Lack of Pediatric Optometrists?

[NCAAPedsOD]

Hi! I'm new to the forum. I have a couple of questions concerning Pediatric Optometry:

1. Is it just me or are there a lack of Pediatric Optometrists? I can't seem to find one to talk to.

2. Do you think it would be hard (i.e. make enough money to stay in business) to have a business that's solely focused on seeing children?

3. Last but not least, why is it so hard to find a provider that accepts Medicaid? Am I missing something? I'd like to provide vision care to lower income communities and I'm sure the bulk of my patients would be on Medicare.

Thanks!

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[cloud99]

I think you mean medicaid. Medicare is for senior citizens.

 

[KHE]

Hi! I'm new to the forum. I have a couple of questions concerning Pediatric Optometry:

1. Is it just me or are there a lack of Pediatric Optometrists? I can't seem to find one to talk to.

2. Do you think it would be hard (i.e. make enough money to stay in business) to have a business that's solely focused on seeing children?

3. Last but not least, why is it so hard to find a provider that accepts Medicare? Am I missing something? I'd like to provide vision care to lower income communities and I'm sure the bulk of my patients would be on Medicare.

Thanks!

Historically, a "pediatric optometrist" has been one who had an interest in vision therapy or behavioral optometry. In most cases, these things are hard to make a good living at. Insurance companies generally don't pay or the cover a very limited number of visits. Parents are often unwilling to pay out of pocket for these services because they feel it's something that the school should be paying for and of course, schools aren't interested in paying for it.

As far as medicaid goes, the reason that so few providers take it is because the reimbursements are so incredibly piss poor, that many doctors actually lose money by seeing medicaid patients. Couple that with the fact that many medicaid patients have a much higher rate of non compliance with therapy as well as appointment no-shows and it just becomes a losing proposition in most cases. There are too many other areas of optometry that are much more profitable (and a hell of a lot less stressful) than doing medicaid exams all day. Is there a need? Yea...but as the old saying goes, you can't lose money on every patient and make it up in volume.

 

[DryEye]

Historically, a "pediatric optometrist" has been one who had an interest in vision therapy or behavioral optometry. In most cases, these things are hard to make a good living at. Insurance companies generally don't pay or the cover a very limited number of visits. Parents are often unwilling to pay out of pocket for these services because they feel it's something that the school should be paying for and of course, schools aren't interested in paying for it.

As far as medicaid goes, the reason that so few providers take it is because the reimbursements are so incredibly piss poor, that many doctors actually lose money by seeing medicaid patients. Couple that with the fact that many medicaid patients have a much higher rate of non compliance with therapy as well as appointment no-shows and it just becomes a losing proposition in most cases. There are too many other areas of optometry that are much more profitable (and a hell of a lot less stressful) than doing medicaid exams all day. Is there a need? Yea...but as the old saying goes, you can't lose money on every patient and make it up in volume.

How much does medicaid and medicare cover for an eye exam, out of curiosity....???

 

[KHE]

How much does medicaid and medicare cover for an eye exam, out of curiosity....???

Varies from state to state and region to region. Where I am in Connecticut, medicare covers around $125 for a new patient exam and you can charge the refraction fee separately.

Medicaid pays around $60 and you can't charge the refraction fee separately.

Some of the managed care medicaid programs reimburse anwhere from $30 to around $48 and you can't charge the refraction fee separately.

 

[NCAAPedsOD]

I think you mean medicaid. Medicare is for senior citizens.

Yes, you are correct...I definitely meant Medicaid. I always do that.

Historically, a "pediatric optometrist" has been one who had an interest in vision therapy or behavioral optometry. In most cases, these things are hard to make a good living at. Insurance companies generally don't pay or the cover a very limited number of visits...

Wonder if that's not really an interest? I mean, I'm not against it; I just know I only want children as patients...

Maybe I should just join a Pediatric Ophthalmology practice. Hhhmmm...

Thanks for the info!

 

[jefguth]

I think that a pediatric limited practice could be successful, even in a medicaid environment, if you are able to severely limit your practice expenses. If you think about it, childrens eye care doesn't really require a whole lot of very expensive equipment, you could just about do it with just the equipment you buy in optometry school. The other consideation is volume, you'd really have to go out of your way to find enough children to make it all feasible.

In fact this is all somthing that I considered doing myself for a time, and may revisit in the future.

 

[362.04]

Pediatric optometrists can do well if they concentrate on "learning problems". As previously said, this is an area that won't be covered by insurance and its an emotionally charged area. If done right, parents of children with learning problems are likely to invest in vision therapy just to be sure that their children are getting the best training to compete for school slots.

Alternatively, pediatric optometrists can work in pediatric ophthalmology offices or departments in medical schools. They are probably oriented more towards binocular vision.

Evan in the rarefied atmosphere of pediatric optometry, there may be a split in experience and training depending upon the residency program (More vision therapy/developmental vision or more traditional binocular vision/vision therapy?)

 

[362.04]

I think IndianaOD on this forum is a pediatric optometrist.

 

[IndianaOD]

I think IndianaOD on this forum is a pediatric optometrist.

I am in training (residency), but unfortunately don't see as many as I would like. The above posters are correct, it would be very hard to make a very livable income off of peds only. Honestly, I bet I barely break even. Luckily I am liked by the adults so the practice stays heathy.

I actually turned down a Pediatric Ophthalmology job because I didn't want to be an employee my whole life nor did I want to see 40-50 patients a day for around 5 minutes each. There would have been a lot of "cool" pathology and other things.

It is a completely different world with the Ped OMDs. I was also unwilling to throw away Vision Therapy and other treatments that they would have kept me from doing.

If you want all kids all the time a Ped OMD group might be your only shot; though they aren't all too prevalent and you will have to basically trash half of your knowlege of vision care to work in that environment.

Addition: It is very difficult to get a parent to spend $3000-$4000 on vision therapy for strabismus because eye muscle surgery is mostly covered by insurance even though its functionally less effective than vision therapy and has far more risks.