Experienced OD's please reply (Maybe Posner?)

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Princeod2583

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So i have read a lot of negativity on the optometry board, and some (very few positives i.e Posner) But one think I am questioning is the different modes of optometry that are available. Yes, many new OD's will venture into the corporate world after graduation to attain a steady income. But, what is to be said about those OD's who took to the time to specialize in say, behavioral optometry, or even post surgical cases? These OD's certainly would not chose to work in the corporate setting. Wouldn't these ODs be at a distinct advantage because they can offer their patients services that other OD's cannot. I read in a certain post that residency does not improve an OD's salary. This may be true initially, but when that individual decides to open up their own mode of practice, and they are offering patients unique services, does this not help them improve their chances for success. Many of these negative OD's seem to have very little expertise within the field. They seem to expect large salaries or success within the field because they can provide a routine eye exam or a basic medical examination. Lack of skill = lack of opportunity.
 
Princeod2583,


I am only an OD student but I will say with conviction that I agree with you that the purpose of doing a residency allows the OD grad to sharpen skills in a specific area hence make you a better eye doctor. I hear all the time the blabbing about," Oh it doesn't improve your salary....bla bla bla." Is that all these people care about that say that repeatedly? I am interested in ocular disease and will do an ocular disease residency when I am done. A friend of mine I shadowed for 1 year before I went to optometry school did an eye disease residency. He now works in an eye hospital and is affiliated with an ophthalmology practice. A very specialized practice modality like, an ophthalmology practice will take an OD with a specialized residency every time over one who has none. My point is the residency will make you a more experienced and better doctor (2000+ more patient contacts in that year.) It will also make you more marketable in a "specialized" area of optometry. I feel it should be mandatory like it is in medicine (3-5 yrs), podiatry (2-4 years), etc....In that one year you are getting a $30,000 stypen, great expericience, and a great CV boost. We should pursue excellence not the path of least resistance.
 
So i have read a lot of negativity on the optometry board, and some (very few positives i.e Posner) But one think I am questioning is the different modes of optometry that are available. Yes, many new OD's will venture into the corporate world after graduation to attain a steady income. But, what is to be said about those OD's who took to the time to specialize in say, behavioral optometry, or even post surgical cases? These OD's certainly would not chose to work in the corporate setting. Wouldn't these ODs be at a distinct advantage because they can offer their patients services that other OD's cannot. I read in a certain post that residency does not improve an OD's salary. This may be true initially, but when that individual decides to open up their own mode of practice, and they are offering patients unique services, does this not help them improve their chances for success. Many of these negative OD's seem to have very little expertise within the field. They seem to expect large salaries or success within the field because they can provide a routine eye exam or a basic medical examination. Lack of skill = lack of opportunity.

I completed a residency and I strongly recommend one. However, I do not believe that they will provide an increase in a salary offered to you by any potential employer. The vast majority of graduates end up working in two areas: Commercial practice and private practice. Neither of those practice modalities are going to offer you more money because you did a residency. As a practice owner now, I can honestly say that I would not offer someone more money simply because they did a residency.

The advantage of a residency is that when you do have your own practice, it will allow you to keep more of your patients in your office rather than referring them out. I know that I refer patients out at a much lower rate than the majority of my non-residency trained counterparts.

Of all the specialties out there, I believe that only vision therapy is viable enough to be practiced in most places as a true specialty practice. If you want to have a true specialty "low vision" or "contact lens" practice, they are almost universally located in large metropolitan areas and even amongst those practices, the majority of them also provide "traditional" optometric services as well.

I'm not sure if your post had an actual question in it but if it did and that question pertains to residencies, then YES. I strongly recommend one.
 
Princeod2583,


I am only an OD student but I will say with conviction that I agree with you that the purpose of doing a residency allows the OD grad to sharpen skills in a specific area hence make you a better eye doctor. I hear all the time the blabbing about," Oh it doesn't improve your salary....bla bla bla." Is that all these people care about that say that repeatedly? I am interested in ocular disease and will do an ocular disease residency when I am done. A friend of mine I shadowed for 1 year before I went to optometry school did an eye disease residency. He now works in an eye hospital and is affiliated with an ophthalmology practice. A very specialized practice modality like, an ophthalmology practice will take an OD with a specialized residency every time over one who has none. My point is the residency will make you a more experienced and better doctor (2000+ more patient contacts in that year.) It will also make you more marketable in a "specialized" area of optometry. I feel it should be mandatory like it is in medicine (3-5 yrs), podiatry (2-4 years), etc....In that one year you are getting a $30,000 stypen, great expericience, and a great CV boost. We should pursue excellence not the path of least resistance.

When you graduate, you are going to find that "ophthalmology" is not any more of a "very specialized practice modality" than optometry is. I really don't understand what you meant by that comment.

Also, your comment about pursuing excellence and not the path of least resistance, I don't get what you mean by that either. It seems that in your view, the path of least resistance is graduation from optometry school. Can you clarify that please?

I also disagree with your desire for mandatory residencies. I encourage them but if all we graduate are specialists, that's not any better than only graduating generalists. You need a mix of both. I also don't get what you expect to get out of a 3-5 year optometric residency that isn't being provided by current residency programs.

Lastly, I almost NEVER point out spelling mistakes because we all make them, but it's a $30000 STIPEND, not a "stypen". 😱
 
I think a residency can be a beneficial aspect of your career. For me, i didn't think it would advance my career. Ocular disease would for me be the coolest one, but like KHE said Vision therapy could be the most profitable to bring to a practice.

At least in my state where I practice the state board, and statutes specifically state that one can not advertise that he/she is a specialist trained through residency to gain an advantage. So I could have gone through the practice, and not even be able to seperate myself from others through advertising (i.e. phone book, internet, business cards). Dunno why, i just follow the laws.

Best of luck.
 
KHE

Oh thanks for the spelling lesson lol-----I typed that post in 3 minutes between study groups---remember, I am in school. I did win a spelling bee in 6th grade so please back off sir! You are taking what I stated out of context so I will have to delineate for you. 1) I never made the statement that optometric residencies should be 3-5 years in length rather I stated that it should be mandatory to do a one year one. 2) Graduating from optometry school is 4 yrs of hard work and I never diminished that with my post---(I am trying to graduate from an optometry school within 4 yrs!) Graduating from OD school is a tremendous accomplishment. 3) The main argument I hear on here against doing a residency is MONEY---"Oh I don't want to make $30K when I could make my $90K out the door at Walmart or Lenscrafters..." or "I think it is a waste of time because I am going to just be in general practice." HELLOOOOOO? The last time I checked, seeing 2000+ more patients in a year with attendings, rounding through different services, and doing Grand Rounds all make you a BETTER doctor. Every OD I have worked with or observed that did a residency (Eye Disease, Primary Care, Low Vision, etc...) all told me they felt MUCH more prepared when competed versus their counterparts who did not. I felt that they were more confident and had a higher skill set within a year or two out versus their counterparts with no residency experience. All a mandatory one year residency will do is strengthen OD graduates because you can do one in your area (primary care, eye disease, etc). You cannot argue that having more training is not to one's advantage.

"Shoot for the stars. If you land on the moon you still have achieved something great."
 
residency might let you feel "more prepared" but take that year and go out in the real world, when all is said and done, two graduates of the same year, one year post graduation, who feels like they can tackle the real world better?

take that year and go work at a decent private practice. all the training is great, but real world experience is golden.
 
Well I was just trying to stress that I think residency will help your practice thrive because you can offer services that Wal-Fart or For Eyes or whoever the competition is has to offer. Personally I think that a residency can only develop your skill set and make you a better doctor as the gentlemen on this thread said earlier. I think that overlooking the medical aspect of optometry is what makes alot of new OD's vulnerable to corporate optometry. That is what I meant by my initial post. If the money comes along then it does, but at least you can take pride in your accomplishments, and more importantly help your patients with ocular disorders. I m guessing that a good fraction of entering optometry students don't even know what vision therapy is.
 
KHE

1) I never made the statement that optometric residencies should be 3-5 years in length rather I stated that it should be mandatory to do a one year one.

This quotation from your original posting lead me to believe that you were advocating for a 3-5 year optometric residency. Sorry for the confusion.

It will also make you more marketable in a "specialized" area of optometry. I feel it should be mandatory like it is in medicine (3-5 yrs), podiatry (2-4 years), etc....

The last time I checked, seeing 2000+ more patients in a year with attendings, rounding through different services, and doing Grand Rounds all make you a BETTER doctor. Every OD I have worked with or observed that did a residency (Eye Disease, Primary Care, Low Vision, etc...) all told me they felt MUCH more prepared when competed versus their counterparts who did not. I felt that they were more confident and had a higher skill set within a year or two out versus their counterparts with no residency experience. All a mandatory one year residency will do is strengthen OD graduates because you can do one in your area (primary care, eye disease, etc). You cannot argue that having more training is not to one's advantage.

As I have said before, I did a residency and I highly recommend one. I am a long ways away from thinking they need to be mandatory. Yes, it is true that having more training is advantageous but until people have a place to use that additional training, it is a waste of time and resources to train them. Right now, current optometric training and the current level of residency participation by graduates is more than adequate to meet the needs of the public. At least, IMHO. We already have far too many residency trained people working in corporate environments.
 
I think that overlooking the medical aspect of optometry is what makes alot of new OD's vulnerable to corporate optometry. That is what I meant by my initial post. If the money comes along then it does, but at least you can take pride in your accomplishments, and more importantly help your patients with ocular disorders. I m guessing that a good fraction of entering optometry students don't even know what vision therapy is.

I don't think that new graduates are overlooking "medical optometry." In fact, I think that the majority of them are eager to participate in that area. Unfortunately, Walmart and Lenscrafters do not need those skills and sadly, neither do the majority of private offices out there. That is why I am still not in favor of making residencies mandatory. There are simply not enough positions available for every residency trained graduate to make use of the skills they would acquire by doing the residency in the first place.
 
Is it true that OMD will only hire residency trained optometrists to work for them? Or they just prefer that?
 
I also heard from the optometrist that I'm working with that the word "specialty" cannot be used in any advertisement for an optometrist clinic. He says this is stated in the law. So technically, you can't get more patients through having a specialty since it will not even be acknowledged anywhere. But like KHE said, you can, however, have a better patient retention rate. I think you should do a residency if you like a certain topic. It seems to me that you would probably be disappointed if you are only doing one just for the money.

After reading the above posts, I have a few questions I was hoping that maybe one of you can help answer.

1. What is the advantage of doing a residency in ocular diseases, since an OMDs' work seems to be more related to treating ocular diseases. What does the ocular disease residency train you to do? Do you see 2000+ patients and get trained on diagnosing ocular diseases? Or do you actually treat certain diseases?

2. I have heard that vision therapy has a bad rep. Most students who initially thinking that they want to go into vision therapy, back out after doing some of these b/c they think it is not really optometry, even a high school graduate with good skills with kids can do it. Is this true? I know as a kid, I had to get vision therapy and it helped me a lot. How has the vision therapy field advanced in the last 10 years or so?

3. If I want to find out what % of optometrists did their residency in a certain specialty, where would I go to? Is this information even being collected and released?

Thanks!
 
I also heard from the optometrist that I'm working with that the word "specialty" cannot be used in any advertisement for an optometrist clinic. He says this is stated in the law. So technically, you can't get more patients through having a specialty since it will not even be acknowledged anywhere. But like KHE said, you can, however, have a better patient retention rate. I think you should do a residency if you like a certain topic. It seems to me that you would probably be disappointed if you are only doing one just for the money.

After reading the above posts, I have a few questions I was hoping that maybe one of you can help answer.

1. What is the advantage of doing a residency in ocular diseases, since an OMDs' work seems to be more related to treating ocular diseases. What does the ocular disease residency train you to do? Do you see 2000+ patients and get trained on diagnosing ocular diseases? Or do you actually treat certain diseases?

2. I have heard that vision therapy has a bad rep. Most students who initially thinking that they want to go into vision therapy, back out after doing some of these b/c they think it is not really optometry, even a high school graduate with good skills with kids can do it. Is this true? I know as a kid, I had to get vision therapy and it helped me a lot. How has the vision therapy field advanced in the last 10 years or so?

3. If I want to find out what % of optometrists did their residency in a certain specialty, where would I go to? Is this information even being collected and released?

Thanks!

I'll try to answer some of your questions.

First of all let me address the "specialist" issue. In Texas, Optometrists become Optometric Glaucoma Specialists after completing an "extra" 8 hours of glaucoma education. This material was covered in Optometry school, but our association agreed to a compromise to make everyone happy. We can advertise as "specialists" after this extra education. Now to your questions.

#1 - The reason for doing an ocular disease residency is to learn how to recognize and manage ocular pathologies. These residencies are usually based in a hospital, so you are overwhelmed with sick eyes. These docs do treat sick eyes. We are fortunate enough, in some states, to manage and treat ocular pathologies just like OMD's. This includes everything short of surgery. Of course there is the old "pucker" factor that OMD's even have to deal with.
An OMD colleague of mine refers almost as much as I do. Of course these are retinal problems or acute problems that need emergent surgery and long term follow up (He is based in a small town). OMD's do not always hire Optometrists with ocular disease residencies. I have a good friend who did not do a residency and he works for an OMD, managing and treating pathologies.

#2 - Vision therapy is the stepchild of Optometry, these days. It is a highly specialized part that is neglected. It is very difficult to start a vision therapy practice. It can be done, but lots of marketing and palm pressing must take place to recognize yourself as a vision therapy specialist. Some insurances reimburse for this, but some do not. Makes life even more difficult. I like pathology, so I have neglected vision therapy, as well. Most of the vision therapy Optometrists I know are in an academic setting. Vision therapy has advanced tremendously in the past 10 years, mostly because of computer involvement. Kids enjoy working with a computer more than simple little cards and strings.

#3 - I don't know a source for the % of Optometrists doing residencies. I really don't think this is relevent, as your decision will be based on your preference.

Let me give you a little background on my situation. I did not do a residency. I was too old when I got out of Optometry school and opted for the money route. I did however do a "self-induced" residency. I worked in many different Optometric modes - private practice, corporate, OMD employee, and nursing homes. I saw 3 -4000 patients in one year (worked 7 days a week) and learned how Optometry was in the "real" world. I learned volumes about pathology, practice management and patient relations. These things were very valuable when I made the decision to buy a practice and strike out on my own.

Did not doing a residency hurt me? I don't think so, but I feel residencies are valuable tools for Optometrists....especially in this day and age. I only had one Optometrist refuse to hire me because I did not do a residency. He believed that an ocular disease residency was necessary in his practice, since it is an hour removed from a major city.

Hopefully this has answered your questions.

Good luck.
 
The advantage of a residency is that when you do have your own practice, it will allow you to keep more of your patients in your office rather than referring them out.


Really?? Don't many state laws restrict what an OD can do (in terms of prescriptions and procedures) and up to a point you would have to refer them out? I was under the impression that many times it's because of restrictions placed on practice that is the reason why ODs refer to MDs and not because they didn't feel comfortable enough to treat the individual. According to the OD I shadow it was only recently that he was able to prescribe certain medications to treat infections before then he would refer out just so they can get the proper prescription.

On the whole residency issue, I'm really glad to hear experienced optometrists advocate it. When I first started researching optometry one of the main things that attracted me to the profession was the residency option for those that are interested in a particular area. My background is in genetics and so I thought it'd be cool to go into infant or pediatric optometry; however, both optometrists I shadowed didn't seem to have a favorable opinion of residency and said few people do it. One told me residency is really for people who'd like to go into teaching, so I'm really glad to hear a different opinion from experienced optometrists.
 
So i have read a lot of negativity on the optometry board, and some (very few positives i.e Posner) But one think I am questioning is the different modes of optometry that are available. Yes, many new OD's will venture into the corporate world after graduation to attain a steady income. But, what is to be said about those OD's who took to the time to specialize in say, behavioral optometry, or even post surgical cases? These OD's certainly would not chose to work in the corporate setting. Wouldn't these ODs be at a distinct advantage because they can offer their patients services that other OD's cannot. I read in a certain post that residency does not improve an OD's salary. This may be true initially, but when that individual decides to open up their own mode of practice, and they are offering patients unique services, does this not help them improve their chances for success. Many of these negative OD's seem to have very little expertise within the field. They seem to expect large salaries or success within the field because they can provide a routine eye exam or a basic medical examination. Lack of skill = lack of opportunity.

While your point is well made, I would submit that the overwhelming majority of ODs that "specialize" have primary eyecare as the driving force of their practices. There are of course exceptions(i.e. some large VT practices), but I know of very few OD practices that are truly specialty practices like one would think of when they think of some of the MD specialities. ODs are primary care providers first and foremost. This does not mean you cannot develop meaningful and profitable specialities within your practice, but ignoring primary eyecare would be done at your peril.

Posner
 
I'll try to answer some of your questions.

First of all let me address the "specialist" issue. In Texas, Optometrists become Optometric Glaucoma Specialists after completing an "extra" 8 hours of glaucoma education. This material was covered in Optometry school, but our association agreed to a compromise to make everyone happy. We can advertise as "specialists" after this extra education. Now to your questions.

#1 - The reason for doing an ocular disease residency is to learn how to recognize and manage ocular pathologies. These residencies are usually based in a hospital, so you are overwhelmed with sick eyes. These docs do treat sick eyes. We are fortunate enough, in some states, to manage and treat ocular pathologies just like OMD's. This includes everything short of surgery. Of course there is the old "pucker" factor that OMD's even have to deal with.
An OMD colleague of mine refers almost as much as I do. Of course these are retinal problems or acute problems that need emergent surgery and long term follow up (He is based in a small town). OMD's do not always hire Optometrists with ocular disease residencies. I have a good friend who did not do a residency and he works for an OMD, managing and treating pathologies.

#2 - Vision therapy is the stepchild of Optometry, these days. It is a highly specialized part that is neglected. It is very difficult to start a vision therapy practice. It can be done, but lots of marketing and palm pressing must take place to recognize yourself as a vision therapy specialist. Some insurances reimburse for this, but some do not. Makes life even more difficult. I like pathology, so I have neglected vision therapy, as well. Most of the vision therapy Optometrists I know are in an academic setting. Vision therapy has advanced tremendously in the past 10 years, mostly because of computer involvement. Kids enjoy working with a computer more than simple little cards and strings.

#3 - I don't know a source for the % of Optometrists doing residencies. I really don't think this is relevent, as your decision will be based on your preference.

Let me give you a little background on my situation. I did not do a residency. I was too old when I got out of Optometry school and opted for the money route. I did however do a "self-induced" residency. I worked in many different Optometric modes - private practice, corporate, OMD employee, and nursing homes. I saw 3 -4000 patients in one year (worked 7 days a week) and learned how Optometry was in the "real" world. I learned volumes about pathology, practice management and patient relations. These things were very valuable when I made the decision to buy a practice and strike out on my own.

Did not doing a residency hurt me? I don't think so, but I feel residencies are valuable tools for Optometrists....especially in this day and age. I only had one Optometrist refuse to hire me because I did not do a residency. He believed that an ocular disease residency was necessary in his practice, since it is an hour removed from a major city.

Hopefully this has answered your questions.

Good luck.

Hi Dr, thanks a lot for answering my questions. I really admire how you did a self-induced residency. I truly believe that equipped with more knowledge you will be able to help more patients, providing better care.
 
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