High Debt and Failing Demand for VMDs - The Future of Optometry?

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Optogal

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Anyone see this in the NYT? I didn't realize there was a vet over-saturation problem. It's kinda interesting to read since it overlaps a bit with the issues in our profession.

High Debt and Falling Demand Trap New Vets
http://www.nytimes.com/2013/02/24/b...p-new-veterinarians.html?smid=fb-nytimes&_r=0

"The problem is a boom in supply (that is, vets) and a decline in demand (namely, veterinary services). Class sizes have been rising at nearly every school, in some cases by as much as 20 percent in recent years. And the cost of vet school has far outpaced the rate of inflation. It has risen to a median of $63,000 a year for out-of-state tuition, fees and living expenses, according to the Association of American Veterinary Medical Colleges, up 35 percent in the last decade."
 
When do you guys think an article like that will be released for optometry? Over/Under 5 years?
 
When do you guys think an article like that will be released for optometry? Over/Under 5 years?

It should have been released 5 years AGO, but there are too many con artists, crooks, and investors, who benefit by hiding the truth from pre-opts. The AOA is at the top of the list. So are the new(er) schools. Sad, but true. The numbers we're producing are unsustainable, and the people who will pay the ultimate price, are the students paying top dollar for a degree that won't be able to support its own weight.

As long as the AOA and the schools (via ASCO) keep feeding nonsense, false information about optometry's future to the BLS data collectors, we'll never see the truth in print.
 
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The AOA use to represent its members (36000 of us)across this country at one point. They DID alot of good to promote our wonderful profession on every level-national and state. Then, greed set in. A few elected to represent us these past 4-5 years ran everything to the ground. Like a fail business. The AOA has lost thousand of members from every state who no longer want anything to do with them. Failed leadership is what I call it.

There is no longer any AOA journal published each month. Do you care to ask why?
A few delusional academics and bright clinicians who elevated our profession to great heights in the past took it upon themselves to create the ABO and thus board certification. To quote a colleague of ours from Minnesota what he thinks of board certification sums it up: "a professional and personal embarassment to Optometry." A bogus piece of certificate that holds NO MERIT. This has divided our profession like never before. We are our own worse enemy. Better believe it.

I'm very disappointed in our profession, one I truly believe in and love and work hard each day to help people to the best of my ability.
Our profession has becme a disgrace because exactly what the person above me said. It's filled with too "many con artist, crooks and investors who benefit by hiding the truth from preopts."

The AOA and its disgraceful failed leaders should be ashamed of themselves. 4 new schools have opened up from 16 in the past. This leads to saturation, decreased salaries and decreased demand for your services. Disheartening.
 
There is no longer any AOA journal published each month. Do you care to ask why?
A few delusional academics and bright clinicians who elevated our profession to great heights in the past took it upon themselves to create the ABO and thus board certification. To quote a colleague of ours from Minnesota what he thinks of board certification sums it up: "a professional and personal embarassment to Optometry." A bogus piece of certificate that holds NO MERIT. This has divided our profession like never before. We are our own worse enemy. Better believe it.

If medicine has board certification, why can't optometry? It's beneficial to become board certified because then you can separate yourself from those are unable to meet those qualifications.
 
If medicine has board certification, why can't optometry? It's beneficial to become board certified because then you can separate yourself from those are unable to meet those qualifications.


You gotta be kidding me? I'm assuming you are neither an optometrist nor any healthcare professional to make such a comment. Do you have any idea what is going on in the Optometric profession regarding board certificaton or are you just trolling the message boards?


Medicine has board certification for each medical and subsurgical sub specialty after a residency is finished. There is NO distinction in Optometry to warrant board certification.
Separate yourself from those who are unable to meet those qualifications? You are smoking crack. Any licensed OD in the USA can pass this exam as long as they sit down study for it and prepare for it.

And what good will it do to be board certified ?

Who are you?
 
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If medicine has board certification, why can't optometry? It's beneficial to become board certified because then you can separate yourself from those are unable to meet those qualifications.

You don't seem to understand what true board certification denotes. In fields that have "real" board certification, a practitioner must go through some extensive, post credential training in order to be eligible to sit for the BC process. If you're a dentist, and you want to become a Board Certified orthodontist, you can't just get up one day and say, "I"m going to go take a written exam and become board certified." You have to go do a residency in orthodontics, get your certificate or MS from that program, add it to your DMD/DDS, complete some other requirements, and viola, you're eligible to sit for the BC exam. You're then a SPECIALIST, who can no longer practice general dentistry, as long as you hold yourself out as a specialist.

Optometry is different. We have ZERO specialties. Our residencies do not lead to specialty practice, and there is basically no way to survive as an OD, without doing general practice optometry. Because of this, we will NEVER have specialties in the way that medicine, dentistry, veterinary has them. So, to create a BC system that basically attempts to make us look like “the cool guys,” is a pathetic display of the “little brother syndrome,” in which the little kid puts on his big brother’s football jersey and runs around trying to look like his idol. We look pathetic when we do this, and it only diminishes the profession – period. If you want to be a board certified medical specialist in something, go to medical school, go to dental school, go to veterinary school, go to podiatry school, but don’t go to optometry school. Just because you WANT optometry to be a certain way, doesn’t mean it will be or is that way.

Optometric BC does NOT denote a higher level of competence, as it does in other fields. It does not allow you to hold yourself out above your peers. In fact, the law states that practitioners are not permitted to hold themselves out as being more highly trained than their non-BC peers. The courts were brought in to decide whether or not the public was being deceived by our BC label, since most would assume that our BC’d optometrists are comparable to a BC’d surgeon or other MD specialist. They incorrectly decided that the public is not deceived, although they did come out and state that pretty much any certification by any board allows for the title of “Board Certified.” So, in essence, every OD who’s passed the NBEO (the National BOARD of Optometry), is Board Certified by the NBEO. We can all now say that we're "Board Certified."

It’s a complete farce, designed to drum up revenue for the ABO (and the ailing AOA). The people that stand to gain from BC (ABO/AOA) have created a panic that is unfounded. "Yo'll need BC to be on medical panels!!" FALSE: no panel has ever required BC for ODs. "We need to keep up with other professions!" FALSE: we don't. If you want to look like an MD, go to medical school.

It’s up to you, though. If you want to go out and commit to thousands upon thousands of dollars to get and maintain the false credential, more power to you. You’ll basically be proving that you can pass the same test you already passed when you graduate from optometry school, and you’ll be allowed to pay several thousand dollars to do so. Then you’ll be allowed to pay more money every year to prove that you still know the information that you’ve already proven you know…..twice.

It’s a joke and I’m embarrassed for the profession because of it. It makes us look ridiculous.
 
You don't seem to understand what true board certification denotes. In fields that have "real" board certification, a practitioner must go through some extensive, post credential training in order to be eligible to sit for the BC process. If you're a dentist, and you want to become a Board Certified orthodontist, you can't just get up one day and say, "I"m going to go take a written exam and become board certified." You have to go do a residency in orthodontics, get your certificate or MS from that program, add it to your DMD/DDS, complete some other requirements, and viola, you're eligible to sit for the BC exam. You're then a SPECIALIST, who can no longer practice general dentistry, as long as you hold yourself out as a specialist.

of course you *can* still practice general dentistry....perhaps most orthodontists don't want to as orthodontics is generally more lucrative and their practice is likely streamlined to do ortho cases, but they can do general dentistry stuff if they want.

Likewise, lots of physicians who did fellowships in internal medicine subspecialties and are board certified/board eligible in those practice *a lot* of internal medicine outside of their subspecialty. This would be more common in rheumatology, nephrology, infectious disease, endocrinology than cards and GI.

Also, medicine is a little different in dentistry in that every single physician does a residency in *something* where board certification is considered the norm.

agree with the general concept of how board certification seems ridiculous for OD's.
 
opto2be- read the comments carefully not once but twice from what Jason K stated.
This guy is sharp, realistically perceptive and one of the most honest ODs I have ever read posts from. He doesn't sugar coat it. Says it exactly as it is. REAL.

If you wanna look and smell and taste like an MD, the process is infront of you. Apply, get in, go to med school do residency and then you've become one of them. In the meantime, be proud of who you are and what you represent. And that is being an OD. Optometrist. We make a difference in people's life by helping them see better and safeguard their vision by any means we are licensed to. (drugs, etc.....)
 
"Yo'll need BC to be on medical panels!!" FALSE: no panel has ever required BC for ODs.

But that was before Obamacare. Part of the motivation behind BC could've been the anticipated changes under the new health law. Although I don't think Obamacare has affected the status of ODs on medical panels.

It's up to you, though. If you want to go out and commit to thousands upon thousands of dollars to get and maintain the false credential, more power to you. You'll basically be proving that you can pass the same test you already passed when you graduate from optometry school, and you'll be allowed to pay several thousand dollars to do so. Then you'll be allowed to pay more money every year to prove that you still know the information that you've already proven you know…..twice.

I was not aware of this. It was my (false) impression that only those ODs who were highly knowledgeable about their profession would be able to meet the standard for BC.
 
But that was before Obamacare. Part of the motivation behind BC could've been the anticipated changes under the new health law. Although I don't think Obamacare has affected the status of ODs on medical panels.

When board certification was initially presented three years ago (or revived from 12 years ago if you want to go back that far) the motiviations were good but the powers that be in our field acted far to rashly and as such, the implementation was horrible.

Basically, we were all fed a line that some senator from Montana named Max Baucus who at the time was the head of some senate health care committee responsible for coming up with and implementing Obama care was going to want to some sort of board certification type program for doctors to be eligible.

But there was never any actual demand made by the senator or anything even close to approaching a demand made.

So rather than coming up with a program that was ready to go should that demand have been made, they came up with a poorly designed, poorly implemented program that ultimately isn't needed and isn't any where close to likely to be needed.

So in the end, we're left with a program that isn't needed, isn't liked, and doesn't mean anything. A terrible, terrible mistake.


I was not aware of this. It was my (false) impression that only those ODs who were highly knowledgeable about their profession would be able to meet the standard for BC.

Absolutely false. Taking one of the prep courses and a few days of studying and you'll breeze right through it.
 
opto2be- read the comments carefully not once but twice from what Jason K stated.
This guy is sharp, realistically perceptive and one of the most honest ODs I have ever read posts from. He doesn't sugar coat it. Says it exactly as it is. REAL.

If you wanna look and smell and taste like an MD, the process is infront of you. Apply, get in, go to med school do residency and then you've become one of them. In the meantime, be proud of who you are and what you represent. And that is being an OD. Optometrist. We make a difference in people's life by helping them see better and safeguard their vision by any means we are licensed to. (drugs, etc.....)

Thanks for the props, hello07 😀 One of these days, people will start to see the light that practicing ODs have seen for years. It's not about what you want optometry to be; it's about what it is. It's a shame to look at what it's become.
 
In general, do you guys support the viewpoints of the AOS as compared to the AOA? The AOS also happened to be against board certification. I think they've disagreed on a number of other issues as well.
 
In general, do you guys support the viewpoints of the AOS as compared to the AOA? The AOS also happened to be against board certification. I think they've disagreed on a number of other issues as well.

The AOS is a one trick pony that is essentially dedicated to derailing the board certification initiative. They claim otherwise but that's really the only issue they devote any time or resources to. They are irrelevant.

The AOA on the other hand is relevant but clueless. They do some decent advocacy work on the federal level but as far as most of the issues facing optometry, they do little or nothing, preferring to hide behind the excuse of anti-trust concerns.
 
The AOA makes the claim in its publications that those optometrists who are AOA members have a higher income than those who are not and quotes numbers to support its claim. Obviously, they are marketing themselves to up-and-coming ODs and encouraging them to join, but what is the explanation behind the discrepancy in income between members and non-members?
 
The AOA makes the claim in its publications that those optometrists who are AOA members have a higher income than those who are not and quotes numbers to support its claim. Obviously, they are marketing themselves to up-and-coming ODs and encouraging them to join, but what is the explanation behind the discrepancy in income between members and non-members?

What you'll find with any set of data, is that a skilled accountant/ mathematician / actuary, whatever....can take the numbers, and make them "say" whatever he/she wants. Politicians have been doing this since the beginning of politics, so it's nothing new. I trust the AOA about as much as I trust anything coming out of the White House. It's all propaganda, and it's all designed to promote an agenda.

If there's one thing I've learned in the past 8 years or so, it's that the AOA is now a completely self-serving organization that has no regard for practicing ODs, or the stability of private practice optometry in the future. Remember that whenever you read anything coming with an AOA/ABO logo on it.
 
Are there any advantages to being an AOA member? What are the disadvantages (besides the fees and their viewpoints)? Are there a large number of optometrists who have shunned the AOA? Is the situation similar in medicine and dentistry with the AMA and ADA? If there are enough optometrists dissatisfied with the AOA, why don't you guys use it as a platform to urge a reduction in schools and promote other issues that would help the profession?
 
Are there any advantages to being an AOA member?

In my opinion, not anymore.

What are the disadvantages (besides the fees and their viewpoints)?

Besides the outrageous dues? Nothing, really, except for the fact that you're paying hard-earned money to an organization that is pretty much working hard to crush your profession.


Are there a large number of optometrists who have shunned the AOA? Is the situation similar in medicine and dentistry with the AMA and ADA?

Yes, and yes. However, I should say that the ADA hasn't even begun to do the nonsense that our AOA has been doing for years now. The ADA is not perfect, but they're still working for dentistry, overall....at least that's what my dental friends tell me. I don't know a single OD, except for a couple of die-hards on ODWire, that will stand up publicly for the AOA.

If there are enough optometrists dissatisfied with the AOA, why don't you guys use it as a platform to urge a reduction in schools and promote other issues that would help the profession?

The AOA has cowered behind anti-trust laws for years, as ODs have screamed and yelled about new schools and their damaging effects on everyone in optometry. There are several reasons that the AOA will never come out against the new schools, but the most entertainig to me, is that they want as many new grads as they can get. More grads - more $. They fail to see, however, as most politicians do, that you can only shovel so much crap into people's back yards before they start to smell it.

What will eventually stop the herpetic replication of new OD programs, is the reality that is hitting new grads as they exit school with more debt than they can support. Opportunities will diminish, salaries will drop or remain stagnant, and sooner or later, programs will start closing because they can't fill their classes with anything but bottom-tier students who can't even pass boards.

Don't take my word for it, read the study that was conducted over 12 years ago, before the new schools even came to be, and see how they correctly predicted a massive over supply even without the new programs. That study, which was ordered by the AOA, was buried in the archives of the AOA in St Louis, and is probably wedged between two manilla envelopes right now....with a big post-it note that reads "anyone who releases this to the public will be locked in a canvas bag with an angry badger. - signed, your AOA president."

Sooner or later, the gloom and doom that others and I discuss on here will become all too real for people considering optometry. Right now, it's a fantasy in your mind. In a few years, it'll be massive debt that you'll never escape from.
 
Don't take my word for it, read the study that was conducted over 12 years ago, before the new schools even came to be, and see how they correctly predicted a massive over supply even without the new programs. That study, which was ordered by the AOA, was buried in the archives of the AOA in St Louis, and is probably wedged between two manilla envelopes right now....with a big post-it note that reads "anyone who releases this to the public will be locked in a canvas bag with an angry badger. - signed, your AOA president."

Is that study available online? It's disappointing that the AOA ignored the warnings.
 
Is that study available online? It's disappointing that the AOA ignored the warnings.

Here's a link to the abstract. I'm sure the document is available online somewhere, or you can log in to see it on Pubmed. Notice that we've almost doubled the amount of actual grads each year, and the retirement numbers have lessened. Enjoy.

http://www.ncbi.nlm.nih.gov/pubmed/10998943
 
Thanks for the link. I've pasted the results section of the abstract below. The part in bold doesn't make sense. If patient volume is increasing and optometrists are needing less time to conduct eye examinations, isn't that a good thing financially?

RESULTS:

Workforce projections suggest an excess supply of optometrists is likely over the next 20 years. Over the next five years, approximately 550 optometrists are expected to retire each year, while more than 1,100 optometrists enter practice annually. Patient encounter volume is projected to increase steadily, but the effects of this increase are largely offset by an anticipated decrease in optometrist time requirements for routine eye examinations.
 
Thanks for the link. I've pasted the results section of the abstract below. The part in bold doesn't make sense. If patient volume is increasing and optometrists are needing less time to conduct eye examinations, isn't that a good thing financially?

The problem is, you're assuming that more patients = more money. It doesn't. What insurance companies have done (primarily vision plans), is to lure ODs into taking their terrible plans by saying "Don't worry, we pay you nothing, but you'll make up for it since you'll have a lot of people coming through the door with our plan." That's all well and good, but reimbursement rates have remained the same for the last 20ish years, while everything else has become ridiculously more expensive.

Many vision plans pay so little for your service, that you actually lose money if the patient decides to shop for materials elsewhere, something that's happening more and more. Now, it's easy to say "Well, you just have to make your patients buy from you." This con has been played, and is still being played on ODs all over the nation.

We've priced ourselves out of our own profession. With Walmarts, Sam's, VisionMarts offering "eye exams" for $40 or less, that's become the perceived value of our services. We're now expected to give away services, and the real pain hits when doctors give away services, and then the patient takes their Rx online or to a retail outlet.

Read the entire article. I'm sure it's online somewhere, because I have found it myself in the past. Look at the numbers. The grim outlook was based on the assumption that the number of schools, and the retirement rate would remain constant. Well, the number of schools has increased about 50%, and the retirement rate has dropped from over 500, down to about 400 per year. It all adds up to one thing, but only if you're willing to look from an unbiased perspective.
 
I decided a long time ago that when a problem is so blatant like optometric oversupply is and there are people who deny the problem, those people are either stupid or liars.

All of life basically comes down to "is this person stupid or are they a liar?"

I think with respect to optometric oversupply, the issue is stupid. The people who believe there is an undersupply aren't lying. They are true believers, wrong as they may be.
 
Thanks for the link. I've pasted the results section of the abstract below. The part in bold doesn't make sense. If patient volume is increasing and optometrists are needing less time to conduct eye examinations, isn't that a good thing financially?

RESULTS:

Workforce projections suggest an excess supply of optometrists is likely over the next 20 years. Over the next five years, approximately 550 optometrists are expected to retire each year, while more than 1,100 optometrists enter practice annually. Patient encounter volume is projected to increase steadily, but the effects of this increase are largely offset by an anticipated decrease in optometrist time requirements for routine eye examinations.

No because basically what it means is that the same number of optometrists can service an increased number of patients in the same amount of time due to technology, delegation, whatever.....

As such, it makes oversupply WORSE.
 
To break it down into the simplest terms.

In decades past, a lone OD would see about 6-8 'patients' (really customers) per day. Before computerization, he would spend 45 minutes doing (mostly ridiculous) made up tests like NRA/PRA, dynamic retinoscopy, MEM, etc..... This would make the refraction last about 25 minutes. Then a quick peek into the undilated eye for a pretend look at the retina and then they'd move into the optical area to purchase a $350 pair of glasses. Add in the $50 exam and there was a pretty decent profit for the OD. Six patients per day was a good living because every patient bought glasses or $400/pair daily-wear B3 Bausch and Lomb yearly contact lenses.

As technology progressed, so did commercialization. Big corps figured out that this lowely ODs was marking up the glasses about 400% and they (correctly) figured they could sell them in bulk for much less overhead and make more money (the entire concept behind Wal-Mart for everything). On top of this, other corps figured out that they could form "vision plans" and sucker ODs into believing that they could make a bunch of money because these "vision plans" have a lot of "bodies" they will send to us in return for a much reduced fee. We will "MAKE IT UP IN VOLUME".

Well this worked for a while as ODs, using technology (autorefractors, auto-lensometers) etc...... and more staff, were seeing twice as many patients as before for at a 50% less exam fee. The carrot that was dangled was that ODs could "make it up" in optical sales, which were too cut by 50% but at least there were a few more patients to buy them.

THEN came the INTERNET and on-line opticals and the BOOMING of commercial opticals. Gradually the discounted eyewear that ODs were fighting over disappeared as customers cut out the middle-man (ODs) and figured out they can get pretty decent glasses and contact lenses on-line for 75% off what their ODs were selling them for.

As this was happened, ODs began to bribe congressman in various states to begin to allow ODs to treat more eye diseases, somewhat making up for the loss of eyewear sales. But this was just a short-term Band-Aid as there is not enough eye disease to keep the ever-increasing number of ODs busy.

And this is where we are today. Exam fees dramatically down. HUGE loss of optical sales, And reducing reimbursement for the limited medical care that we provide. ADD to this a blossoming number of unneeded new ODs schools pumping out more docs and its a TOTAL FAILURE WAITING TO HAPPEN. We are watching it in slow-motion right now. The only light in my tunnel is that I got in right before the internet boom part. So I was able to make a little money before all hell broke loose.
 
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No because basically what it means is that the same number of optometrists can service an increased number of patients in the same amount of time due to technology, delegation, whatever.....

As such, it makes oversupply WORSE.

Although you guys have painted a dire picture for optometry, I do remember you mentioning before that it is possible for new grads to find success, even in private practice, if they have the right approach and proper planning. Is this true even in California? Or is California the one exception?
 
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Some stats from a city in canada: 900+ OD registered in this city, ~400 practices registered and 1~2 FT, 3~5 PT opportunities recently, city pop is 1mil

saturated or not? i dont know
 
Although you guys have painted a dire picture for optometry, I do remember you mentioning before that it is possible for new grads to find success, even in private practice, if they have the right approach and proper planning. Is this true even in California? Or is California the one exception?

I have never practiced in California but talking to colleagues who practice there and reading postings from other optometrists in California on other forums, it would seem to me that if there was ever a state where you are the LEAST likely to be able to succeed, it's California.

Sorry.

🙁
 
Jason K, you welcome for the props 🙂 Hopefully your posts enlighten those in our field and those who potentially are thinking of entering our field. I'm not discouraging anyone nor am I advocating it.

To answer someone's post earlier. The AOA no longer represents 36,000 ODs in the USA. They have their own self interests and agenda while they rest of us 90% do not support or care.

It's a shame what we have become. Divided than ever.
IMO, the board certification sometime next few years will dissipate. Then again, I might be very wrong.
 
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