Looking for practice advice - where to go

[4Eyes]

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Sorry, I know this post is huge. Thanks to anyone who takes the time to look over it.

Anyway, I graduated this year and I still don't have a job lined up.

I've been flamed for being picky on location. I've been rather adamant about returning to my hometown for family reasons...not necessarily IN my hometown but within 45 minutes. There were some communities in the area that would have been good for start-up, but they have become saturated since I started school (irrelevant now since I wouldn't have the means to start cold anyway). There is one city about 3.5 hours from home that we would consider, but it's pretty saturated as well. Basically, I want to do what's right for me and what's right for the profession, but I won't sacrifice my family life for any of that because it's what I treasure most. Also, my husband's profession requires a biggish city. So I can't be that flexible in where I live.

At any rate, some job options are starting to surface, but I can't say anything really sticks out as a great option. I'd like to hear some thoughts on the issue.

Recently, a private practice OD in my hometown contacted me about working at his office a day or two a week. I met with him recently, and he's a great guy--I think I'd get along really well with him on the personal level. His office is small but has a nice atmosphere, nice staff, nice equipment. It sounded like some time down the road there would be the opportunity to buy in. I would have to find something else to fill in the gaps (probably in retail...if I can even find something like that) to make money while the practice grew enough to support two doctors, but I'm fine with that when it's part time and temporary.

The problem--after speaking with him, I'm not sure his practice can realistically support two ODs. It's pretty new. He sees 12-16 patients a day. There's no room in the building to expand (there are two lanes). 50% of the patients pay by Medicaid.

He wants another OD because he wants extra time to work on the business side of things. He can't afford to take any sort of hit financially, and I'm realizing I'm not sure where I'd fit in. He has to see fewer patients to work on business, so I guess I'm supposed to fill in that gap. But in that case, where does the money come from? If he's paying himself the same amount and I'm supposed to get paid something reasonable too? I realize these are questions for him, but I started thinking about most of this after I met with him, and we actually have yet to discuss financial details. He's saying he can't offer me a lot of money (at least not at 1-2 days a week), but he's offering me opportunity. What I'm not sure about is if this is really much of an opportunity at all, as much as I'd like it to be (being in my hometown, being private practice).

My only other option--retail in the other city 3.5 hours away. (I was contacted about a retail position in my hometown, but they told me up front that it's 7 days a week and I was supposed to just refract the whole time...how honest. 😛 Thanks but no thanks...at least the one 3.5 hours away seems a lot better than that....)

 

[KHE]

Sorry, I know this post is huge. Thanks to anyone who takes the time to look over it.

Anyway, I graduated this year and I still don't have a job lined up.


My only other option--retail in the other city 3.5 hours away. (I was contacted about a retail position in my hometown, but they told me up front that it's 7 days a week and I was supposed to just refract the whole time...how honest. 😛 Thanks but no thanks...at least the one 3.5 hours away seems a lot better than that....)

Never underestimate the ability for a cold startup. Contact lenders such as MATSCO and GE financial both of which specialize in lending to health care providers and are willing to provide 100% financing as well as a loan for initial operating expenses.

 

[eyestrain]

Recently, a private practice OD in my hometown contacted me about working at his office a day or two a week. I met with him recently, and he's a great guy--I think I'd get along really well with him on the personal level. His office is small but has a nice atmosphere, nice staff, nice equipment. It sounded like some time down the road there would be the opportunity to buy in. I would have to find something else to fill in the gaps (probably in retail...if I can even find something like that) to make money while the practice grew enough to support two doctors, but I'm fine with that when it's part time and temporary.

The problem--after speaking with him, I'm not sure his practice can realistically support two ODs. It's pretty new. He sees 12-16 patients a day. There's no room in the building to expand (there are two lanes). 50% of the patients pay by Medicaid.

He wants another OD because he wants extra time to work on the business side of things. He can't afford to take any sort of hit financially, and I'm realizing I'm not sure where I'd fit in. He has to see fewer patients to work on business, so I guess I'm supposed to fill in that gap. But in that case, where does the money come from? If he's paying himself the same amount and I'm supposed to get paid something reasonable too? I realize these are questions for him, but I started thinking about most of this after I met with him, and we actually have yet to discuss financial details. He's saying he can't offer me a lot of money (at least not at 1-2 days a week), but he's offering me opportunity. What I'm not sure about is if this is really much of an opportunity at all, as much as I'd like it to be (being in my hometown, being private practice).

This deal sounds a little fishy to me. He's basically saying he can't pay you much (which may be true) but he's offering you an "opportunity". The problem is that this sounds like a pretty amorphous, "down-the-road sometime" type of opportunity. That's not too enticing. I'd like to get something in writing to the effect that he has to offer a buy-in by a certain time or you walk.

My only other option--retail in the other city 3.5 hours away. (I was contacted about a retail position in my hometown, but they told me up front that it's 7 days a week and I was supposed to just refract the whole time...how honest. 😛 Thanks but no thanks...at least the one 3.5 hours away seems a lot better than that....)

Sounds like what you spent four years in school for, huh? That makes me so proud of this profession. I'm sure some other eager new grad will snatch up that "opportunity".

Other than that, I don't know what to tell you. If you're absolutely set on living in a certain area, you've essentially painted yourself into a corner. Make the best of it, i guess.

 

[cpw]

If your private practice guy only sees 14-16 patients a day and can't take a financial hit, how's he going to pay you? If he pays you to see his patients so he can do paperwork he's basically taking a hit by not paying himself. Doesn't make much sense. I'd be wary, but if it's just a temp job until you find something else it would put some cash in your pocket.

I did get your PM. I'll respond just as soon as I can. I've been hammered at work the last two days!

 

[stonegoat]

Too bad you spent all that money and time just to be disappointed. It must suck to be so attached to mom and dad that you will sacrifice your career to be close to them.

And what a different situation than where I live. I am actively searching for an associate, and last week went to a "welcome" reception for new optometrists coming to the province. None of the ODs were interested in living in a smaller city, so I never even got a bite. There are many others like me....super busy, able to provide full-time hours with a guaranteed six-figure minimum, but unable to attract an associate because opportunities far out number new ODs. Some great clinics have been advertising for years, with no interest. Think about that.

Why not take a chance in life and try something different. I'm not saying come to Canada, but keep your options open.....or risk regretting your career choice.

 

[xmattODx]

Too bad you spent all that money and time just to be disappointed. It must suck to be so attached to mom and dad that you will sacrifice your career to be close to them.

Well this was completely unnecessary.

4Eyes - if family is that important to you you'll be miserable elsewhere. Realize that by choosing family you may have to sacrifice income at least for a while. When I was really struggling to find more than a day or two of work after graduation I wrote a letter and enclosed my CV and sent it to over 100 ODs indicating that I was available for PT/Fill-in/Maternity coverage etc. I got some work from that and then my name began to spread and I got phone calls from people who never even received the letter. It wasn't the best way to make a living (a lot of driving/not being able to take care of patients until resolution) but it was work. Had I not received any interest from the letters I would have started to go practice to practice with a business card and my CV.

 

[JAZZEYE]

Originally Posted by stonegoat
Too bad you spent all that money and time just to be disappointed. It must suck to be so attached to mom and dad that you will sacrifice your career to be close to them.

Well this was completely unnecessary.

xmatt,,,,,, I have to agree with stonegoat..... who may lack the ability to counsel with tact (the sarcasm is not necessary) but his point is well taken.... you do have to go where opportunity lies or sacrifice your career !
This is true for any professional .....no ?

 

[4Eyes]

Okay, the location thing isn't really my concern. For one, the job outlook in my area 4 years ago compared to the job outlook now is vastly different. When I saw this was happening, of course I knew what I was getting myself into. That is really neither here nor there. I was just saying a bit as background so every suggestion wasn't just to move.

I guess my question is more like this. Am I selling myself short if I take a job with poor pay if it's the way to get my foot in the door of private practice? Is it a common scenario? Or am I just opening myself up to abuse (whether it's intended or not)?

In other news, I have another meeting with a private practice doc next week.

 

[xmattODx]

Am I selling myself short if I take a job with poor pay if it's the way to get my foot in the door of private practice? Is it a common scenario? Or am I just opening myself up to abuse (whether it's intended or not)?

Nobody can answer these questions but you. If you think you can learn from said private OD and then take that knowledge elsewhere is it worth the lower pay? If it is the only opportunity in the area is it worth it to you? Is it worth it to you to be in a private practice for lower pay and you can make up that low pay with a few days in commercial?

Personally I wouldn't do anything without a written agreement. I would need a guaranteed daily wage (incentives could be built in) and if a buy-in is indeed a possibility I would need a time-line in writing. I've never worked anywhere that didn't outline at the first meeting what the pay structure would be.

 

[KHE]

Okay, the location thing isn't really my concern. For one, the job outlook in my area 4 years ago compared to the job outlook now is vastly different. When I saw this was happening, of course I knew what I was getting myself into. That is really neither here nor there. I was just saying a bit as background so every suggestion wasn't just to move.

I guess my question is more like this. Am I selling myself short if I take a job with poor pay if it's the way to get my foot in the door of private practice? Is it a common scenario? Or am I just opening myself up to abuse (whether it's intended or not)?

In other news, I have another meeting with a private practice doc next week.

A lot of competition isn't always a bad thing IF you do something different than everyone else. If you're the shining star in a sea of donkeys, you will have a thriving practice no matter how many ODs or OMDs are around you.

Regarding your second question, you aren't necissarily selling yourself short taking a poor paying job as long as you have a plan of what you want to get out of the position. You aren't opening yourself up to abuse per se, you're just at a higher risk so go in with eyes wide open.