p { margin-bottom: 0.08in; } I am considering a career in optometry. I do have some concerns with the career choice. I would like to know if these are valid concerns and if so is there any solutions
- Saturation
- Insurance
- Technology
- Saturation is the most commonly heard complaint. But saturation is only a problem if there are fewer patients. Has anyone actually seen if the number of optometrist exceed the number of people needing eye care?
- Insurance is mostly a concern with LASIK. Will there come a time when LASIK costs less than an optometrists eye care. If this could happen it would be irrational for an insurance company to pay more for a lifetime of glasses when the long term cost of one LASIK procedure would be cheaper.
- Technology may be a problem in the far future, but I am just putting it out there. Biomedical engineers are going to have the greatest increase in jobs. Who is to say that they won't invent a machine that can do refractions autonomously. Seeing that the University of Utah has almost completed research on implants that will allow blind people to receive optical input and see the idea of a machine that can do refractions does not seem too outlandish.
These are my concerns that I think pose the greatest threat to optometry. I would like to know if these can be resolved because optometry seems like the perfect career for me, but if I won't be able to support my family then I have to find something else.
I would agree that saturation depends on where you want to practice. If you practice in a big city with an optometry school, it's saturated beyond belief. If you practice in a more rural state with no optometry school, it's fairly unsaturated (and less saturated the smaller the city). So there is everything in between. I know of a doc that graduated a year or two ago and set up a small practice in a rural town in Texas. He grossed nearly $500k in his first year - that's pretty absurd and not common, but shows that it is possible if you are in the right location. In large cities, doctors aren't filling their schedules as much as they would like to.
Insurance problems definitely don't stop at LASIK. The office where I work now gets denials for coverage all the time, even though they check initially and get word that the patient should be covered. Or what was listed as a $10 copay, the insurance company comes back and says the patient should pay $30 later. Then it's up to the optometry office - do you bill the patient (in which case they often fault the optometrist's office and get mad and might go elsewhere) or do you eat the loss. Lots of docs just suck it up and take the loss. Insurances like VSP don't pay enough money for someone's appointment for an optometrist to break even (given the cost for the employees checking the patient in, doing diagnostic tests, the cents/dollars per patient you factor in for equipment costs, energy bill, rent, etc). Docs actually lose money on just the appointments. So most optometrists make their money on frame sales (there isn't much of a profit margin on contacts, especially with online sites competing for business). There is certainly more money in billing an appointment as medical if there is a therapeutic issue (dry eye, foreign object, etc.). But I've shadowed docs who deal with just eye disease and bill everything to medical and they complain about lack of payout from insurance companies too. It's definitely a challenge. BUT...the optometrist I work for now said that in the course of managing your practice, you will find that 20% of your patients give you 80% of your business...so be good to those patients
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Technology...I don't think technology will take away the job, but I do worry that 10 or 20 years from now, opticians will be allowed to refract (but keep in mind that optometrists do a whole lot more than just refracting). There are already autorefractors that give lots of info about the prescription and astigmatism, but I don't think you will really get 100% what a person can do for you...especially with knowledge about refraction and the tweaks you can do to make a patient happy. Plus then you get into discussing things like progressive lenses with patients and that changes things. One place in Canada is already allowing opticians to refract, but that will go on awhile there before they try to spread it. I think low vision and vision therapy are pretty safe specialties for optometrists for awhile, as is eye disease and comanaging pre and post care for patients who undergo LASIK or cataract surgery. I think solely relying on frames and contacts has its risk of income stability in the future though...but who knows! I wouldn't worry about that now because if you do decide to pursue optometry, your future practice can change over time to fit the market.
I agree with the previous person though - you should do this out of a passion for the field and what's within the scope of practice now. Don't go into it hoping to have a different scope, because you never know where things will go. Don't do it for the money - you will be miserable. Do it for the right reasons, and you'll enjoy it (especially if you go into it with a super open mind about where to practice after school). If that's not how you feel, then definitely look at medicine or other fields, because they certainly have their pros/cons too.
