My only regret starting

[Ryan_eyeball]

So i'm a pretty open new doctor, but I work all the time. Which is great, because i like to work. Although I'm getting married this summer, and she's returning to live with me so I can't work all the time.

Since August (1st yr out) I've made about $77,000 working commercial (yeah its only March). My BIGGEST regret is not taking medical insurances sooner. I only take Eyemed/CMV right now, but filled out all the applications for Medicare, Bluecross/blueshield, and others. I wish I had done this right out of school instead.

Get on these asap, and I think the reason I didn't earlier was fear of billing/coding. Also, practice in a state that you can get on these because there is so much growth potential by taking these insurances. I can definitely see the pros that I'm not taking advantage of.

just my 2 and a half cents

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[hokulele]

may I ask, where do you practice?

do you know where we can read more information regarding the insurances & the differences between states?

 

[Ryan_eyeball]

may I ask, where do you practice?

do you know where we can read more information regarding the insurances & the differences between states?

I practice in Kansas, but its a tough license to get. Although, not as hard as Florida, North Carolina or New Mexico. But then again I'm from the state, and its home to me which i like. I'm really not sure where to get a list on state and insurance availibility. I've just heard some states its extremely difficult to get accepted as a provider on a medical plan. I would say just call
up the state board of the state you're thinking about practicing in.

 

[4Eyes]

Thanks for the info, and congrats on the upcoming wedding.

 

[gochi]

Hey,

Why is it so hard to get a license ? Cant you obtain your degree, and from their on choose to work where ever you wish ?

Is their an exam which you must pass after obtining the the OD ?

thanks

 

[Ryan_eyeball]

Hey,

Why is it so hard to get a license ? Cant you obtain your degree, and from their on choose to work where ever you wish ?

Is their an exam which you must pass after obtining the the OD ?

thanks

Kansas is a tough state in my opinion. It requires an interview in front of a five doctor panel. 2nd) there is a state law test (pretty much every state has it though). 3rd) is the clinical proficiency test, which really asks you to evaluate "real" patient scenarios, and not an easy NBEO III patient. Finally you have a very hard written exam, which is like the TMOD.

The state board was a lot more challenging than the national NBEO.

 

[IndianaOD]

So it was difficult to get the license and you sold out to commercial? I have several classmates practicing in Kansas in private practice and are doing very well. Most find it difficult to do real medical optometry in commercial.

 

[Ryan_eyeball]

So it was difficult to get the license and you sold out to commercial? I have several classmates practicing in Kansas in private practice and are doing very well. Most find it difficult to do real medical optometry in commercial.

I haven't sold out to commercial, its an avenue to get started. I am planning to open my own practice soon. And I probably will continue to practice commercial part-time to generate extra revenue to supplement the private practice as it grows. Even if most find it difficult, I do not. Punctal plugs, retinal photos, FDT visual fields, pachymetry do not require that you own your dispensary. It sounds like you are so focused on bashing/slandering doctors for the way they want to practice.

 

[IndianaOD]

I bash it because it hurts everyone in Optometry. Its like secondhand smoke, it shouldn't hurt others but it does. If there wasn't any commercial you could have had a private gig from the start. Congratulations on making the leap to private!

 

[Ryan_eyeball]

I bash it because it hurts everyone in Optometry. Its like secondhand smoke, it shouldn't hurt others but it does. If there wasn't any commercial you could have had a private gig from the start. Congratulations on making the leap to private!

I am very excited about eventually opening. Commercial has been a great start, but you are always replaceable. I think that has created a fear in me because they can get rid of you so quickly if they want. Best of luck!

 

[ICU23]

IndianaOD, you're full of ****. You're a consultant barely out of school. you know nothing about working in the real world setting. Medical commercial setting will always be around, whether you like it or not. If you like the medical aspect so much, you should have gone to med school. You should have known what you've gotten yourself into. People have bills/ loans to payoff. They have family to support. Who made you the guardian of optometry to go around bashing other optometry school and now bashing people for how they want to practice? Take care of your own ass and leave other's alone.

 

[IndianaOD]

IndianaOD, you're full of ****. You're a consultant barely out of school. you know nothing about working in the real world setting. Medical commercial setting will always be around, whether you like it or not. If you like the medical aspect so much, you should have gone to med school. You should have known what you've gotten yourself into. People have bills/ loans to payoff. They have family to support. Who made you the guardian of optometry to go around bashing other optometry school and now bashing people for how they want to practice? Take care of your own ass and leave other's alone.

Can we get this poster banned? All he does is attack other posters directly. My opinion is obviously popular. I have had several private practice job offers. I chose a low paying residency to avoid commercial. I actually back up what I say. Offer useful advice or leave the forums please. Take care of yourself hippocrite. Head over to the 4000 member odwire forums and see how long your crying lasts.

ICU you must not give a crap about optometry, because you obviously don't know the challenges the profession faces. Though you'll probably be a walmart jockey and just milk it for all its worth. Are you a first year failing out or something?

BTW I love what I do and since I focus on non-medical issues in my post-doc you have no room to talk.

 

[ODduck]

All I know is that when I get done with Optometry school I will be about 230 large in debt from undergrad and graduate school combined. Lets just say that I plan on having a private practice one day but to start with, I will do whatever job gets that debt paid off as soon as possible, whether it be commercial or private.

 

[ICU23]

I'm a hypocrite? Look at your responses to this thread before I posted.
Secondly, I dont attack anyone besides you because all you do is post some stupid things about how the scope of practice is horrible here horrible there. Then you go off on how bad some schools are, how they don't do any research and "contribute" back to the profession. Now you bash on people who do commercial work. Guess what smartass, not everyone can afford to do residency (which doesn't mean much in optometry anyway, besides the fact you're getting paid min. wage for doing professional work).

And what the hell does 4000 members in another forum has to do with me? BAN ME, I don't care. At least I don't go around putting myself on a high horse because I graduated from a small school known for doing research.

 

[Ben Chudner]

All I know is that when I get done with Optometry school I will be about 230 large in debt from undergrad and graduate school combined. Lets just say that I plan on having a private practice one day but to start with, I will do whatever job gets that debt paid off as soon as possible, whether it be commercial or private.

This is a very common scenario, and I think a lot of young OD's feel the way you do. They think they'll take the corporate dollars until debts are paid. Afterall, $100-150K at Wal-Mart is a lot more than the $70-80K offered by private practice docs. The inherent problem with that line of thinking is that debts never go away. By the time you pay off your student loan debt, you will have a new car, maybe a house, etc. Your experience at Wal-Mart will not make you more marketable to private practice docs. So that means you will go from $100-150K to $70-80K. Do you think you will be able to take that big of a pay cut? If you try to go out on your own, you will make even less for the first couple of years. You could buy an existing practice, but the money won't be much better until the practice loan is paid off. Therefore, what happens to a majority of people (not all) is they end up financially stuck at a corporate setting. If you want to eventually work in a private practice then my advice is to bite the bullet and live lean for several years, go with a 30 year note with no prepayment penalty, limit your vacations, etc. In the long run, you will do much better starting in private practice from the beginning.

Good luck.

 

[ODduck]

This is a very common scenario, and I think a lot of young OD's feel the way you do. They think they'll take the corporate dollars until debts are paid. Afterall, $100-150K at Wal-Mart is a lot more than the $70-80K offered by private practice docs. The inherent problem with that line of thinking is that debts never go away. By the time you pay off your student loan debt, you will have a new car, maybe a house, etc. Your experience at Wal-Mart will not make you more marketable to private practice docs. So that means you will go from $100-150K to $70-80K. Do you think you will be able to take that big of a pay cut? If you try to go out on your own, you will make even less for the first couple of years. You could buy an existing practice, but the money won't be much better until the practice loan is paid off. Therefore, what happens to a majority of people (not all) is they end up financially stuck at a corporate setting. If you want to eventually work in a private practice then my advice is to bite the bullet and live lean for several years, go with a 30 year note with no prepayment penalty, limit your vacations, etc. In the long run, you will do much better starting in private practice from the beginning.

Good luck.

Great info, thanks for the advice. I especially appreciate that you can give me information and a different point of view without calling me an idiot or something. Thanks.

 

[IndianaOD]

Takes a big person to name call. I think I'm getting sad, oh wait I'm laughing.
I hope the Walton's send you a thank you for all your hard work. They are only worth about $19B each. How can you say anything about commercial is good? You're so lost you can't even come up with a decent thought. I was burning some time on the other threads and there is plenty of discussion of private schools vs university schools. If you practice in CA I hope you enjoy the 160 students a year that the Western school will soon be churning out.

Yeah I'm a real reject for expanding my knowlege base and offering more to my patients. So sad I'm not makeing the commercial managers thousands of dollars. Hey I've seen 20 patients today, how about you?

 

[Ben Chudner]

Great info, thanks for the advice. I especially appreciate that you can give me information and a different point of view without calling me an idiot or something. Thanks.

You're welcome. I have a slightly different point of view with regards to corporate optometry. Maybe it's because I don't believe that my office is in competition with the big boxes. I don't feel threatened by them and so I don't believe corporate docs are destroying our profession. I happen to agree with KHE when he says that there are plenty of private practices located next to nail salons in strip malls that have an even less professional appearance than a corporate location. And while Wal-Mart may ony care about how many Rx's are filled, so do a lot of private practice OD's that don't bother to get full TPA priviledges when their states passes new laws.

I have lectured at most of the schools of Optometry and based on data we collected, the majority of third years do not expect to work in a corporate setting. The reality is that many of them will. I can only theorize that the reason for this is a lack of opportunity in private practice, real or perceived. Either way, if we are placing blame for destroying our profession, let's include any OD that practices in what amounts to a retail store with a refracting lane in the back. At least places like Wal-Mart have equipment that wasn't made before I was born.

 

[stonegoat]

I was wondering why private practice opportunities in the US pay so poorly for new grads starting out? Is this a case of optometry "eating its young"? I think private Drs. need to take some responsability and pay their associates a wage competative with corporate. Why woudn't they? In Canada, corporate optometry exists, but it is less tempting for new ODs to go that direction because private practices pay as much, or more. I wouldn't want to work for ~70k/year either. As an associate starting out, first year should be at least 100K. I pay my associate an average of $700/day....he works on percentage and often makes over $1000/day. I think it's time private ODs stop using new grads as a slave labour pool. It's bullsh*t.

JP

 

[JeffChou]

I was wondering why private practice opportunities in the US pay so poorly for new grads starting out? Is this a case of optometry "eating its young"? I think private Drs. need to take some responsability and pay their associates a wage competative with corporate. Why woudn't they? In Canada, corporate optometry exists, but it is less tempting for new ODs to go that direction because private practices pay as much, or more. I wouldn't want to work for ~70k/year either. As an associate starting out, first year should be at least 100K. I pay my associate an average of $700/day....he works on percentage and often makes over $1000/day. I think it's time private ODs stop using new grads as a slave labour pool. It's bullsh*t.

JP

Perhaps that is just the reality of capitalist economics. I'd love to go out and work for an optometrist in a private practice when I'm out of optometry school but truthfully, 100k a year DOES sound incredibly more enticing than 70k.

Perhaps this is quite a stretch to say this but, Just as much as new Wal-Mart OD is be "selling-out" his profession, the comfortably established optometrist hiring a new OD for 70k (or whatever the low end of private employers is) is capitalizing on the freshmen of optometry. Both are only looking out for #1, not exactly an unjust philosophy. In a situation such as this, who should be the steward of optometry? Who should work to ensure the wage security of the profession? Should the optometrists pay more to the new graduates in spite OD supply? Should the recent grad take a little less to ensure the profitability of his profession in the future?

I know this isn't an altogether accurate portrayal of hiring dynamics, but how should we remedy the dilemmas we face in optometry nowadays? Idealists and realists are all welcome to comment.

I'd like to think that private practice is a viable and probable avenue for me right out of school. Perhaps higher wages in private will stifle the growth of corporate market share and foster more competition/incentive to do well in optometry school and--eventually--to apply to optometry school. If academia doesn't respond to increased applications by granting more degrees, perhaps the profession may benefit even more. That isn't to combat oversupply, but rather to increase the overall quality of students.

Ok, I think I've gone off topic long enough for now...

 

[still_confused]

private docs arent paying 100K because thier practice cant support it. duh

 

[4Eyes]

Okay, I think it's a little sad that Ryan was just trying to offer us students a little of what he's learned and yet the thread has devolved into yet another corporate debate. It's a very real issue that should be discussed, but maybe not in this thread (although Dr. Chudner has been very well spoken ).

Anyway, I'm a hypocrite and I do have a few questions that kind of spiral off from where this thread was going. Maybe someone can PM me if they like...I just didn't want to start yet another thread in this vein....

I'm working on a practice management project right now where we have to write a business plan. For this business plan, we are to assume that we are starting cold.

Okay, so as I understand it, if you're to start cold you're expected to personally front at least 20% of the start up costs. HOW does a person do this? I've been in school non-stop, never working more than 10 hours a week except during summers. I'll never have that kind of money right after graduation. I don't have anyone who has the kind of money to loan to me, and no one who could co-sign for a loan. I've never made enough money to so much as have a credit card. My only real chance, unless I'm not understanding things properly, is to be employed by someone

Part of my problem when I graduate is the fact that I will be very stubborn on where I want to live. My #1 priority is to be close to family. I know if I wind up in corporate for any length of time I will be unhappy, but when I compare the unhappiness of being far from family ("far" meaning more than an hour away) and the unhappiness of working corporate...I would choose working corporate. Yes, I am concerned with what's important for the profession, but I'm also very concerned with what I think is best for my family. My hometown has a ratio of less than 1 OD:5000 population (closer to 4000 I think), so I PRAY PRAY PRAY someone will hire me, but the poor odds scare me! When I started school, I was hoping to start a practice in one of two suburbs of my hometown...at that point there were NO optometrists there (or in one case one guy who worked 1 or 2 days/week) and now there are 2 or 3 (i.e. saturated)! I'm trying to be hopeful, but thinking about it makes me very nervous.

See, I digressed more than anyone else here. Sorry, Ryan.

 

[KHE]

I'm working on a practice management project right now where we have to write a business plan. For this business plan, we are to assume that we are starting cold.

Okay, so as I understand it, if you're to start cold you're expected to personally front at least 20% of the start up costs. HOW does a person do this? I've been in school non-stop, never working more than 10 hours a week except during summers. I'll never have that kind of money right after graduation. I don't have anyone who has the kind of money to loan to me, and no one who could co-sign for a loan. I've never made enough money to so much as have a credit card. My only real chance, unless I'm not understanding things properly, is to be employed by someone

Most start up costs range from 100-200k with most of them being closer to 200k in order to allow for a buildout and to pay yourself a living wage. Realistically, its impossible for students to come up with 20% to put down.

Your best bets are to one of the following if you desire ownership immediately upon graduation:

1) Find a seller willing to finance
2) Use one of the companies like HSPC or Matsco that offer 100% financing, though it is at a higher interest rate than SBA loans.

If you desire to open cold, option 2 is your only real choice.

My experience with SBA lenders was catastrophic. Reams and reams and reams of paperwork only to be told time and again "your credit is excellent but you have too much debt." I would avoid SBA like the plague. I know of no doctors who have successfully navigated that avenue though I'm sure there are a couple out there. Your best bet is to stick with the private lending companies that specifically finance doctors because they understand the business of doctors much better whereas most banks are clueless.

 

[4Eyes]

Thanks for the info. Starting cold is not my first choice. I'm just having a hard time understanding how it's even feasible. What you're saying makes complete sense.

 

[daysend85]

I have one question: what ever happened to honestly caring about your patients? Obviously people seek eye care at both commercial and private practice settings. Why is it always about money and damaging the field of optometry? The simple fact is that most OD students, upon graduation don't have the money to start their own practice...let's be realistic here. That's why they go to commercial...I plan on going into commercial after I graduate. Is it because I want to? NO. So why are you wasting people's time with whining about how optometrists who work in commercial businesses are ruining the field. There will always be commercial businesses and you can't do anything about it.

 

[4Eyes]

It is a reality. I don't post much, but I'm more sympathetic to the corporate docs than a lot of people on here. I do agree, however, that for many or most people, starting out in a private practice and making a small net income at the beginning is a wiser investment if and when it's actually possible.

My ideal situation would be this: start out as an employee in an private practice with 1-3 ODs and have the option to buy in down the road. That situation is not as common as most of us would like. But I'm pretty sure it's my only real alternative to corporate (or perhaps as KHE mentioned an OD selling out who's willing to finance, which, as I understand it, is also pretty uncommon), as I will not be in a position to score an SBA loan for the reasons I mentioned above. Also, some lenders came in to speak today and said 100% financing pretty much just doesn't happen unless you already have some experience (at least 2 years). Which obviously a new grad doesn't. Only exception would be past successful business owners.

 

[KHE]

I have one question: what ever happened to honestly caring about your patients? Obviously people seek eye care at both commercial and private practice settings. Why is it always about money and damaging the field of optometry? The simple fact is that most OD students, upon graduation don't have the money to start their own practice...let's be realistic here. That's why they go to commercial...I plan on going into commercial after I graduate. Is it because I want to? NO. So why are you wasting people's time with whining about how optometrists who work in commercial businesses are ruining the field. There will always be commercial businesses and you can't do anything about it.

So what are you doing now to prevent yourself from going commercial or is your mind already made up?

The problem with going commercial is that you'll make good money right off the bat, maybe pay off some debts, and maybe save up some money to open a practice but the problem is going to be that once you do take that step to opening, your salary will plummet. Will you be able to handle that after a number of years of working commercial and making "good" money? Very very few people can.

I would encourage you to try to find a way to avoid commercial practice right from the start.

 

[Ben Chudner]

My experience with SBA lenders was catastrophic. Reams and reams and reams of paperwork only to be told time and again "your credit is excellent but you have too much debt." I would avoid SBA like the plague. I know of no doctors who have successfully navigated that avenue though I'm sure there are a couple out there.

I was one that successfully navigated the SBA mindfield. Having said that, I would avoid the SBA as well. Reams and reams of paperwork doesn't even begin to describe the process. It gets worse after you are approved because they require more paperwork every year. I think the only way I was able to make it happen was that I had been out of school for 4 years, and the seller held 20% of the note so the SBA was only on the hook for 80%.

 

[Ben Chudner]

So what are you doing now to prevent yourself from going commercial or is your mind already made up?

The problem with going commercial is that you'll make good money right off the bat, maybe pay off some debts, and maybe save up some money to open a practice but the problem is going to be that once you do take that step to opening, your salary will plummet. Will you be able to handle that after a number of years of working commercial and making "good" money? Very very few people can.

I would encourage you to try to find a way to avoid commercial practice right from the start.

Ken, it's like you are in my head.

 

[IndianaOD]

I have one question: what ever happened to honestly caring about your patients? Obviously people seek eye care at both commercial and private practice settings. Why is it always about money and damaging the field of optometry? The simple fact is that most OD students, upon graduation don't have the money to start their own practice...let's be realistic here. That's why they go to commercial...I plan on going into commercial after I graduate. Is it because I want to? NO. So why are you wasting people's time with whining about how optometrists who work in commercial businesses are ruining the field. There will always be commercial businesses and you can't do anything about it.

There wouldn't be commercial if ODs wouldn't work there. If you don't want to go commercial then why are you?

Commercial docs:
1. Create a very unprofessional image for the profession. Just wait until you hear an MD say...Oh those so called "doctors" who work for walmart. Yes there are some private docs that are nearly as bad, but not nearly as many.
2. Lower the percieved value of an eye exam. Charging $40 for an eye exam is rediculous. Ever worse, places like America's Best giving away eye exams for free, gulp. Most women spend more than that on their hair.
3. Reguardless of how good a clinician you are at first, if you don't use it you lose it. You are there for one reason: to generate optical sales. Think they are going to be happy if you spend your time managing disease?
4. I was invited to a luncheon with the regional walmart recruiter because of my open opposition to his presention. He admitted that almost no wally docs were AOA members. Thus then didn't even support the profession in that way. Its nice that others paid for the scope of practice they enjoy.

I had 3 classmates open cold a year ago. All of them are meeting or exceeding their practice and income goals.

Why is it so hard for students to not "live in the moment?" You are already used to living on next to nothing, why can't you start out at 70k if 10 years down the road you are making $30k more than the local commercial doc and have the pride of building a practice for yourself. I had an interview with a private practice last year that stated specifically that I could fill in for other private offices, but not commercial. They didn't want their doctor associated with these places. How would you feel if you were a small town private doc loving what you were doing only to have a walmart come in and take just enough of your patients to pull you under? This happend to a doc in southern Indiana a few years back. The commercial doc had nothing invested, the private doc grew up in the town. Tell me there's not something wrong with that.

 

[orangezero]

Gone are the days that you could be a successful OD DESPITE your lack of business skills. Now you are a successful OD BECAUSE of your good business skills. I've personally heard this out of the mouth of an older OD I talked with. He said that there are plenty of his OD friends that had no business skills whatso ever but still had a good private practice. Now, more than ever, it takes a lot of skills and planning.

No matter what anyone may tell you, giving away one of the cores of your business to a non-ethical, controlling, corporation is NOT a good business or career decision.

Try as best you can to avoid it.

Commercial optometry is a temptress, and they do a great job overshadowing all the negatives that are associated with it. The truth is, when I was working commercial, I was not excited to tell newly met friends, business associates, collegues at CE. It is not a good way to build esteem in the community. You are there simply to ***** out your license. There is no long term future. The ODs I know in commercial practices long term are the ones with very little drive to better themselves. I know plenty that are not happy there, but they THINK there are no other options.

 

[KHE]

I had 3 classmates open cold a year ago. All of them are meeting or exceeding their practice and income goals.

Perhaps you could explain a bit better what your history is and what your current work situation so that people can have a better perspective on where you are coming from.

Another poster has accused you of being a consultant barely out of school. In another posting you mentioned that you are a resident. If that's the case then I don't see how you could have had 3 classmates open cold a year ago because none of you would have even been close to graduating a year ago.

Some clarification please....

 

[PBEA]

I have an SBA loan, and yes it was a pain in the arse. If I remember correctly I was able to get it due to the fact that I was buying a well established practice. I also had excellent credit, but that did not matter so much. 100% finance and a small amount for working cap. Im halfway done with the note and very happy with my numbers. After graduation I signed a 1 year lease with wallyworld, 6 months into it I forced my way out of the contract and never looked back. I am so glad I escaped the vortex of corporate practice, however I have no problem with a recent grad doing a little prostitution. If its how you pay the bills then the rest is just scenery. On a side note, my take home pay from my private office is more then double what it was at wallyworld, and I was very busy at wallyworld. I often dont understand how some people consider corporate settings as a moneymaker relative to pp.

 

[IndianaOD]

I have an SBA loan, and yes it was a pain in the arse. If I remember correctly I was able to get it due to the fact that I was buying a well established practice. I also had excellent credit, but that did not matter so much. 100% finance and a small amount for working cap. Im halfway done with the note and very happy with my numbers. After graduation I signed a 1 year lease with wallyworld, 6 months into it I forced my way out of the contract and never looked back. I am so glad I escaped the vortex of corporate practice, however I have no problem with a recent grad doing a little prostitution. If its how you pay the bills then the rest is just scenery. On a side note, my take home pay from my private office is more then double what it was at wallyworld, and I was very busy at wallyworld. I often dont understand how some people consider corporate settings as a moneymaker relative to pp.

Great post PBEA. Our classes graduate in April, the classmates I was talking about were working on their pratices well before graduation. One is in Texas, one in Nebraska, the other Kansas. In fact the docs in Texas and Nebraska have already added associates. It can be done. I considered opening cold, but found a great private practice to join leading to partnership.

 

[KHE]

Great post PBEA. Our classes graduate in April, the classmates I was talking about were working on their pratices well before graduation. One is in Texas, one in Nebraska, the other Kansas. In fact the docs in Texas and Nebraska have already added associates. It can be done. I considered opening cold, but found a great private practice to join leading to partnership.

So again, would you mind clarifying what year you graduated and what your present work situation is? Have you made partner yet?

 

[IndianaOD]

So again, would you mind clarifying what year you graduated and what your present work situation is? Have you made partner yet?

You'll have to join some other more private optometry only forums to find that out. All I can affirm is that I am not making anything up. There are too many crazies on here.

 

[daysend85]

IndianaOD, you make some good points. I guess I'll have to see how things are down the road. Thanks for your input.

 

[KHE]

You'll have to join some other more private optometry only forums to find that out. All I can affirm is that I am not making anything up. There are too many crazies on here.

I am a member of most "private optometry only" forums and have not the slightest clue who you might be.

I am not sure where your reluctance to describe your present work situation is coming from but if you are truly a resident and you have classmates who graduated less than a year ago, managed to get licensed, credentialed on insurance plans, open practices cold and grow them to the point that they are taking on associates less than a year out then those people need to immediately stop practicing optometry and get out there on the practice management circuit becuase they could easily command $25000 per head at any seminar they conducted.

 

[IndianaOD]

I am a member of most "private optometry only" forums and have not the slightest clue who you might be.

I am not sure where your reluctance to describe your present work situation is coming from but if you are truly a resident and you have classmates who graduated less than a year ago, managed to get licensed, credentialed on insurance plans, open practices cold and grow them to the point that they are taking on associates less than a year out then those people need to immediately stop practicing optometry and get out there on the practice management circuit becuase they could easily command $25000 per head at any seminar they conducted.

The one opened a Medicare/Medicaid practice in an underserved urban area and became busy very quickly. You have a year to file those claims. The other took on limited part time help. I'm not saying they are getting rich yet, just that their goals are being met. I'm sure they still have large practice loans, but are happy with the way things are going.

 

[Ben Chudner]

The one opened a Medicare/Medicaid practice in an underserved urban area and became busy very quickly. You have a year to file those claims.

Try getting paid on a claim for a date of service on which you were not yet credentialed, no matter how long you have to file.

 

[iiiimonica]

You'll have to join some other more private optometry only forums to find that out. All I can affirm is that I am not making anything up. There are too many crazies on here.

Ummm, I would really like to know how long you have been out of school - you can say 1-3 years, 3-5 etc. and how long you have been in private practice - again 1-3 years etc. I am not trying to track you down or cyber stalk you, but it would help me gain some perspective as to what you post.

As of now, I think you are a resident, with an offer to be a partner. Is this correct? If so what have you done to make sure that you will be made partner? I have seen many many many many new grads promised partnerships only to have "something" happen to that offer.

(I've been a certified optician/contact lens tech for +10 years, so even though I am not yet an optometrist, I have been in the field for some time now.)

 

[Ryan_eyeball]

Sorry,

I didn't mean to start any wars on here. My only intention was to reinterate the importance of insurance plans. Also, another intention was to give income examples, and wish others would give ball park figures. Also, to give the best patient care at the very highest quality that your knowledge and skill allows.

Ben Chunder made a great point, if your not yet creditialed getting paid on a claim is "cross your fingers" and still not get paid. I've been burned on insurance claims but you learn as you go and not make the same mistake again.

Corporate has been good to me, but I can already tell that it does get tiring seeing just spectacle and CL exams. Recently I've added dry eye management with some plugs to increase insurance billing. I've only had to remove one cornea foreign body in 7 months, so most people still do not think of OD's as the first round of care.

I'm looking forward to opening, but you know life happens. I'm getting married in June to a wonderful woman, and her parents couldn't afford it so I'm footing the bill. My mom is battling cancer, so I'm trying to help her out as much as can. I work seven days a week between three different offices, and dream of my own practice. Still, own the same clinical clothes that I went to school with and drive a 97 mustang with a 180k miles. I save as much as I can toward opening cold, but to be honest I'm doing commercial to save faster.

I'm sorry if others feel like I'm a "cancer" to our professional image, but I would rather support my mother in her situation since she can't work, and save to open cold.

 

[blazenmadison]

I'm sorry if others feel like I'm a "cancer" to our professional image, but I would rather support my mother in her situation since she can't work, and save to open cold.

I don't think so. You do what you gotta do. Good luck!

question,
if you HAD to work commerical, which commerical chain would you choose and why?:
lenscrafter/pearle vision/target/jcpenny/sears, Costco, America's Best, Sam's Club, Wal-mart, BJ's, missing anything?

 

[Ben Chudner]

I've only had to remove one cornea foreign body in 7 months, so most people still do not think of OD's as the first round of care.

To clarify, most people don't think of corporate docs (or retail oriented private practice docs, for that matter) as "the first round of care". That's not meant to be a slam on corporate docs, it's simply a fact. I see, on average, 3 patients a day for "emergencies". Nothing major like open globes, but red eyes, foreign bodies, flashes and floaters, etc. My practice is set up and run like an ophthalmologist's office. I sell glasses and contacts, but patients can tell right from the beginning that my office is an eye doctor's office that happens to have a dispensary, not the other way around.

 

[iiiimonica]

Sorry,

I'm sorry if others feel like I'm a "cancer" to our professional image, but I would rather support my mother in her situation since she can't work, and save to open cold.

Ryan,

I am so sorry to hear of your mother's poor health. Please don't take the rantings on this (or other boards) to heart. Live your life and do what's best for your family.

Good luck to you (and the soon to be Mrs. Ryan)

 

[ZSclark]

I have heard many times on these boards that the drop in salary will be too great for many optometrists going from commercial to private practice but I think I have a solution. If you work commercial why don't you just put enough of your salary towards student loans so that your post-debt take home-pay is what it would be in a private practice or better yet what it would be if you opened a practice cold. This way you could pay off student loans faster and when you would be otherwise taking a pay cut you could actually make a "take home" pay increase when you go solo. The problems associated with making too much money in corporate when you plan to go solo seem to me to be mostly psychological.

 

[IndianaOD]

The problem is complicated by the fact that the current generations are impulsive and greedy with a "gotta have it now" mentality. Sure you might make 90-100k in commercial right away or 70k in private the first year out, however, with hard work you could be doubling the commercial pay in a private practice down the road.
The problem is that commercial ODs get out and buy a new car, house, golf membership, and start families. You get all these loan payments adding up and then you get the "golden shackles", where you can't afford to take a temporary pay cut and commercial HAS you.
Also please keep in mind that 100k as an independent contractor in a commercial shack is not the same as 100k in private. In the commercial setup you will pay significantly more taxes and have fewer deductions to claim.

 

[nova2010]

Wow!!!! I am a 1st year and of course haven't gotten into the private/commerical aspect yet. I am fortunate and will only have opt. school loans, not undergrad, but still am concerned with paying them off
ASAP. Please, educate me as to the opinion of working for commerical as compared to private. I do agree that some private practices have the "I don't care" attitude. You can't say that ALL commerical, ie... WalMart docs have sold out. The bottom line is they have bills to pay. It's not a matter of better eye care. That's indiviual wherever you practice. Don't you think?

 

[stonegoat]

Commercial practice, especially Wal-Mart, promotes a pathetic, non-professional paradigm of optometry. Those who think otherwise are delusional. I, however, think that a part of the blame rests with private clinics paying new grads so poorly. A starting salary of 70K is often mentioned in this forum. That really is pathetic. I think an associate should net ~22% of the gross revenue they generate. If an associate works 220 days/year, that would mean they're making about $320/day. That should mean they're only generating ~$1400/day gross revenue. If a practice only has the potential for an additional $1400/day by employing an associate, I would say that the practice cannot support a new associate. If the average patient yields, say $200, which is on the low end, seeing 16 patients/day (a very relaxed schedule) would gross $3200. The associate SHOULD make ~$700 for that day...that's more like $135K/year......any less is not in-line with the length of schooling, debts, and sacrifices required to become an eye doctor.

JP

 

[Ben Chudner]

Commercial practice, especially Wal-Mart, promotes a pathetic, non-professional paradigm of optometry. Those who think otherwise are delusional. I, however, think that a part of the blame rests with private clinics paying new grads so poorly. A starting salary of 70K is often mentioned in this forum. That really is pathetic. I think an associate should net ~22% of the gross revenue they generate. If an associate works 220 days/year, that would mean they're making about $320/day. That should mean they're only generating ~$1400/day gross revenue. If a practice only has the potential for an additional $1400/day by employing an associate, I would say that the practice cannot support a new associate. If the average patient yields, say $200, which is on the low end, seeing 16 patients/day (a very relaxed schedule) would gross $3200. The associate SHOULD make ~$700 for that day...that's more like $135K/year......any less is not in-line with the length of schooling, debts, and sacrifices required to become an eye doctor.

JP

I'm not sure how you go from $320 per day for 220 days equals $70K to $700 per day equals $135K/year. An associate making 700 per day on average (as you have said you pay), would make $154K. There are a lot of docs that own their practice that do not make that much per year. Furthermore, $70K is a starting salary, and is low because there is no guarantee how much an associate will produce. Plus, there will be very little money comming in for the first 3-6 months due to waiting for insurance to pay. That's a big risk for an owner to take. In my opinion, it's not worth the 8% of gross you are willing to accept (average net is 30%, minus the 22% you think the associate should get).