Grads of new schools have employment trouble?

[Eyes Only]

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On second thought, the employed OD would be generating money for the practice by allowing you to see more patients than you would just by yourself. I really thought that was the point of hiring another OD. I am not really sure what else the OD can do!

For me to pay your salary, I have to generate more gross income. With a practice the nets about 35% of gross, I have to bring in about $286,000 additional dollars to pay you $100,000.

So the question is: How will you bring in an additional $286,000? And that just takes care of your salary. I assume you will also desire benefits that will cost me an additional 15 to 20% of your income.

It's one of the first questions I would ask a prospective associate.

Also...I think the average gross per exam is about $300 today, although I'm sure this varies greatly from one place to another. So I need an additional 1,000+ patients per year to hire an associate.

 

[319671]

For me to pay your salary, I have to generate more gross income. With a practice the nets about 35% of gross, I have to bring in about $286,000 additional dollars to pay you $100,000.

So the question is: How will you bring in an additional $286,000? And that just takes care of your salary. I assume you will also desire benefits that will cost me an additional 15 to 20% of your income.

It's one of the first questions I would ask a prospective associate.

Also...I think the average gross per exam is about $300 today, although I'm sure this varies greatly from one place to another. So I need an additional 1,000+ patients per year to hire an associate.

DAMN. still want to do optometry. but damn

 

[imemily]

So the question is: How will you bring in an additional $286,000? And that just takes care of your salary. I assume you will also desire benefits that will cost me an additional 15 to 20% of your income.

In this scenario, do you want to hire an OD so they would generate more patients for your practice or do you want to hire an OD to help in the already growing practice?

Most pp ODs would get an associate to fill the patient demand I presume, so I am not sure if it is in the best interest of the owner to get an associate for the sole purpose of generating more revenue, when there are cheaper routes, such as getting techs, opticians, equipment etc.

Regardless, it is a tough question to answer since ODs are in the business of selling eyecare, which is slowly beginning to become dominated by online and corporate entities.

 

[Tippytoe]

This is called strategically positioning the practice to survive without material sales (ie. glasses and contacts). It's called the future of private optometry practice. I make my income on services and medical treatment.....not on being an 'eyeglass *****' (general industry term--nothing implied against emily).

Again, in your Walmart, it will not matter.

 

[KHE]

For me to pay your salary, I have to generate more gross income. With a practice the nets about 35% of gross, I have to bring in about $286,000 additional dollars to pay you $100,000.

So the question is: How will you bring in an additional $286,000? And that just takes care of your salary. I assume you will also desire benefits that will cost me an additional 15 to 20% of your income.

It's one of the first questions I would ask a prospective associate.

Also...I think the average gross per exam is about $300 today, although I'm sure this varies greatly from one place to another. So I need an additional 1,000+ patients per year to hire an associate.

That's not exactly true because you should net more off of the associates income since all the overhead is already covered. The new associated doesn't generate any significant additional overhead in the vast majority of cases outside of COGS.

But the point being made is an important one. In order to pay you $100,000 the practice has to bring in hell of a lot more than that. So....how you gonna do that? I might be able to start you off with a few patients but what are you going to do to grow the business?

 

[Eyes Only]

That's not exactly true because you should net more off of the associates income since all the overhead is already covered. The new associated doesn't generate any significant additional overhead in the vast majority of cases outside of COGS.

But the point being made is an important one. In order to pay you $100,000 the practice has to bring in hell of a lot more than that. So....how you gonna do that? I might be able to start you off with a few patients but what are you going to do to grow the business?

Ok, but I can't add an associate without increasing my overhead. In my case I'd have to add another exam lane. Since COGS is about a third, that doesn't change as I won't experience any significant economies of scale. The point is I'm not making a lot of money off a new associate. I've got to worry about lower efficiency and issues like remakes.

 

[Eyes Only]

In this scenario, do you want to hire an OD so they would generate more patients for your practice or do you want to hire an OD to help in the already growing practice?

Most pp ODs would get an associate to fill the patient demand I presume, so I am not sure if it is in the best interest of the owner to get an associate for the sole purpose of generating more revenue, when there are cheaper routes, such as getting techs, opticians, equipment etc.

Regardless, it is a tough question to answer since ODs are in the business of selling eyecare, which is slowly beginning to become dominated by online and corporate entities.

I can't speak for the motivations of other ODs, but for me it would be about finding someone to take over in the long run. However, I don't want to decrease my income in the meantime, so the new ODs has to pay their own way.

I know a bunch of ODs with this situation. They have a great one doctor practice but are afraid they don't have enough patients for another doctor. This is why I suggest you learn as much about business now as you can so that when you graduate you can show someone with a practice that you have ideas for growth. Also specialties are a plus since you can expand the scope of the practice.

It's not a big deal in an area with a burning need for another OD, but these areas aren't that common.

 

[319671]

I can't speak for the motivations of other ODs, but for me it would be about finding someone to take over in the long run. However, I don't want to decrease my income in the meantime, so the new ODs has to pay their own way.

I know a bunch of ODs with this situation. They have a great one doctor practice but are afraid they don't have enough patients for another doctor. This is why I suggest you learn as much about business now as you can so that when you graduate you can show someone with a practice that you have ideas for growth. Also specialties are a plus since you can expand the scope of the practice.

It's not a big deal in an area with a burning need for another OD, but these areas aren't that common.

my family od is old, like in his early 60s, and he just hired a part time od (also a grandmother), but not any full time ones. what do you think are his intentions?

 

[optsuker]

my family od is old, like in his early 60s, and he just hired a part time od (also a grandmother), but not any full time ones. what do you think are his intentions?

You're saying the PT OD is older also?

More than likely, he wants to slow down, but keep a doc in the practice every day so the practice value won't go down when time comes to sell.

A young OD doesn't want to buy a practice that only sees patients 3 days

 

[imemily]

A young OD doesn't want to buy a practice that only sees patients 3 days

Why not? Isn't there potential to see more patients if you were to expand business hours?

 

[KHE]

Why not? Isn't there potential to see more patients if you were to expand business hours?

In rare cases yes but in the vast majority of cases, no.

If a private practice is only seeing patients three days a week it's almost always because that's all the demand there is.

So if you're going to buy a practice like that and hope to turn it into a 5 day a week practice, you're going to have to have a game plan far beyond just opening up two more days a week.

 

[Eyes Only]

Why not? Isn't there potential to see more patients if you were to expand business hours?

Each situation is unique. You'd have to investigate the market and see if the patients are there.

Another concern is whether or not you can live on the income from the practice after debt service and is there potential for extra income in the area while you build the practice. I've seen this work, just depends on the area.

 

[Tippytoe]

Why not? Isn't there potential to see more patients if you were to expand business hours?

THERE ARE NO MORE PATIENTS! That's what we've been screaming about. The market is saturated. You can open till 8 pm every night and every Saturday and Sunday and you may see a few more stragglers but they likely won't even pay the light bill for the extra hours.

 

[Jason K]

Why not? Isn't there potential to see more patients if you were to expand business hours?

 

[optsuker]

Why not? Isn't there potential to see more patients if you were to expand business hours?

Like all the other OD's stated, you can't just decide to make a PT practice a full time practice.

Not always, but in general, when you show me a retiring OD selling a practice that's open 3 days/week, I'll show you a practice that:

1. can't support a doctor seeing patients 5 days/week
2. where the seller hasn't upgraded any equipment/tech for 20 years
3. has been listed for sale for 3 years (all while seller works less and less).
4. the seller is asking what it was worth at it's peak production & he'd rather die with it unsold than be insulted by a lowball offer

 

[blaba]

So the increased demand anticipated from baby boomers and general demand is a total farce? Because there are still more than enough optometrists currently to handle them all?

BTW, I have already reapplied to two optometry schools. I am still seriously considering whether to pull out. And its not due to any inherent interest issues. No, not at all. It's the FINANCIAL burden that is at the heart of the issue, the outlook on this profession that looks grim to me despite the incredible groupthink that happens in this forum.

I have also shadowed 4 optometrists in private practice. They are all at least middle-aged, one in his 80s. The only young optometrist I have seen is the one at my local Walmart. Please, please don't scathe these young graduates for going corporate - they practically have no choice, unless you want them to go far, far away - and even then what?

I apologize for bringing up a thread nearly a month ago, but I find the dissenters' arguments very compelling.

 

[janedoe88]

Like all the other OD's stated, you can't just decide to make a PT practice a full time practice.

Not always, but in general, when you show me a retiring OD selling a practice that's open 3 days/week, I'll show you a practice that:

1. can't support a doctor seeing patients 5 days/week
2. where the seller hasn't upgraded any equipment/tech for 20 years
3. has been listed for sale for 3 years (all while seller works less and less).
4. the seller is asking what it was worth at it's peak production & he'd rather die with it unsold than be insulted by a lowball offer

What about working for a Hospital? I don't see any downsides to that...

 

[optsuker]

What about working for a Hospital? I don't see any downsides to that...

For some, it's a great option, but:

• There are few hopsital-based positions outside of the military/VA system. Low turnover, since most stay long-term.
• Capped pay scale in most cases.
• You won't be the boss-a goal for many OD's
• many get relegated to tech work if an OMD present

 

[janedoe88]

For some, it's a great option, but:

• There are few hopsital-based positions outside of the military/VA system. Low turnover, since most stay long-term.
• Capped pay scale in most cases.
• You won't be the boss-a goal for many OD's
• many get relegated to tech work if an OMD present

I don't need to be a boss lol. Do you mean working for a VA hospital? I don't see why that would be a problem, most VA hospitals are really nice.

 

[optsuker]

I don't need to be a boss lol. Do you mean working for a VA hospital? I don't see why that would be a problem, most VA hospitals are really nice.

Agree. I think job satisfaction is very high among VA OD's, but they tend to stay at their job for a long time (qualify for pension, need seniority to achieve the higher GS level pay rate), so these spots don't open often.
There are some really bad VA hospitals as well.

Others don't like the limited patient demographics (all old men, no kids).

If a VA job is your goal, you need to be sure to do a rotation at a VA during your 4th year, & strongly consider a ocular disease residency at a VA (better be in the top 20% of your class).

Other hospital settings can be HMO's or working in a ophthalmology clinic (again mostly older patients unless LASIK or strabismus surgeon).

 

[janedoe88]

Agree. I think job satisfaction is very high among VA OD's, but they tend to stay at their job for a long time (qualify for pension, need seniority to achieve the higher GS level pay rate), so these spots don't open often.
There are some really bad VA hospitals as well.

Others don't like the limited patient demographics (all old men, no kids).

If a VA job is your goal, you need to be sure to do a rotation at a VA during your 4th year, & strongly consider a ocular disease residency at a VA (better be in the top 20% of your class).

Other hospital settings can be HMO's or working in a ophthalmology clinic (again mostly older patients unless LASIK or strabismus surgeon).

thanks for your advice, I never thought about a VA hospital like that- working with only older people would probably get annoying lol, probably try to get a position in a regular hospital.

 

[KHE]

thanks for your advice, I never thought about a VA hospital like that- working with only older people would probably get annoying lol, probably try to get a position in a regular hospital.

I'm not sure I've ever even heard of a "traditional" hospital having an optometrist on staff. I know ODs have hospital privledges in some smaller towns but as far as actually being on staff and working there on a daily basis, I've never heard of that.

 

[janedoe88]

I'm not sure I've ever even heard of a "traditional" hospital having an optometrist on staff. I know ODs have hospital privledges in some smaller towns but as far as actually being on staff and working there on a daily basis, I've never heard of that.

Doesn't everyone go to like Kaiser or their Hospital to see their eye doctor...? I'm confused on what you mean.

 

[Eyes Only]

Doesn't everyone go to like Kaiser or their Hospital to see their eye doctor...? I'm confused on what you mean.

You can't be serious.

Q. How many people go to a hospital for an eye exam?

A. None (unless you are a down and out veteran and you go to the VA)

 

[Jason K]

Doesn't everyone go to like Kaiser or their Hospital to see their eye doctor...? I'm confused on what you mean.

There are, in deed, ODs who work at Kaiser and from what I hear, the gig is actually pretty good. It pays reasonably well (FT is 100K to 120K w/ full benefits). It's one of the better positions to land for ODs in places like CA that have Kaisers, especially since most employed ODs in CA don't ever get into the 6 figures, even with considerable experience.

The problem is, there are NOOOOOOOO positions open within Kaiser and when they do pop up, they're gone before anyone even hears about them. They offer PT per diem stuff with no benefits, a couple of days per week, that's about it. Getting a FT position within the walls of Kaiser Permanente is pipe dream that almost no OD ever realizes.

 

[janedoe88]

You can't be serious.

Q. How many people go to a hospital for an eye exam?

A. None (unless you are a down and out veteran and you go to the VA)

everyone I know? Why would you go to Lenscrafters and pay for an eye exam if your insurance covers eye exams at your hospital.

 

[Eyes Only]

everyone I know? Why would you go to Lenscrafters and pay for an eye exam if your insurance covers eye exams at your hospital.

I think you are talking about a staff based HMO which is fairly unique. Most of the country does not have these types of jobs.

 

[janedoe88]

I think you are talking about a staff based HMO which is fairly unique. Most of the country does not have these types of jobs.

I do live in California. I go to my city's medical foundation and my mother goes to Kaiser...I guess technically they're not hospitals? I feel like most medical foundations in california have optometrists? I've never head of someone not having an optometrist they could see at their regular doctor.