Jason & Tippytoe

[mclem222]

I am not sure what you mean by unsaturated areas..
I was in Maryland for some time after school and before I came home to practice...the ODs who were in practice in St Mary's county (total rural area) were struggling pretty bad, and even in Charles county. OD practices there were shutting down all the time..also even some of the ones in D.C but they were more stable..Is there evidence that being in a rural area makes it easy to be busy? I am just asking because I am not sure. I think there are more people in big cities who have the money to afford our services. A lot of noninsured people hold off getting eyecare once the economy goes south... I would love to see the data on that...just to make sure it is the truth not a perception.

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[Rivets]

I really don't see how anyone has been thrown under the bus here. I think, when you finish school, and you realize the truth in what he's saying, you'll be on board. Four years of undergrad (for a cool 60K to 100K+ in expenses), four more years of optometry school (for another 100-200K in expenses), maybe a year of residency (that'll cost you about 40K when you factor in lost income as well as interest that you can't pay because your income is in the low 30s.) Add all that up, and if you can't see that it's worth more than 70K per year (less about 12K per year for loan payments), then you might actually be thrilled with the income that future optometrists will enjoy.

It's true that there are TONS of Americans out there who would kill to make 70K, 58K, or even to just have a job, but the fact is, the great majority of those folks didn't drop hundreds of thousands of dollars into their education along with 8-10 years of study, and commit to paying back student loans for a good portion of their professional lives.

I just registered for these forums, after lurking for many months. Jason K, I can't thank you and folks such as TippyToe enough for elucidating upon matters such as the Quote above.

I've been thinking about Optometry for 15+ years. Always wanted to be a Doctor and see patients (social type who enjoys science). For various reasons pursued an M.S. in Chemistry instead (no debt; youthful interest in the intricacies of the Universe, etc) and now work in Pharma. Burned out on that industry utterly, and with that I must say being "The Doctor" and having even a modicum of autonomy is almost worth the price of admission. Almost. Having worked in nearly every therapeutic area and dealing with the lives of every kind of Doctor (including Optometrists), it is still, professionally, an enviable day to day gig so long as you're the interactive type. Of course, some specialties need/require less socialization, but the interaction is primarily structured around You --> Patient. Anyone who has worked in the Corporate Cube Farms and seen "The Office" understands.

I'm now in my 40s, and have been accepted to Optometry School. After really sitting down to research the expense, locales, and future trends, I have to sadly proclaim that I will not be attending. Most young people do not grasp the grind and attrition of life - and being a slave to debt. 200k and 4 years of lost wages? Wading into a future of an economy in tatters, where the Student Loan racket is the next SubPrime bubble waiting to explode. Going to school at present is like buying a House in 2007 at the height of the market. Sure, you live only once and have to work doing something, but unless student loans are partially forgiven in the future, wage pressure due to economic forces (much like the deflation of 2007-2009) will result in making debt payments acutely painful (job losses; less older O.D.'s retiring; lower wage/debt ratios). This speaks nothing of the additional pressures that oversaturation (6 or 7 new schools in 10 years? What's that, a 25% increase in the number of schools?) and the government's creeping Control and socialization of Medicine will sow.

For some of you to take the time to come on these forums and share well-constructed arguments is greatly appreciated by probably more than a few of us. Sure, I'd like the message to be different, and yes, the Internet is generally a pissing/venting medium given human psychology and anonymity, but there's no reason for people to spend their precious time on a forum expounding on their experiences with verbosity and thoughtful prose. Just know that these discussions do impact and influence some of us out there.

Thank You

 

[CL Doc]

I am not sure what you mean by unsaturated areas..
I was in Maryland for some time after school and before I came home to practice...the ODs who were in practice in St Mary's county (total rural area) were struggling pretty bad, and even in Charles county. OD practices there were shutting down all the time..also even some of the ones in D.C but they were more stable..Is there evidence that being in a rural area makes it easy to be busy? I am just asking because I am not sure. I think there are more people in big cities who have the money to afford our services. A lot of noninsured people hold off getting eyecare once the economy goes south... I would love to see the data on that...just to make sure it is the truth not a perception.

I've been in rural practice and it isn't the solution to saturated urban practice. For example lots of new grads pick up extra money working retail on the side. We don't have that option. The myth of rural practice is being promoted by someone who lives in NYC. I wonder if he has ever lived any place else.

Like the theater? We don't have one. Like the mall? It's a long drive. Want to see professional sports? Get Direct TV. Like fine dining? Forget about it.

 

[pinipig523]

Here's my viewpoint as a new ER attending physician - money is NOT easy to earn. Sometimes, what you see on paper is different that actually doing it. I've had people tell me that money isn't easy to earn or it's tough to work 40h a week as an ER attending and I've poo-pooed them all as merely speaking nonsensense. Then I started my job as an attending and man... what they said was true!

Jason and TT are right to be very vocal about optometry on these boards - it's best to know exactly what you are getting into before you dive right in.

But either way, money is not easy to earn... in any field.

 

[Shnurek]

Very true. If people would enjoy doing it, you wouldn't get paid to do it.

 

[Meibomian SxN]

Ya my parents just bought a new car and didn't bother for the extended warranty. Gotta agree with everyone on here that leasing is a bad financial investment.

I disagree. Leasing makes better sense than buying in most cases. You bought a product that depreciates the minute it drives off the lot. And 3-5 yrs from now it'll look like a decade old! Lease is cheaper monthly and allows for a new vehicle every 3yrs. Buying only makes sense if you're planning on keeping the vehicle for a while.

To each their own.

 

[thanotoriousfob]

I disagree. Leasing makes better sense than buying in most cases. You bought a product that depreciates the minute it drives off the lot. And 3-5 yrs from now it'll look like a decade old! Lease is cheaper monthly and allows for a new vehicle every 3yrs. Buying only makes sense if you're planning on keeping the vehicle for a while.

To each their own.

You couldn't be more wrong. I worked in a family car dealership before optometry school. I can't tell you how many times I've seen people be approved for low finance rates and low monthly payments only to turn around and spend the same amount on a 3 year lease. The 3 year loan would be very comparable to the 3 year lease in terms of monthly payments and at least in the end, you have a car to show for it.

The stupidest people were the ones that focused on how much their monthly payments were going to be. As long as the monthly payment is at least $200 for example, they wouldn't care how long the loan is. Dealerships love hearing you have a set monthly budget because if you have decent enough credit, they will approve you for that $200 and tell you that you are approved! In reality however, these customers were approved for $150. But by then it's a moot point because both parties are happy, client got their $200 monthly payments and the dealership got themselves a deal,an extra $50 a month for 3 to 5 years, and a loyal customer. These people should have have been focusing on total price (price of the car, and total interest from the loan) instead of the monthly payments. These are the same breed of people that like to get their loans from dealerships because it's convenient rather than putting in a little effort and going to their credit union or bank to get pre-approved for x% interest rate and x amount of dollars.

Back to leasing; it makes sense in certain situations such as living somewhere temporarily, being unable to be approved for better loan rates, or money isn't an issue and you just want the newest model. More often than not however, owning a car vs leasing a car makes more financial sense. Look at the post from earlier about the person that "got to give the car back" to the dealership. I can bet that poster is the dealership's favorite customer, and they were laughing at her the moment she signed the contract.


Sorry I turned this into a loan vs lease post, but I thought it was a nice change of pace from the daily doom and gloom sponsored by our resident OD's.

 

[KHE]

These people should have have been focusing on total price (price of the car, and total interest from the loan) instead of the monthly payments. These are the same breed of people that like to get their loans from dealerships because it's convenient rather than putting in a little effort and going to their credit union or bank to get pre-approved for x% interest rate and x amount of dollars.

.

That's peculiar.

Last year, I bought two cars....one brand new and one a 2007. In both cases, I got a much better rate and term from the finance company associated with the dealer than I did with my bank or credit union, particularly on the new car.

My bank manager basically said that the bank wasn't particularly interested in the car loan business because the hassle factor can be very high and they would almost prefer that you went somewhere else. Credit union guy said basically the same thing.

I wonder if that has forced the dealer financing to become much more competitive than it has in the past in a down economy?

 

[thanotoriousfob]

That's peculiar.

Last year, I bought two cars....one brand new and one a 2007. In both cases, I got a much better rate and term from the finance company associated with the dealer than I did with my bank or credit union, particularly on the new car.

My bank manager basically said that the bank wasn't particularly interested in the car loan business because the hassle factor can be very high and they would almost prefer that you went somewhere else. Credit union guy said basically the same thing.

I wonder if that has forced the dealer financing to become much more competitive than it has in the past in a down economy?

You're probably on point with this statement. Times have definitely been tough for the car dealerships. Competitive interest rates do help. Most of the money made in dealerships nowadays is from the service department, not the sales.

 

[Meibomian SxN]

You couldn't be more wrong. I worked in a family car dealership before optometry school. I can't tell you how many times I've seen people be approved for low finance rates and low monthly payments only to turn around and spend the same amount on a 3 year lease. The 3 year loan would be very comparable to the 3 year lease in terms of monthly payments and at least in the end, you have a car to show for it.

Well, I can not say I am an expert in auto financing. But I will say I prefer to have the latest vehicle every 3 years, something you can not do when you buy a vehicle. But again, to each their own.

 

[calvnandhobbs68]

I disagree. Leasing makes better sense than buying in most cases. You bought a product that depreciates the minute it drives off the lot. And 3-5 yrs from now it'll look like a decade old! Lease is cheaper monthly and allows for a new vehicle every 3yrs. Buying only makes sense if you're planning on keeping the vehicle for a while.

To each their own.

Haha so buying only makes sense if you want to save money? I think you made everyone's point for them.

 

[Meibomian SxN]

Haha so buying only makes sense if you want to save money? I think you made everyone's point for them.

No, buying makes sense for someone who isn't into having the latest up to date vehicle and plans on keeping it, so yes they 'save'.

I prefer to 'live' a little. By the time that financed vehicle is finished being paid off, I will have went through 2 NEW leases. So have fun 'saving'...

 

[Jason K]

I think the key here, is the term "financial." It rarely makes financial sense to lease when compared to buying (especially if you buy a 1 year old car), but sometimes, people prefer to spend more, even if it's not necessarily the best financial decision, in order to satisfy their desires.

Everyone caters to their desires - for some people, it's cars, for others, it's shopping at Whole Foods, paying 180% of what you'd pay at any other grocery store, and for still others, it's shelling out a few thousand dollars to the AOA.....I mean ABO so you can have a shiny new "Board Certification" plaque to tell your buddies about and impress the ladies at the Wal Mart. None of those things makes financial sense, but people do them because they can.

I'd argue that if you're a current OD student and you're accustomed to leasing cars, shopping at Whole Foods, and buying pieces of worthless paper that cost thousands of dollars, you might be in a bit of pinch when you get out of school and start working as an OD.

 

[odieoh]

No, buying makes sense for someone who isn't into having the latest up to date vehicle and plans on keeping it, so yes they 'save'.

I prefer to 'live' a little. By the time that financed vehicle is finished being paid off, I will have went through 2 NEW leases. So have fun 'saving'...

Just my 2 cents on the buy/lease debate-- both are decent options depending on your goals/desires. From a purely financial standpoint, yes buying usually makes more sense, buying and driving the same car into the ground for 5-7 years. That does come with some downside however.

After about 3 years cars often start to have mechanical problems. Dealing with breakdowns and mechanics can be quite costly, both financially and in terms of time spent dealing with it. A person on a 3 year lease doesn't have to deal with that, at least not nearly as often. That peace of mind, along with being able to drive a perpetually new car, is the reason a lot of people lease.

I've never leased, but I understand why some people would.

 

[thecgrblue]

I love the evolution of this thread..."Jason K and Tippytoe ----> financial advising re: vehicles"

I love SDN.

Squirrel?!

 

[Shnurek]

what does CGR stand for I've been curious for a while

 

[thecgrblue]

what does CGR stand for I've been curious for a while

*sigh*...I hate my screen name. I've been contemplating becoming a lifetime donor so I can get it changed or even creating a new one...but who wants to lose their post count?!?

The mascot at my ugrad university is a cougar and our main color is blue...ergo thecgrblue...the product of my lack of creativity.

What is Shnurek supposed to be? I always read it as Shrek.

 

[Shnurek]

*sigh*...I hate my screen name. I've been contemplating becoming a lifetime donor so I can get it changed or even creating a new one...but who wants to lose their post count?!?

The mascot at my ugrad university is a cougar and our main color is blue...ergo thecgrblue...the product of my lack of creativity.

What is Shnurek supposed to be? I always read it as Shrek.

hehe can't go into details as it would make my identity obvious

 

[NYCBlues]

You asked the question, I answered it with a simple comparison. I never placed the two events on the same plane, you did.

Maybe this will be more pleasing to you:


I find it amusing that there are ODs on here who quietly agree with most of what I and other "naysayers" claim, and yet they're the first ones to criticize anyone who would take the time to point out the slope that optometry is sliding down. They're also the first ones to paint on a smile when the wide-eyed, bushy-tailed pre-optometry students come hopping into their office. Are you helping anyone by hiding the truth? What good are you doing by ignoring the realities that we both know are hidden from view?

Optometry is diseased and its days as a private, independent profession are numbered. It says nothing of its members, it just is what it is. You know it and I know it. Tippytoe knows it, and the vast majority of the ODs in the nation know it. You know who doesn't know it? The people who are placing their entire professional futures, spending hundreds of millions of dollars on a bet that optometry will provide a solid future. They're continuing to flood into a profession that can't support them while most of the ODs in the nation stand by and twiddle their thumbs saying "Not my problem." They complain, moan, and scream on ODWire, some angry, some sad, some just plain disappointed with what the profession has become and is becoming, but virtually none of them do anything to warn others about what they, themselves, already know.

Personally, I think it shows a degree of callousness that there aren't more ODs on here. The lack of presence certainly doesn't stem from a shortage of ODs who know the truth about what's coming. I'd feel a little guilty if I knew a store were selling broken, vastly over-priced, unwarranted computers, and then chose to stand outside the store and throw banana peels at the guy who was telling people that what they're buying is not what they think it is. That's pretty cold, dude....maybe you need the counseling.

I'm not on here to make friends. I'm not on here to make people feel good or bad about themselves, I'm not even on here to tell people not to go to optometry school. I'm on here to warn people about the fact that optometry, as a profession, is sick, and if they devote their entire future to it, they'd better be sure it is what they think it is. In most cases, it's not.

love this post.

 

[pudgie84]

I love the evolution of this thread..."Jason K and Tippytoe ----> financial advising re: vehicles"

I love SDN.

Squirrel?!

haha, most days i come on here purely for the entertainment value. although sometimes i learn stuff.

...can't we all just get along? lol

 

[BeesKnees22]

It is what it is... but it is not even remotely close to "losing a child or loved one to some unadvoidable cause" .

For real.

 

[Jason K]

It is what it is... but it is not even remotely close to "losing a child or loved one to some unadvoidable cause" .

For real.

Alright, now.....for the third time, I'll go ahead and clarify....

Stubbing your toe hurts.
Breaking your toe hurts.
Having a 9 ft concert Steinway - land on your foot - hurts.
Losing your entire left leg in a freak attack by a pack of wild pomeranians - hurts.

They all hurt, people. In that way, they all share a common element...in that they all......hurt. Each one of those things might be what you'd describe as...."uncomfortable."

They are not all equal.

In much the same way, I never said the two events in question were equal. I simply compared them to one another as both being unpleasant. IandI was the one who stepped in and made them equal - I didn't.

And that's.....fuh real.

 

[Poetic Silence]

Wild pomeranians.

 

[IandI]

You know when you see on the news how some family loses a child or a loved one to a drunk driver or some other avoidable cause? They usually find some way to make it a purpose in life to prevent others from experiencing the same loss. Well, I lost my career to optometry.

These are your words not mine, it certainly sounds like your using a tragedy of inappropiate portion to make your point.

Someone, somewhere loses a love one to a drunk driver, their devastated and their life is never the same so they start a new life which is dedicated to stopping drunk driving.

Jason went to school to be an Optometrist the profession is not as rewarding as he imagined so he is devastated and now has dedicated himself to warning others of the horrors of this career choice.

My point is that your comparing tradgedy to unhappiness and they are not the same thing to different degrees as in your analogy about toes and pianos...not at all.

But I'm sure you'll have some smart ass reply..because your intelligent just not very wise.

 

[Jason K]

These are your words not mine, it certainly sounds like your using a tragedy of inappropiate portion to make your point.

Dude, you really need to let this one go. You’ve already been shut down several times so I don’t really know why you’re still pursuing this topic. The comparison is valid and it makes my point effectively….WITHOUT implying that the two events are on equal par with each other. You did that equalizing, not me.

My point is that your comparing tradgedy to unhappiness and they are not the same thing to different degrees as in your analogy about toes and pianos...not at all.

Your point is meaningless because I never once indicated that “unhappiness” and “a personal tragedy” are the same thing. Again, now for probably the 6th time, you made that statement, not me. My point, since you seem to be taken to making my points for me, was to explain why I am here, not to place those two items on an equal plane. Something “bad” happened to me. I am warning others so they can make their decision with more information than I had. This approach is nothing new to the human psyche – as my point illustrated.

But I'm sure you'll have some smart ass reply..because your intelligent just not very wise.

Oh, I've got wisdom, baby – I got wisdom out the ying-yang.

 

[odieoh]

But I'm sure you'll have some smart ass reply..because your intelligent just not very wise.

Oooh the irony

 

[Jason K]

Oooh the irony

Your dead on, odieoh. Their really is some very poor grammar out they're.

Sorry, looks like IandI was right....there was my smartass response. I don't think the George Costanza quote really counts. I waited quite some time, though - you have to give me credit.

 

[odieoh]

Your dead on, odieoh. Their really is some very poor grammar out they're.

Sorry, looks like IandI was right....there was my smartass response. I don't think the George Costanza quote really counts. I waited quite some time, though - you have to give me credit.

Yes, kudos for patience

 

[NCiDOC]

Well I have not been on this forum in about 1.5 years. Sounds like it is worse than when I left it. What a shame.

While some doctors have chosen to spend their time sharing the doom and gloom that apparently many of you are buying into, (with exception of KHE and a few others), I bought a practice from another doctor and just finished our first year in business as a new practice.

We are booked up 5 days a week and are at the point where I am looking for an associate doctor to bring in part time with the goal of them being full time as soon as their schedule allows. I think this will take one year to accomplish.

Yes, I worked very hard in this past year. Yes, I had to take a loan out to do it after I had my student loans paid off. Yes, my stress level went up over the past year. However, I am doing what I love and am taking great care of patients and building relationships in my community that are invaluable. I provide for my family and we are able to take some reasonable vacations.

Do I think that the future is rosy for optometry? No. Do I think that a doctor on top of his/her game can have a successful business in our profession? YES, absolutely. It is not as easy as it once was but life would be boring without challenges right?

There are SO many resources out there these days for younger docs that are looking to get into private practice. You do not have to be an expert at all the things you used to because you can get help with the pieces you need.

I am a member of a group called OD Excellence and have been for a few years. It keeps me on top of all the new medical coding, billing and treatments that come along. It gives me a way to communicate with like-minded doctors around the country. I can benchmark my practices' performance against others in a confidential way to make sure that I am doing well where I need to. I have availability to staff training and education ongoing. I could go on and on but if someone really wants to hear more they can private message me.

I am just so sorry to see that something that could be so useful has remained so negative since I was here last. Glad to see a guy like KHE is still fighting the good fight. Keep on with it brother!

NCIDOC

 

[Jason K]

Well I have not been on this forum in about 1.5 years. Sounds like it is worse than when I left it. What a shame.

Yes, optometry is worse than when you left.....and it is a shame.

So, here's the problem, as I've pointed out before. You, KHE, and some others, are speaking to the few students that might find a way to climb over the 100ft wall that is blocking them, a valid effort. I'm speaking to the vast numbers of students who cannot and will not get through to the other side. Who has the more noble cause? I really don't care. But I can say this, if you keep welcoming in droves of students, the ones that don't succeed will serve to drown everyone else - you included.

While some doctors have chosen to spend their time sharing the doom and gloom that apparently many of you are buying into, (with exception of KHE and a few others), I bought a practice from another doctor and just finished our first year in business as a new practice.

I feel for you, dude. What are you, a year or two out of school? You've pretty much bought a sinking ship and you don't even realize it. All of medicine is sinking, but optometry is on the 4th class deck, right beneath the freight. It's great that you had the sack to buy an office, but you're crying success a little prematurely, my friend. I wonder what a pharmacist who bought a private pharmacy in the early 90s said when he went under.

We are booked up 5 days a week and are at the point where I am looking for an associate doctor to bring in part time with the goal of them being full time as soon as their schedule allows. I think this will take one year to accomplish.

If this is true, that's wonderful - too bad it separates you from just about every other OD office in the country. It's very difficult to find an OD office at which you can't get a slot within 72 hours.

Yes, I worked very hard in this past year. Yes, I had to take a loan out to do it after I had my student loans paid off. Yes, my stress level went up over the past year. However, I am doing what I love and am taking great care of patients and building relationships in my community that are invaluable. I provide for my family and we are able to take some reasonable vacations.

It's great that you seem to have found your optometric nirvana. The problem is, this forum isn't about what you or I can do as individuals. That's the flaw that many succumb to. It's about what the vast majority of new optometric grads can do. They couldn't do what you're doing, even if they wanted to. There are not enough practices to available to sell one to every recent grad who would consider buying one, even if that were a prudent investment. A few can, which is what I've said all along. The rest, will funnel into commercial, growing the cancer. The numbers don't support any other outcome.

You can come on here and do a happy dance about buying an office, but it changes absolutely nothing. There simply are not enough places to land, given the insane numbers of new grads and current ODs.

Do I think that the future is rosy for optometry? No. Do I think that a doctor on top of his/her game can have a successful business in our profession? YES, absolutely. It is not as easy as it once was but life would be boring without challenges right?

As I've said, too many times to count, there will be a fortunate few that will occupy the "good" spots that might always exist. It could be through hard work, random chance, or back stabbing, but the end result is the same - a few will slip through the cracks while the rest perish by the wayside.

Look, your story is great (for now). If more new grads were able to get out of school and buy a successful office, I wouldn't be here. Let's assume that your practice will be enormously successful. The truth is, your situation is exceedingly rare - the numbers just don't support that as a possibility. If every "good" practice for sale in the US were bought up by the next graduating class of ODs, you'd run out of offices before you filled up one school's class, not to mention you'd have dumped a large number of "dead duck" practices on unsuspecting new grads.

Sorry to burst your bubble, but your uplifting story does nothing to change reality.

....and I haven't even gotten to the Obamacare debacle. If that stands (and since America is full of lemmings who will believe anything they're told by their quasi-socialist leader, it probably will), we're going to see the final nail in the coffin of private health care in America. Anyone who believes that Obama isn't out to squash private health care out of existence is kidding themselves.

 

[Tippytoe]

Well I have not been on this forum in about 1.5 years. Sounds like it is worse than when I left it. What a shame.

While some doctors have chosen to spend their time sharing the doom and gloom that apparently many of you are buying into, (with exception of KHE and a few others), I bought a practice from another doctor and just finished our first year in business as a new practice.

We are booked up 5 days a week and are at the point where I am looking for an associate doctor to bring in part time with the goal of them being full time as soon as their schedule allows. I think this will take one year to accomplish.

Yes, I worked very hard in this past year. Yes, I had to take a loan out to do it after I had my student loans paid off. Yes, my stress level went up over the past year. However, I am doing what I love and am taking great care of patients and building relationships in my community that are invaluable. I provide for my family and we are able to take some reasonable vacations.


NCIDOC

Good job buying the practice. However, you are still a newlywed. Get back with us in 10 years. Most everybody is gung-ho for the first few years until reality really sinks in. I was so pumped after I graduated that I began writing articles in Optometric Management. (but even at that time I was a little disappointed at how easy it was to get published. I don't even think they checked if I was even an OD--any clown off the street can send them an article and they will print it as if it's expert opinion).

As far as adding an associate OD, I don't think I've ever seen an OD office that couldn't benefit from delegating more to techs and adding more exam rooms instead of paying another doc salary. OMD can see 40+ per day yet ODs feel the need to hire another OD once they are seeing 15 per day. Why not have 10 exam lanes and 5 techs? But, I digress.

It's your practice and you are free to run it as you please, of course (one of the benefits of private practice most future ODs will never see). Thanks for crawling out of the Mart-Wall sludge, away from all the other ODs and getting a respectable job. That you should be commended on.

If you ever wonder why all older docs are zombies. It's because for 20+ years, they've been beaten down by patients, parents, insurance and employees until they have no will to care anymore. Then they just begin going through the motions every day. You see this in all medical fields. The system is set up against the doctor now.

 

[q1we3]

Good job buying the practice. However, you are still a newlywed. Get back with us in 10 years. Most everybody is gung-ho for the first few years until reality really sinks in. I was so pumped after I graduated that I began writing articles in Optometric Management. (but even at that time I was a little disappointed at how easy it was to get published. I don't even think they checked if I was even an OD--any clown off the street can send them an article and they will print it as if it's expert opinion).

As far as adding an associate OD, I don't think I've ever seen an OD office that couldn't benefit from delegating more to techs and adding more exam rooms instead of paying another doc salary. OMD can see 40+ per day yet ODs feel the need to hire another OD once they are seeing 15 per day. Why not have 10 exam lanes and 5 techs? But, I digress.

It's your practice and you are free to run it as you please, of course (one of the benefits of private practice most future ODs will never see). Thanks for crawling out of the Mart-Wall sludge, away from all the other ODs and getting a respectable job. That you should be commended on.

If you ever wonder why all older docs are zombies. It's because for 20+ years, they've been beaten down by patients, parents, insurance and employees until they have no will to care anymore. Then they just begin going through the motions every day. You see this in all medical fields. The system is set up against the doctor now.

I am crying on the inside for you. How do you get through a day? Was there ever a time in your life when you were happy? Do you often reminisce about those days?

 

[Loptometriste]

Since I grew up in a family of 5 with a net income of less than $30,000 a year in a trailer house, I think I will be just fine with whatever I will make as an O.D. Life is not about money. It's about family and enjoying life. If I wanted a Maserati, I'd buy a lottery ticket--not go to Optometry school. If I wanted to donate my time in places in the world where health care isn't available so someone can read again with a pair of donated glasses, I'll go to Optometry school--and guess what, that person will be happy I went to school too.

Maybe it's because I live in part of the states that the closest Optometry school is 2 states away, but I know 2 new grads who both found employment upon graduation. I've worked as a tech in a private practice and in the Mayo Clinic system, and all the docs I know are encouraging me to go for an O.D. Maybe I'm oblivious, but I'll keep reaching for this dream.

 

[hello07]

If you wanted a Maserati, you wouldn't buy a lottery ticket. You'd apply to Medical school and become a physician which would lead to greater opportunities as being marketable over any other healthcare practitioner. You would aspire to become an OMD, Radiologist, Ortho Derm to buy that nice luxury car you mentioned. Some or many will say, that there hey days are also over- they make a substantial amount of money more than ODs do. You could buy a Maserati if you open a successful private or retail chain practice. However, those days are far and few in between.

Make sure you want to become an OD and realize what is happening around-job opportunities, salary decreases across the board, insurance companies and the great division among our profession.

Invest carefully- 250,000 bucks over 4 years to get your OD before you commit. The return IMO is no longer worth it. Inflation vs. salary vs. job opportunities.

Read jason K' s posts.
GLTY!

 

[kmccartin]

I really would like some advice, and I'm being completely serious. I am interviewing at optometry schools, and I honestly am quite set on it. I find it interesting and I can't think of another job that would be a better fit for me. I don't expect to make $100,000 right away, or even after a few years. I am understanding of the economy, the job markets, and the saturation of optometrists, and coming from a family with little money, $60,000 starting would suit me just fine (and I understand the debt would be an issue, but I'm willing to accept it). If you advice not going to optometry school so much, do you have any other careers or fields that are doing well? Do you have recommendations of other careers that I could look into and that show promise for better success? Any advice really would be appreciated.

 

[CL Doc]

The problem isn't just the low starting salaries, it's that plus high student loan debt. Most students have no experience with taxes. If you grow up in a low income family, your family has probably never paid taxes.

Take a $60k income, subtract $10k in federal taxes (add state and local taxes if applicable). Pay your social security and medicare tax. Subtract out another $1,000 to $2,000 ( per month) in student loan repayment. There's not much left for rent, food, utilities, gas, clothing, etc.

Don't worry about having money...you won't.

 

[NCiDOC]

Good job buying the practice. However, you are still a newlywed. Get back with us in 10 years. Most everybody is gung-ho for the first few years until reality really sinks in. I was so pumped after I graduated that I began writing articles in Optometric Management. (but even at that time I was a little disappointed at how easy it was to get published. I don't even think they checked if I was even an OD--any clown off the street can send them an article and they will print it as if it's expert opinion).

As far as adding an associate OD, I don't think I've ever seen an OD office that couldn't benefit from delegating more to techs and adding more exam rooms instead of paying another doc salary. OMD can see 40+ per day yet ODs feel the need to hire another OD once they are seeing 15 per day. Why not have 10 exam lanes and 5 techs? But, I digress.

It's your practice and you are free to run it as you please, of course (one of the benefits of private practice most future ODs will never see). Thanks for crawling out of the Mart-Wall sludge, away from all the other ODs and getting a respectable job. That you should be commended on.

If you ever wonder why all older docs are zombies. It's because for 20+ years, they've been beaten down by patients, parents, insurance and employees until they have no will to care anymore. Then they just begin going through the motions every day. You see this in all medical fields. The system is set up against the doctor now.

Well now that I read this post your point of view makes more sense. You have missed the point about what I believe optometry and other health care professions are/used to be/should be about. Relationships.

I know plenty of docs, both MD and OD, that can see 40 patients a day. However, you cannot create a relationship with your patients that way. Patients are looking for doctors who care and who see them as a person, not just the next office visit they can mark off their schedule for the day. Unfortunately, a lot of that is missing in health care today. When you focus on caring for patients, they notice. They refer you more patients. You go home feeling good about improving people''s lives.

Funny enough, your practice thrives because people are looking for this kind of care and they tell others because it is so rare these days. So, while you are patient focused, your bottom line works too.

I will say that it makes it harder to find the right associate OD to hire because they need to share the core values of our practice. However, I have 3 good candidates in mind at this point.

Oh, and to answer TippyToe and Jason K:

I have been in practice for 21 years now. I am a 20+ year doctor that loves our profession and believe that young doctors can thrive if they work at it like I and many of my friends have. I believe that some doctors get beat down over the years (as you described) because they do not have a balance in their life. It is very important to have your physical, psychological and spiritual life balanced. Otherwise you do run into a slump.
The reason I am looking for an associate instead of just adding more staff/lanes/appointments is that as the CEO of the business, I need to be able to work ON the business and not just IN the business. It allows me to set a marketing plan for the coming year, look at new ways to communicate to our patients and improve their experience. It gives me time to meet with other doctors in our area to increase professional referrals. I can join the chamber and the local breakfast club and speak to schools or corporate luncheons. These are the things you must do to be successful. If I do not feel good about myself or my practice, I am certainly not going to go tell others about it.
As for the first year in my new practice: as you can see, I am not new to practice. I have run (as president/CEO) a large multi-location OD/MD practice in the past that was one of the top 50 eye care practices in the US. I have been a partner in a thriving private practice. I have also been an employee at varying times in my career. Those experiences have given me a leg up on how to run my own practice and make it succeed.
It is true that most ODs coming out of school or in their first years of practice will not have those skills or experience. However, as I mentioned in my last post, there are groups like OD Excellence out there that take the learning curve and really improve it. I can get a membership for any optometry student to OD Excellence at no cost while they are in school. Contact me by private message if you are interested. You will find a wealth of knowledge there that is so much more positive than what you are finding in this type of thread.
I will say that Jason is right on one point. Not everyone will have a great story to tell when they get in practice. However, not everyone is ready to go out there and prove themselves by doing what it takes to be successful. I strongly believe in our profession and the ability for it to thrive and survive in the future. I see it with practices that I meet with all across the country. Believe what you will. Good luck to all of you regardless of your opinion!

 

[KHE]

I really would like some advice, and I'm being completely serious. I am interviewing at optometry schools, and I honestly am quite set on it. I find it interesting and I can't think of another job that would be a better fit for me. I don't expect to make $100,000 right away, or even after a few years. I am understanding of the economy, the job markets, and the saturation of optometrists, and coming from a family with little money, $60,000 starting would suit me just fine (and I understand the debt would be an issue, but I'm willing to accept it). If you advice not going to optometry school so much, do you have any other careers or fields that are doing well? Do you have recommendations of other careers that I could look into and that show promise for better success? Any advice really would be appreciated.

You'll get many responses to this posting and many of them will be shrill but let me a make a couple of suggestions...

First is to understand that when you say that you would be fine with $60,000, does that mean you'd be willing to go into a multi six figure debt for a job that pays $60,000? It's fine to not be materialistic but there are very real and very major financial realties to the decisions you're going to make in the next couple of years so it really is best to not stick your head in the sand.

Secondly, if I were advising anyone who was pursuing a career in ANY field, I would strongly encourage them to pursue their career in such a way that they can own their own business. Whether you want to be an optometrist, an accountant, a plumber, a mechanic, a butcher, a baker, a candlestick maker. Be the owner.

 

[KHE]

Well now that I read this post your point of view makes more sense. You have missed the point about what I believe optometry and other health care professions are/used to be/should be about. Relationships.

I know plenty of docs, both MD and OD, that can see 40 patients a day. However, you cannot create a relationship with your patients that way. Patients are looking for doctors who care and who see them as a person, not just the next office visit they can mark off their schedule for the day. Unfortunately, a lot of that is missing in health care today. When you focus on caring for patients, they notice. They refer you more patients. You go home feeling good about improving people''s lives.

If that's the case, then why are there so many OMD offices seeing 50 patients a day with patients waiting 2 or 3 hours for appointments and being booked out 4 months in advance? The issue is not time spent. It's whether that time spent solved the patients problem in a comfortable fashion. I see about 25 patients a day and no issues with "relationships."

There is a practice in the next town over where the doctor specifically advertises that his eye exams take over an hour and how the doctor himself performs every single test. He's on the verge of closing down. (At least according to the reps that I see.) Fact is, most patients don't want an exam to take an hour. They don't want to be rushed through but they want to get in and out with their problem solved and on with their busy lives. While I"m sure you can find a handful of little old ladies who have nothing better to do than go and chat with the eye doctor for an hour and get doted on, most patients don't want that.

I have been in practice for 21 years now. I am a 20+ year doctor that loves our profession and believe that young doctors can thrive if they work at it like I and many of my friends have. I believe that some doctors get beat down over the years (as you described) because they do not have a balance in their life. It is very important to have your physical, psychological and spiritual life balanced. Otherwise you do run into a slump.
The reason I am looking for an associate instead of just adding more staff/lanes/appointments is that as the CEO of the business, I need to be able to work ON the business and not just IN the business. It allows me to set a marketing plan for the coming year, look at new ways to communicate to our patients and improve their experience. It gives me time to meet with other doctors in our area to increase professional referrals. I can join the chamber and the local breakfast club and speak to schools or corporate luncheons. These are the things you must do to be successful. If I do not feel good about myself or my practice, I am certainly not going to go tell others about it.

I have never once spoke at a breakfast club, a school or a corporate luncheon and I do just fine. I did join the chamber of commerce for a year and it was a titanic failure that brought me zero additional patients. What it did bring me was a large group of vendors such as cleaning services, printers, office supply salesmen et al. who badgered me to use their business even though I already had good relationships and was quite happy with the cleaning service and printer I already used.

As for the first year in my new practice: as you can see, I am not new to practice. I have run (as president/CEO) a large multi-location OD/MD practice in the past that was one of the top 50 eye care practices in the US.

I am always highly skeptical of posts like that.

In what medical or trade journal has there ever been published a list of the "top 50 eye care practices in the US?" I've never seen such a list. Although I was once listed as one of the top OPHTHALMOLOGISTS in my state because I sent in the $40 fee or whatever it was. I even have the plaque to prove it!

On what basis are you saying that you were the CEO of one of the top 50 practices in the country?

 

[Jason K]

I have been in practice for 21 years now. I am a 20+ year doctor that loves our profession and believe that young doctors can thrive if they work at it like I and many of my friends have.

Sorry, dude - I don't buy for one second that you've been in practice for 21 years. You lost me with "I was president/CEO of a large, multi-center OD/MD practice." This makes absolutely no sense. OD/MD offices are usually owned by one or more MDs with ODs as employed docs. Even if an OD were allowed to buy in, I can't think of any circumstance in which he/she would be appointed CEO/president.

I'm not crapping on what you're claiming. If you honestly believe that there's great opportunity out there for the tens of thousands of new grads that will flood the system in the next few years, that's your right. It may not be based in reality, but it's certainly your right.

 

[Tippytoe]

I am crying on the inside for you. How do you get through a day? Was there ever a time in your life when you were happy? Do you often reminisce about those days?

Sweetheart, I'm happy everyday with a great life, great family, money in the bank, real estate investments and good health. But I'm sad for you and others that follow me. I sold typewriters when everyone was buying them. Now computers are all the rage but you fools are paying incredible money going to typewriter repair school, in denial that their popularity is over.

Fail. Try again.

 

[Tippytoe]

The reason I am looking for an associate instead of just adding more staff/lanes/appointments is that as the CEO of the business, I need to be able to work ON the business and not just IN the business. It allows me to set a marketing plan for the coming year, look at new ways to communicate to our patients and improve their experience. It gives me time to meet with other doctors in our area to increase professional referrals. I can join the chamber and the local breakfast club and speak to schools or corporate luncheons. These are the things you must do to be successful. If I do not feel good about myself or my practice, I am certainly not going to go tell others about it.
As for the first year in my new practice: as you can see, I am not new to practice. I have run (as president/CEO) a large multi-location OD/MD practice in the past that was one of the top 50 eye care practices in the US. I have been a partner in a thriving private practice. I have also been an employee at varying times in my career.
!

I see by your statements above that you have recently been to some motiviational practice managment seminars (Gerber, Gailmard). Comes across like as Amway meeting info. You are word for word repeating them. We all know what it takes to succeed in private practice. But the # 1 success tip is -- Having a Large Enough Patient Base--- People like attention but not an hour eye exam. What they really like is consistentcy and you, being a doc that seems to jump around from place to place every few years, do not yet offer that. That will be your biggest challenge.

Honestly, I would have to slice my wrist if I was starting cold after 20 years in practice. I plan to be well retired from the dying profession by year 20. "President and CEO of a mutilocation OMD/OD practice". I highly question that as well. It would be the first one I've ever heard of in the U.S. In that position, you should have earned enough money to not have to worry about attracting patients because you should be able to get by with only 1 or 2 patients per day. Really, President and CEO?? You sure you wanna stick with that claim?

 

[q1we3]

But I'm sad for you.

Don't worry about me I don't plan on staying in US to practice, heading back to Canada. I know there won't be another optometry school opening any time soon there. Whereas we are heading to 22 in US and who knows how many more.

 

[NCiDOC]

If that's the case, then why are there so many OMD offices seeing 50 patients a day with patients waiting 2 or 3 hours for appointments and being booked out 4 months in advance? The issue is not time spent. It's whether that time spent solved the patients problem in a comfortable fashion. I see about 25 patients a day and no issues with "relationships."

There is a practice in the next town over where the doctor specifically advertises that his eye exams take over an hour and how the doctor himself performs every single test. He's on the verge of closing down. (At least according to the reps that I see.) Fact is, most patients don't want an exam to take an hour. They don't want to be rushed through but they want to get in and out with their problem solved and on with their busy lives. While I"m sure you can find a handful of little old ladies who have nothing better to do than go and chat with the eye doctor for an hour and get doted on, most patients don't want that.



I have never once spoke at a breakfast club, a school or a corporate luncheon and I do just fine. I did join the chamber of commerce for a year and it was a titanic failure that brought me zero additional patients. What it did bring me was a large group of vendors such as cleaning services, printers, office supply salesmen et al. who badgered me to use their business even though I already had good relationships and was quite happy with the cleaning service and printer I already used.



I am always highly skeptical of posts like that.

In what medical or trade journal has there ever been published a list of the "top 50 eye care practices in the US?" I've never seen such a list. Although I was once listed as one of the top OPHTHALMOLOGISTS in my state because I sent in the $40 fee or whatever it was. I even have the plaque to prove it!

On what basis are you saying that you were the CEO of one of the top 50 practices in the country?

KHE - I totally agree with you that nobody needs to spend an hour with a patient. It does not take more than 15-20 minutes to do everything needed in an exam and still make the patient feel connected to your practice. That is one of the main things I stress to staff as well as new doctors or externs - people have other things to do with their lives than spend a lot of time in an eye exam. Be efficient but care about what you are doing.

I have practices in my town where they are booked 3-4 months out as well. I constantly gain new patients from them because eventually many patients get fed up waiting for an appointment and then waiting again when they are in the office to be seen and it takes 2 hours or more to get in and out because they get log jammed.

I agree that you have to find the networking that works for you. I tried the rotary and it was useless. Our local chamber is very good as is the local breakfast club. It is different in every city.

Vision Monday does this report every year:http://www.visionmonday.com/ViewContent/tabid/211/content_id/28198/Default.aspx
At the time I took over as GM of the practice, it was already a $6M practice. When I became CEO a year later, we (We = a great team of doctors, managers and employees) built it to a $10M practice by the time I left it 8 years later. As you can see from the list, that is not anywhere near the top but it would have been on the list.

I totally understand you being skeptical. Quite frankly, if you would have asked me what I would be doing when I graduated in 1991, it would not have been what it has been. And to Jason K's point, it is not great to move around all your life as an OD. However, I have gone through the doors as they have opened for me and there has been reward and challenge each time.

Know that I was not saying all of that to brag but to make the point that you never know where hard work and integrity in business will take you in any type of profession.

 

[NCiDOC]

Sorry, dude - I don't buy for one second that you've been in practice for 21 years. You lost me with "I was president/CEO of a large, multi-center OD/MD practice." This makes absolutely no sense. OD/MD offices are usually owned by one or more MDs with ODs as employed docs. Even if an OD were allowed to buy in, I can't think of any circumstance in which he/she would be appointed CEO/president.

I'm not crapping on what you're claiming. If you honestly believe that there's great opportunity out there for the tens of thousands of new grads that will flood the system in the next few years, that's your right. It may not be based in reality, but it's certainly your right.

Hey Jason, sorry you do not buy what I am saying. I graduated in 1991 from SCO. Matter of fact, I am headed back there for CE in a few weeks. I know that most practices are as you describe them. However, it is factual. I meet twice a year with other large practices around the country and some are OD/MD that are owned by MDs while others are owned by ODs. So whether or not it makes sense to you or not, it is factual.

I understand what you are trying to say to someone that is considering a career in optometry. Don't want people thinking it is a walk in the park. However, from everything I have seen, including the Bain Report on optometry (that is very eye-opening - pun intended) shows that the profession, while changing, is still a good one.

 

[Tippytoe]

I completely agree that there some people that find optometry enjoyable and exciting. But I think these are the same people that can spend all day long sitting on their porch watching cars pass by (ie. not exactly mental giants).

If you could be happy putting widgets into boxes all day long on a conveyor belt but need a little more money, then optometry might be the job for you.

If you expect mental stimulation, challenge, and creativity , it ain't.

 

[NCiDOC]

I see by your statements above that you have recently been to some motiviational practice managment seminars (Gerber, Gailmard). Comes across like as Amway meeting info. You are word for word repeating them. We all know what it takes to succeed in private practice. But the # 1 success tip is -- Having a Large Enough Patient Base--- People like attention but not an hour eye exam. What they really like is consistentcy and you, being a doc that seems to jump around from place to place every few years, do not yet offer that. That will be your biggest challenge.

Honestly, I would have to slice my wrist if I was starting cold after 20 years in practice. I plan to be well retired from the dying profession by year 20. "President and CEO of a mutilocation OMD/OD practice". I highly question that as well. It would be the first one I've ever heard of in the U.S. In that position, you should have earned enough money to not have to worry about attracting patients because you should be able to get by with only 1 or 2 patients per day. Really, President and CEO?? You sure you wanna stick with that claim?

Tippytoe, for sure I have seen many seminars over the years. I always like what Neil Gailmard has to say. I have been to Ciba's MBA program and Vistakon's Lean program as well as spent time learning from trainers at the Ritz Carlton, Disney, Nordstroms, etc. I will never stop learning because I can always be better, whether in optometry, as a father/husband or serving in my community.

You make a great statement about needing a large patient base. So true. My term is "butts in chairs", ha! However, if you do not have a good product (being your professional practice and delivery of products) to sell, then most people will not want to buy.

I also agree that moving around the country as an OD is not the best way to build a practice. However, as I said to KHE, I have gone through the doors as they have opened for me and have enjoyed every step of the way. I am where I plan to be until I retire. So, consistency is definitely part of the growth plan. And, I am not making the practice about me as much as I am about what we do in our practice so that as we grow, other ODs can join us and patients will get the same level of care they have been used to.

I did not "start cold" as much as I purchased a practice I had seen patients in since 2008. So it was not as risky as hanging a shingle and hoping patients would come. I would not want to open cold right now (at this point in my career) either and looked at that as one of the options.

Lastly, yes I was the president and CEO of a large OD/MD practice. I did fine on the compensation end of things but obviously not like the CEO of a fortune 500 company would do so no golden parachutes or million dollar bonuses - ha-ha. So, I still have to work hard but I do not mind it. Gotta love what you do or you definitely should be doing something else.

 

[NCiDOC]

I completely agree that there some people that find optometry enjoyable and exciting. But I think these are the same people that can spend all day long sitting on their porch watching cars pass by (ie. not exactly mental giants).

If you could be happy putting widgets into boxes all day long on a conveyor belt but need a little more money, then optometry might be the job for you.

If you expect mental stimulation, challenge, and creativity , it ain't.

So, it is obvious that you do not find optometry enjoyable. Why do you feel it is necessary to put down those who do? It is one thing to have an opinion about a profession that you feel is not for you. Your feelings are yours to share. However, I am certain that you have not come across some of the bring minds in our profession that I have.

I learned from some of the brightest people in our profession by listening and gleaning the pearls that would help me grow. I have been able to utilize that for my own practice but also to help business professionals in other fields. There are a lot of people in small businesses all around the country that are learning how to run their businesses. Because I have had some good mentors along the way, I am trying to pay it forward to others in need.

Eye care is a constantly changing profession. Just look at some of the amazing things that have happened in the last 10-20 years. Some good, some bad. If it was staying the same all the time then I might agree with your assessment of a lack of mental stimulation. It is not like that at all. Hard to imagine how great the future will be with things like treatments for dry amd, bionic eyes, etc on the horizon.

 

[Tippytoe]

So, it is obvious that you do not find optometry enjoyable. Why do you feel it is necessary to put down those who do? It is one thing to have an opinion about a profession that you feel is not for you. Your feelings are yours to share. However, I am certain that you have not come across some of the bring minds in our profession that I have.

I learned from some of the brightest people in our profession by listening and gleaning the pearls that would help me grow. I have been able to utilize that for my own practice but also to help business professionals in other fields. There are a lot of people in small businesses all around the country that are learning how to run their businesses. Because I have had some good mentors along the way, I am trying to pay it forward to others in need.

Eye care is a constantly changing profession. Just look at some of the amazing things that have happened in the last 10-20 years. Some good, some bad. If it was staying the same all the time then I might agree with your assessment of a lack of mental stimulation. It is not like that at all. Hard to imagine how great the future will be with things like treatments for dry amd, bionic eyes, etc on the horizon.

I've yet to find any brilliant people in optometry honestly. There are a bunch of clowns that lecture but they know nothing more than the average OD out there. There is just not that much to know about the eye. It's 2 inches of the body and a bit of the brain. Once you master that info (in a few years), you are working with you mind in another place 95% of the time.

How many times can one describe presybopia before one loses their mind? I predict the average OD will describe it roughly 50,000 times in their career (5 times per day, blah, blah, blah....). It doesn't change. It's the same thing over and over and over and over. Again, for some people, that don't like having to think much, this is an ideal career for them. I have a friend like this. He is happy as can be sitting and watching football for 10 hours a day. But most people that aim to achieve an advanced degree expect a more intellectual day job where they can think, learn and grow and KEYWORD HERE----- ADVANCE. There is no advancement in optometry. ODs either plant their own little practice (a growing minority) or live as nomads going from place to place to find work.

If you find it stimulating, more power to you. You are in the right place. I find it utterly boring and non-cerebral. Fortunately I've made good money. And this is what keeps me and many others addicted to the work and we seek mental stimuation elsewhere.

I'm glad you enjoy your work.