medical optometry

[aladdinboy12]

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Can a practice focusing mainly towards medical optometry(w/ no optical sales) be successful or are we years away from this?

 

[Meibomian SxN]

Can a practice focusing mainly towards medical optometry(w/ no optical sales) be successful or are we years away from this?

Why would you want to "get away from this." 😕

 

[aladdinboy12]

Why would you want to "get away from this." 😕

I recently heard of an optometrist who has a practice based on glaucoma patients alone. The ideal situation, would be to have a practice of medical and optical care. But I was just wondering can optometrists make a good living through medical optometry alone? I have heard that billing medical insur. pays better than vision plans, but then again I am not sure what those reimbursements are and if they can replace the optical revenue. Also, I know it also depends where you practice and if you can get on medical panels.

 

[stonegoat]

Can a practice focusing mainly towards medical optometry(w/ no optical sales) be successful or are we years away from this?

If you want to deal with medical issues alone..GO TO MEDICAL SCHOOL...

 

[aladdinboy12]

If you want to deal with medical issues alone..GO TO MEDICAL SCHOOL...

I would love to deal with both, but I just wanted to see how dealing with it alone would work. Optometry keeps pushing towards more medical and that's why I was curious. Thanks for the answer.

 

[stonegoat]

I would love to deal with both, but I just wanted to see how dealing with it alone would work. Optometry keeps pushing towards more medical and that's why I was curious. Thanks for the answer.

You will deal with both as an OD...especially in rural practice. However, to make a living exclusively dealing with ocular disease would be tough. You would really need the right location, with a great primary care physician referral base. Most of my patients see me for vision problems or just for a check-up to ensure all is well.

 

[Oculomotor]

In general the AVERAGE optometrist will earn roughly 65% of his/her income from refractive care (glasses & contacts) which technically are medical devices (AOA practice survey 2007). That being said there are some OD's who put themselves in unique circumstances through proper planning and training (i.e. eye disease residency and connections) to work in a practice (usually in an eye hospital or ophthalmology practice) who can focus on eye disease and not do any refraction. I know one who works for CEI in Ohio who works in the glaucoma wing and medically treats glaucoma (prescribing travaprost, latanaprost, bimatoprost,etc.....) all day long. In general you can have a very medially based practice but you will still earn half your income from refractive care. The Doctor of Optometry Degree trains you to be a primary eye care physician which includes a lot of refractive care by design. Being an optometry student I agree with stonegoat but you can't " just go to medical school"....You have to finish in the top 15% of your medical school class and compete (for a highly competitive) ophthalmology residency. Your USMLE (United States Medical Licensiing Exam) ---> Step I has to be a 232 (2009) average which is very high. So carefully think about it. I had the option of going to medical school and chose optometry school because I was not concerned with doing surgery or treating medically complex eye disease. I chose it for primary eye care/ treating primary eye disease/ less malpractice liability. Remember optometry school is challenging and voluminous so you will work hard. From a therapeutics standpoint, the overwhelming majority of states allow you to treat primary eye diseases independently with topical ocular medications and oral systemic medications. These state laws are variable from state to state so understand that from a medical eye care standpoint:

doctor of optometry (O.D.)--optometrist
--limited license to treat diseases and disorders of the visual system with medications, some minor surgical procedures (not real eye surgery), and with medical devices such as glasses, contacts, therapeutic contacts, visual aids, etc.....

doctor of medicine (M.D.)--ophthalmologist
--unlimited medical license to treat the entire spectrum of medical and surgical eye care. Most however treat within the scope of their residency training (avoiding lawsuits is an important thing!)


The doctor of optometry degree is the only vision/eye care doctorate degree. Ophthalmology is a residency training not a degree.

good luck

 

[RTM]

The idea of optometrists getting away from optical care is just weird. Who else is going to do it if we don't?
Anyway, if you are interested in a practice mode in which you can do both, seek out a residency. The residency track will provide opportunities that you otherwise would not have.
I would say that most ocular disease modes of practice are salaried positions, and although you will provide optical services, you will not necessarily profit from them.

Good Luck!

 

[PADPM]

I'm a podiatrist, and this question is not unique to your profession. This question is in a way analogous to comparisons between our profession and the orthopedic profession.

The podiatric profession has come quite a long way over the years, from providing simple "palliative care" such as nail clipping and treating corns and calluses, to performing major foot and ankle and reconstructive surgery.

Today's podiatric graduates now have to complete a hospital based 3 year residency program, and most come out very well trained to perform complex foot/ankle/reconstructive surgeries.

However, many forget their "roots" and the everyday practical aspects of our profession. Although I also am residency trained, board certified in surgery and perform complex foot/ankle surgery with hospital privileges, etc., I still spend the vast majority of my time and earn the greatest portion of my income by providing general podiatric care.

That means that I still see diabetic patients that come to my office for nail care, and I still treat young children for simple warts. I see many patients daily for ankle sprains, heel pain/plantar fasciitis and a plethora of other non surgical ailments of the foot/ankle, and don't earn a majority of my income by performing the "glamour" procedures such as foot/ankle reconstructive surgery that the newer graduates would like to think.

I have several friends that are optometrists, and I'm very familiar with the profession and understand how bright they are and how well trained they are regarding diseases and pathology of the eye. However, it seems as if some of the new O.D. graduates aren't happy with the present situation, similar to new D.P.M. grads, and want more "glamour", and simply forget the uniqueness that created our professions, and what sets your profession apart from the opthamologists and our profession apart from the orthopedists.

 

[Oculomotor]

PADPM,

Hey I loved your post. What do you like the most about your daily responsibilities as a DPM-->the general care or the complex surgical care? I was telling a friend of mine who is a pharmacist and now applying for optometry school that although his drug knowledge is tremendous because of his RPh and he will prescribe ocular and oral meds as an O.D. + be a great resource for therapeutics, he needs to understand that refractive care will dominate his time on most days. He is happy with that and he will be a great O.D. in the future. I just wanted to make it clear to him that although General O.M.D.'s and Optometrists due have a significant amount of overlap in primary eye care they are different fields and one has to appreciate that to be happy as an optometric physician.

 

[PADPM]

The part I enjoy most about the daily care I provide is being able to provide immediate relief for a significant number of ailments that enter my office. Often, patients enter my office with acute pain and/or injuries and I can usually provide some form of immediate relief for their discomfort. I think it's an accurate statement that the majority of my patients walk out of my office much more comfortable than when they walked in my office, and of course that's very rewarding.

On the other hand, if my day is filled with patients coming in with ingrown nails, fungal nails, athlete's foot, warts, etc., it's not very mentally "challenging". Naturally, going into the hospital and performing a major reconstructive surgical procedure with a lot a screws, instruments and hardware is much more "macho" and ego-boosting as well as mentally challenging, though it is also very time consuming and in today's environment makes a doctor much for vulnerable to legal/malpractice issues.

So, the answer is that I really enjoy the balance of a well rounded practice. The way I look at it, when it comes to the foot and ankle I'm basically a GP, neurologist, dermatologist, surgeon, etc. I treat the symptoms of certain medical conditions such as diabetes, gout, etc., I treat and diagnose complications of those conditions and their neurological manifestations, I treat skin and nail conditions, perform biopsies, etc., and of course perform surgery.

Some DPM's specialize in sports medicine, some specialize in diabetic patients, some specialize in wound care, some of the younger docs are attempting to specialize in surgery or are working for orthopedic groups, but the overwhelming majority of DPM's are simply in "general" practice, performing the full scope of podiatric medicine and surgery, which I believe is still the best way to survive and what makes our profession unique.

I do enjoy the variety of pathology that I treat daily, and would simply be bored if I performed the same procedure on every patient daily. Isn't variety the spice of life?!

 

[362.04]

Can a practice focusing mainly towards medical optometry(w/ no optical sales) be successful or are we years away from this?

In general, there simply isn't enough patients with eye disease to keep all eye care providers busy. However, it's quite possible to have a majority of your medical if given the right circumstances.

It might be interesting for optometry if access to health care becomes a major issue. If the health care mavens thought that the distribution of eye care was more of a problem that who should see what, then I believe that ODs might see more medical-type patients in the future.

 

[aladdinboy12]

I appreciate the responses. From what I understand, medical optometry, at this time, would be difficult to rely on alone rather it is something that should be incorporated into an optometrist's practice. Also PP optometrists main profit comes from refractive care and medical devices (glasses,cls). Optometry's "roots" is refractive care and since optometrists are the best at this, I can understand how it would be strange for one to steer away from it. Having a blend of medical and refractive care makes sense since optometrists are the primary eyecare physicians.

 

[Meibomian SxN]

I appreciate the responses. From what I understand, medical optometry, at this time, would be difficult to rely on alone rather it is something that should be incorporated into an optometrist's practice. Also PP optometrists main profit comes from refractive care and medical devices (glasses,cls). Optometry's "roots" is refractive care and since optometrists are the best at this, I can understand how it would be strange for one to steer away from it. Having a blend of medical and refractive care makes sense since optometrists are the primary eyecare physicians.

Even oMDs have a blend in todays competitive market. Ocular cosmetics, opticals, etc. Just down the street from me is a Pediatric Ophthalmologist who also advertises LASIK. Podiatrists make good money selling orthotics from what I recall from some friends of mines. Those diabetic medical macho surgeries are just that; necessary but certainly not the end all.

You should feel proud to prescribe glasses & contacts. They are medical devices that ONLY ECPs (Eye Care Professionals) can Rx. No one else. Even the Heart surgeon has to come to us for his readers lol.

 

[Commando303]

But it's understandable to want to do more than prescribe corrective lenses all day, isn't it? As nice as ego-stroking can be, "the heart-surgeon" does something immediately inaccessible to most people, whereas using the apparatus that allows an eye-doctor to determine a patient's vision-correction requirement feels like something "anyone" could learn well in a couple of weeks. Optometrists must learn lots of material, and just using a refracting-device all the time doesn't put to use very much of it.

I hope, as an optometrist, I can do things in addition to prescribe corrective-wear.

 

[PBEA]

But it's understandable to want to do more than prescribe corrective lenses all day, isn't it? As nice as ego-stroking can be, "the heart-surgeon" does something immediately inaccessible to most people, whereas using the apparatus that allows an eye-doctor to determine a patient's vision-correction requirement feels like something "anyone" could learn well in a couple of weeks. Optometrists must learn lots of material, and just using a refracting-device all the time doesn't put to use very much of it.

spoken like someone who has much to learn.

 

[Commando303]

spoken like someone who has much to learn.

Stated like someone who has nothing to teach.

 

[PADPM]

Commando303,

I can certainly understand your point, IF you believe that your education exceeds what you will actually be practicing/performing on a daily basis. If that's the case, you will probably be unhappy and/or frustrated with your chosen profession and may want to reconsider your career choice.

Although I'm licensed to prescribe medications, and I can perform surgery, admit patients to the hospital with full privileges, etc., I still have colleagues that are "frustrated" because of our limited license. Because despite all the obstacles my profession has overcome, we're still limited to the foot/ankle and lower leg in some states. And this has caused some of these DPM's to remain frustrated with their choice of careers, despite their ability to do just about everything they want with the foot/ankle medically and surgically. For some reason, they still want more.....???

Therefore, if you haven't started your optometry education yet, please think it through thoroughly. If you're really concerned whether you believe the limited license and scope of practice will leave you frustrated and/or unhappy, now is the time to make that decision.

 

[Commando303]

Commando303,

I can certainly understand your point, IF you believe that your education exceeds what you will actually be practicing/performing on a daily basis. If that's the case, you will probably be unhappy and/or frustrated with your chosen profession and may want to reconsider your career choice.

Although I'm licensed to prescribe medications, and I can perform surgery, admit patients to the hospital with full privileges, etc., I still have colleagues that are "frustrated" because of our limited license. Because despite all the obstacles my profession has overcome, we're still limited to the foot/ankle and lower leg in some states. And this has caused some of these DPM's to remain frustrated with their choice of careers, despite their ability to do just about everything they want with the foot/ankle medically and surgically. For some reason, they still want more.....???

Therefore, if you haven't started your optometry education yet, please think it through thoroughly. If you're really concerned whether you believe the limited license and scope of practice will leave you frustrated and/or unhappy, now is the time to make that decision.

Yes, that's what I mean. I imagine it could become frustrating to invest a great deal of time, energy, effort, and money in obtaining a vast and diverse education of which you daily will apply on a very limited segment. That said, I think a bit of variety in work can help ease such distress. I appreciate your advice to consider whether or not I should really wish to pursue optometry, and my response is, I think I do. Optometry is something I like, something I believe I wouldn't mind having a profession in. I hope not to look to my career for all the contentment to be had in life, but I feel, too, if I do more than sit in a LensCrafters every day of my existence — if I do some other work, as well, related to vision health — I will be satisfied with my decision.

 

[PADPM]

1) I'm confident that the majority of practicing optometrists have other interests in life outside of their profession where they also obtain happiness and contentment, and don't count on work to fulfill that need 100%.

2) I'm also confident that if you're motivated, you can be sure that you won't spend your entire career "sitting in LensCrafters" or in a similar situation, refracting patients all day. Your profession and knowledge is vast enough that you will be able to find some interest within your field to utilize your skills and background to fulfill your professional goals and needs.