New Schools Hurting the Profession

[ibalz]

I would respectfully submit that that is not the norm. Most private practices for sale today are tired, old offices with equipment from the 70s which is grossly overvalued and which usually just end up being shuttered and sold off for assets once the seniordoc dies, becomes disabled, or finally just gives up trying to sell their tired old optical shop.

Ok, here's where I defer to you -
When you purchase a tired old worn out practice, aren't you essentially buying the patient files? Isn't there usually a large remodel (equipment included) over the couple of years after the transition?
I know that the equipment is being charged for, but isn't it mainly the patient base that exchanges hands?

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[KHE]

Whoa, slow down there buckaroo!!

Context, context, context!

He doesn't charge for any of those procedures because he chose not to perform them. His thing was "when in doubt, refer out", and he did - a lot.

See, that type of thing does more damage to the profession than all the Walmarts and Lenscrafters put together. All that does is tell people that if they have anything wrong with their eyes other than a need for spectacles, that that type of doctor (the optometrist) is NOT the person to go to.

I was merely relaying a specific successful operation to Indianadoc. That was in no way commentary on my specific goals. Yes, a doc in the box, but close to a 7-figure-after-expenses-laughing-all-the-way-to-the-bank-at-age-45-doc-in-the-box!!!

Again, more damage to the profession than all the Walmarts in the world. And again, I'm not knocking opticians. But that person is essentially running an eyeglass store. There is no need to put yourself through years and years of schooling and incur tens of thousands of dollars in debt to run an eyeglass store. As far as making good business decisions, I would respectfully suggest that that person is not doing a good job.

BTW - don't knock opticians
1- Having been an optician, I take offense to that. (I realize none was intended)

Huh? Then why did you take offense?

2- Been there done that - (as a partner - sold to partner to return to school)

I'm not saying that everyone can or will achieve success in the same way. My point was that the two anecdotes were examples of independents that are quite successful because they - and here's business 101 - addressed a need in a particular area that was not being met.

Never said there's anything wrong with opticians. A good optician is highly valuable but for the 5th time, if your goal is to run a high end eye glass store, there's no need to put yourself through optometry school.

 

[KHE]

Ok, here's where I defer to you -
When you purchase a tired old worn out practice, aren't you essentially buying the patient files? Isn't there usually a large remodel (equipment included) over the couple of years after the transition?
I know that the equipment is being charged for, but isn't it mainly the patient base that exchanges hands?

You're essentially purchasing the equipment, the files, the fixtures, and the goodwill of the business.

Patients who frequent a tired old practice almost universally expect quick and dirty exams for rock bottom prices, OR they expect a long drawn out exam with plenty of nice chit-chat with the nice old doctor, but of course, for rock bottom fees.

Purchasing a practice like that and remodelling it is almost a universal recipe for failure because the former patient base will not be attracted to a remodelled location, particularly if the new person wants to charge more money for their services.

It's almost akin to purchasing a diner and trying to turn it into an upscale French bistro.

So unless your goal is to continue running the practice in the manner in which it has been run, the patient base you are purchasing has little or no value.

 

[KHE]

As I stated before, it is up to the OD to write his/her own ticket. True, the current climate makes that more difficult, but they'll do it. This profession is not in trouble. It is what you make it for yourself. Plain & Simple.

I want to comment on that part specifically because I STRONGLY disagree with it. In fact, I think that that attitude itself is the most dangerous thing for students and it's what leads to the largest amount of dissatisfaction with the profession.

I have found that "success" in optometry is not "what you make of it." It's how content you are with what optometry makes of YOU.

Now, that does not mean that there's nothing you can do about anything. But it also means that a willingness to "work hard" and have a positive attitude is going to be no where near enough to get the vast majority of you where you are likely fantasizing you want to go.

You are going to encounter all kinds of obstacles that you did not expect or think about. Some of them you may be able to handle or influence. Others you will have no ability to influence whatsoever. As such, your ability to be content with those you can't handle will have a large impact on your satisfaction. For me, the big issue was medical insurance plan accessibility. I've harped on that for what.....5, 6 years now on this forum?

That's the kind of thing no one thinks about before entering school but it's going to matter tremendously for the vast majority of you.

So go foward with your eyes open as wide as you possibly can. You need a specific plan and you need long before you give even a nickel to any school of optometry.

 

[ibalz]

See, that type of thing does more damage to the profession than all the Walmarts and Lenscrafters put together. All that does is tell people that if they have anything wrong with their eyes other than a need for spectacles, that that type of doctor (the optometrist) is NOT the person to go to.



Again, more damage to the profession than all the Walmarts in the world. And again, I'm not knocking opticians. But that person is essentially running an eyeglass store. There is no need to put yourself through years and years of schooling and incur tens of thousands of dollars in debt to run an eyeglass store. As far as making good business decisions, I would respectfully suggest that that person is not doing a good job.



Huh? Then why did you take offense?



Never said there's anything wrong with opticians. A good optician is highly valuable but for the 5th time, if your goal is to run a high end eye glass store, there's no need to put yourself through optometry school.

Obviously this is going nowhere. I try to be positive, but am shot down at every turn. For the doc in the box - how does he hurt you or the profession? How does a "hairstylist to the stars" mess it up for Joe Schmoe Barber?


Look, I respectfully submit that you guys take solace in preaching doom & gloom for the vast majority of us. I don't get it. One of us could come up with a Nobel prize-winning business plan for optometry or the cure for cancer and you'd still find the negative in it. I'm not saying that everyone will live up to your standard of full-scope optometric success. Some will specialize - others just want to run a mom & pop operation.

I mean I can't give a viable example without it being torn to shreds. You docs can't have it both ways. I guess it's only success if you deem it so.

I mean no disrespect, but this doom & gloom in the guise of advice and concern is leaving a really bad taste in my mouth.

The taking offense comment was a joke.

So, KHE & IndianaOD - please tell us what your idea of success is? Your perfect work setting? Maybe I'll just strive for that.

 

[KHE]

Obviously this is going nowhere. I try to be positive, but am shot down at every turn. For the doc in the box - how does he hurt you or the profession? How does a "hairstylist to the stars" mess it up for Joe Schmoe Barber?

I told you. Because what he does is convinces every single patient (customer in his case) that comes in his place that if they have anything wrong with their eyes OTHER than a need for spectacles, that the OPTOMETRIST is NOT the person to see.

Look, I respectfully submit that you guys take solace in preaching doom & gloom for the vast majority of us. I don't get it. One of us could come up with a Nobel prize-winning business plan for optometry or the cure for cancer and you'd still find the negative in it. I'm not saying that everyone will live up to your standard of full-scope optometric success. Some will specialize - others just want to run a mom & pop operation.

Untrue. If you came up with a cure for cancer, I would be sufficiently impressed. There's nothing wrong with "mom and pop" operations but if by that you mean "selling glasses" then I still say that there's no reason to subject yourself to years of optometry school and tens of thousands of dollars in debt to do that.

I mean I can't give a viable example without it being torn to shreds. You docs can't have it both ways. I guess it's only success if you deem it so.

You seem to be defining success as financial. I do not. There are all kinds of ways to make money in this field doing "7 and 4 and out the door" or selling high end eyewear. I've said repeatedly that no one is going to starve in this business. I would submit however that that is not good for the profession and it's not a particularly sustainable business model.

I mean no disrespect, but this doom & gloom in the guise of advice and concern is leaving a really bad taste in my mouth.

I take no pleasure in doom and gloom. The thing is, I KNOW that the vast majority of people entering school dream about owning in and/or working in a fine private practice will lots of interesting patients and working to the extent of their training.

For many of you, that's not going to happen. You will end up providing routine care to routine patients at the mall or Walmart in the evenings and on Sundays. I KNOW that that's NOT what the vast majority of you want. It sure isn't what I wanted for myself. I'm lucky because I was able to get where I wanted to go but it was a lot harder and it took a lot longer than I ever anticipated and I fear strongly that for the next generation of ODs, it's going to be that much harder if not impossible to get where the majority of you are thinking of going.

The point of this whole thread was the new schools. That's really the point I'm trying to make. Many people have the attitude that the new schools are "meh...whatever. They probably aren't needed but what's the big deal?" The "big deal" is that they schools are going to substantially contribute to the difficulty you're going to experience getting where you want to go.

So, KHE & IndianaOD - please tell us what your idea of success is? Your perfect work setting? Maybe I'll just strive for that.

I won't speak for him but to me, my ideal situation (and I have it) is owning a private practice where I can practice to the extent of my training. Please correct me if I'm wrong but I think that that's what the majority of you want.

That's it. Notice I didn't say anything about money. I make great money, no doubt so there's no reason that that's not a check in the plus column. But I would much rather do what I do for $75000 a year than work in the mall for $100000.

 

[Commando303]

You will end up providing routine care to routine patients at the mall or Walmart in the evenings and on Sundays. I KNOW that that's NOT what the vast majority of you want. It sure isn't what I wanted for myself. I'm lucky because I was able to get where I wanted to go but it was a lot harder and it took a lot longer than I ever anticipated and I fear strongly that for the next generation of ODs, it's going to be that much harder if not impossible to get where the majority of you are thinking of going.

I won't speak for him but to me, my ideal situation (and I have it) is owning a private practice where I can practice to the extent of my training. Please correct me if I'm wrong but I think that that's what the majority of you want.

All right, once more, you're wrong. I'm quite tired of this "You don't know what we know; you can't: you simply don't have the experience needed to"–"We know what we want. We love this. We're doing this. Stop trying to burst our joy-bubble" back-and-forth. If your concern really is that entering optometry students simply have an understanding of what to expect upon graduation, by and large, they do (and neither of us has some objective stick by which to measure how many do and how many don't; I've spoken to them, you've spoken to them, and, evidently, we've walked away with different impressions). They know they'll work at a franchise store for some time. They know they'll have to scrimp and save for several years before being able to settle into what they got into optometry for (and, hell, plenty of them will happily work at a Wal-Mart in that time). They know evenings and weekends are likely and that they won't right away get to use nearly the knowledge they gained over four years and ~$150,000 (and that, honestly, from state laws, they'll probably never get to use it all). They get it. If that was your main concern — that O.D. grads. not face disillusionment and regret — fret not: they get it.

 

[KHE]

They know they'll work at a franchise store for some time. They know they'll have to scrimp and save for several years before being able to settle into what they got into optometry for (and, hell, plenty of them will happily work at a Wal-Mart in that time). They know evenings and weekends are likely and that they won't right away get to use nearly the knowledge they gained over four years and ~$150,000 (and that, honestly, from state laws, they'll probably never get to use it all). They get it. If that was your main concern — that O.D. grads. not face disillusionment and regret — fret not: they get it.

"They will work in franchise stores for some time." Is that what they WANT?

What what are they scrimping and saving for? What did they "get into optometry for?"

Why would they not get to use the knowledge they spent years and thousands accumulating? What do you mean by that?

 

[ibalz]

That's it. Notice I didn't say anything about money. I make great money, no doubt so there's no reason that that's not a check in the plus column. But I would much rather do what I do for $75000 a year than work in the mall for $100000.

But you ASSUME that all I'm after is a paycheck or to sell eyewear. You couldn't be more incorrect. You keep harping on only one of the two examples I gave (seemed to be very selective). What about the other one? No problems with that, huh? The money will follow the success. Yes, it's a plus. Some people are motivated by it. Please don't count me as one of them.

Different people define success differently. It is purely subjective. You may not agree with what Jane, John, or Jim classify as success. That doesn't mean that their mode of practice is wrong, irrelevant, or damaging to the profession (unless their business practices are unlawful or unethical). That, sir, is your OPINION. Everyone is entitled to one, but it doesn't mean yours is any more viable than theirs.

The docs in both of the anecdotes I provided would surely count themselves as very satisfied on a job satisfaction survey. Why fault them for that? Just because one chose a different business model than you? Does that make him a bad OD?

Look, I guess we have to agree to disagree. I have ideas that I've been cultivating for the mode of practice I plan to enter. Yes I am an individual (not part of the vast majority). I'd be willing to bet a year's income that I will absolutely positively not in a million years work a corporate gig. Ever.

I agree, there will be a large number of new grads that fall into your neat little box of corporate shills. I get it.

But to say that you can't write your own ticket is - pardon my French - a load of crap. This is where you are incorrect. Explain how finding and exploiting an unmet need isn't writing your own ticket? (insert Bill Gates, Mark Zuckerberg, Steve Jobs, etc.)

Some will shine in the face of adversity. Necessity is the mother of invention. There's also a lot to be said for hard work and motivation (and having a sugar mamma )

I know that we don't see eye to eye on this. But what are you doing from atop your perch to change things?

We're not expecting you to do it for us. We'll have to tackle that on our own. But yes, I feel that doom and gloom are being preached. Guess some of us should just pack it up & go home.

 

[ibalz]

All right, once more, you're wrong. I'm quite tired of this "You don't know what we know; you can't: you simply don't have the experience needed to"–"We know what we want. We love this. We're doing this. Stop trying to burst our joy-bubble" back-and-forth. If your concern really is that entering optometry students simply have an understanding of what to expect upon graduation, by and large, they do (and neither of us has some objective stick by which to measure how many do and how many don't; I've spoken to them, you've spoken to them, and, evidently, we've walked away with different impressions). They know they'll work at a franchise store for some time. They know they'll have to scrimp and save for several years before being able to settle into what they got into optometry for (and, hell, plenty of them will happily work at a Wal-Mart in that time). They know evenings and weekends are likely and that they won't right away get to use nearly the knowledge they gained over four years and ~$150,000 (and that, honestly, from state laws, they'll probably never get to use it all). They get it. If that was your main concern — that O.D. grads. not face disillusionment and regret — fret not: they get it.

Well said, Commando303

 

[KHE]

Well said, Commando303

I feel badly. I'm clearly not getting my point accross. Let me try to clear up a few things here:

First of all....I am NOT trying to be doom and gloom. There is success to be had in this business. I know all kinds of people who love their work and the income they make from it. The point I'm trying to get accross is that it is going to be much harder and take much longer for the vast majority of you to obtain that success than you think it is and you're going to be dealing with crap you're not expecting. Since the title of this thread is specifically about the new schools, I'm trying to point out how and why the new schools specifically will impact your chances of success.

But you ASSUME that all I'm after is a paycheck or to sell eyewear. You couldn't be more incorrect. You keep harping on only one of the two examples I gave (seemed to be very selective). What about the other one? No problems with that, huh? The money will follow the success. Yes, it's a plus. Some people are motivated by it. Please don't count me as one of them.

Nowhere in this thread did I ever suggest that you are just after a paycheck. You however have mentioned that anecdote as an example of "success." All I'm trying to say to you and to any one else reading this is that there are a lot more efficient ways to have that scenario for yourself than going to optometry school.

Different people define success differently. It is purely subjective. You may not agree with what Jane, John, or Jim classify as success. That doesn't mean that their mode of practice is wrong, irrelevant, or damaging to the profession (unless their business practices are unlawful or unethical). That, sir, is your OPINION. Everyone is entitled to one, but it doesn't mean yours is any more viable than theirs.

That I disagree with. While it is true that there are many different modes of practice that are viable and professional I would respectfully submit that the example you provided of the person simply selling high end eyewear and referring everything else out IS in fact very damaging to the profession for the reasons I've previously stated. I don't see how anyone can make the argument that it's NOT damaging.

The docs in both of the anecdotes I provided would surely count themselves as very satisfied on a job satisfaction survey. Why fault them for that? Just because one chose a different business model than you? Does that make him a bad OD?

Yes. Because of the very reasons I've stated multiple times already. That person is someone who may well be satisfied with their job and their income and may not be unethical per se but they are BAD for the profession. I'm not sure what the other example you are talking about is but if it's the one where you mentioned a doc with 3 exams rooms, a reception area and a waiting room, I would say that there is not enough information to comment.

Look, I guess we have to agree to disagree. I have ideas that I've been cultivating for the mode of practice I plan to enter. Yes I am an individual (not part of the vast majority). I'd be willing to bet a year's income that I will absolutely positively not in a million years work a corporate gig. Ever.

You've already stated that you have a professional spouse and that will help keep you out of corporate gigs. That's great!

I agree, there will be a large number of new grads that fall into your neat little box of corporate shills. I get it.

Please understand that it's not MY box.

But to say that you can't write your own ticket is - pardon my French - a load of crap. This is where you are incorrect. Explain how finding and exploiting an unmet need isn't writing your own ticket? (insert Bill Gates, Mark Zuckerberg, Steve Jobs, etc.)

Bill Gates? What does that have to do with anything?

I don't know how much more I can say this. I never said you can't "write your own ticket" in this business. What I'm trying to say is that it is much harder to do so than any of you realize, that the obstacles that you are going to face are not the ones you're thinking about, that it's only going to get worse, and that the new schools are contributing to this.

Some will shine in the face of adversity. Necessity is the mother of invention. There's also a lot to be said for hard work and motivation (and having a sugar mamma )

Hard work and motivation are not enough. If that's all it took, everyone would be successful.

I know that we don't see eye to eye on this. But what are you doing from atop your perch to change things?

Well, I hired an associate. And I've spoken at a few colleges. And I spend time on here answering PMs and trying to help you all out when I could be watching hockey or farting around with my 5 year old.

I'm not on a "perch." Please don't think that. I'm not any "better" than any of you are.

But here's my concern. I know what you all want. (At least I think I do.)

You all want to work in and/or own a nice private practice with a waiting room full of grateful patients with cool and interesting ocular pathologies and willing to pay good money for your expertise. None of you are fantasizing about working at Walmart or the mall.

Am I wrong about that? If I am, then please let me know because I'm operating on the assumption that you all are like my class was.....desirous of private practice ownership and avoidance of the mall.

If you all are actually looking forward to a career at Lenscrafts or Walmart, then let me know and I'll stop talking. I'm operating on the assumption that all things being equal you'd rather avoid that. I'm trying to help you be aware of the things you need to be aware of so you can get there faster without having to deal with the crap that I did.

We're not expecting you to do it for us. We'll have to tackle that on our own. But yes, I feel that doom and gloom are being preached. Guess some of us should just pack it up & go home.

NO! NO! NO! But I'm trying to tell you (again) is that you are going to face all kinds of obstacles that you are NOT expecting! Optometry students (like most doctoral students) generally tend to worry about repaying student loans, finding a “job” and finding an area to settle down in which the competition from other providers is low. I would submit that none of those things are things that need to be worried about.

 

[Arctic]

Quoting KHE:
"But here's my concern. I know what you all want. (At least I think I do.)

You all want to work in and/or own a nice private practice with a waiting room full of grateful patients with cool and interesting ocular pathologies and willing to pay good money for your expertise. None of you are fantasizing about working at Walmart or the mall.

Am I wrong about that? If I am, then please let me know because I'm operating on the assumption that you all are like my class was.....desirous of private practice ownership and avoidance of the mall."


I can only speak for myself, but I assure you that I (who will be starting optometry school this fall) have absolutely no illusion that I will EVER be in the 'fantasy' type position you feel most prospective optometry students want. I will never, ever, "work in and/or own a nice private practice with a waiting room full of grateful patients with cool and interesting ocular pathologies and willing to pay good money for your expertise".

I am almost certain that I will work for a corporate 'gig' as some have called it once I graduate because, what else can I possibly do? I'll have no money to speak of, a large amount of debt, so I am quite realistic about my prospects. Even if I manage to eventually work in a private practice setting, the overwhelming majority of my patients will not have "interesting and cool ocular pathologies".

I KNOW all of this as a pre-opt. student, but honestly, the vast majority of careers available to someone like me have far more serious problems. My brother went into research, and if his grant funding ever runs dry, he's screwed. Completely screwed. Several of my friends have tried going into teaching, and they are struggling mightily to even get hired anywhere at all, and obviously at wages vastly lower than optometrists.

Optometry seems like a VERY sensible career path to me, and that's just on the economic side of things. I find many of the comments on here to be absolutely INSANE!!!!

 

[IndianaOD]

You guys think most pre-opts know all this stuff? I'm sorry guys but that is laughable. I'm glad some of you are content with crapping all over MY profession by working at corporate opticals throughout the weekend.

One of my responsibilities of being a resident was organizing the weekly case conferences for the 4th year OD students. One lecturer presenting 2 months before graduation asked for a raise of hands which students knew what they were doing after graduation. Less than HALF of the students had a plan! I could just see the walmart execs laughing all the way to the bank.

Some of you may be happy schlocking your license for a corporate master but just know you are pissing on every OD trying to do it right by providing full scope care at decent fees worthy of our training.

 

[RTM]

To all those not sorely tired of this thread. . .

Ibalz has given us a great example of a Bad OD. Unsure so refer?!? WTF? It is these kind of jackass ODs that make us all look bad. Like I said in my original post, its bad OD's that are the problem, not the new schools. (I know this thread has had tangents off of tangents, but I was out of town while all this chaos ensued)

What Ibalz is describing as optometry is not, in fact, optometry. The practice of optometry strives to serve all patients with all kinds of eye problems. True optometrists know their retinal anatomy as well as their eyeglass anatomy. True optometrists manage iritis, infections, CRVO, trauma, cataract, DM retinopathy. . . I think you get my drift.

As a matter of fact, our profession better get on board with the medical side of eyecare. The value of our profession, with the coming obesity and DM epidemics will not be choosing the right progressive to put in those Armani frames. It will be managing retinopathy, looking at OCT scans, knowing when FA is warranted, how to tell irma from nve, etc.

All these OD's who make a living by a 4X markup are fakes! I don't care how many times someone has been around the block with their horn tooting all the way. To quote Forrest Gump, stupid is as stupid does. Even Forrest can see that, why can't Ibalz?

I'd like to write Ibalz a ticket for impersonating an opticianist or optotician or whatever he strives to become. Thanks for supporting the virus that infects our profession. Great job!

To all the students out there reading this forum, I sincerely hope you all strive to be good optometrists and not just fill some money grubbing niche. That mode of practice makes me want to vomit. . .

 

[Commando303]

"They will work in franchise stores for some time." I that what they WANT?

What what are they scrimping and saving for? What did they "get into optometry for?"

Why would they not get to use the knowledge they spent years and thousands accumulating? What do you mean by that?

It's part of what they want — they're not naïve.

They're scrimping and saving to pay rent, bills, and $120,000 in tuition-debt that isn't as exorbitant as it is because three new schools have opened.

For example, they learned about numerous illnesses, but most people who walk into the mall in which they work won't be coming in for help with problems; they'll be there just to get eyeglasses or contact lenses. As I said, the students realize they'll have to wait some years before they can expand their own practice and deal with a different sort of patient base. As for the second thing, say, they learned how LASIK is performed, but their state won't let them perform it.

 

[Commando303]

You guys think most pre-opts know all this stuff? I'm sorry guys but that is laughable. I'm glad some of you are content with crapping all over MY profession by working at corporate opticals throughout the weekend.

One of my responsibilities of being a resident was organizing the weekly case conferences for the 4th year OD students. One lecturer presenting 2 months before graduation asked for a raise of hands which students knew what they were doing after graduation. Less than HALF of the students had a plan! I could just see the walmart execs laughing all the way to the bank.

Some of you may be happy schlocking your license for a corporate master but just know you are pissing on every OD trying to do it right by providing full scope care at decent fees worthy of our training.

.

 

[4u2see]

Please give this thread and TOPIC a rest already.... you can't change what is already in place. Besides we have the "American Board of Optometry" that will govern our practice in the future.....!! An entire new topic of hot debate.... like NBEO wasn't enough.

Let's focus on what and how "ABO" will affect our profession v. "new schools and influx of new ODs....... that is a more meaningful discussion than on and on and on and on about new schools..... let it go!

 

[KHE]

I can only speak for myself, but I assure you that I (who will be starting optometry school this fall) have absolutely no illusion that I will EVER be in the 'fantasy' type position you feel most prospective optometry students want. I will never, ever, "work in and/or own a nice private practice with a waiting room full of grateful patients with cool and interesting ocular pathologies and willing to pay good money for your expertise".

I am almost certain that I will work for a corporate 'gig' as some have called it once I graduate because, what else can I possibly do? I'll have no money to speak of, a large amount of debt, so I am quite realistic about my prospects. Even if I manage to eventually work in a private practice setting, the overwhelming majority of my patients will not have "interesting and cool ocular pathologies".

What?

So again, correct me if I'm wrong here, but it sounds like all things being equal, you'd rather have the nice private practice instead of the corporate gig. Is that what I'm reading there? Or are you actually looking forward to the corporate gig?

 

[KHE]

It's part of what they want — they're not naïve.

They're scrimping and saving to pay rent, bills, and $120,000 in tuition-debt that isn't as exorbitant as it is because three new schools have opened.

For example, they learned about numerous illnesses, but most people who walk into the mall in which they work won't be coming in for help with problems; they'll be there just to get eyeglasses or contact lenses. As I said, the students realize they'll have to wait some years before they can expand their own practice and deal with a different sort of patient base. As for the second thing, say, they learned how LASIK is performed, but their state won't let them perform it.

Ok, so AGAIN then....correct me if I'm wrong but it seems to me that all things being equal, students would rather have the private practice gig right out of school but have resigned themselves to the commercial gig. Is that what I'm reading here? Or are people actually looking forward to a career in the mall?

 

[KHE]

My plans are quite similar. I, too, plan to enter the corporate world of optometry when I graduate. That certainly isn't to say I will stay in a corporate optometric setting forever; however, I feel confident I will pursue the corporate experience initially.

Why? Is that your preferred route or is that what you've resigned yourself to?

 

[ibalz]

To all those not sorely tired of this thread. . .

Ibalz has given us a great example of a Bad OD. Unsure so refer?!? WTF? It is these kind of jackass ODs that make us all look bad. Like I said in my original post, its bad OD's that are the problem, not the new schools. (I know this thread has had tangents off of tangents, but I was out of town while all this chaos ensued)

What Ibalz is describing as optometry is not, in fact, optometry. The practice of optometry strives to serve all patients with all kinds of eye problems. True optometrists know their retinal anatomy as well as their eyeglass anatomy. True optometrists manage iritis, infections, CRVO, trauma, cataract, DM retinopathy. . . I think you get my drift.

As a matter of fact, our profession better get on board with the medical side of eyecare. The value of our profession, with the coming obesity and DM epidemics will not be choosing the right progressive to put in those Armani frames. It will be managing retinopathy, looking at OCT scans, knowing when FA is warranted, how to tell irma from nve, etc.

All these OD's who make a living by a 4X markup are fakes! I don't care how many times someone has been around the block with their horn tooting all the way. To quote Forrest Gump, stupid is as stupid does. Even Forrest can see that, why can't Ibalz?

I'd like to write Ibalz a ticket for impersonating an opticianist or optotician or whatever he strives to become. Thanks for supporting the virus that infects our profession. Great job!

To all the students out there reading this forum, I sincerely hope you all strive to be good optometrists and not just fill some money grubbing niche. That mode of practice makes me want to vomit. . .

What is it with the personal attacks? You don't know me or what I plan to do. Nice job coming in at the end to launch a personal attack on someone. If you really cared to actually READ my previous posts, with any sort of attention to detail, you'd realize that I never said or implied that that was the preferred path I would take. I was merely presenting a counter point to a post. Now, I am going to take the high road and not return the personal insults that nobody would blame me for being tempted to entertain. I truly hope you enjoy your bitter existence! Really professional and mature of you. Just remember, you have to give respect to get respect. Good evening.

 

[Commando303]

Ok, so AGAIN then....correct me if I'm wrong but it seems to me that all things being equal, students would rather have the private practice gig right out of school but have resigned themselves to the commercial gig. Is that what I'm reading here? Or are people actually looking forward to a career in the mall?

. Never mind.

 

[ibalz]

Can we close this thread down?

 

[Commando303]

Can we close this thread down?

Yeah, what are the criteria by which threads are closed, anyway? Some get shut down way too fast, and for seemingly no good reason, whereas others — which are immediately evident as nothing but breeding grounds for soap-boxing and gripe-sharing — go on till the end of time. This god-damned thing should have been shot out of the stable, and here we are on its second page (and counting).

*I know I'm a hypocrite for contributing to the discussion I'm lambasting, but my hypocrisy doesn't preclude the merit of my query.

 

[KHE]

As of right now, the corporate world is my preferred mode of practice. To tell you the truth, I wouldn't mind working in a mall. I have done a great deal of shadowing in corporate, private, and specialty practice settings. I don't see anything wrong with the corporate route and I have four years of optometry school to help me make these decisions. My decisions will not be dictated by a public forum where many "blankety blank blanks" are essentially "trashing" an entire legitimate aspect of the optometric profession, the corporate practice.

I am almost certain that I will work for a corporate 'gig' as some have called it once I graduate

Well, I have to admit I'm surprised. I guess I was wrong. I did not anticipate that so many of today's entering students were planning careers in the mall.

For those of you who would prefer practice ownership when you graduate, send me a PM and I'll try to help you out as best as I can so as not to continue this thread further.

I'll bow out of this discussion and offer my apologies.

 

[IndianaOD]

Well, I have to admit I'm surprised. I guess I was wrong. I did not anticipate that so many of today's entering students were planning careers in the mall.

For those of you who would prefer practice ownership when you graduate, send me a PM and I'll try to help you out as best as I can so as not to continue this thread further.

I'll bow out of this discussion and offer my apologies.

It is sad. Why is Optometry attracting such apathetic students. Oh, I think I know some reasons stated above.

I too would be happy to help students striving for private practice for you will be my colleagues. Those going to corporate are not my colleagues.

FYI I started this thread and it has no reason to get closed down. I have gotten several more PMs from pre-opts who seem to be listening.

 

[StushOD]

As an OD student I would urge all pre-opts to step back and look who is offering this advice. Its not coming from docs who log on here to bash the profession. It is coming from those who have a long history of providing pre-opts invaluable advice covering many topics. By doing a search of some of their old posts you would see that.

There are ODs on here who are unhappy with what they do, and offer nothing substantial to students looking for info. They just bash bash bash the profession. KHE and IndianaOD are not in this category. Whether it comes across to some of you or not, they really are trying to save you a lot of headaches by avoiding pitfalls they are aware of. You can have a closed mind to their experience or you can look at the context of their posts and investigate for yourself.

There are many reasons to avoid corporate optometry. Some reasons that I will not go into it include:
1) Having a high school educated (or dropout) manager tell me how to care for patients
2)Having same manager tell me when I work (Weekends + Holidays)
3) Allowing the corporation to tell me if/which medical insurances I can accept which in turn basically determines if I can do anything beyond refractions.
4)Many more reasons that you can search on this forum

If non of that matters to you now, then take they advice of a speaker that came to PCO last fall.

She discussed 2 different career paths that 2 students in her class took. The 1st was offered $180,000 right out of school to work in commercial. She had 2weeks vacation per year and could afford to take nice vacations. She worked 6 days a week and many holidays. After 5 years she was still making the same, still had 2 weeks vacation, but was "asked" to work Sundays too by the manager. During this time she could not practice what she spent all that time in OD school learning. At this point she was burned out and possibly looking for a career change.

The other student started her own practice out of school. During the 1st 2 years she supplemented her income with part time commercial work while she built her practice. Initially she worked 7 days/week, and made half of her what her friend made. By year 3 she was working 5 days a week, all in her practice and had time for vacations. By year 4 she added an associate to meet the demand of the growing practice.

THE GOOD PART - By year 5 she grossed the same as her friend in commercial whether she was physically in the office or not. (ie. She worked much less than her friend) In addition, her friend may have grossed $180,000 out of the gate but as an employee only took home $90,000. The PP OD owned the building the practice was in - collected rent from the practice, and wrote off as much as she could and took home MUCH MUCH more than her friend, had 2x more vacation, and practiced optometry to the fullest extent.

KHE - I really enjoy your tips posted on here and on ODwire. Reading yours and other OD's advice about commercial caused me to look into it and understand what a mistake that would be for me as an OD. Hopefully pre-opts will come around and figure this out too.

 

[achirum]

Well, I have to admit I'm surprised. I guess I was wrong. I did not anticipate that so many of today's entering students were planning careers in the mall.

For those of you who would prefer practice ownership when you graduate, send me a PM and I'll try to help you out as best as I can so as not to continue this thread further.

I'll bow out of this discussion and offer my apologies.

I appreciate your comments and have been reading this thread quietly. I personally do not want to succumb to a mall job to be honest. If this thread isn't the place for direction away from commercial optometry, then maybe when the time comes, I'll be sending you some PM's for advice

 

[KHE]

As an OD student I would urge all pre-opts to step back and look who is offering this advice. Its not coming from docs who log on here to bash the profession. It is coming from those who have a long history of providing pre-opts invaluable advice covering many topics. By doing a search of some of their old posts you would see that.

There are ODs on here who are unhappy with what they do, and offer nothing substantial to students looking for info. They just bash bash bash the profession. KHE and IndianaOD are not in this category. Whether it comes across to some of you or not, they really are trying to save you a lot of headaches by avoiding pitfalls they are aware of. You can have a closed mind to their experience or you can look at the context of their posts and investigate for yourself.

KHE - I really enjoy your tips posted on here and on ODwire. Reading yours and other OD's advice about commercial caused me to look into it and understand what a mistake that would be for me as an OD. Hopefully pre-opts will come around and figure this out too.

Well thank you for the kind words.

It seems that this thread has pretty much run it's course but I've gotten a few PMs from people who wish to avoid commercial practice. This is an exceprt from one of them:

I did not think that too many people were fantasizing about careers in commercial practices. It seems I may be wrong. At the very least, many people seemed to have resigned themselves even before entering school to spending a significant portion of their career in a commercial location and that is unfortunate because it does NOT have to be that way if they don't want it to be.

I commend you for trying to be aware. If you are a current student, you should start planning your career NOW. Try not to fall into the trap of "oh well, I deal with that in my 4th year or after boards." Start thinking about it now. Ask lots of questions. Particularly of faculty members who have private practices outside of academia.

These are the questions I would ask them:

1) How did you get started
2) What mistakes did you make?
3) If you had to do it again, what would you do differently with respect to practice ownership?
4) What strategies would you recommend for a current student who is desirous of private practice ownership to make that happen as soon as possible?
5) What are the BAD things about optometry and private practice ownership that you DID NOT EXPECT before you entered the field or started/purchased your practice?

Those questions will give you plenty of things to think about. And that doesn't mean that you necessarily have to follow every piece of advice because different docs will give you opposite opinions and they both have value. You can decide what you think will work for you because you know yourself. You know your strengths and weaknesses. You know what you like and what you don't. You know your family situation. You know your financial situation. In other words, you know what's important to you.

 

[Tippytoe]

I just finished reading these 2 pages of posts. Interesting.

Just a few points:

1. I hope you guys (students) realize how extremely lucky you are to have the internet with all these great optometry discussion groups. When I started OD school in 1995 even, we didn't really have much in the way of the internet (internet? What's that?). So for whatever it's worth, you really could learn alot. Practicing ODs here are not worried about you or your competition directly. They are just trying to tell you things no one told us in the beginning.

2. To the former optician: Seems like former opticians are some of the toughest ones to talk to. They have spent upteen years watching the, big, rich doctor and thinking how dumb he is and how he knows more than the doctor and how the doctor can't even measure PDs correctly. He thinks it's vastly unfair that all the OD has to do is just flip a few dials and walk out at 7 pm. The optician only sees one side and sees the other side as MUCH greener.

3. It cost $20,000+ per month to run a small private optometry practice. Just the yellow page ad alone cost $1,000 PER MONTH (yep, one thousand dollars) in most places!!

4. Optometrists have always fought for scraps. Scraps left over from ophthalmologists and large commercial eye care centers

5. Fact is, optometrists make GOOD money. That fact alone is what motivates most students. It did me. I went from working construction to being an OD. Guess which one I like better? $15,000/yr or $130,000-/yr.
And for most people, all the crap that goes with the profession does not over-ride the six-figure income. In fact, I'm guessing many will be willing to wash the optical center manager's car, paint his house and date is ugly daughter...................as long as the money is there.

6. You will be 100% at the mercy of the insurance companies, who will pay you want they want, when they want, and if they want and there isn't a damn thing you can do about it. There is no such thing as "speciality practice" in optometry. Vision therapy, low vision, peds vision, etc......are all hobbies, not a viable business model. For every "boutique" $1,000 per frame optical shop there are 500 offices that live and die by the $50 VSP exam and, in fact, live paycheck to paycheck and live off lines-of-credit.

But it's all good. Like I said, you could be digging holes or washing cars for a living.

One last point: Do you ever really see a happy pharmacist behind the counter of Walgreen on Sunday afternoon? This WILL be optometry in 10 more years. It is what it is!

 

[lnh]

2. To the former optician: Seems like former opticians are some of the toughest ones to talk to. They have spent upteen years watching the, big, rich doctor and thinking how dumb he is and how he knows more than the doctor and how the doctor can't even measure PDs correctly. He thinks it's vastly unfair that all the OD has to do is just flip a few dials and walk out at 7 pm. The optician only sees one side and sees the other side as MUCH greener.

I know you weren't talking to me, but I'd just like to throw in that I am an optician and I agree wholeheartedly that commercial optometry and corporate is indeed evil, and we'd be better off without it.

My optician experience has taught me first hand exactly how evil commercial practices can be. The worst was when I worked for LensCrafters for two years. I can fill pages with their transgressions against the better interests of the patient. Fortunately the ODs next to LensCrafters are independent (at least in my area ), so most of their corporate BS falls on us opticians. I have lost count of the many times I have been given an order that puts company before patients. Of course I find ways to ignore these instructions every time, but that hasn't exactly made me popular with my managers. It takes some ingenuity and a willingness to play dumb and forgetful, but I can only pull that for so long. This is the exactly the kind of thing I don't want to put up with as an optometrist. Are there any optometrist who have worked in commercial and want to share first hand how corporate stood in the way of you providing the best possible care to patients?

I agree that the saddest thing for our profession is crappy ODs, but that is just a small battle. Those who are against commercial optometry are out to win a war. They're just asking for you to join their efforts because we are all in this together. Of course I am a good optician, and of course there are some good ODs in commercial fighting for the patients--but we can both do our jobs a hell of a lot better with corporate out of the picture.

SAM, I've actually seen a few decent commercial practices as well, but they are sadly few and far between. Unfortunately you can't just look at the best case scenario and use it to justify the entire mode. Take a look at the ugly side, and I think you'll come to agree it will be worth sacrificing the few good practices to save the whole. Wouldn't it be nice to start your PP right off the bat? It'll be a lot of hard work initially no matter which path you take. Why not invest it all into the PP from the start?

Sorry to add to this tiresome thread, but I thought it'd be good to throw in my voice since I am not "yet another disgruntled OD." I am just another pre-opt hopeful who is thrilled to enter into optometry. I just don't want to enter into optometry only to suffer the same trash I had to deal with as an optician.

 

[IndianaOD]

I actually had the opportunity to meet with a private practice ophthalmologist this afternoon to discuss the pros and cons of corporate optometry. I had shadowed him for 20+ hours last summer and we have grown quite close. I truly gained a great deal from our meeting. I am more acutely aware of the potential over-saturation involved within the optometric profession because of the addition of the new optometry programs. Also, I am trying to find the "evil" affiliated with corporate optometry. To most of you, it seems to be blatantly obvious. His overall advice was to "flood" around after I graduate from PCO. In other words, maybe work 4 days at a corporate practice and one day with a private practice optometrist. Once I can start paying back some of my student loans from my optometric education, I can join another OD in a private practice setting or start a small office for myself. He said the best situation and often the most lucrative one, is where there are two practicing optometrists within a private practice setting. Also, he just recently started interviewing optometrists to help him with his two private practice offices. I'm sure this would be a tremendous opportunity.

Honestly,

Many ophthalmologists probably think commercial optometry is swell. Commercial ODs are ODs that frequently refer ANYTHING medical out. Its an ophthalmology gravy train. Commercial optometry also damages the image of optometry and many greedy OMDs I'm sure love that.

 

[KHE]

I have never had the intention to stay in corporate optometry; however, I feel that it may be the most feasible route to take after graduation.

If your long term goal is private practice, you should enter optometry school with that mindset. Make commercial the fall back position, not "the plan" even if it's only a short term plan.

Have you, IndianaOD or KHE, been affiliated with a corporate practice setting? If so, for how long? Maybe you can tell us about your experiences. Personally, I would like to hear from corporate optometrists to tell us the pros and cons of their work. Maybe another thread should be started.

When I first finished my residency, I took a position as clinic director for TLC Laser Eye Centers in Las Vegas. My new wife and I both knew that we would be back in the east in a few years. The plan was to just head out west, try something different for a few years and then move back home. At that time, they told me that the clinic was struggling and they wanted me to "turn it around." Of course, I had no idea what I was going to do, but full of bravado I said "no problem."

Once I got out there, I found out that in order to break even, the center had to do surgery on 133 eyes per month (eyes, not patients) to break even. The month before I got there, they had done 19. lol. So needless to say, it was like rearranging deck chairs on the titanic. I started in August of 2001. 6 weeks later, September 11th happened and about 250000 people in Las Vegas got laid off because NO ONE WAS FLYING. The airport was shut down. Then a month after that, they started with the whole anthrx thing so really, no one knew if the world was going to end or not so no one was getting elective eye surgery, and a very very bad situation at my clinic turned worse very fast and the center folded.

Since Las Vegas was still in the toilet, no one was hiring. I managed to work some days doing fill ins at commercial locations. I also took a lease at a Sears Optical.

The people at Sears told me that the location was busy, but that the current leaseholder was not giving them enough hours. I told them I would give them the 40 they wanted and they terminated his lease, after he had been with them for 10 years. (more on that later.) I worked the 40 hours and quickly found the location was not nearly busy enough to support that. I don't know how much of that had to do with the economy at that time but there were plenty of days of seeing 1-2 patients all days. There were many days when my secretary made more than me. On the whole, I made what would have been about $60000 a year when all was said and done though I only stayed at that location for about 6 months before my wife and I pulled the plug on our little west coast adventure and moved back east.

While at Sears, I experienced little corporate influence other than them insisting that I be open on Saturdays, that I take certain poor playing vision plans, and that I keep my exam fee within reasonable distance of other locations in the same mall. I charged $5 more than the other locations which all charged $55 at the time. I charged $60.

Back east, I worked part time at a few different Lenscrafters locations, and a few private practices trying to find the right one to settle down in. This took a lot longer than I thought. I was never a lease holding doctor at any of the LC locations I worked at so I experienced little direct commercial influence but I know that the lease holding docs I worked for were constantly under siege to recommend more multiple pairs of glasses, recommend certain contace lens brands, reduce fees, work more hours et al. Two of the three I worked for were both forced out of their leases. One after being with LC for about 10 years, the other after being with them for 12.

I worked about a total of 5 fill in days at a Walmart where I was given no hassles other than the optical department constantly bringing over "walk ins."

The only way to make money in a commercial location is to be the lease holding doctor in a very busy location. Being employed by the commercial location (if you're in a state that allows it) or working for a lease holding doctor will never make you any real money. But in order to be the lease holding doctor, it requires a near Faustian bargain.

As I mentioned before with the Sears I worked at, the problem with commercial practice is that you are never really independent. As long as the optical is doing well, or is doing as well as the optical/regional/district/corporate manager THINKS it should be doing, then the corporate entity will generally leave you alone. The problems always start once the optical isn't doing as well as some corporate manager THINKS it should be doing and that's when the "independent doctor of optometry next to XXXXX" will start getting the friendly "visits" or "meetings" from various people with their recommendations of lower fees, more hours, willingness to accept more walk ins, accept certain insurance plans, recommend certain contact lens brands, recommend more sunglasses, don't do so many dilations, etc. etc.

If the "independent doctor of optometry next to XXXXX" doesn't get with the program, they will find out exactly how independent they are. In fact, they will be SO independent, they won't even work there any more. How's that for independence?

The only time I would ever recommend commercial practice is if you find yourself in a situation where you know for certain that you will not be in a particular city, state or area for very long. If you know you're leaving the state in 2 years, it makes little sense to purchase or start a private practice.
Ideally, if your goal is private practice you should try to work in one, preferably more than one so that you can learn and observe what works and what doesn't and what's important to you. Even in my worst private practice jobs, I learned a lot about what I did NOT want to do once I had my own.

If you must be involved in commercial practice, I would suggest Lenscraftes, Pearle and similar such entities.

I would avoid Walmart, Costco, Sears, Target, JC Penney etc. etc.

The reason for that is that at least Lenscrafters and Pearle are "eye places." Only "eye" stuff goes on there. Whereas Sears is a place to get appliances and Craftsman chainsaws, walmart is a place to get cheap socks and shoes, and Costco is a place to get a 50 pound bag of cat litter. Not exactly the best impression for any sort of doctor.

 

[Optogal]

Cool post.

 

[Penguin2012]

excellent post, thanks Khe

 

[VA Hopeful Dr]

Honestly,

Many ophthalmologists probably think commercial optometry is swell. Commercial ODs are ODs that frequently refer ANYTHING medical out. Its an ophthalmology gravy train. Commercial optometry also damages the image of optometry and many greedy OMDs I'm sure love that.

I would think that an ophtho who is willing to take on a pre-opt to preceptor and then didn't spend the whole time talking crap about optometry is likely one of the OD-friendly ones. My experience with those has been that they don't give 2 ****s about medical stuff that a willing OD could handle - they want to be in the OR. Pink eye, diabetes follow-ups, and glaucoma suspects don't really do that.

Though I'm certainly not denying that there are plenty of them out there who think as you described.

 

[RTM]

Honestly,

Many ophthalmologists probably think commercial optometry is swell. Commercial ODs are ODs that frequently refer ANYTHING medical out. Its an ophthalmology gravy train. Commercial optometry also damages the image of optometry and many greedy OMDs I'm sure love that.

 

[Meibomian SxN]

...Ideally, if your goal is private practice you should try to work in one, preferably more than one so that you can learn and observe what works and what doesn't and what's important to you. Even in my worst private practice jobs, I learned a lot about what I did NOT want to do once I had my own....

So true. Very beneficial statement for those looking to start a career in a private practice setting.

 

[IndianaOD]

I really appreciate your input Ken. I will be referring back to this post throughout my optometric studies. Very informative!

Indeed, Ken's been around the block! Good post.

 

[LionSight]

Chances are, grads of the new schools will fare incrementally worse than the folks from other schools. Not a lot worse, but something measurable in percentage points, similar to how their GPA is just slightly off.

As such, the trend will still remain an overwhelming overlap in terms of performance with students at the established schools. Those who want to defend the new schools will point to this overlap to evidence that they are producing essentially "equally" competent clinicians. Those who are against it will point to the fact that they, on average, perform (just slightly) worse than everyone else.

There is no question that GPA doesn't correlate perfectly with being a good OD. Anecdotally, we all know of several folks who just got by and are doing more than well. But the issue is - optometry is an academic endeavor, and education is an academic pursuit. If we don't use GPA as the primary means of selection, then what criteria do we use?

This was such a great point! Hopefully in the near future the education system will find a way to evaluate the complete overall candidacy of an applicant. Right now GPA and OAT are it. What about the single parent or lower SES student who makes the slightly lower scores because they are forced to devote a fraction of the time to studies? There is no way to show adequately that this person could very well be the best doctoral candidate in an applicant pool. Very frustrating!

 

[LionSight]

If your long term goal is private practice, you should enter optometry school with that mindset. Make commercial the fall back position, not "the plan" even if it's only a short term plan.



When I first finished my residency, I took a position as clinic director for TLC Laser Eye Centers in Las Vegas. My new wife and I both knew that we would be back in the east in a few years. The plan was to just head out west, try something different for a few years and then move back home. At that time, they told me that the clinic was struggling and they wanted me to "turn it around." Of course, I had no idea what I was going to do, but full of bravado I said "no problem."

Once I got out there, I found out that in order to break even, the center had to do surgery on 133 eyes per month (eyes, not patients) to break even. The month before I got there, they had done 19. lol. So needless to say, it was like rearranging deck chairs on the titanic. I started in August of 2001. 6 weeks later, September 11th happened and about 250000 people in Las Vegas got laid off because NO ONE WAS FLYING. The airport was shut down. Then a month after that, they started with the whole anthrx thing so really, no one knew if the world was going to end or not so no one was getting elective eye surgery, and a very very bad situation at my clinic turned worse very fast and the center folded.

Since Las Vegas was still in the toilet, no one was hiring. I managed to work some days doing fill ins at commercial locations. I also took a lease at a Sears Optical.

The people at Sears told me that the location was busy, but that the current leaseholder was not giving them enough hours. I told them I would give them the 40 they wanted and they terminated his lease, after he had been with them for 10 years. (more on that later.) I worked the 40 hours and quickly found the location was not nearly busy enough to support that. I don't know how much of that had to do with the economy at that time but there were plenty of days of seeing 1-2 patients all days. There were many days when my secretary made more than me. On the whole, I made what would have been about $60000 a year when all was said and done though I only stayed at that location for about 6 months before my wife and I pulled the plug on our little west coast adventure and moved back east.

While at Sears, I experienced little corporate influence other than them insisting that I be open on Saturdays, that I take certain poor playing vision plans, and that I keep my exam fee within reasonable distance of other locations in the same mall. I charged $5 more than the other locations which all charged $55 at the time. I charged $60.

Back east, I worked part time at a few different Lenscrafters locations, and a few private practices trying to find the right one to settle down in. This took a lot longer than I thought. I was never a lease holding doctor at any of the LC locations I worked at so I experienced little direct commercial influence but I know that the lease holding docs I worked for were constantly under siege to recommend more multiple pairs of glasses, recommend certain contace lens brands, reduce fees, work more hours et al. Two of the three I worked for were both forced out of their leases. One after being with LC for about 10 years, the other after being with them for 12.

I worked about a total of 5 fill in days at a Walmart where I was given no hassles other than the optical department constantly bringing over "walk ins."

The only way to make money in a commercial location is to be the lease holding doctor in a very busy location. Being employed by the commercial location (if you're in a state that allows it) or working for a lease holding doctor will never make you any real money. But in order to be the lease holding doctor, it requires a near Faustian bargain.

As I mentioned before with the Sears I worked at, the problem with commercial practice is that you are never really independent. As long as the optical is doing well, or is doing as well as the optical/regional/district/corporate manager THINKS it should be doing, then the corporate entity will generally leave you alone. The problems always start once the optical isn't doing as well as some corporate manager THINKS it should be doing and that's when the "independent doctor of optometry next to XXXXX" will start getting the friendly "visits" or "meetings" from various people with their recommendations of lower fees, more hours, willingness to accept more walk ins, accept certain insurance plans, recommend certain contact lens brands, recommend more sunglasses, don't do so many dilations, etc. etc.

If the "independent doctor of optometry next to XXXXX" doesn't get with the program, they will find out exactly how independent they are. In fact, they will be SO independent, they won't even work there any more. How's that for independence?

The only time I would ever recommend commercial practice is if you find yourself in a situation where you know for certain that you will not be in a particular city, state or area for very long. If you know you're leaving the state in 2 years, it makes little sense to purchase or start a private practice.
Ideally, if your goal is private practice you should try to work in one, preferably more than one so that you can learn and observe what works and what doesn't and what's important to you. Even in my worst private practice jobs, I learned a lot about what I did NOT want to do once I had my own.

If you must be involved in commercial practice, I would suggest Lenscraftes, Pearle and similar such entities.

I would avoid Walmart, Costco, Sears, Target, JC Penney etc. etc.

The reason for that is that at least Lenscrafters and Pearle are "eye places." Only "eye" stuff goes on there. Whereas Sears is a place to get appliances and Craftsman chainsaws, walmart is a place to get cheap socks and shoes, and Costco is a place to get a 50 pound bag of cat litter. Not exactly the best impression for any sort of doctor.

Wow... that was wonderfully said. Thank you for sharing your experience.