commercial optometry

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jlaha

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I do a lot of reading here and on other optometry forums (seniordoc.org) and I generally keep hearing the same opinions about commercial optometry: it's bad for the profession, for the image of optometrists, you'll get sick of it, it's only good to start out w/ to pay off loans, they make you work long hours, and so on.

As has been mentioned before somewhere on this forum, people have compared this to how pharmacy became very commercialized years ago. But, I personally don't really see pharmacists "complaining" about how the pharmacy profession has become commercialized... probably because the pay is very good, esp. in California. I personally know of a lot of pharmacists making 45 an hour with plenty of opportunities to go around to work more than 40 hours a week.

Which leads me to my main question... other than the whole negative "image" of optometrists working in commercial establishments, how is the pay in commercial establishments, let's say, in relation to commercial pharmacy? Do commercial ODs generally have a better income than private practice ODs?

Sorry for changing this into another salary thread, but I don't think there have been to many on here. I think this is an important question. :)

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I'll address the last thing first, salary. You will most likley make more at a commercial setting at first, but probably cap out around 100k. That is more than you will make at a private place starting, but the differecne comes in after a few years. In private the sky is the limit. I know private ODs makeing over 500k, I know some who have made over a million. Those docs are out of the normal, but there is no way you even have a chance of making anywhere near that if you work at Walmart.

As far as Pharm.D's not complaining about commercial pill counting. I went to undergrad at a school with a pharm program and most of my friends were in it. They all complained about it and had hopes to get a good job in a hospital so they could actually use their education.

I have never talked to a person who loved there job while working commercial, but I know tons who love what they do when they work in private.
 
rpames said:
I'll address the last thing first, salary. You will most likley make more at a commercial setting at first, but probably cap out around 100k. That is more than you will make at a private place starting, but the differecne comes in after a few years. In private the sky is the limit. I know private ODs makeing over 500k, I know some who have made over a million. Those docs are out of the normal, but there is no way you even have a chance of making anywhere near that if you work at Walmart.

As far as Pharm.D's not complaining about commercial pill counting. I went to undergrad at a school with a pharm program and most of my friends were in it. They all complained about it and had hopes to get a good job in a hospital so they could actually use their education.

I have never talked to a person who loved there job while working commercial, but I know tons who love what they do when they work in private.


Did you mean you know an OD that has made a million total or what? And where was this at?

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I'm talking per year, 500K to over a million. I admit that is rare, but it does happen. I know of a partnership practice (2 docs) who have a practice that grosses 1.2 million. That number is a couple years old so they most likely are make more now. Obviously they don't take home that much, but they sure has heck do better than a commercial OD. Just to further the story, they bought a small old practive from a retired OD in Indiana right after they graduated (I think in ~1999). Within a couple years they more than doubled its income. They had student loans just like all of us, but they still are swinging it and doing better than probably anyone of their friends who went the commercial route. I'm not trying to talkdown those who decided to work corprate for a few years and then hope to move on to some form of private practice. What I'm trying to do is show everyone that going private right away is not out of the question. You can still make money and be proud to walk into work every day.

If you are married, I really don't see why you would dismiss private. With two incomes, you can live off one even if the practice is struggling at first. If single, I can see why it is a little more scarry, but it still can be done.
 
The online review of optometry writes about a number of these success stories and also published articles about the whole commercial vs. private thing. http://www.revoptom.com/

Although I can't forsee a day when we are able to eliminate the commercial optometry practices, maybe there is more that OD's in that area of practice can do to improve their autonomy from the opticals so that they may practice as they wish - full scope, complete optometry. Maybe the colleges or even associations could step in to educate, and provide new OD's with the tools necessary to prevent the likes of Walmart and others from dictating the terms of practice before they make it to the work world.
 
From what I gather, Commercial Optometry used to be looked down upon by many as the 'easy' way to a job, but is gaining popularity....I've worked as an OA for Commerical and Private Optometrists. All of them seemed very happy with what they did.

On the Private side, especially in Ontario (although maybe a bit less, now they OHIP has uninsured those 19-64), you need to dispense in private practice, which means you have to pay staff to do so, and it means a lot more business on your end. Where in a private practice, the company will take care of all the business stuff, and all you have to do is show up, see your patients, and be done. Most places (IRIS, for example) have a 50/50 partnership with the OD's. They don't need to worry about paying, etc, because salespeople are hired for that, and there is a Manager who also takes care of things. They seem to make a decent amount of cash (and hey, free trips to Mexico!). It's also great because you tend to get awesome equipment. From my perspective, we got some of the newset VF Equipment, as well as top of the line edging machinery as well.

As I say though, all the docs who I've worked with seem quite happy in Optometry, and wouldn't have chosen anything else.

CH
 
Most of the people in Optometry don't look down on commercial practice because is an easy way to a job, but because the optical chain are percieved as influencing what the optometrist does in their practice (ie. doing as many refractions as possible and nothing else). Of course, this is in the natural interests of the opticals; to sell as many frames and lenses as possible they need optometrist to do as many refractions as needed, leaving little time for more advanced norms of practice. The faculty at Waterloo like to call this 'complete optometry,' practicing to highest professional standards, and providing a diverse range of services to the community. Unfortunately it seems that alot of these chains are most interested in limiting the scope of their optometrists and probably don't provide much of the equipment to perform anything more than the basic oculo-visual assesment.

However, it sounds like this IRIS place is much better than some. Where are they located (never heard of them)? Ironically, even though I am not yet in optometry, when the manager of a Sears optical has now twice tried to recruit me for that day when I (hopefully) have my OD. I have to say it sounds pretty attractive; they provide all the equipment and administration and the OD gets to keep 100% of the OHIP reimbursement, althoug I don't know how that is working now that so many aren't covered by OHIP. I think the concerns with commercial practice are less here in Ontario since I don't think the optical are as predatory and demanding... and I don't think they can afford to because many (or at least that Sears store) are having trouble finding OD's.
 
IRIS is based out of Quebec and is the largest eye-care centre in Canada, with 165(?) locations across Canada (However, there are non in Ontario, Manitoba, Saskatchewan, or the atlantic provinces). They also have 2 Ophtho Clinics in Quebec and BC, where Laser (LASIK and PRK, as well as....wave______? It's a new procedure) is performed.

The Optometrists still practice to a high standard...if they are billin OHIP, or charging for a full exam, they can't just do a refraction...from what the ODs at IRIS told me, if a Px isnt' seeing 20/20, they OD is obligated to find out the reason why.

Opticals in Ontario are still very much alive, and you'd be amazed how much patients will pay for the EXACT same frames. However, the reason they have trouble competing is because the COO has some bizarre rules that they can't get changed (although they are trying to on a consistent basis). For example, IRIS usually has an optician and an Optometrist working together. In ON, a lisenced Optician cannot work with a lisenced Optometrist. Both Colleges have been trying to change this for years.

Another issue is that Opticals tend to have amazing quality in Ontario (from my experience) because it's how they get their money. Even if they don't have an OD, they take external Rx's, and Px's pay more. That being said, they are at a disadvantage, because OD's in ON can only mark up their frames so much (actually, I don't think they can at all). Their profit is made through 'dispensing fees' (which cary depending on the type of lens you are getting).

De-insurance is a whole different issue. It's about time. Ontario OD's were making $39.15/Px. Most of the Doctors in Ontario who had been praciting for a while saw 3/hour, those new to the field saw 2/hour. While it's not BAD pay, if you're an independant, and you have to pay expenses...not cool. BC (where I worked at IRIS), the OD recieved $75/Px (now standard for most places in ON).

Then there is the major issue about Opticians recieving the right to refract, and the protection of the public. Most people think going to the OD is to get glasses, nothing more. So if they can get a free "Sight Test" with their glasses, hey, why not? Why pay $75 for a "Visual Examination". When it was OHIP, it was a no brainer...see the Doctor. But $75....

Luckily, most people have insurance that covers it. De-insurance only came in Mid-November, so time will tell. BC de-insured a few years back and the Doctors where i was had no issue getting patients.

CH
 
The optometrist is obligated to perform an entire visual assessment no matter the patients visual acuity. That means that the OD not only refracts for a Rx. but also examines the structures, looking for any pathology or other problems. A prof I had for an Intro optometry course likes to remind her students of the results of one here her studies: that 1 in 7 patients examined by an optometrist will be disagnoses for pathologies that the patient was unaware of and presented no apparent symptoms for. Thats alot of people with severe visual problems going unchecked when patients in BC opt for the accuity test performed by an optician. Hopefully, the gov't in BC will realize that this puts the vision of many at risk, and adjust their regulations accordingly.

Although I fear that the some members of the publis will suffer as a result of de-listing, your are absolutly right; $39.15 is ridiculous, especially since that hadn't been changed even since 1989, not even adjusted for inflation. However, from what I have heard recently, most optometrist will be charging upwards of $80 in ontario, some more than $100 and they don't expect their patient load to decline either!
 
Not Brampton practices....Dr. Cooper and Associates, one of the largest private practice in the City, will charge $77...and her I imagine her load won't decrease much. I suppose it also depends on clientelle. Again, it's also a business :).

Wasn't looking too good when I left BC. The OD's were furious. The governments justification was that ODs were getting TPA's, so Opticians should get the right to refract. I think it's an asinine arguement. As one Optometrists are trained to Rx (and besides, it means they get more work, for no more pay), and while Opticians are also trained, I guess you could say it's a matter of protecting the public from itself.

CH
 
Hye cdh86

which Iris did you work in when you were/are in BC?
I was just volunteered couple months at an IRIS located in metrotown!! Iris is expanding!!!!
 
'was'. I live in Nova Scotia now ;)

I worked at Mayfair, in Victoria. :) Good times.
 
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