Is this in all states?

[Oogilily]

I'm just curious. A lot of people have been saying how hard it is to open a new practice and that the only jobs are found in corporate. Also they say there are too many ODs out there in the first place. So is this happening in every state? Or are some states worse than others? You're opinions would be helpful.

Thank you!

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[hye345]

This is what I have heard (on this forum):

If you want to open your own opt business, you need to accept various insurance plans (which can sometimes be a very tedious process). If you don't, then business will be hard to come by.

Also, it helps if your state is a two-door state; this means that even if you work in the mall (just an example), you are still considered an independent entity, and therefore, you have more choices on how to run your business. You have your own entrance/exit or something like that (hence, the tern two-door).

Here is a web page that offers helpful information on how to open/manage your own optometry business: http://www.findarticles.com/p/articles/mi_qa3921/is_200411/ai_n9470925

As far as the walmartization of optometry, I have recently run a search at careerbuilder.com (keyword optometrist; location California), and only came up with 4 results (one of them was for an optician, and two were for the army/navy). So, I am a little skeptical about optometry turning into pharmacy anytime soon.

(Case in point, I ran the job search again, except I put pharmacist instead of optometrist, and came up with over 250 results).

 

[posner]

I'm just curious. A lot of people have been saying how hard it is to open a new practice and that the only jobs are found in corporate. Also they say there are too many ODs out there in the first place. So is this happening in every state? Or are some states worse than others? You're opinions would be helpful.

Thank you!

It is not impossible to open cold, but damn near. I think it has less to do with the state(though I am certain there are better states than others for a cold practice)and more to do with the Optometry schools. Tuition is skyrocketing everywhere and the number of new grads is staggering, far outpacing the need for new ODs and available good jobs. Furthermore, since many of the new OD students picked for admission are social ******s from the start, they gravitate to the Wal Marts of the world where they can treat like minded patients for $29 an exam. This of course drags the entire profession down, takes patients out of your office, and plays into the hands of big corporations. You see how this works?

I do think it is possible in some instances. First of all, if you have the financial means to not graduate with a mountain of loan debt this is a huge plus. If this is not possible, then you would need the physical wherewithall to go without food and shelter for long periods of time.

Posner

 

[drgregory]

they gravitate to the Wal Marts of the world where they can treat like minded patients for $29 an exam. This of course drags the entire profession down, takes patients out of your office, and plays into the hands of big corporations. You see how this works?

this phrase should be a beacon. understand this cycle, and you'll understand where all of this "optometric doom" comes from. whats worse is that even though some ODs understand it, they still choose to prostitute their services. its those whom my hatred is focused. my pity is for those poor young ODs who dont know any better, and usually those are the ODs who are providing exceptional care, all for "free with the purchase of two pairs of eyeglasses".

 

[cpw]

who are providing exceptional care, all for "free with the purchase of two pairs of eyeglasses".

I had someone call yesterday to ask if my office did this .... um... No.

 

[drgregory]

I had someone call yesterday to ask if my office did this .... um... No.

be sure to thank your local commercial OD who is doing this in your area.

 

[cpw]

be sure to thank your local commercial OD who is doing this in your area.

well, I AM a commercial OD... but I've set my exam fees as high (if not higher) than some of the private docs in this area. But, that's something I've discussed ad infinitum.. so I'll leave it at that.

 

[drgregory]

I've set my exam fees as high (if not higher) than some of the private docs in this area.

then would you say your services (which should be on par with your fee level for those services), are as good (if not better) than some of the private docs in this area? or is your examination technique and accuracy only "just as good" as the private docs? why are they the benchmark?
or, if you consider yourself a competent clinician, shouldnt your fees exceed even that of the "private docs" in the area who are basically just refractionists in a medical office? shouldnt YOU, and not local docs or any district manager determine fees?

i seriously doubt your fees are appropriate for the services YOU provide. careful though, because if you charge what youre actually worth you'll stick out like a sore thumb (because youll be the only one doing it), and you'll be avoided like the plague.
its the real pioneers who try it...

 

[cpw]

i seriously doubt your fees are appropriate for the services YOU provide. careful though, because if you charge what youre actually worth you'll stick out like a sore thumb (because youll be the only one doing it), and you'll be avoided like the plague.
its the real pioneers who try it...

Why must you always go on the attack ? I've almost completely stopped posting on the forum I moderate because every time I do I get attacked.

I've got patients to go see...

 

[drgregory]

Why must you always go on the attack ?

the attack is not on you, its on a CRITICAL PROBLEM IN EYE CARE. there are many future eye doctors in audience here, and SOMEONE should present them with the situation that is occuring. im sorry if you felt i was attacking you.
my hope is that as these future optometrists graduate, they at some point remember "that angry, bitter guy on SDN" that warned them of urinating on the profession they now belong to. perhaps my tactics are too forward?

 

[posner]

Why must you always go on the attack ? I've almost completely stopped posting on the forum I moderate because every time I do I get attacked.

I've got patients to go see...

If I may attempt to speak for Greg...the problem is that there are many of us that love very much the profession of optometry and we want to see it continue to thrive. When we come across those(who seem to be ever increasing in numbers) that embrace a mode of practice that is so irrefutably damaging to the profession, we cant help but to respond emotionally. It is not unlike someone calling your mom a bitch...you cant help but get worked up about it.

Posner

 

[cpw]

If I may attempt to speak for Greg...the problem is that there are many of us that love very much the profession of optometry and we want to see it continue to thrive. When we come across those(who seem to be ever increasing in numbers) that embrace a mode of practice that is so irrefutably damaging to the profession, we cant help but to respond emotionally. It is not unlike someone calling your mom a bitch...you cant help but get worked up about it.

Posner

Except, no one asked y'all to be judge and jury. You've made the forum that I helped START become a very hostile place for me (and any other commercial doc). I graduated 100k in debt like most other new grads. When I could only find work ONE DAY A WEEK in private practice.. I did what I had to do to eat. The private practice doc was 15 years from retiring. Am I supposed to starve for 15 years and wait patiently to buy him out ?! I can't take out a 200k loan from Mom and Dad to start a business. And, with my debt to income ratio out of school no bank would give me a loan.

I have a state of the art practice.. that happens to be in a Lenscrafters. If you want to go on the attack.. go find out how it's legal that some corporations are forcing their docs to give away "Free" exams with glasses and contact lens purchases. The only exams I've done free are my pro bono patients.

I would appreciate no longer being the example of "what not to do". I'm sick of it... and if it keeps happening I'll be retiring from SDN a lot earlier than expected.

For the record: I just hit my one year anniversary at my pratice. Patient volume has increased almost 200%.

Why don't we agree to discuss our practices and strategies--show students what's out there, what we like and don't like (without attacking).. and let THEM decide what's best for them. Treat them like the educated adults they are.

 

[posner]

Except, no one asked y'all to be judge and jury. You've made the forum that I helped START become a very hostile place for me (and any other commercial doc). I graduated 100k in debt like most other new grads. When I could only find work ONE DAY A WEEK in private practice.. I did what I had to do to eat. The private practice doc was 15 years from retiring. Am I supposed to starve for 15 years and wait patiently to buy him out ?! I can't take out a 200k loan from Mom and Dad to start a business. And, with my debt to income ratio out of school no bank would give me a loan.

I have a state of the art practice.. that happens to be in a Lenscrafters. If you want to go on the attack.. go find out how it's legal that some corporations are forcing their docs to give away "Free" exams with glasses and contact lens purchases. The only exams I've done free are my pro bono patients.

I would appreciate no longer being the example of "what not to do". I'm sick of it... and if it keeps happening I'll be retiring from SDN a lot earlier than expected.

For the record: I just hit my one year anniversary at my pratice. Patient volume has increased almost 200%.

Why don't we agree to discuss our practices and strategies--show students what's out there, what we like and don't like (without attacking).. and let THEM decide what's best for them. Treat them like the educated adults they are.

Again, I dont think this was meant to be a personal attack. I hear alot of new graduates concerns on student debt. They are very real concerns. This is why the solution must begin at the schools(see other posts on oversupply, etc)You talk of the "private practice doc" not retiring for 15 years as if he or she were the only other optometrist in the United States. If you are unwilling to either find something that is workable in the area in which you want to live or to explore other areas where there may be opportunity, then you leave yourself no choice but to do what you have done. I dont pretend to know all the circumstances that may have led to your decision to do what you have but there must have been some conscious decision(family, spouse, etc) that put you into your current situation.

I am glad you are doing well. Although I ultimately believe corporate OD are the undoing of solo private practice, it is still nice to see other ODs doing well and for that I congratulate you. The problem many of us have with your mode of practice, is that you have given the power of controlling eyecare delivery to a corporation that cares nothing about you or the rest of us. This is not only a problem for the profession, but it is angering to see someone knowingly undermine your chosen profession and justify doing so with a paycheck.

Posner

 

[cpw]

If you are unwilling to either find something that is workable in the area in which you want to live or to explore other areas where there may be opportunity, then you leave yourself no choice but to do what you have done. I dont pretend to know all the circumstances that may have led to your decision to do what you have but there must have been some conscious decision(family, spouse, etc) that put you into your current situation.

Call me crazy, but that sounds kind of like an attack right there.

Not that I need to justify my decision to anyone.. but, I was one of the only students IN MY CLASS to move out of state. There were opportunities that I researched here in Tampa that were not available in Texas. I watched my classmates literally fight for RELIEF work in Houston.

I did some research.. found a need in Tampa and moved my entire life. I knew no one when I moved here. The daily rate is higher here than almost anywhere else I've researched. My husband could find work here,also. This area is currently SCREAMING for docs. Most docs I talked to at a county wide dinner two nights ago talked about how they have to close their offices to take vacations because there are no relief docs in this area. But, ask them if they want to take on an associate.. and you get an entirely different answer. ODs are defensive of their turf.

Areas in Florida really desperately need docs. (Basically anywhere out of Miami/Ft Lauderdale) But, people are intimidated by the Florida Board exam. It's very expensive, offered once a year, and brutally hard. But, I studied, did some research and passed it. It's not impossible. Tampa is growing like mad... and I'm watching/researching areas. I was one of only two or three people in my class researching areas to live BEFORE graduation.

I never said I was going to stay at my current location forever. I've already incorporated I'm only a year and a half out of school. My decision to pay off some debt before I take on even more debt is my and my husband's business.

 

[prettygreeneyes]

Except, no one asked y'all to be judge and jury. You've made the forum that I helped START become a very hostile place for me (and any other commercial doc). I graduated 100k in debt like most other new grads. When I could only find work ONE DAY A WEEK in private practice.. I did what I had to do to eat. The private practice doc was 15 years from retiring. Am I supposed to starve for 15 years and wait patiently to buy him out ?! I can't take out a 200k loan from Mom and Dad to start a business. And, with my debt to income ratio out of school no bank would give me a loan.

I have a state of the art practice.. that happens to be in a Lenscrafters. If you want to go on the attack.. go find out how it's legal that some corporations are forcing their docs to give away "Free" exams with glasses and contact lens purchases. The only exams I've done free are my pro bono patients.

I would appreciate no longer being the example of "what not to do". I'm sick of it... and if it keeps happening I'll be retiring from SDN a lot earlier than expected.

For the record: I just hit my one year anniversary at my pratice. Patient volume has increased almost 200%.

Why don't we agree to discuss our practices and strategies--show students what's out there, what we like and don't like (without attacking).. and let THEM decide what's best for them. Treat them like the educated adults they are.

Can I get an "AMEN SISTER"!!!!!!!!!!!!!!!!

*climbs up onto soap box and grabs a megaphone*

While I do appreciate the argument that posner and drgregory make an almost daily basis, (sometimes more...) we get it already! Everybody who posts on this forum gets the fact that you guys are very against corporate optometry, but must you constantly bash us against the head with it? I've been posting on SDN for a little over a year, and ever since both of you joined this forum, it has gone downhill. And our own moderator, who has a wealth of knowledge to offer because she was a student like us very recently, never posts on here anymore because you guys are salivating at the chance to attack her. And now, the minute I disagree with you guys, I'll be labeled a "commercial OD apologist" or a naive student "who just doesn't get it." What I am, however, is a student who is actively seeking information so that when I graduated in 3.5 years, I will be ready to face the world with my OD degree in hand. Basically nothing you guys post is helping me do that. Take a note from doctors like Dr. Chudner, Dr. Hom, and KHE who have something constructive to offer the forum. If you feel the burning desire to offer opinions against corporate optometry (although surely everyone realizes where you guys stand), they would be much better received if you weren't so arrogant and condescending in your posts.

*steps off soapbox*

 

[iiiimonica]

pge, as usaul is right on target!

back off cpw. she is an asset to our field. her advice has always been great and she serves our profession well. don't judge her by where she treats her patients, look at how she treats them. some of the best od's i've worked with have been in retial setting. some private od's have been horrible. good patient care is what makes you a good od. period.

stop calling non private practice od's names, and belittling them. i want to hear how they have made it possible to practice in their settings. just like i want to learn how private doctors practice, how kaiser docs, how va docs. just beacuse it's a mode of practice you would not do doesn't mean it's not of value for us as students to learn about.

and i swear if you keep calling us students names (ie social ******s) it will get ugly here pretty quick.

 

[cpw]

and i swear if you keep calling us students names (ie social ******s) it will get ugly here pretty quick.

 

[posner]

Can I get an "AMEN SISTER"!!!!!!!!!!!!!!!!

*climbs up onto soap box and grabs a megaphone*

While I do appreciate the argument that posner and drgregory make an almost daily basis, (sometimes more...) we get it already! Everybody who posts on this forum gets the fact that you guys are very against corporate optometry, but must you constantly bash us against the head with it? I've been posting on SDN for a little over a year, and ever since both of you joined this forum, it has gone downhill. And our own moderator, who has a wealth of knowledge to offer because she was a student like us very recently, never posts on here anymore because you guys are salivating at the chance to attack her. And now, the minute I disagree with you guys, I'll be labeled a "commercial OD apologist" or a naive student "who just doesn't get it." What I am, however, is a student who is actively seeking information so that when I graduated in 3.5 years, I will be ready to face the world with my OD degree in hand. Basically nothing you guys post is helping me do that. Take a note from doctors like Dr. Chudner, Dr. Hom, and KHE who have something constructive to offer the forum. If you feel the burning desire to offer opinions against corporate optometry (although surely everyone realizes where you guys stand), they would be much better received if you weren't so arrogant and condescending in your posts.

*steps off soapbox*

While I appreciate your point of view I have to respectfully disagree. YOu are correct in that many of my posts have become downward spirals of inflammatory bickering, and for this I have apologized. I am making an effort to disagree more respectfully and I feel my last post was a good example(in fact I even went so far as to applaud cpw for her success). If it were not for some of the posts of mine and/or Gregs, the only other perspectives presented on this board would be despair or false hopes of the commercial optometry stepping stone to private practice. THe fact is(I am glad to see cpw seems to be an exception in this regard) that most commercial ODs never really have a plan to get out and so they usually dont. You make just enough money in corporate optometry that it is difficult to take an initial pay cut for private practice and so you spend your time searching for the private practice pipe dream that will allow you to walk right into a high/higher earning private practice opportunity.

I for one, am truly concerned about the profession of optometry. I want to see all new graduates have the opportunity to practice as they have been trained and to enjoy what I feel is a very rewarding profession. ODs like myself, ben, greg, etc already enjoy what we do and have large/successful practices. Whether you or others run to corporate optometry is not likely to affect our situations. I personally am more concerned about the future of the profession rather than its current state as far as my situation goes. I am going to sincerely try to refrain from inflammatory comments on corporate practice and try to get back to the true spirit of this boards which I believe is the constructive excahnge of ideas. I feel that I do have much to offer in the way of pearls and suggestions for successful private practice. I learned from a very wise OD(and am still learning) and would be more than happy to share.

POsner

 

[posner]

pge, as usaul is right on target!

back off cpw. she is an asset to our field. her advice has always been great and she serves our profession well. don't judge her by where she treats her patients, look at how she treats them. some of the best od's i've worked with have been in retial setting. some private od's have been horrible. good patient care is what makes you a good od. period.

stop calling non private practice od's names, and belittling them. i want to hear how they have made it possible to practice in their settings. just like i want to learn how private doctors practice, how kaiser docs, how va docs. just beacuse it's a mode of practice you would not do doesn't mean it's not of value for us as students to learn about.

and i swear if you keep calling us students names (ie social ******s) it will get ugly here pretty quick.

Take a look around at your next CE seminar or at the incoming class of students at your local OD school. Tell me how many of these folks YOU would go see.

Posner

 

[cpw]

Take a look around at your next CE seminar or at the incoming class of students at your local OD school. Tell me how many of these folks YOU would go see.

Posner

I wouldn't have wanted to see me before I took one class, either. Remember, you were once a first year student yourself

You sure you weren't the one in the back of the last CE I attended playing Suduko?

 

[prettygreeneyes]

Take a look around at your next CE seminar or at the incoming class of students at your local OD school. Tell me how many of these folks YOU would go see.

Posner

Excellent start to moving beyond your inflammatory past... Out of curiousity, how many of the 1000 or so incoming 1st years have you met so far?

PGE
Social ******
Member, Incoming Class of 2006

 

[KHE]

guys post is helping me do that. Take a note from doctors like Dr. Chudner, Dr. Hom, and KHE who have something constructive to offer the forum. If you feel the burning desire to offer opinions against corporate optometry (although surely everyone realizes where you guys stand), they would be much better received if you weren't so arrogant and condescending in your posts.

Wow.

When did I go from a extremely negative person who does nothing but discourages students to "having someting constructive to offer the forum?"

lol.

 

[Ben Chudner]

Wow.

When did I go from a extremely negative person who does nothing but discourages students to "having someting constructive to offer the forum?"

lol.

When you started hanging out with me.

 

[posner]

Excellent start to moving beyond your inflammatory past... Out of curiousity, how many of the 1000 or so incoming 1st years have you met so far?

PGE
Social ******
Member, Incoming Class of 2006

I have not met many of the incoming class. However, I regularly attend several of the larger CE meetings and I see numerous 4th years(especially at academy), new graduates, and those that have been at it for a while. Unless there has been a paradigm shift in admissions for the OD schools that I am unaware of? I sincerely hope the new class is a huge step in the right direction, and if so I stand corrected.

Posner

 

[prettygreeneyes]

Unless there has been a paradigm shift in admissions for the OD schools that I am unaware of? I sincerely hope the new class is a huge step in the right direction, and if so I stand corrected.

Posner

Well, I'm not biased or anything, but Pacific's entering class this year was pretty spectacular...

 

[prettygreeneyes]

Wow.

When did I go from a extremely negative person who does nothing but discourages students to "having someting constructive to offer the forum?"

lol.

I think you're a cuddly teddy bear deep down, KHE.

When I first joined this forum, I didn't have enough experience or background knowledge to appreciate your posts. The pharmacy-model prediction for optometry's future still bums me out though.

 

[Opii]

I have not met many of the incoming class. However, I regularly attend several of the larger CE meetings and I see numerous 4th years(especially at academy), new graduates, and those that have been at it for a while. Unless there has been a paradigm shift in admissions for the OD schools that I am unaware of? I sincerely hope the new class is a huge step in the right direction, and if so I stand corrected.

Posner

Posner, I'm at the AAO right now. PM me so we can meet.

 

[drgregory]

i can clearly see that my efforts, however fanatic, have failed. again, naiveness wins out, affording victory to corporate optometry. this theatre of my war has been lost. its sorrows me to see how many stand up for commercial optometry, and have absolutely NO idea the damage it does to the profession they worked so hard to be a part of. that is the simple message i attempt to project.

 

[xmattODx]

i can clearly see that my efforts, however fanatic, have failed. again, naiveness wins out, affording victory to corporate optometry. this theatre of my war has been lost. its sorrows me to see how many stand up for commercial optometry, and have absolutely NO idea the damage it does to the profession they worked so hard to be a part of. that is the simple message i attempt to project.

drgregory, you have every right to be upset about commercial optometry. Today was a slow Saturday for me today; 15 exams (the majority were walkins taken with a smile and "we'll see you in a minute"). Our CVE fee, for the next three weeks, is $29. I see the poor and the rich. I see the educated and the middle school drop-out. I steal private practice patients. They won't go back to private practice.

You can yell and scream at me all day and night. I don't sleep at nights so I'll be awake. I hate my life, I hate my job, I am angry 90% of the time. I am these things because of my job. I was asked by an "optician" today how long it takes to be an OD. She was surprised that it was a professional degree.

I am damaging optometry. I should be the brunt of the anger that is expressed on this site so often. CPW should not. I do not understand the problem with practicing full scope optometry - which if one can believe what CPW writes she does - next to a corporately owned optical. She charges appropriately and represents our profession well.

How is a LC in an upscale mall worse than the filthy private practice advertising "free exam with glasses" and "hearing aids available" that I see everyday?

I've worked in a plethora of private practices that take low ball vision plans and take in very little more than the $29 exams I was doing today.

You say the image is better because it's a "private practice". Sure, I guess I'll accept that. I guess I'll have to, you are right. You are always right.

I don't come to this site much anymore. It's not worth it. The rhetoric without listening to the other side is disappointing. The inability to see that there are different levels of "commercial optometry" is sad. The unwillingness to communicate with kindness is disgusting. Is commercial optometry bad? My commercial optometry, YES! CPW's commercial optometry?, not so much.

Don't chase her away guys. She has a lot to offer the students on this site - and isn't that what this site is for anyway? - the students?

 

[prettygreeneyes]

I don't come to this site much anymore. It's not worth it. The rhetoric without listening to the other side is disappointing. The inability to see that there are different levels of "commercial optometry" is sad. The unwillingness to communicate with kindness is disgusting. Is commercial optometry bad? My commercial optometry, YES! CPW's commercial optometry?, not so much.

Don't chase her away guys. She has a lot to offer the students on this site - and isn't that what this site is for anyway? - the students?

A very well written response, xmattodx. I hope that with your MPH, you will be able to take your career in a new and more personally satisfying direction.

Thank you for coming back to join in the discussion.

 

[KHE]

i can clearly see that my efforts, however fanatic, have failed. again, naiveness wins out, affording victory to corporate optometry. this theatre of my war has been lost. its sorrows me to see how many stand up for commercial optometry, and have absolutely NO idea the damage it does to the profession they worked so hard to be a part of. that is the simple message i attempt to project.

We really have to start being honest about this issue with ourselves as a profession.

Yes, commercial optometry is bad. I agree wholeheartedly.

But there is just much "commercial" optometry being practiced at the OD owned "private practices" of America. I have said this dozens of times. When I practiced, I worked about 50% private, 50% commercial. I saw just as much 7 and 4 and out the door in private as commercial. I saw just as many dusty BIOs in private than commercial. (probably more so because most privates were owned by old guys who probably couldn't even turn the BIO on.) I saw just as many pump action chairs and Green's phoropters in private than I did in commercial. I saw way more "doctors only" contact lenses in private offices than I ever did in commercial.

When I was clinic director at TLC, one of the main facets of my job was to travel around to different offices seeing referals. I saw and worked with about 50-60 ODs in the southwest and I can honestly say that 95% of the practices I saw and worked with were essentially optical stores with exam lanes in the back. Fundus camera? Nowhere to be seen. Field analyzer? What's that? Designer merchandise? Step right this way, sir. Do you take Spectera? Certainly, sir!

I can appreciate and agree with having doctors working in commercial places is not ideal. However, the vast majority of private offices are just as commercial. And when you have most private offices in between the pizzeria and the nail salon down at the local strip mall, what image is that projecting? I know I've told the story of a collegue in Los Angeles who looked at purchasing a private practice for sale and was shocked to find it located next to a store that sells adult toys and naughty lingerie. That's obviously an extreme example, but the image projected by most private offices is not any less degrading to the profession than the Lenscrafters. As a profession, we have to come to grips with that and do something about it, or my prediction of optometry ending up like pharmacy is going to come true. As long as private optometry continues to make the majority of its revenue from materials and not from services, its on the road to ruin. That played well 40, 30, even 20 years ago. In 2006, it's professional suicide.

Bash, bash, bashing away at commercial optometry is fun sometimes but it accomplishes absolutely nothing, and it's more than just a little bit hypocritical.

 

[cpw]

i can clearly see that my efforts, however fanatic, have failed. again, naiveness wins out, affording victory to corporate optometry. this theatre of my war has been lost. its sorrows me to see how many stand up for commercial optometry, and have absolutely NO idea the damage it does to the profession they worked so hard to be a part of. that is the simple message i attempt to project.

they're not standing up for corporate optometry.... they're standing up for ME!

 

[VA Hopeful Dr]

i can clearly see that my efforts, however fanatic, have failed. again, naiveness wins out, affording victory to corporate optometry. this theatre of my war has been lost. its sorrows me to see how many stand up for commercial optometry, and have absolutely NO idea the damage it does to the profession they worked so hard to be a part of. that is the simple message i attempt to project.

As has been stated over at Dr. Farkas' forum, if we eliminate the oversupply problem then commercial optometry will mostly take care of itself. I would bet that most ODs would much prefer to work in a private practice/medical setting if it didn't involve the major sacrifices at first which many new ODs cannot endure without defaulting on very large student loans.

Fix either the oversupply or the high cost of school, and I think you'd see a decline in coporate optometry.

 

[Richard_Hom]

I have been fortuante to live through the transition of "professional" to mixed (commerical and professional) to medical model/gls only model of the profession.

I have always found fault with peers who trumpet, "this is how I did it, you should do it this way". I don't believe that anyone can "copy" another's success. I do believe, though, that we should match our expectations with relative truths.

I"ve talked with many WM/Costco etc optometrists in CA and on the whole, they are a contented lot. They make a very comfortable living. Of course, I don't personally talk about their deep issues with finance, but I know most are not "Struggling" with practice.

I've also talked to many older and younger private practice optometriss. I think optometry schools create either kind of individuals (employyees and owners). Because of this, I don't believe that all optometrists are cut out to be owner-operators and not all are cut out to be employees.

I think the profession cannot rest in the status quo however some would want.

I do believe, though, deep down, all optoemtrists do want to help their patients and I also believe that there isn't a single way to do so. I think we should embrace all in the profession and look how it helps the patient. IN the end, it is the patient who has determined what much of optometry does, not us or any law.

In summary, the current state of optometry is affected by consumerism, governmental deregulation, profitability and supply of optometrists. Let's see how we can make this all work out.

 

[drgregory]

Bash, bash, bashing away at commercial optometry is fun sometimes but it accomplishes absolutely nothing, and it's more than just a little bit hypocritical.

tell me the address of a corporate location leased or owned by an OD that:

- has fundus cam, vf, gdx, ocular blood flow, IOL master, wavefront, OCT, ect
- has licensed opticians
- has appropriate fee levels (appropriate = on par with dental or podiatric chair time efficiency)
- has ophthalmology on staff

until then, i cant correlate hypocracy with many private practice situations that i know of. how can a practice as described above NOT create a better image for optometry?
its likely that the referral recruiting you did for TLC brought you to the doorsteps of some worthless practices - any decent practice would have already had affiliation with surgeons, and likely wouldnt have been included on your call list.

 

[KHE]

tell me the address of a corporate location leased or owned by an OD that:

- has fundus cam, vf, gdx, ocular blood flow, IOL master, wavefront, OCT, ect
- has licensed opticians
- has appropriate fee levels (appropriate = on par with dental or podiatric chair time efficiency)
- has ophthalmology on staff

until then, i cant correlate hypocracy with many private practice situations that i know of. how can a practice as described above NOT create a better image for optometry?
its likely that the referral recruiting you did for TLC brought you to the doorsteps of some worthless practices - any decent practice would have already had affiliation with surgeons, and likely wouldnt have been included on your call list.

Greg,

I have seen a few cameras and field machines in commercial practices. I have never seen OCT, GDx, IOL master or blood flow analyzers. (One person did have a loaner GDx that he got rid of because no one would pay extra for that advanced screening.)

The states that I have practiced in all have licensed opticians who by law must be on site all the time.

The recruiting I did for TLC did bring me to the door of some worthless practices, but I visited them all whether they had an affiliation with a surgeon already or not. In fact, I was more aggressive with the ones that did because I was trying to garner their patients. Sometimes it worked, sometimes not.

Obviously, the practice you describe should create a professional image. But even you have to admit that the majority of practices are not like that. The AOAs own numbers have shown that more than 85% of OD owned practices make the majority of their revenue from materials, not professional fees. That would lead me to believe that those practices either don't have that advanced technology you describe, or they sure aren't using it that much. That's the hypocrasy. I don't doubt that your office is state of the art and projects a positive image. But most private optometric practices don't.

And that's the problem. Private practices like to pat themselves on the back because they're "private" but when you make most of your revenue selling glasses, and you're in between the nail salon and the Payless Shoe Source, you're just as commercial as any Lenscrafters out there.

 

[drgregory]

And that's the problem. Private practices like to pat themselves on the back because they're "private" but when you make most of your revenue selling glasses, and you're in between the nail salon and the Payless Shoe Source, you're just as commercial as any Lenscrafters out there.

i dont doubt that there are tons of private practices like this. but in my immediate area, there are none like it. most are older and established, and have been able to bring forth the money to locate themselves in more professional locations. most also have at least some affiliation with surgeons, and working and symbiotic relationships. but, there are so few private practices in my area vs the numbers of corporate practices. daily i see patients who come from corporate offices because they now have VSP. they often times expect their choroidal nevus (which must have either been missed or astonishingly just appeared) photographed and documented for free, "because at Americas Best i got my whole exam and two pair of glasses for $69, and now youre telling me that just the retinal photo is going to cost $77?" how in the hell do you document when someone refuses to undergo further diagnostic if they have CDs of .8 and IOP of 30 -- "the optician at vision world didnt mention anything about this".
our office makes substantial income from materials. although meager, we would still have survivable income from services only. why? because services fees are set appropriately. materials SHOULD BE icing on the cake. not the cake. AND I AGREE WITH YOU, IT IS THE NATURE OF THE OPTOMETRIST TO, FOR SOME REASON UNCLEAR TO ME, DESIRE TO GIVE AWAY THEIR SERVICES AND DEPEND ON MATERIAL SALES. and for every private OD who is a refractionist in disguise, and for every commercial OD who signs a lease or agreement, we get further away from concentration on patient care. so, my criticism is towards ANY and ALL commercial ODs, because ive yet to see one who appropriately concentrates on patient care and has corresponding fee structure, and to ANY private ODs who are ancient spectacle peddlers. and if you are described above and dont even realize this concept, i dont criticize you - i pity you. and all of this isnt to stoke my ego, its in hopes to help the naive understand what they are doing when they sign the dotted line under the smiley face.

 

[posner]

i dont doubt that there are tons of private practices like this. but in my immediate area, there are none like it. most are older and established, and have been able to bring forth the money to locate themselves in more professional locations. most also have at least some affiliation with surgeons, and working and symbiotic relationships. but, there are so few private practices in my area vs the numbers of corporate practices. daily i see patients who come from corporate offices because they now have VSP. they often times expect their choroidal nevus (which must have either been missed or astonishingly just appeared) photographed and documented for free, "because at Americas Best i got my whole exam and two pair of glasses for $69, and now youre telling me that just the retinal photo is going to cost $77?" how in the hell do you document when someone refuses to undergo further diagnostic if they have CDs of .8 and IOP of 30 -- "the optician at vision world didnt mention anything about this".
our office makes substantial income from materials. although meager, we would still have survivable income from services only. why? because services fees are set appropriately. materials SHOULD BE icing on the cake. not the cake. AND I AGREE WITH YOU, IT IS THE NATURE OF THE OPTOMETRIST TO, FOR SOME REASON UNCLEAR TO ME, DESIRE TO GIVE AWAY THEIR SERVICES AND DEPEND ON MATERIAL SALES. and for every private OD who is a refractionist in disguise, and for every commercial OD who signs a lease or agreement, we get further away from concentration on patient care. so, my criticism is towards ANY and ALL commercial ODs, because ive yet to see one who appropriately concentrates on patient care and has corresponding fee structure, and to ANY private ODs who are ancient spectacle peddlers. and if you are described above and dont even realize this concept, i dont criticize you - i pity you. and all of this isnt to stoke my ego, its in hopes to help the naive understand what they are doing when they sign the dotted line under the smiley face.

I could not agree any more with what you say. Sadly, I have come to realize that our posts in criticism of the corporate OD are not cause for introspection like they are intended, but rather a rallying cry for those that would champion the cause of "individual preference" at the expense of the profession. It makes me want to wretch. I have always thought that each of us has at least some obligation to see to it that our profession continues to flourish and to move forward. Apparently, not every OD feels the same. The frustration you are expressing towards those that undermine the future of our profession, was the same frustration I was trying to convey in my original post "my rant...". It is difficult to stand by and watch a profession which has been so good to me unravel before my eyes. I can only hope that the views expressed by the corporate ODs on this board are not widespread(though the increasing number of box stores with eager beaver ODs would suggest otherwise).

Posner

Posner

 

[iiiimonica]

i think you both glossed over KHE's argument about private od's who peddle glasses in the same way as corporate optometry.


your best points are about fees. big optical should do some serious cost benefit analysis and raise their exam fees. i 100% agree.

if your only problem with commercial optometry is fees, then why don't you guys push for fee increases within the corporation? posner can invest some of his millions and become a major stock holder

but seriously, i think your real problem is the image of corporate optometrists, and seeing as some privite ods work in strip malls and have lower fees than corporate od's, it seems like you are just boosting your egos at the expense of others.

and your "if your not with us your against us" mentality is getting old. really we are thinking "socially ******ed" adults. stop bullying us with CAPITAL letters and rehashed opionions.

okay back to ventral visual pathways
eye>retina>lgn>V1>V4>IT

 

[drgregory]

your best points are about fees. big optical should do some serious cost benefit analysis and raise their exam fees. i 100% agree.

if your only problem with commercial optometry is fees, then why don't you guys push for fee increases within the corporation?

this reeks of naiveness. and here come the caps to facilitate visual processing: GENERALLY, MOST STATES' STATUTES REQUIRE THAT ODS ARE INDEPENDENT OF ANY FRANCHISE. THEY DID THIS TO PREVENT DICTATION OF CARE BY A NON-OD. SO, TECHNICALLY ITS UP TO THE OD TO RAISE THEIR FEES, NOT THE CORPORATION. THAT IS WHY I REPETITIVELY SLAM CORPORATE ODS TO RAISE THEIR FEES - THEY NEED TO TAKE THE SMALL AMOUNT OF INITIATIVE TO PUSH FOR IT, AND GRANTED THEYLL BE OPPOSED. FOR GOODNESS SAKES, HOW HAVE YOU MISSED THIS POINT? IVE ONLY ARGUED IT FOR ONE THOUSAND, NINE-HUNDRED AND EIGHTY FIVE TIMES NOW. obviously, more repitition is needed to drive this point home - we've just observed first hand how someone has missed the point.

 

[iiiimonica]

this reeks of naiveness. and here come the caps to facilitate visual processing: GENERALLY, MOST STATES' STATUTES REQUIRE THAT ODS ARE INDEPENDENT OF ANY FRANCHISE. THEY DID THIS TO PREVENT DICTATION OF CARE BY A NON-OD. SO, TECHNICALLY ITS UP TO THE OD TO RAISE THEIR FEES, NOT THE CORPORATION. THAT IS WHY I REPETITIVELY SLAM CORPORATE ODS TO RAISE THEIR FEES - THEY NEED TO TAKE THE SMALL AMOUNT OF INITIATIVE TO PUSH FOR IT, AND GRANTED THEYLL BE OPPOSED. FOR GOODNESS SAKES, HOW HAVE YOU MISSED THIS POINT? IVE ONLY ARGUED IT FOR ONE THOUSAND, NINE-HUNDRED AND EIGHTY FIVE TIMES NOW. obviously, more repitition is needed to drive this point home - we've just observed first hand how someone has missed the point.

why must you do this? really does it make you feel better to call people names? and type in all caps, like a 2 year old (well actually more like my aunt who is ~80ish and doesn't know it's bad to type out like that)

and if you really think corporations don't set exam fees :laugh that's why corporate docs DON'T raise their fees, if the base exam fee in a corporation increased to say $150, then every other store within that chain could raise their fee to this and maybe a little higher. fees are based on what the other stores in your region charge.

 

[VA Hopeful Dr]

this reeks of naiveness. and here come the caps to facilitate visual processing: GENERALLY, MOST STATES' STATUTES REQUIRE THAT ODS ARE INDEPENDENT OF ANY FRANCHISE. THEY DID THIS TO PREVENT DICTATION OF CARE BY A NON-OD. SO, TECHNICALLY ITS UP TO THE OD TO RAISE THEIR FEES, NOT THE CORPORATION. THAT IS WHY I REPETITIVELY SLAM CORPORATE ODS TO RAISE THEIR FEES - THEY NEED TO TAKE THE SMALL AMOUNT OF INITIATIVE TO PUSH FOR IT, AND GRANTED THEYLL BE OPPOSED. FOR GOODNESS SAKES, HOW HAVE YOU MISSED THIS POINT? IVE ONLY ARGUED IT FOR ONE THOUSAND, NINE-HUNDRED AND EIGHTY FIVE TIMES NOW. obviously, more repitition is needed to drive this point home - we've just observed first hand how someone has missed the point.

But what's to stop the corporate masters from finding new ODs who will put prices where the optical folks want them?

Too may grads, too much debt, not enough private opportunities. Fix any of those and corporate will go down quite a bit.

Or here's an even neater thought... granted my exposure is limited to my own state, but the ratio of private/corporate docs in the state association is skewed pretty heavily towards private. Get involved and work to change things. Same applies to the Board of Examiners.

 

[drgregory]

fees are based on what the other stores in your region charge.

youve just now finally solved the sarcasmic riddle of many of my posts? of course i know this. and nearly every damn post i make belittles those who put up with corporate masters, and as KHE pointed out, dont even need corporate influence to practice this way. ive sent three letters to my state association regarding fee-splitting. i am part of the POP movement to stop this. im in touch with the AOA. do you know that Dr. Classe, and OD JD is taking this on? have you the initiative to even understand the process?

im attacking the naiveness of ODs. im not above them. but im sure as hell trying to make optometry better.
i think most ODs want to, but their greedyness takes control and they give up. what have you done as a student? you are taking the initiative to communicate with others like we are doing here. will you take it further? what happens when its time for you to find an opportunity? will you sign on the line with a franchise and agree to give away your services? or maybe, just maybe, you'll remember that a-hole on SDN named Drgregory and think twice. that is my goal, and if i spark a little anger, well at least someones listening, and that makes me feel a little better.

 

[posner]

why must you do this? really does it make you feel better to call people names? and type in all caps, like a 2 year old (well actually more like my aunt who is ~80ish and doesn't know it's bad to type out like that)

and if you really think corporations don't set exam fees :laugh that's why corporate docs DON'T raise their fees, if the base exam fee in a corporation increased to say $150, then every other store within that chain could raise their fee to this and maybe a little higher. fees are based on what the other stores in your region charge.

Earth to Monica....you are missing the point. The corporations are establishing(whether you think so or not) the fees you see at Vision World, Wal Mart, etc. It is not accidental. They know there is a line of ODs waiting to ***** their services for next to nothing so that they can reap the rewards in the dispensary. It is this simple. The reason corporate docs often dont raise their fees is because they may steer patients elsewhere which results in unrealized revenue for the dispensary. While I respect your opinion(see how I am trying to be less inflammatory?) you couldnt be more incorrect.

Posner

 

[prettygreeneyes]

Earth to Monica....you are missing the point.

Posner... and even more so...drgregory,

I would respectfully offer that perhaps you guys are the ones who are missing the point. You seem hell bent on beating us into submission in regards to your feelings on corporate optometry. The thing is, I think most people on this forum agree with your overall sentiment that corporate optometry isn't good for the profession as a whole. If you stopped your ranting long enough to read what we actually write, you might realize that. What I, and perhaps others, don't agree with are your tactics. Let your message and arguments stand on their own. Leave the personal attacks, name calling, and emotional ranting out of it. And for Pete's sake... turn the damn caplocks key off.

If cpw retires, and I don't get to look at her Matthew McConaughey avatar anymore... I'm going to be VERY upset.

 

[cpw]

If cpw retires, and I don't get to look at her Matthew McConaughey avatar anymore... I'm going to be VERY upset.

Just for you, PGE --


(my friend took this for me at the BCS Championship Game last year)

 

[prettygreeneyes]

Just for you, PGE --


(my friend took this for me at the BCS Championship Game last year)

Yummy.

 

[VA Hopeful Dr]

Yummy.

Apparently eye candy falls under scope of practice for you ODs types as well

 

[WoodyJI]

I don't understand why so many people on this board start off by saying that they totally agree with Posner and Dr. Gregory, only to follow that statement with a "but...". Personally, I respect the two of them highly for taking the time to come out here and be RUDE.

And maybe I'm being little naive here with what I'm about to say, and really should not "judge people," but this is a no-brainer, isn't it? Come on. Commercial optometry harms our image--period. I don't care if patients get the best care in the world there...they can get the best care in the world at a private practice without diminishing the public perception of our skills.
"Optometry...is that a two year program?" is not a question I believe I should have to field when I chit chat about my career choice with people. The argument that some private practices are "commercial" in that they peddle glasses or are located next to porn stores does nothing to help corporate optometry's image. I don't like either of those modes of practice, and taking the time to point out supposed hypocrisy doesn't justify anything.

Posner and Dr. Gregory get emotional on this forum because they believe in something. It seems to me that the corporate optometrists on this forum get emotional because they're undergoing "personal attacks." I do think it's great that we have emotions running either way here though, because this is important stuff.

In the end, I would say that VA Hopeful Dr and Richard_Hom state the situation the best...but that's mostly because they know that "naive" people don't like caps. If some of what they're saying is true, then how are we going to prevent oversupply (if there really is oversupply) and lower student debt? And would that really stop people from choosing the lucrative/convenient corporate golden handcuff route? Maybe a small group of us are "social ******s" (as some would say), or "not owners/employees" (as others would more delicately put it) and will always be? Maybe Senior Docs need to work harder at bringing up associates and retiring at a reasonable age?