Nursing Home Practice

[StushOD]

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From my personal experience and the recent posts on SDN I have been able to determine that working in a commercial setting isn’t for me. While a few in this setting seem to have found good situations, it appears that most grads will not be so fortunate. I am grateful for this information as it will help me find a more rewarding practice setting.

This lead me to find more information about OD's that focus their practice serving nursing home patients. On the surface it appears to offer some unique benefits such as no nights/weekends/holidays (unless on call), less overhead and lots of pathology.

Of course there seems to be some drawbacks, ie. required physician signature for Medicare reimbursement and loss of retail sales.

Any insight from OD's with experience in this field would be appreciated. Is this type of practice rewarding for you? How does the reimbursement in this setting compare to other settings? Other benefits/drawbacks that you have experienced?

 

[Tippytoe]

Nursing home work can be financially and emotionally rewarding.

Unfortunately it has some drawbacks. Some (many) areas already have contracted ODs stopping by (see OD oversupply----we even have ODs begging to get contracts at the prisons while they have to beg even nurses to work there)....but I digress.

Usually there are services that hire ODs to go to local homes to provide care at a salary or commissioned rate.

The work is not particulary enjoyable. Smells, rude/dementia patients, usually no reliable history, very poorly trained staff, frequent turnover of administation, family members that don't care, etc...

Sometinmes you just have to guesstimate at an spectacle Rx. Then you have to wrestle with "it is worthwhile to try to convince the nurses that an 88 year old patient that thinks Truman is still the president and with one foot in the grave, to use a glaucoma drop bid. A losing battle most times.

But, if you can get a contract to provide sole care to maybe 10 homes, you can do well. It's a very depressing job though. Remember, you might only see each patient one time. They die very quickly in nursing homes.

Probably a better long term plan is to do home visits to shut-ins.