my day at a commercial eye place...and questions

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vistaril

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A couple months ago I needed a new glasses prescription(I usually wear contacts but wear glasses maybe 1 day a week)....it had been about 3 years since I last got a prescription, so needed another one.

Driving home from work, a saw an ad.....basic eye exams for 39.99, or advanced eye exams for 59.99. At some commercial place in a large sorta run down shopping center. 39.99? What the heck can anyone get for 39.99 these days? Gotta be a catch right?

I walk in and ask a guy wearing a polo shirt too small and no undershirt how much it will cost to get a prescription for eyeglasses? He points at the sign and says "just like it says". Then I ask- "so it's not going to be one of those bait and switches where you hook me with a 39.99 offer and then add a lot of stuff at the end to make it 120 bucks or so? The guy says "nope, if anything else needs to be done we would tell you ahead of time"....then I ask about the 59.99, and what I can get for an extra 20 bucks....he doesn't really seem like he knows what he is talking about, but I go along with it anyways as I don't know that I have ever had an 'advanced' eye exam.

Well ok, let's rock and roll with this I'm thinking. The place is pretty empty, although off in a corner I see someone helping someone put on contacts(at least it looked like it).

They usher me back in a room where some guy in his late 20's/early 30s introduces himself as 'James'. I look on his nametag and it says he is the optometrist(had an OD on it). At this point I'm a little skeptical. Who the heck introduces themselves with first name only and no professional title in a supposedly clinical environment? To a complete stranger....weird I thought.

the guy, other than the name thing, was very professional. He gave me a little card to fill out about my past eye history while he fiddled with some of his eye equipment. Then after that he asked questions about my eye history and wrote some on his own paper. Then he explained tonometry to me and did that test....he said my pressures were normal. Then the usual- a bunch of letters starting coming up on the wall, and the endless dial turning and rote questions. That lasted awhile. But he seemed intent on getting it just right. Then came the eye drops, and dilation time. I've been dilated before of course, and I have to admit there is something I sorta enjoy about it. Then he looked in the back of my eye again, and I asked him what was the point of the drops and looking again in the eye and he gave way more detail on retina disease and renal vascular than I ever knew. Even brought out a book and showed me pictures identifying pathology he had seen in optometry school, then telling me mine was normal.

the whole thing took over thirty minutes. maybe closer to 40. I guess he was just taking his time because there didn't appear to be any other customers. And like advertised it was only 59.99 + tax.

My question is how the hell are they making any money? I didnt buy glasses there(I do that online). There didn't appear to be a steady stream of customers after me. And the gross revenue from that visit for them was only 60 bucks. And I have no idea what kind of setup they have(contractor or salaried), but think about all the cuts coming out of that 60 dollars.....the rent is not trivial, even though it wasn't in the most exclusive shopping center in town or anything. There were a couple of employees besides the OD who are being paid by the hour Im sure. There is that all the eye equipment in his office, which Im assuming isn't cheap. And then of course there are the business fees and taxes. And then of course paying the opto himself. It just seems like the worst economic model I have ever seen.....and I liked the guy after my encounter with him, but I can't believe he is happy or has any satisfaction doing that. What % of opto's do this kind of work? If I went to school for 4 years *after college* to do that in that environment and make whatever it is he makes(70K???) I would be miserable. I say this as someone who practices in the most looked down upon and least respected specialties in all of medicine(psychiatry), so I'm definately not trying to antagonize or anything....I just felt bad for the guy and hope he is just going through a rough spot in his career.

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Vistaril, interesting what you experienced. That happens everyday across the USA in cities alike where employed or self employed optometrists work in retail -corporate or franchise settings. Some days may be very busy(high vloume) other days, slow.

I can't answer your question except for the one you mentined about him introducing himself to you as James. There are many of us out there in corporate practice, private or clinic based where it is not unusual to introduce ourselves by our first name toout patients. From my experience, this has absolutely nothing to do with professionalism but at putting the patient at ease -comfort level and work with him/her like family. These clinicians IMO are often the best. No matter what the setting.

The OD's that I've worked with in the past in every sort of setting, who are clinically competent and excellent clinicians all around have no hang ups as introducing themsleves as Dr. so-so. The ones who are not so confident of themselves, and have a hang up on their title- along with their attitude (ego) didctate your pattern.

Ask around. You'll see what I say happens to be true.
For the rest of your questions, I cannot answer. I'm not in business
 
sounds like a classic retail based model optometrist. Loss leader exam fees, hoping to capture material sales, etc. Like some who offer "free lasik consultations", obviously trying to capture some sx dollars at the end of that rainbow. The only problem with that OD's model is that material markups have been cut significantly, and while some product pricing remains/appears high, the profit is still limited. These retail-based ODs also dont really offer much else. Sometimes it is deliberate but often they dont practice their full scope, havent made any (or the wrongkind of) equipment purchases to truly enhance pt care, probably don't participate with any medical plans, dont know the ins and outs of cpt/icd, etc. With the race to the bottom comes the cannibilization and failure of unsustainable models that is already occuring. Throw in aLOT of oversupply and you have the makings of a difficult road for many ODs. Sure they can piece together some jobs to pay the bills, etc and some will even prosper (I do, but I am still underpaid). The associations, schools, policymakers, whatever should all be ashamed of dragging the field ever downwards. I'd say ODs are the best value in healthcare period, paradoxically they are the most underutilized.
 
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You are right most ODs don't make much, just enough to survive.
 
I agree. I practiced in a retail environment for a few months, and it was horrible. Many patients felt sorry for me. I had maybe one secretary (not all the times). Sometimes I called the patient, did he pretesting/examination, and checked out the patient myself. Depending on your practice mode, you can see 1-2 patients per hour but your income is very limited. It sounds like you went to a retail based clinic where they charge extra for 'dilation'. Very few private practices separate the dilation fee.

My classmate worked at BJ's Optical (Like Costco) and because it is a 2 door state, she never had any help from the optical. She was the check-in person, pretester, examiner, and check-out person. She never made enough money to hire a technician/secretary. One of her patients felt sorry for her and gave her an extra $20 to help her 'struggling' business. After 2 years, she finally left and joined a private practice.
 
I agree. I practiced in a retail environment for a few months, and it was horrible. Many patients felt sorry for me. I had maybe one secretary (not all the times). Sometimes I called the patient, did he pretesting/examination, and checked out the patient myself. Depending on your practice mode, you can see 1-2 patients per hour but your income is very limited. It sounds like you went to a retail based clinic where they charge extra for 'dilation'. Very few private practices separate the dilation fee.

My classmate worked at BJ's Optical (Like Costco) and because it is a 2 door state, she never had any help from the optical. She was the check-in person, pretester, examiner, and check-out person. She never made enough money to hire a technician/secretary. One of her patients felt sorry for her and gave her an extra $20 to help her 'struggling' business. After 2 years, she finally left and joined a private practice.

Commercial practices seem to be divided into two types...

Some that are super busy and are usually controlled by a doctor who holds multiple leases and employes a small armada of ODs to staff the locations while the lease holder makes a ton of money

-or-

The ones described here where the OD sits around most of the day hoping for a walk in to come walking on in.
 
This is why I say the market is "mature'. There really are not many new positions. There have been so many ODs in the market for so long that there is saturation overload.

I feel so sorry for new grads. I just don't know what they are going to do.
 
This is why I say the market is "mature'. There really are not many new positions. There have been so many ODs in the market for so long that there is saturation overload.

I feel so sorry for new grads. I just don't know what they are going to do.

If the salaries really are that low(70-75k with the potential to be even further squeezing) and the work that unpleasant(some saturdays, managers who are non-clinicians, etc), why does anyone do it? I don't think comparisons to medical and dental schools are appropriate since I don't think a very high% of optom students(especially at many of the schools) are really candidates for medical or dental school, but what about other fields entirely?

I've seen teaching mentioned on here before, and the economic outlook of that is much better than what some here describe in optometry. Average salaries in many districts for classroom teachers are 70-75k(look at the average chicago k-12 teacher salary), with guaranteed pay increases for graduate degrees(easy to obtain) as well as in many cases good opportunity to transfer into administrative roles. Plus, benefits and retirement are great(as opposed to say what the guy I saw likely gets for benefits and retirement).....or if not that other non-health care fields(like accounting) that do not require 4 years post bacc work and big loans.
 
I don't know where that 70-75K figure is coming from but that's not even close to what teachers make. At the most, with 20+ years experience you are looking at a top salary in the high 40s. Administrators make a lot, but teacher do not.
 
I don't think comparisons to medical and dental schools are appropriate since I don't think a very high% of optom students(especially at many of the schools) are really candidates for medical or dental school, but what about other fields entirely?


whatever your highness!!
 
I don't know where that 70-75K figure is coming from but that's not even close to what teachers make. At the most, with 20+ years experience you are looking at a top salary in the high 40s. Administrators make a lot, but teacher do not.

depends on the state....maybe teachers top out in the very lowest paying states in the high 40s, but in many areas of the country)and in many districts) they top out near 100k.....

also, administrator salaries closely track teachers salaries(just higher by a certain % depending on the role)...so in these extremely poor paying districts/states administrators wouldnt make a lot either.

Look at the most recent teacher strike in Chicago...if you had been following the news any during it you would have noticed that the average school teacher(not administrator) in chicago makes 75k.....obviously if the average is 75k those that do a few things to maximize their income(upgrade from ba/ms to specialists degree for example) can easily make more.

http://www.cnn.com/2012/09/10/us/illinois-chicago-teachers-strike

And chicago is not an abnormally high paying district, although it is above average. There are plenty of nice suburban districts in fairly populated urban areas(especially in the midwest and northeast and along the atlantic coast) where teacher salary averages are 20% more than this.
 
whatever your highness!!


wasn't meant as an insult.....heck, if 5% of the stuff said by many ODs on these forums is true regarding the field and people are actually turning down acceptances to dental schools to go to optom school, that decision just wouldn't make any sense.
 
I don't know where that 70-75K figure is coming from but that's not even close to what teachers make. At the most, with 20+ years experience you are looking at a top salary in the high 40s. Administrators make a lot, but teacher do not.

That is simply untrue. 70-90K is not at all unheard of for teachers who have been teaching for over 20 years. It depends on the district.
 
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Depressing but realistic picture.
This should be in the pre-optometry forums, but sadly the students will just say that we're being passive and don't have "people" skills.
 
That is simply untrue. 70-90K is not at all unheard of for teachers who have been teaching for over 20 years. It depends on the district.

Nonsense. Only in a few very large cities (NY, LA), where cost of living eats up any increased salary, are teachers making anywhere near $90,000. For instance, here is the current pay scale for a medium-size city in America.
Clearly, anyone can see, even with 20 years experience and certification, pay tops out at
a little over $40,000.

BACHELOR'S DEGREE CERTIFIED TEACHER SALARY SCHEDULE

Effective July 1, 2012

Years Bachelor's Teacher Bachelor's w/ NBPTS Certification
Monthly Annual Salary

0-2 $2,566.67 $30,800
3-4 $2,566.67 $30,800
5 $2,601.67 $31,220
6 $2,639.17 $31,670
7 $2,752.50 $33,030
8 $2,870.83 $34,450
9 $2,983.33 $35,800
10 $3,092.50 $37,110
11 $3,180.00 $38,160
12 $3,220.80 $38,650
13 $3,261.67 $39,140
14 $3,304.17 $39,650
15 $3,345.83 $40,150
16 $3,388.33 $40,660
17 $3,431.67 $41,180
18 $3,475.83 $41,710
19 $3,521.67 $42,260
20 $3,568.33 $42,820
 
A 70-90K salary is more likely for a community college teacher with a master's degree than for a school teacher.

Notice that payscale gives the median salary as 45K in Chicago while the article states the average as 75K. Average values are misleading when compared to median values. A few outlier teachers making a lot of money can skew the overall numbers and give the false impression that the typical teacher makes a lot more than in actuality. You see the same thing in optometry when people quote average income vs median income (somewhere along the lines of 150K vs. 100K).
 
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Nonsense. Only in a few very large cities (NY, LA), where cost of living eats up any increased salary, are teachers making anywhere near $90,000. For instance, here is the current pay scale for a medium-size city in America.
Clearly, anyone can see, even with 20 years experience and certification, pay tops out at
a little over $40,000.

BACHELOR'S DEGREE CERTIFIED TEACHER SALARY SCHEDULE

Effective July 1, 2012

Years Bachelor's Teacher Bachelor's w/ NBPTS Certification
Monthly Annual Salary

0-2 $2,566.67 $30,800
3-4 $2,566.67 $30,800
5 $2,601.67 $31,220
6 $2,639.17 $31,670
7 $2,752.50 $33,030
8 $2,870.83 $34,450
9 $2,983.33 $35,800
10 $3,092.50 $37,110
11 $3,180.00 $38,160
12 $3,220.80 $38,650
13 $3,261.67 $39,140
14 $3,304.17 $39,650
15 $3,345.83 $40,150
16 $3,388.33 $40,660
17 $3,431.67 $41,180
18 $3,475.83 $41,710
19 $3,521.67 $42,260
20 $3,568.33 $42,820

Nationwide, the average salary for *ALL* k-12 teachers is 49,720...iow 50k.....that includes education levels from bachelors to doctorate, years experience from 0 to 30+, etc....this number is misleadingly low though for someone who knows they want to make a career out of teaching, because if one does they will make sure they get the advanced degrees to get the increased pay. Also many districts offer 10% increase in salary for national board certification(which is becoming more common)

Part of the problem with your salary survery above(despite picking a very low paying district and/or state) is that it is for bachelor degree'd teachers.....very very few teachers more than 6-7 years into their work are just going to have a bachelors degree. It is very easy to do part time graduate work in the summer(a lot of it online) to get advanced degrees in education, and with those advanced degrees comes more salry.

my dad is a retired school teacher(in a non-urban non-rural area) and the last year he retired after 30 years of teaching his salary was 81k at age 53. He had a specialists degree(one level above a masters). His retirement was 60% of his last 3 years base average + medical/dental. Had he wanted to he could have worked part time, drawn half of his salary, and then still drawn the retirement. The average pay in his district was above the national average, but not markedly so.

A lot of school teachers are content making 45-55k well into their careers(depending on their district) because they arent all that driven by money. But if one *wants* to move into administration, work summers in education, take on additional responsibilities, etc the pathway isn't all that difficult or noncompetitive. These people could easily do things to maximize their income more if they wanted to.


Also, if teachers are concerned about maximizing their income they need to look at what state they work in. For example, the AVERAGE base salary of all teachers k-12 in georgia last year was 53k. That doesnt include administrators, extra work(ie workshops, summer school). So if the average is 53k obviously a good number of veterans with graduate degrees are comfortably making 70k. But over in alabama/mississippi/fl the average is anywhere between 8 and 11k less......so obviously those things play large roles in education. It's not that it is more or less expensive to live in Georgia than Florida(in many cases it is cheaper depending).....
 
A 70-90K salary is more likely for a community college teacher with a master's degree than for a school teacher.

Notice that payscale gives the median salary as 45K in Chicago while the article states the average as 75K. Average values are misleading when compared to median values. A few outlier teachers making a lot of money can skew the overall numbers and give the false impression that the typical teacher makes a lot more than in actuality. You see the same thing in optometry when people quote average income vs median income (somewhere along the lines of 150K vs. 100K).

1) the 'payscale' site is garbage and doesn't seemed to be based in reality...just go to the chicago district website and see what the payscale is for teachers. Put in years experience(pick 11 years for example) and then pick degree level(pick masters degree for example)......I don't think that those are outliers in any way. And you can see that that person makes about 77k. It bumps up considerably if one gets a specialist degree and as one approaches 20 years(which would be 42 years old...hardly ancient). Just out of curiosity I typed in what I could expect to make next year and it says 138k.....the lowest paying/easiest/slackest jobs I could possibly find that are full time(and even some of them are 36 hours) are 170ishk......200-225k is more reasonable. Yet this 'payscale' somewhow came up with a number nowhere close to that.

2) Your first comment is even more bizarre. For starters, someone with a masters degree wouldn't be salaried/full time at a 'community college', and if they were they certainly wouldnt make 75-90k. There may be doctoral(and post-doc) salaried faculty making that(and a bit more perhaps).....someone with a masters degree teaching at a 'community college'(which would only be possible in a few areas) would likely be adjunct and just being paid to teach a course here and there...maybe 3k or so per course per semester with no other responsibilities. In non-full time non-salaried adjunct by the course positions in junior colleges, salaried k-12 teachers in general have much better/more secure jobs than this.
 
1) the 'payscale' site is garbage and doesn't seemed to be based in reality...just go to the chicago district website and see what the payscale is for teachers. Put in years experience(pick 11 years for example) and then pick degree level(pick masters degree for example)......I don't think that those are outliers in any way. And you can see that that person makes about 77k. It bumps up considerably if one gets a specialist degree and as one approaches 20 years(which would be 42 years old...hardly ancient). Just out of curiosity I typed in what I could expect to make next year and it says 138k.....the lowest paying/easiest/slackest jobs I could possibly find that are full time(and even some of them are 36 hours) are 170ishk......200-225k is more reasonable. Yet this 'payscale' somewhow came up with a number nowhere close to that.

2) Your first comment is even more bizarre. For starters, someone with a masters degree wouldn't be salaried/full time at a 'community college', and if they were they certainly wouldnt make 75-90k. There may be doctoral(and post-doc) salaried faculty making that(and a bit more perhaps).....someone with a masters degree teaching at a 'community college'(which would only be possible in a few areas) would likely be adjunct and just being paid to teach a course here and there...maybe 3k or so per course per semester with no other responsibilities. In non-full time non-salaried adjunct by the course positions in junior colleges, salaried k-12 teachers in general have much better/more secure jobs than this.

I don't know what state you live in, but yes, most community college faculty I know of have master's degrees not doctorates. And they are full time faculty. I've taken quite a few classes at different community colleges so I know this to be true.

The payscale numbers seem consistent with with the actual salaries of teachers here in California. I don't know why you would think that a school teacher with a bachelor's degree is likely to make more money than a full-time/salaried teacher with a master's degree at a community college.
 
What is going on here? :laugh:
Thanks for the info?
 
I don't know what state you live in, but yes, most community college faculty I know of have master's degrees not doctorates. And they are full time faculty. I've taken quite a few classes at different community colleges so I know this to be true.

The payscale numbers seem consistent with with the actual salaries of teachers here in California. I don't know why you would think that a school teacher with a bachelor's degree is likely to make more money than a full-time/salaried teacher with a master's degree at a community college.

There are a lot of misconceptions above:

1) there is literally no comparison between the k-12 teachers and 'community college' teachers. One is a teacher, and one is not an educator. They are two different careers. The 'community college' person is in post-secondary education whereas the other is in k-12 education. The 'community college' person did not aspire to be in academia at such places, whereas the k-12 person likely did aspire to be where they are at.

2) I'd be curious where you took courses from all these salaried/faculty 'community college' professors with masters degrees. I think that partly reflects on your education if that is the case. Furthermore, why in the world would a community college put such people on salary and pay them decent salaries? Hell there are an infinite number of post-doc failure types who would be happy to gobble up adjunct course teaching assignments....why not go with them instead of a salaried masters degree person? And btw what subjects/courses were these?

3) You mention pay scale numbers but the fact is that national teacher average salary is 50k(base, not extras or summers) and that is with ridiculously good benefits. And that includes all the transiently certified and newly certified teachers......if you sliced things apart and looked at just teachers with >10 years experience and teachers with at least a masters degree, you would see the averages(again without benefit packages included) be around 60k......
 
Why are you throwing insults? You don't even know me, dude. Show some maturity.

Again, I don't know what classes you were talking about, but in many fields such a thing as a masters degree isn't even practical/doesn't exist.....the whole story just seemed fishy.

Now there are some fields(and some classes taught at cc) which are not very 'academic' and perhaps a terminal degree is not super important. But why in the world would you make this person salaried?
 
This thread has veered way off course. We're in the optometry forum, not the one on teacher's salaries and credentials.

The point comes back to this, with loans rising to 150K - 200K for a four year education it doesn't matter how much you "love looking at eyes all day," be ready to live in the boonies with a tight budget.
 
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