OD Students, Who did you shadow?

[IndianaOD]

Just curiosity. It is a fact that greater than 90% of 1st and 2nd year OD students aspire to private practice, yet over 50% will end up in commercial/retail practice.

I know a lot of young ODs who are struggling due to the optometric oversupply. Many are discouraged working in commercial but can't find anything else.

Did most of you shadow a successful established private practice OD? How many shadowed multiple commercial ODs? How many shadowed a struggling younger OD?

I think most pre-optoms think optometry mainly consists of successful private practices where fewer an fewer ODs are finding jobs. Have many of you realized that the odds are you are going to be working commercial after graduation? Including nights and weekends?

Just curious who most of you shadowed.

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[Oogilily]

I shadowed two private ODs and one commercial place. One of them owned two practices that he worked himself and the other one had two ODs. As far as I know, the one is still working both by himself and the one with two ODs now only has one OD. I also shadowed one commercial place at a Target. The doc was super nice and he loved the commercial scene. I guess it is important to note that he also ran a practice on an Air Force base. But he enjoyed it at Target as well. That's all I shadowed before I started school. I understood before I started school that not everybody gets into a successful private practice.

 

[thecgrblue]

I shadowed a 4 OMD/2 OD practice. I also shadowed a solo OD practice, he was kind of a eccentric (took 50 vitamins a day) and only saw about 6 patients a day...not sure if he did that on purpose or wasn't that busy at all. I attempted to shadow at multiple commercial sites, but they never wanted me to shadow. One flat out said, "I hate having students shadow and I know you hate doing it...if you want me to sign a paper saying you had x amount of hours I'll do it." I have gone to an OD at Costco and a commercial setting...so I got a feel of what that was like.

 

[IndianaOD]

Students.

If you shadowed a commercial OD did they treat medical conditions and bill medical insurance? Did they have the equipment to treat glaucoma and other conditions? Did you ever see them Rx oral meds?

I happily allow pre-optoms to shadow my private practice but I spend most of the time recommending something else besides optometry. I have already had 1 student come back and thank me once he was enrolled in dental school.

Surprisingly, some optometry school faculty and administration are finally starting to admit there is oversupply.

 

[Shnurek]

Discouraging a few students to not pursue optometry isn't really going to change much except lessen the quality of applicants because less competition. There are about 3 people that want to get into opto school for every enrolled student so someone else will take their spot. If you like, petition the AOA to not open up/accredit anymore schools.

 

[JMU07]

Students.

If you shadowed a commercial OD did they treat medical conditions and bill medical insurance? Did they have the equipment to treat glaucoma and other conditions? Did you ever see them Rx oral meds?

I happily allow pre-optoms to shadow my private practice but I spend most of the time recommending something else besides optometry. I have already had 1 student come back and thank me once he was enrolled in dental school.

Surprisingly, some optometry school faculty and administration are finally starting to admit there is oversupply.

I shadowed/worked at a commercial practice, and I'll be working there after graduation. The doc who owns it (it's a franchise) does in fact treat medical conditions, bills medical insurance, and has no issue with rx'ing orals.

 

[jeh198]

If you like, petition the AOA to not open up/accredit anymore schools.

It's been done. Even if you had a petition with the signature of every optometrist in the US with a million dollar check attached the AOA would still not address the issue. Ever since the AOA was sued for alleged price fixing about a decade ago they refuse to undertake any meaningful issue that would benefit the profession.

 

[IndianaOD]

It's been done. Even if you had a petition with the signature of every optometrist in the US with a million dollar check attached the AOA would still not address the issue. Ever since the AOA was sued for alleged price fixing about a decade ago they refuse to undertake any meaningful issue that would benefit the profession.

Yes, the oversupply problem is off the leash. All the new schools are private with the only goal of collecting tuition. It is clear there was no need.

I apologize for veering into a commercial / oversupply route. It is hard for me to resist the two things I think are doing the most damage to the profession.

The point is prospective students need to shadow multiple ODs. I would say an established PP doc, a younger PP doc trying to make ends meet, and a couple of commercial locations including a walmart and super low end glasses mill like eyemart or americas best (worst) etc.

I already know the applicant pool is weaker over the past few years than it has been in the past so that point is moot. I don't want you younger pre-opts choosing optometry based on one successful private practice.

 

[mclem222]

I read the previous posts and have a practice where I do a lot of glasses, some exams, glaucoma management but have to ask the question, when you were applying to Optometry school what did you think that we did? I mean, when I was apply I researched optometry school vs ophthalmology and med school and chose to do optometry knowing that I may decide to work for a chain, be on my own doing a lot of refractions etc.. I think the disappointment is when someone goes through the OD process thinking they will practice as an ophthalmologist and then are devastated to be working at Americas best or Lenscrafters etc...That is a reality of our field and I think those who are disappointed are ones who didn't research it properly. I think that most people think of "eye doctors" as someone who works at Lenscrafters etc.. or in a private office in a strip mall. How does one think of that as a private practice doctor who treats eye diseases all day? I think if we think of optometry of somehow moving away from that model as what some of us do, we are sadly mistaken. I really dont think there is an oversupply of ODs (different thread topic) but maybe too many people who want to practice as one type of optometrist. Just like there is not an oversupply of physicians but if you ask all plastic surgeons if there is an oversupply they all say yes.. To answer the thread question, I shadowed a a private practice OD, an OMD, and a group of 3 OMDs with 6 ODs.

 

[IndianaOD]

I read the previous posts and have a practice where I do a lot of glasses, some exams, glaucoma management but have to ask the question, when you were applying to Optometry school what did you think that we did? I mean, when I was apply I researched optometry school vs ophthalmology and med school and chose to do optometry knowing that I may decide to work for a chain, be on my own doing a lot of refractions etc.. I think the disappointment is when someone goes through the OD process thinking they will practice as an ophthalmologist and then are devastated to be working at Americas best or Lenscrafters etc...That is a reality of our field and I think those who are disappointed are ones who didn't research it properly. I think that most people think of "eye doctors" as someone who works at Lenscrafters etc.. or in a private office in a strip mall. How does one think of that as a private practice doctor who treats eye diseases all day? I think if we think of optometry of somehow moving away from that model as what some of us do, we are sadly mistaken. I really dont think there is an oversupply of ODs (different thread topic) but maybe too many people who want to practice as one type of optometrist. Just like there is not an oversupply of physicians but if you ask all plastic surgeons if there is an oversupply they all say yes.. To answer the thread question, I shadowed a a private practice OD, an OMD, and a group of 3 OMDs with 6 ODs.

IE: You are saying there are too many optometrists who want to practice to the level they have been trained? Are you sh#$&^ting me?

8 to 9 years of school and 6 figures of debt to spin and grin in a warehouse or glasses mill, no thanks. An OD can do anything but invasive eye surgery and is trained like crazy to do it.

Dude, you are optometry poison.

 

[hello07]

in commercial settings, you can dilate, diagnose and treat ocular disease as well as refract fit CL's. what do you do different in private practice that a retail OD doesn't? OCT'? VF's? pachymetry?

If you treat a corneal ulcer in commercial practice or refer someout out for a retinal hole what does a private OD do that a retail practice doesn't? There are pvt practices out there that pump 35- 40pts a day?

Enlighten me

 

[IndianaOD]

in commercial settings, you can dilate, diagnose and treat ocular disease as well as refract fit CL's. what do you do different in private practice that a retail OD doesn't? OCT'? VF's? pachymetry?

If you treat a corneal ulcer in commercial practice or refer someout out for a retinal hole what does a private OD do that a retail practice doesn't? There are pvt practices out there that pump 35- 40pts a day?

Enlighten me

There obviously aren't any differences in scope of practice. Experience shows that far fewer retail ODs provide medical eye care, bill properly for it, or charge properly for it. That is not all cases just the trends.

Retail locations have the OD there for one reason only. To help them sell glasses. If they are selling glasses you are fine. If they aren't selling the glasses as fast as they want you might be looking for a new job. Medical eye care doesn't help them sell glasses.

That's it. I don't think the average commercial practice puts a good face on the profession. It also really cheapens our profession to have patients watching advertisements for free exams at eyemart or $39 eye exams when they walk into a walmart.

A retail joint could have all the latest technology but how many actually do? Our practice isn't the biggest and baddest but we do have a GDx, Retinal camera, anterior segment camera, pachymeter, and perimeter. Doesn't make me better, just allows me to treat glaucoma as I was trained. Optometrists should be seen as THE primary eye care provider.

 

[Shnurek]

IE: You are saying there are too many optometrists who want to practice to the level they have been trained? Are you sh#$&^ting me?

8 to 9 years of school and 6 figures of debt to spin and grin in a warehouse or glasses mill, no thanks. An OD can do anything but invasive eye surgery and is trained like crazy to do it.

Dude, you are optometry poison.

I agree with your point. Optometry will never get the respect optometry deserves without a change in the term optometry. Just like OSTEO-pathic physicians confuse the public and they can do eye surgery, opto-METRISTS can treat eye disease and surgery in two states and not just measure vision.

Alternate terms that more closely relate scope of practice:
1) Optometric Physician
2) Oculus Doctor (my fav)
3) Optometric Doctor

 

[mclem222]

I think the reality of the situation is that commercial practice is a significant part of what optometry does in the U.S. If you ask the average layman what an optometrist does, that is their image of it. Its not like I decided that, I am just explaining to you what the reality is. In terms of being trained to do, I agree with you but what people are trained to do and what they do are completely different. My brother is an OMD and he was trained to do blepharoplasties and ptosis repair. Does he do it? No. Does he want to do it? No. He sends those out to an oculoplastic specialist. The reality of the situation is that optometrists will have to do glasses as that is a large part of eyecare. I understand that we are trained to do a ton of things but there is a lot of variability to optometry training in 2011. I have colleagues who are recently trained who don't treat basic eye problems (corneal abrasion, etc..). My brother has been sent patients for referral who have normal IOPs, normal visual fields, normal nerves and a positive family history of glaucoma by people who are recently trained. He has shown me the script which says "+ family hx of glaucoma..please evaluate". And these are people that have come out of school 1-2 years ago. Would I do that? No. I saw that and thought "seriously?". But a significant number of people do...These docs have the equipment and they are choosing not to follow these patients. And these are not just commercial ODs, they are private practice ODs as well.

Most people are healthy and thus only need glasses. For them, Lenscrafters etc.. is all they need. There are a smaller percentage of people that have eye diseases that need monitoring and even smaller percentage that need surgery. To go into optometry thinking that you are only or largely doing only eye disease monitoring is foolish. This is analogous to a pediatrician who goes into practice and then is shocked that a large part of their practice are well baby visits and immunizations.

I think that retail ODs may also not see as many patients with medical problems as a private practice OD or an ophthalmologist. I know OMDs that see only people who are there for medical problems or walk ins as such. The commerical OD may bill less because they are seeing less. A diabetic patient may not instictually think " I should go to Costco to get my eyes checked". etc..Sort of selection bias.. When you see these commercials that have free eye exam etc... I see your point but I have seen those commercials since I was 4 and I am 40 years old now. Who did you think did those free eye exams? Those aren't going away...

Finally I noted that you stated 8-9 years for training. I trained for 4 years (no residency) but I don't count undergraduate for our training. I mean were you not going to college if you didnt decide to be an optometrist? I agree 4-5 years to spin a wheel isn't ideal but I think it is a reality of our practice. You are welcome to your opinion of me..but I think I am just stating what the truth is. What your practice is reflects a smaller percentage of what the standard practice of an optometrist is in the US. I applaud you for how you practice. You and I both treat diseases and problems that a lot of optometrists do not choose to treat. It doesnt reflect what patients think or their perceptions but what some people when they went to optometry school wanted to do. I am totally ok with that but you clearly are not..

 

[KHE]

I agree with your point. Optometry will never get the respect optometry deserves without a change in the term optometry. Just like OSTEO-pathic physicians confuse the public and they can do eye surgery, opto-METRISTS can treat eye disease and surgery in two states and not just measure vision.

Alternate terms that more closely relate scope of practice:
1) Optometric Physician
2) Oculus Doctor (my fav)
3) Optometric Doctor

I don't think that has anything to do with it.

The problem is that in 100% of commercial practices, you walk in and it's basically and eyeglass store with an exam lane in the back.

For private practices, it's about 95% the same thing.

That's what the perception is. The public walks into the overwhelming majority of our offices and it screams "eyeglass store."

 

[mclem222]

totally agree

 

[IndianaOD]

I think the reality of the situation is that commercial practice is a significant part of what optometry does in the U.S. If you ask the average layman what an optometrist does, that is their image of it. Its not like I decided that, I am just explaining to you what the reality is. In terms of being trained to do, I agree with you but what people are trained to do and what they do are completely different. My brother is an OMD and he was trained to do blepharoplasties and ptosis repair. Does he do it? No. Does he want to do it? No. He sends those out to an oculoplastic specialist. The reality of the situation is that optometrists will have to do glasses as that is a large part of eyecare. I understand that we are trained to do a ton of things but there is a lot of variability to optometry training in 2011. I have colleagues who are recently trained who don't treat basic eye problems (corneal abrasion, etc..). My brother has been sent patients for referral who have normal IOPs, normal visual fields, normal nerves and a positive family history of glaucoma by people who are recently trained. He has shown me the script which says "+ family hx of glaucoma..please evaluate". And these are people that have come out of school 1-2 years ago. Would I do that? No. I saw that and thought "seriously?". But a significant number of people do...These docs have the equipment and they are choosing not to follow these patients. And these are not just commercial ODs, they are private practice ODs as well.

Most people are healthy and thus only need glasses. For them, Lenscrafters etc.. is all they need. There are a smaller percentage of people that have eye diseases that need monitoring and even smaller percentage that need surgery. To go into optometry thinking that you are only or largely doing only eye disease monitoring is foolish. This is analogous to a pediatrician who goes into practice and then is shocked that a large part of their practice are well baby visits and immunizations.

I think that retail ODs may also not see as many patients with medical problems as a private practice OD or an ophthalmologist. I know OMDs that see only people who are there for medical problems or walk ins as such. The commerical OD may bill less because they are seeing less. A diabetic patient may not instictually think " I should go to Costco to get my eyes checked". etc..Sort of selection bias.. When you see these commercials that have free eye exam etc... I see your point but I have seen those commercials since I was 4 and I am 40 years old now. Who did you think did those free eye exams? Those aren't going away...

Finally I noted that you stated 8-9 years for training. I trained for 4 years (no residency) but I don't count undergraduate for our training. I mean were you not going to college if you didnt decide to be an optometrist? I agree 4-5 years to spin a wheel isn't ideal but I think it is a reality of our practice. You are welcome to your opinion of me..but I think I am just stating what the truth is. What your practice is reflects a smaller percentage of what the standard practice of an optometrist is in the US. I applaud you for how you practice. You and I both treat diseases and problems that a lot of optometrists do not choose to treat. It doesnt reflect what patients think or their perceptions but what some people when they went to optometry school wanted to do. I am totally ok with that but you clearly are not..

Thanks for your opinion. I don't mind a reasonable debate. I say 8-9 because you have to have undergraduate to attend any doctoral medical profession. Yes you can get into medical, optometry, and dental school with 3 years undergrad but over 90% have bachelors degrees.

The glasses and contact lens model is not sustainable. In case you haven't noticed the profit in materials is nosediving rapidly. I think eventually this will lead to walmart and others removing their opticals due to lack of profit. For some reason people think optometrists mark up the glasses like crazy. They don't actually know that many retail goods like clothing and dollar stores have a much higher actual mark up. Good quality frames and lenses cost us much more than people realize.

 

[thiaeyemd]

just reading this thread...maybe the solution would be to let opticians do the lenscrafters walmart deal..let optometrist do primary eye care (eye disease) and let ophthalmologists do advanced eye disease and surgery

 

[IndianaOD]

just reading this thread...maybe the solution would be to let opticians do the lenscrafters walmart deal..let optometrist do primary eye care (eye disease) and let ophthalmologists do advanced eye disease and surgery

Won't work. You can't separate refractive care (glasses) from eye health. There is too much overlap. Just like the patient I saw today who came in just for glasses but is coming back for more testing because it looks like a definite case of glaucoma.

Plus there are WAY too many ODs to just provide medical eye care.

 

[mclem222]

Debate is always good. My point on the 8-9 years statement was that for most people who are going to optometry, they are going to do the undergrad if they are going to optometry school or not. Yes, if you are a high school student you do have to do 8 years to become an optometrist but the optometry part is really 4 years after undergrad. Saying 8 years (for me) is a little misleading. If we are going that far why don't we include high school and say 12 years? If any of us had not gotten into optometry school, we wouldve finished undergrad etc. and done something else. In general, we are part of the population that is going to college anyway. Not too many OD's or people who thought about ODs would decide to bag college altogeher if they changed their mind about Optometry school.

I think you are right.. I dont' know how sustainable glasses alone are in time. With the online Rx stuff and price wars I don't know what the future will hold. However that being said that is still a large part of what we did. I don't know anyone for example who started school with me who hoped they wouldnt have to refract at all once they were out or do just medical exams without refractions. Our profession is in a changing time, it may turn for the better or worse. I am not sure what will happen.