you should go to whatever school you are most comfortable with that is in whatever city you would like to live in for 4 years. Obviously if it comes down to a choice between two that are identical, then go with the cheap one but I would not go to a school I didn' really want to go to just on account of tuition.

I agree, but I would add that you should look at cost of education as one of the main criteria in choosing a school. I think cost and location are the two biggest factors you should consider in your decision.

KHE · Aug 12, 2007

My question is specifically for KHE.

You keep saying that one mistake you made was spending too much time dealing with small time thinkers. What exactly do you mean by this, and is there a way to go straight to the 'big thinkers'? Thanks.

The way that I was told the optometric world works when I was in school was that when you graduate, you find some old guy who is getting close to retirement, and then you join their office and slowly build up as they wind down and you eventually buy them out or partner up. In order to grow the office, you could add things like disease management, later hours, or other services that the practice wasn't currently offering.

Unfortunately, far too many doctors out there of a certain age just aren't willing to make the effort to add those services. They merely pay lip service to them. One doctor who's office I worked in for a while talked about adding glaucoma managment to his very "old school" practice. I would have eagerly done that, but he didn't have a visual field machine and he wasn't willing to spend the money to get one. Well....it's pretty hard to add "glaucoma management" to a practice without at least a rudimentary visual field machine.

Most doctors, once they get to a certain age simply throw it on cruise control. They are making decent money working in their little offices, selling their glasses and doing their exams with their 3 or 4 girls helping them out. They aren't really interested in trying to evolve professionaly, or grow and expand the practice, especially if it involves any sort of capital outlay.

I think I spent far too much time dealing with these types of doctors.

As far as finding out which ones are the big time thinkers...I don't think I have a really good suggestion. The best advice I can give to you is when you are visiting potential employers, just look around their office. If it's got shag rugs and wood panelling, equipment that looks like it's from the Eisenhower administration and gun metal filling cabinets and desks...well then that should be a sign you might want to look elsewhere.

362.04 · Nov 24, 2007

Enlivening this thread a bit.

1. Do you think that the "commercialization" of optometry is a n ew phenemona? That means has it occurred in the last 5 years? the last 10 years? the last 20 years?

2. Can optometry accommodate multiple kinds of practice? Ever since I could remember, the only form of practice that was acceptable or "sanctioned" or "condoned" by most optometrists was private practice.

KHE · Dec 28, 2007

EyeGuy2k4 said:
I have heard that frame representatives know a lot about which/where good practices are for sale.

If I was a 3rd/4th year student, how would I contact these frame representatives?

If you were looking for a private practice for sale today, where would YOU look?

Look up some of the larger frame companies, and find out who the reps are for the areas you are interested in practicing.

As far as where to look for a practice for sale....that answer is different for everyone. THere is little point in buying a practice in an area you aren't interested in living in just because it might be a "great" practice. I still maintain that it is critical that you practice in an area where you can be admitted onto medical insurance panels.

Ben Chudner · Jan 2, 2008

EyeGuy2k4 said:
I have heard that frame representatives know a lot about which/where good practices are for sale.

If I was a 3rd/4th year student, how would I contact these frame representatives?

If you were looking for a private practice for sale today, where would YOU look?

We had access to the frame reps when they visited our school. I am sure they would love to talk to a student that is a potential frame buyer.

As for where I would look, I agree with Ken.

KHE · Jan 10, 2008

Charmin said:
Dear Mentor,

I would greatly appreciate if you could give me a recommendation on an OAT prep textbook. I read on another forum that the "OAT Secrets" was a bad choice and that Kaplan was not very detailed and comprehensive. I was getting a sense that the OAT achiever was used by a good amount of students, but I'm not too sure if it would be the best choice. I know most people recommend using an MCAT text, but I've also heard that some of the material is above and beyond what the OAT tests on. Please share some of your knowledge on what you have experienced or heard.

Thank you~

Unfortunately, this is a better question to ask on the OAT forum under "Optometry Forums." It has been so long since I have taken the OAT that I would be hesitant to recommend a study method for it. I will say that at the time I took it, there were no OAT guides available. Some of my classmates used the DAT prep book. I used my own class notes and scored quite high, so I'm biased towards the class notes method.

KHE · Feb 14, 2008

Hello, my questions are about pre-optometry:

1) What was it that you think got you the acceptance into optometry school? What was your overall undergrad GPA and Science GPA, OAT scores, any extra curricular activities?

2)Since so many applicants can have a high GPA,OAT scores, etc. What do you recommend one do to make themselves stand out to the acceptance committee of each Optometry school?

3) My grades in the first 3 years in college suffered, do you think I blew my chances of getting accepted into optometry school even if I went to retake courses to earn a higher grade, or do you think that perhaps the acceptance committee will consider it if they see that I've took the time to make up for my mistakes?

Admissions committees use a variety of factors, which I'm sure you know. As far as what got me into school, it was probably more the OAT which I did extremely well on and my personal statement. My GPA was respectable but mediocre compared to most of my classmates.

Personally, I think it should be your personal statement that stands out, because most people are going to have decent GPAs and OAT scores. Unless either of those things are really in the stratosphere, which it sounds like in your case they're not, I would focus on the personal statement.

You said your grades suffered....obviously there are varying degrees of suffering. Some people with a 3.5 think they are performing horribly and others with a 2.5 think they are doing great! So you'll have to be a bit more clear on just how bad your grades are.

In general, I do not recommend retaking classes unless you have failed them, or are below the minimum threshold required by the school you want to attend, which I think in most cases is a C. Check with the individual schools but I think most of the time, you are better off taking higher level courses and doing well rather than retaking 1st and 2nd year courses as a junior or senior.

KHE · Mar 27, 2008

Hello Mentors,

I know this question will probably get a variety of answers. But.....one of the biggest concerns for optometry students is the debt coming out of school.....Would you suggest paying off your debt as soon as possible coming out school (i.e. living very moderately the first few years after school, and living within your means) or suggest extending those loan payments as long as possible.

(In answering this question, please keep in mind that my main goal is to open my own clinic within 3-4 years after graduating)

Thank you

You should do both.....live moderately and below your means....but also stretch the loan payments out as far as possible.

If you are going to look to start or purchase a practice, cash flow is going to be key. You don't want a ton of your monthly cashflow tied up in a student loan payment. Generally, student loan interest rates are going to be much lower than just about any other interest rate you have so stretch it out long, and pay it off slowly.

If, as you get on your feet you find you have a few extra bucks at the end of the month, you can throw it onto the loan but you are going to want to have the flexibility of having that option, especially if you are trying to get a business of the ground.

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