How much do optometrists REALLY make? A case study

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PGRG

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Have you ever wondered whether an OD degree is worth it financially? Unless you're getting a free ride from someone or somewhere, you're probably going to graduated with a good sized six-figure student loan.

According to startclass.com, the lowest in state tuition for U.S. optometry school is $16,626 at Northeastern State University and the highest is $41,902 at MCPHS. Note that this does not include fees, books, equipments, or room and board; therefore, it's not uncommon for the average total amount of student loans after four years to be $150,000 to $200,000, not counting undergrad.

Not to fret, salary.com reports that “the median annual optometrist salary is $115,015, as of August 29, 2016, with a range usually between $101,837-$127,443.” Cool! But we all know it's not about how much you make that matters. It's what you get to keep that's important.

In general, many financial college experts recommend this rule of thumb for safe student loans borrowing:

Your total college debt should not exceed your total annual income after graduation and that your monthly loan payment should be less than 10% of gross income.”

Maybe you know something that I don't, but I have yet to see any OD job offer with a salary of $150-$200K for a new or seasoned doctor. EVER! Obviously, many students choose to ignore this rule completely and it has proven to make the financial reward of being an optometrist a lot less appealing.

So, how much do optometrists REALLY take home?

Let's look at a case study*: Warning: A lot of details and number crunching ahead.
*I try using the most realistic average numbers to reflect the majority of CA optometrists' real life experiences:

Dr. Jane is a recent graduate who works 5 days a week as an independent contractor (1099) at multiple offices with a rate of $375/day (average per diem rate in CA). Because she was frugal in school, she has only $150K in student loans at 6.8% interest rate, 20 years term. This means her loan payment is $1,145.01 per month or $13,740.12 annually.

Gross Income: $375/day x 5 days/week x 50 weeks/year = $93,750
(I use 50 instead of 52 weeks because of no paid holidays and time off for continue education).

Hidden costs of maintaining your license. Luckily these are deductible expenses: (yearly)

Malpractice insurance: $425
DEA License: $243.67
OD License renewal: $218.50
Continue education courses: $625
Business Travel/Hotels for CE: $1000
Business meals: $100
Equipment depreciation: $1000
Health insurance: $3,360

Total deductible expenses: $6,972.17
Total Net Business Income: $86,777.83, I use this number to calculate the federal, state, and self employment tax due. Calculator used: https://www.dinkytown.net/java/Tax1040.html

Summary:

Gross Income: $93,750
Total deductible expenses: $6,972.17
Net earnings: $86,777.83
- Self employment Tax: $12,261
- Federal Income Tax: $13,346
- CA State Income Tax: $4,601 ( I used the AGI as the household income for the calculation)
- Yearly Student loans Payment: $13,740.12
Total take home (after taxes, business expenses and student loan payments): $42,829.71 per year or
$171.32 per day or $21.41/hour!


That's right! Your future doctorate degree will earn you $21.41 an hour! Don't forget to include the opportunity cost for the extra four years in school but I think you're depressed enough already.

Feel free to use your own numbers in the calculation. I'm sure it'll be quite an eye opener!

I should also clarify some assumptions that I've made to the case study above:

1) Dr. Jane is a hypothetical example of the lucky few who could find a steady 5 days a week job after graduation. The truth is the majority of new or recent grads are only able to piece together 3-4 days/week due to lack of jobs or childcare needs. Also, many of the job openings usually want the OD to work on the busiest days of the week: Fridays and Saturdays. Social life aside, there are only so many Fridays and Saturdays you have per week, so choose where you work wisely.

2) Because the competition is fierce in urban areas and city centers, many doctors have to commute far from home in order to get a higher daily rate, sometimes as long as 1-2 hours EACH way. Of course, there's always an option to move closer to work, but who would want to live out in the boonies?

3) You can always argue that Dr. Jane can raise her income by negotiating a higher daily rate or open up her own practice. One, good luck with negotiating as a newbie when you're in a high supply/low demand environment, especially in the cities. Two, unless you're planning to inherit a large sum of money or rely on the generosity of family members and friends, you're going to have to take out more loan to start a practice. I'm not saying that it's impossible, but remember to calculate the net take home pay and how long you'd need to work 6-7 days per week while eating ramen noodles.

4) What about student loan interest deduction or income-based repayment program? Unfortunately our lucky Dr. Jane makes too much money to qualify for either program.

5) While I know there are ways to decrease the tax liability such as contributing to retirement and/or health saving accounts, the money saved into these accounts are not spendable because you don't have immediate access to it; therefore, it's not part of the take home pay.

6) Being an independent contractor, Dr. Jane is not entitled to unemployment benefits, sick or holiday pay, CE reimbursement, 401(k) matching, or other perks if she was an employee. So the answer is to be employed right?

Well, not so fast. Check out the next post to see if it's really better.

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Here's the new scenario to compare if being an employed optometrist will be better:

After realizing that she only makes $42,829.71 per year or $21.41 per hour after taxes and expenses as an independent contractor, Dr. Jane wises up and get a job at an ophthalmologist office that pays $350 daily, seeing 25 patients per day. Even though this is less than what she was making before, she believes the trade off is worth it for the employee benefit which includes reimbursement for continue education, license renewal, and even health insurance. Woohoo! However, she still has that pesky student loan payment of $1,145.01 per month or $13,740.12 annually ($150K at 6.8% interest rate for 20 years).

Summary:

Gross Income ($350/day x 5 days/week x 50 weeks/year) = $87,500
Total deductible expenses: $0
Net earnings: $87,500
- SS and Medicare Tax (FICA): $6,694
- Federal Income Tax: $15,059
- CA State Income Tax: $5,238
- Yearly Student loans Payment: $13,740.12
Total take home (after taxes, business expenses and student loans payments) = $46,768.88 per year or $187.08 per day or $23.38/hour!
Source: https://smartasset.com/taxes/california-tax-calculator#bglVlCfEl5

Awesome! Dr. Jane new job pays her an extra $3,939.17 per year or $1.97 per hour. Anyone excited about that?

The purpose of this exercise is to show you not to overlook the details, especially when it comes to taking out a large amount of non-dischargeable student loan for the sake of an education. Be smart, run your own numbers. This will show you the real cost vs. value of the “investment.” Granted, I know some values are intangible and can't be measured by money, but being well compensated for your time, effort, knowledge, and skills certainly makes life and work a lot more enjoyable.

Don't get me wrong, I don't have anything against optometry. It's a very noble profession and many people who enter the field are very passionate about helping others. However, in 2016, with the continuous rise in tuition, stagnant wages, reduced insurance reimbursement, increase oversupply from the new schools, and non-stop competition from technology companies and retailers, the new generation of optometrists really have their work cut out for them. Unfortunately, it doesn't look good. In the end, this is a math problem where high debt coupled with low take home pay equal to a lot of bitter and dissatisfied doctors down the road.
 
Great case, I'm trusting that nothing was manipulated but it looks sound. Granted that the $375 per diem rate seems possibly consistent (+/- $25) for the San Francisco Bay Area or Greater Los Angeles Area, I think most other places in the country that does sound a lot lower, even for a new grad [although I agree with the wage stagnation and increased competition sentiment].

Still in your case though, that leftover take-home money is still enough to pay a mortgage on a 400k-800k house, cover food budget for 2-3 people, still have enough to take a modest vacation trip to Disneyland, and still have some contribution towards savings and spendings. Also factor in that optometry isn't back-breaking work and is very low risk in terms of occupational hazards, and you'd probably be able to comfortably support a small family, if not very comfortably support yourself.
 
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In the state of Connecticut there are several doctors and practices offering six-figure salary as an employee with benefits who cannot find anybody to come here

Connecticut is within an hour or two drive of both New York and Boston. There is ample train service to NYC.

Unlike California, we have wide scope of practice and easy access to medical panels.

So yea, if you want restrict yourself to "the OC" or the "Bay Area" you might well be in for a rough ride.

But if you're willing to broaden your horizons a teeny tiny bit (I'm not talking western Nebraska though that is an option too) there is plenty of opportunity out there.
 
Great case, I'm trusting that nothing was manipulated but it looks sound. Granted that the $375 per diem rate seems possibly consistent (+/- $25) for the San Francisco Bay Area or Greater Los Angeles Area, I think most other places in the country that does sound a lot lower, even for a new grad [although I agree with the wage stagnation and increased competition sentiment].

Still in your case though, that leftover take-home money is still enough to pay a mortgage on a 400k-800k house, cover food budget for 2-3 people, still have enough to take a modest vacation trip to Disneyland, and still have some contribution towards savings and spendings. Also factor in that optometry isn't back-breaking work and is very low risk in terms of occupational hazards, and you'd probably be able to comfortably support a small family, if not very comfortably support yourself.

I agreed in other places outside of northern or southern CA the wages are a lot higher than $375/diem. Even in the case above I was being very generous with the salary and the lower range of student loans. However, I doubt the take home pay (assumed one income) is enough for a mortgage (especially in the SF Bay Area where homes are 1 mil+ and you have to compete with international cash buyers) AND provide a comfortable living for a family of 2-3, even if you're being frugal. As far as optometry being a low risk occupation, that applies to any office type work, but without the extra years in school, excessive loans, or medical liability risk.
 
In the state of Connecticut there are several doctors and practices offering six-figure salary as an employee with benefits who cannot find anybody to come here

Connecticut is within an hour or two drive of both New York and Boston. There is ample train service to NYC.

Unlike California, we have wide scope of practice and easy access to medical panels.

So yea, if you want restrict yourself to "the OC" or the "Bay Area" you might well be in for a rough ride.

But if you're willing to broaden your horizons a teeny tiny bit (I'm not talking western Nebraska though that is an option too) there is plenty of opportunity out there.

I agree. Any place outside of CA or NYC will net you a whole lot more with higher wages and possibly lower cost of living. I worked in upstate NY for a few years out of school but had to move back because the weather was giving me seasonal depression and no amount of money was going to help with that. For those that can deal with the harsh NE winter, it's a great place to practice. It's unfortunate that there are 3 optometry schools in CA and most students choose to stay here to practice after graduating, making it much harder for everyone else, including themselves.
 
My food budget is around $300-350/month. I don't cook that often except easy stuff like fruits, PB&J, cereal, bagels, yogurt. I eat daily at the hospital cafeteria and then usually eat a $10 take out or restaurant dish that usually has left-overs for another meal or two.

I just bought a 400k house in CA, and my mortgage is 1,300/month for 30 years [my apt rent was $1,000/month] - I don' t know the exact details of my loan because I'm a dumb millenial who entrusts this stuff with my accountant/finance officer.

Considering that hospital workers actually have a very high employee injury rate, optometry is among the lower risk ones. My pharmacist sister stands all day and has to wear pressure stalkings to prevent fatigue. My accountant is a 32 year old woman who complains of back problems from sitting all day and has to get a chiropractor. I walk a minimum of 200 steps every time I see a patient (my office is the furthest), I get to sit or stand as I please, I only use the computer in short bursts, and have varied tasks throughout the day at distances and upclose.
 
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My food budget is around $300-350/month. I don't cook that often except easy stuff like fruits, PB&J, cereal, bagels, yogurt. I eat daily at the hospital cafeteria and then usually eat a $10 take out or restaurant dish that usually has left-overs for another meal or two.

I just bought a 400k house in CA, and my mortgage is 1,300k/month for 30 years [my apt rent was $1,000/month] - I don' t know the exact details of my loan because I'm a dumb millenial who entrusts this stuff with my accountant/finance officer.

Considering that hospital workers actually have a very high employee injury rate, optometry is among the lower risk ones. My pharmacist sister stands all day and has to wear pressure stalkings to prevent fatigue. My accountant is a 32 year old woman who complains of back problems from sitting all day and has to get a chiropractor. I walk a minimum of 200 steps every time I see a patient (my office is the furthest), I get to sit or stand as I please, I only use the computer in short bursts, and have varied tasks throughout the day at distances and upclose.

400K house? You must not live in the Bay Area then. That might get you a little 1 bd condo where I am. I'm glad it worked out for you and it seems like you're happy with your situation. Personally for me it's just not worth it.
 
You're right, I live in Central California. It's a 2.5 hour drive to the East Bay if there is no traffic on the Bay Area side. It got me a 4bed/3bath in one of the best school districts in central california.

I couldn't find a f/t job in the Bay. My friend works in Hayward and earns $350/day. I grew up in the Bay. My sister is looking for a home there and she's paying 4x-5x what I could find in Central California, but at least real estate usually tends to appreciate in that area.

Thanks. I initially didn't think it was worth it until I got out of working corporate optometry.
 
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You're right, I live in Central California. It's a 2.5 hour drive to the East Bay if there is no traffic on the Bay Area side. It got me a 4bed/3bath in one of the best school districts in central california.

I couldn't find a f/t job in the Bay. My friend works in Hayward and earns $350/day. I grew up in the Bay. My sister is looking for a home there and she's paying 4x-5x what I could find in Central California, but at least real estate usually tends to appreciate in that area.

Thanks. I initially didn't think it was worth it until I got out of working corporate optometry.

Yup. It's sad that only central CA is "affordable" now. Gotta wait for the next tech or housing bubble to burst because it's crazy time to buy right now.
 
I like this post.

Personally, If you plan on living in the west coast/socal area, it does not seem like a smart idea to go into optometry.

however, lets assume you are a boring gal or guy who wants to live in the midwest or south. 85k seems fine, cause its easy to live off off 20K/year as a single person. Who knows, maybe you could actually net 100K after ten years.

I think dentistry is a better option that optometry, even tho I think optometry is the better workload/gig.
 
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I agree. Any place outside of CA or NYC will net you a whole lot more with higher wages and possibly lower cost of living. I worked in upstate NY for a few years out of school but had to move back because the weather was giving me seasonal depression and no amount of money was going to help with that. For those that can deal with the harsh NE winter, it's a great place to practice. It's unfortunate that there are 3 optometry schools in CA and most students choose to stay here to practice after graduating, making it much harder for everyone else, including themselves.

So.....you created a new account to make this posting, presumably under the guise of being "helpful" buuut.....

You elect to do a "case study" using the example of probably the WORST possible place in the USA to practice yet attempt to present it as the norm.

Then, when it's pointed out that there are all sorts of areas looking to hire people at six figure incomes WITH benefits etc. etc. and these places are not in the middle of the South Dakota badlands, you agree but claim that you don't like winter and that no amount of money would be worth it to you.

If you don't like winter, might I suggest Arizona, Nevada, New Mexico, Texas, Louisiana, Mississippi, Georgia, Florida, South Carolina, North Carolina, Hawaii.
 
PGRG, out of curiosity what profession are you in?
 
So.....you created a new account to make this posting, presumably under the guise of being "helpful" buuut.....

You elect to do a "case study" using the example of probably the WORST possible place in the USA to practice yet attempt to present it as the norm.

Then, when it's pointed out that there are all sorts of areas looking to hire people at six figure incomes WITH benefits etc. etc. and these places are not in the middle of the South Dakota badlands, you agree but claim that you don't like winter and that no amount of money would be worth it to you.

If you don't like winter, might I suggest Arizona, Nevada, New Mexico, Texas, Louisiana, Mississippi, Georgia, Florida, South Carolina, North Carolina, Hawaii.

Maybe I'm a glass half-empty kind of person, but I believe the students or anyone who's interested in optometry should understand some of the challenges they'll be facing, especially with how high student loan payment and taxes will impact their "high income." I've never said this was the norm for the rest of America, just say it's fairly common scenario for ODs practicing in SF Bay Area or LA. I'm sure there are lots of variations even in the best states to practice as well.

Besides, I like to under promise and over deliver. If someone sees this as the worst case scenario and still want to pursue optometry, good for them! If they ended up practicing in a better state with better income, I'm sure they'll be very happy. And if they ended up in CA, at least they can't say I didn't warn them. If anything, take it as DON'T practice in CA if you don't like the numbers and start researching for better places to go.

As for where I want to live and work, it's a personal preference and sometimes you're stuck due to family or other personal matters that you can't move, even for better work opportunity.
 
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