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Not at all, Cataracts were cut from 3500 dollars per eye to 700 dollars per eye over night. That is the main reason why Ophthos do not make as much as they use to.
Optometry is DEAD!
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Sorry, but you're wrong. It's because reimbursements have been plummeting, especially relative to cost of living. Ophthalmologists make the vast majority of their revenue from surgery and procedures, not routine exams and medical management of glaucoma and the like. Optometry oversupply has no significant impact on the former--at least not yet.
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I would also imagine that the fact that with modern techniques, a cataract procedure can take 15 instead of 90 minutes and the complication risk is much lower. As such, one surgeon can now do the work of 3 or 4.
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IDK. Hedge fund traders seem to be doing pretty well these days. lol
I agree with retinologist...its because surgical reimbursements have plummetted. I am an oculoplastic surgeon but even my colleagues who do comprehensive make most of their money from surgery not routine eye exams.
I personally think the main issue with Optometry (and several other health care professions) is insurance related. I take some ODs on this site to task because they spend all of their time complaining about over-supply and trying to scare people away from the profession instead of focusing on their biggest nemesis. Not that over supply doesn't play a part but I believe the insurance companies are putting the biggest squeeze on things. I'm not sure if you could cut enough schools or discourage enough applicants to make as big of a difference as simply getting better reimbursements. You might have more patients per OD (which I'm sure would be fine with most ODs) but the insurance companies would continue to devalue your services. Being passive about it isn't going to make it better either. You'll just lose out while other professions get more per patient. I understand though that it is harder to fight an insurance company than it is to try to discourage folks from entering a profession.
It is organizations like the AOA that could possibly help if they were actually focused on the task. They could make a mission statement that they will work to influence the national politics and insurance companies to the benefit of their constituents. Another goal should be to promote to the public the importance of eye care. These are things that Dentistry has done very well and it's paying off for them. I remember seeing commercials put out by the ADA about dental care back when I was a kid. They're still doing it now. That's how you help keep the perception of your services high in people's minds. I don't know if I've ever seen a public announcement about eye care. I don't know. Maybe with the current level of commercialization, it could already be too late to change public perceptions on the value of these services. However, I'm sure if they stated it as a mission statement and showed proof that they were focused on it, they could get more ODs to pitch in.
My main point is, trolling around forums trying to scare off pre-optometry people seems like a mickey mouse way of influencing change. Especially, when that is not even the biggest danger. I think the biggest danger is your services being massively devalued by insurance companies. I'd be much more encouraged about the future of Optometry if I saw more examples of ODs banding together to address such issues in a more constructive manner.
It is organizations like the AOA that could possibly help if they were actually focused on the task. They could make a mission statement that they will work to influence the national politics and insurance companies to the benefit of their constituents. Another goal should be to promote to the public the importance of eye care. These are things that Dentistry has done very well and it's paying off for them. I remember seeing commercials put out by the ADA about dental care back when I was a kid. They're still doing it now. That's how you help keep the perception of your services high in people's minds. I don't know if I've ever seen a public announcement about eye care. I don't know. Maybe with the current level of commercialization, it could already be too late to change public perceptions on the value of these services. However, I'm sure if they stated it as a mission statement and showed proof that they were focused on it, they could get more ODs to pitch in.
My main point is, trolling around forums trying to scare off pre-optometry people seems like a mickey mouse way of influencing change. Especially, when that is not even the biggest danger. I think the biggest danger is your services being massively devalued by insurance companies. I'd be much more encouraged about the future of Optometry if I saw more examples of ODs banding together to address such issues in a more constructive manner.
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😛
No great arguments here. Insurance SUCKS. Do you want me to tell you how I really feel about insurance companies? 😀 😛
Wait for it..................IF THERE WASN'T A VAST OVERSUPPY we wouldn't be begging for any patients that walked in the door with crappy EyeMed or Superior Vision. We would pass up that $35 patient for one that pays better. But ya gotta pay the bills and $35 is better than ZERO. Smart insurance execs have figured that one out and they've figured there are ENOUGH ODs that need to eat and pay off loans so they will jump like a hungry dog for $35.
WHY..........because there are too many ODs........or perhaps too many LOSER OD's that will take any insurance plan that exists because well, you can always make it in volume, right 🙄.
But we largely have no control over insurances. By coming on here and giving our real life viewpoints, we hope to give a realistic assessment to prospective students. It's KNOWLEDGE and knowledge is power.......even if one doesn't agree with it.
Oh yea, doctors are not allowed to unionize so the ONLY thing we can do about low paying insurances is to refuse to take it.........and THAT ain't gonna happen.
No great arguments here. Insurance SUCKS. Do you want me to tell you how I really feel about insurance companies? 😀 😛
Wait for it..................IF THERE WASN'T A VAST OVERSUPPY we wouldn't be begging for any patients that walked in the door with crappy EyeMed or Superior Vision. We would pass up that $35 patient for one that pays better. But ya gotta pay the bills and $35 is better than ZERO. Smart insurance execs have figured that one out and they've figured there are ENOUGH ODs that need to eat and pay off loans so they will jump like a hungry dog for $35.
WHY..........because there are too many ODs........or perhaps too many LOSER OD's that will take any insurance plan that exists because well, you can always make it in volume, right 🙄.
But we largely have no control over insurances. By coming on here and giving our real life viewpoints, we hope to give a realistic assessment to prospective students. It's KNOWLEDGE and knowledge is power.......even if one doesn't agree with it.
Oh yea, doctors are not allowed to unionize so the ONLY thing we can do about low paying insurances is to refuse to take it.........and THAT ain't gonna happen.
Very true. But many ophthalmologists here have hired ODs to do the scut work and flush out the surgical stuff. Good for you guys. Soon you'll be able you have your very own OD or two for the price of a good receptionist. Hell, I will too.
Bring 'em on. Open more schools. I say put one on every corner beside each CVS or Walgreens.
To the ophthalmologist here:
This post reminded me of a conversation I had with a great (now deceased) ophthalmologist years ago. He had a large surgical center (no primary care) and he told me he'd prefer to be in the O.R. all the time if given the chance because routine exams "bored the hell out of him". He was an outstanding refractive/cat surgeon (mabye because he did live in the OR 🙂 .
Do you think you'd lose your mind doing routine (and basic medical) eye exams all day, all week, all year?
I'd guess most would. And maybe this is why many ODs are ultimately unsatisfied. No matter how you spin it (pun intended 🙂, sitting in a dark room, trying to figure out the axis of a spec Rx is just not the most mentally challenging thing to do day in and day out.
This post reminded me of a conversation I had with a great (now deceased) ophthalmologist years ago. He had a large surgical center (no primary care) and he told me he'd prefer to be in the O.R. all the time if given the chance because routine exams "bored the hell out of him". He was an outstanding refractive/cat surgeon (mabye because he did live in the OR 🙂 .
Do you think you'd lose your mind doing routine (and basic medical) eye exams all day, all week, all year?
I'd guess most would. And maybe this is why many ODs are ultimately unsatisfied. No matter how you spin it (pun intended 🙂, sitting in a dark room, trying to figure out the axis of a spec Rx is just not the most mentally challenging thing to do day in and day out.
you are probably right. I practice oculoplastics and emergency exams for my practice...I would trade any contact lens exam for the most complicated orbital problem or difficult case in a second. One of the "worst" patients I had was a musician who somehow got onto my schedule and came in with a bag of glasses, his music stand, his folding card table from home wanting to get a pair of glasses and bifocal contacts that worked for all three....To me it was pure torture...but that is why I trained to do what I do..so I could avoid that stuff.
Ha, ha. Somehow the word got out that I like to shoot. So now I have a bunch of presbyopic guys bringing pistols into my office so we can trail- frame them to the correct distance.
That's always fun.
Insightful article from a top OD in the field:
weekly e-journal by Art Epstein, OD, FAAO July 18, 2011me 11, Number 29
Off the Cuff: The Coming Eyepocalypse
While I don't usually ask for audience participation, please indulge me this one time. Open a window and do a Google search for "eyeglasses online." Searching those combined terms turns up 19,600,000 hits.
Big shocker! Coastal Contact Lenses, our friends from up North – the same friends who tried to set optometry in Vancouver back to the 19th century – is in the top position. Those clever marketers know a good opportunity when they see one. They gave away 30,000 pairs of Rx spectacles over the past few months just to "soften" the market and now refer to themselves as "the world's largest optical store." Different words come to mind when I think of them.
A bit further down the list is Warby Parker. Never heard of these guys? This online eyeglass boutique was started a year and a half ago by four hip Wharton Business School grads who shared a social conscience and a distaste for Luxottica. Offering "retro" glasses for $95 complete, including polycarb lenses (high index is a $30 upcharge) they have already sold (and additionally given away to needy patients) 60,000 pairs. Articles in Business Week and The New York Times have lauded their success. Watch this video and I think you will agree it is hard to argue with their motives or their business model. You also can't argue with what they figured out – that there is a lot of profit in selling spectacles. And just so you know what we're dealing with here, check out 1-800 Contacts eyeglasses portal. Déjà vu.
Understand that online eyeglass dispensing is a change that will ramp up quickly – much faster than online contact lens sales did. When I wrote about this issue a few months ago, most of the big players were just thinking about potential and logistics. Today, most are either fully engaged or soon will be.
So what of our profession, where a not insignificant proportion of income still comes directly or indirectly from spectacle sales? Are we doomed? We are, but only if we deny what is obvious and steadfastly refuse to change. More to come...
Arthur B. Epstein, OD, FAAO
Chief Medical Editor
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Warby Parker is a PERFECT example of a company that will crash and burn. Or they'll fade away and get bought out by LUX for a small price.
I can produce a pair of single vision polycarbonate glasses in a "retro" made in China frame for far less than what they charge. Competing with Warby Parker is easy.
Perhaps true. But does the public at large know this? As you know, perception is everything.
Just yesterday I had a physician assistant with -10.00 - 4.00 x 070 (roughly) along with Base in and Base up prism and bifocals (age 27) wanting to order her glasses on-line. Unfortuantely I don't get paid to explain for 20 minutes why this would be a terrible idea for her (knowing she will ignore my advice anyway).
But really, for most people, it makes perfect sense to order on-line at a 80% savings. I order stuff all the time on-line at a great savings and convienence.
I agree with Dr. Epstein. It will soon become very common place.
I am a big proponent of treating as much medical eye stuff as possible. But every ODs just can't make a living monitoring glaucoma and treating conjuntivitis all day.
Not the end of the world............but moving toward the end of conventional optometry as we know it, me thinks. With a stable supply, we MIGHT be able to 'suck it up'. But with all the current ODs plus pumping out hundreds additional per year (from new schools), well......... I'm just glad I have most of my debts paid off.
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Warby Parker doesn't do bifocals so they serve basically a smaller segment of the glasses population (<40 in general)..also they don't do prism etc..I don't know how much an impact companies like this will have. You can buy shoes online but shoe stores are still doing well...It may make the optical shops that exist decrease in number
The real end of optometry as we know it will be when (NOT IF) opticians get their act together and bribe enough politicans to allow them to refract independently. Happening in Canada already I believe.
Opticians refract on super accurate equipment and take a retinal photo & maybe even an anterior segment photo. If pt is 20/20ish and nothing shows on photo, off they go to the optical. If anything is unusual, they still go to the optical but a referral is made to the local ophthalmologist.
We can only pay off crooked politicans for so long. Optometrists will be unnecessary middle-men.
The optician-to-ophthalmologist model is how most of the world handles eyecare.........it's efficient and cost effective. Insurance companies will surely be looking closely at it very soon. Wouldn't you if you ran an insurance company looking to cut costs? 😳
Opticians refract on super accurate equipment and take a retinal photo & maybe even an anterior segment photo. If pt is 20/20ish and nothing shows on photo, off they go to the optical. If anything is unusual, they still go to the optical but a referral is made to the local ophthalmologist.
We can only pay off crooked politicans for so long. Optometrists will be unnecessary middle-men.
The optician-to-ophthalmologist model is how most of the world handles eyecare.........it's efficient and cost effective. Insurance companies will surely be looking closely at it very soon. Wouldn't you if you ran an insurance company looking to cut costs? 😳
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I mean that is what is probably going to happen. A bridge program between optometry and ophthalmology will form which will lead some ODs to leave refraction and opticians will start to take that over. As is the case with opticians in most countries. Oral surgeons get their MD for example after getting their DDS/DMD and then taking 2 more years.
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Richard Kattouff (consultant and board of trustees for ICO) in Oct 2010's OM editorial predicted "within five years, private practice O.D. S will have a very small optical department, or none at all."
http://www.optometric.com/article.aspx?article=104827
There certainly isn't enough ocular disease, vision therapy, or low vision to support 50,000 optometrists.
I think everyone knows opticals will no longer be a viable business.
Everyone says private practice jobs are scarce...well...corporate jobs are disappearing too as online opticals are paving a different future for opticals/optometry.
Walmarts are now opening up supercenters WITHOUT vision centers. I know of at least two new supercenters in my area that were built without vision centers this past year. Also Walmart eliminated district managers for opticals and merged the district management with pharmacy. I think they know something is about to change...
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No. Ophthalmic technicians will be the ones refracting. They can refract, do goldman tonometry, and dilate the patient. The ophthalmologist comes into the exam room afterwards and checks the retina then leaves.
There is no room for optometrists.
Thanks to the AOA leadership that has spent all our money on board certification and divided the profession.
The latest news:
With a 650% increase in on-line eyewear purchases since 2007....growth in the online optical market is accelerating. From a VSP newsletter today.
Really? A 650% increase in four years!!!!!!!
Can anyone honestly say optometry has a bright future? Really? Remember, for what it's worth, historically, optometrists (sadly) have made 50+% of their income from the optical.
With a 650% increase in on-line eyewear purchases since 2007....growth in the online optical market is accelerating. From a VSP newsletter today.
Really? A 650% increase in four years!!!!!!!
Can anyone honestly say optometry has a bright future? Really? Remember, for what it's worth, historically, optometrists (sadly) have made 50+% of their income from the optical.
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Give it a break already.
What, does offering applicable facts to make someone a better informed evaluator of professions offend you?
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no, but you're obviously here with an agenda. Searching through your post history will clearly illustrate this.
Come on, did you already know there was a 650% increase on online optical sales? I didn't until today.
Do you get the VSP newsletter too? I'd think this would be important information for you, as a student, and I seriously doubt your professors will give you this info. They don't want to lose their job.
No. No agenda from me. Just an OD in the trenches who had great hopes and dreams like you. In fact, it's in my favor for the school to pump out as many ODs as possible because I plan to sell my practice in 5-8 year and I'd love to have 50 new docs clammering for it.
Didn't have the internet back in the early 1990's so no one to tell me things I didn't know about the profession. In fact no real way to investigate optometry other than college catalogs on a microfiche readers (look it up) and talking to old guys that built their practice in the heyday of optometry-- that is, after therapeutics were allowed but before commercial optometry and the web. A brief 20 year nirvana allowing current 50+ year old ODs to build the offices you visit today and think is still possible but isn't.
My exposure to optometry was a yearly visit to an old curmudgeon OD. He flipped a few dials and sold me some expensive contact lenses. I thought he had a pretty good gig. Spend years in the military busting my ass and THEN went to college. I asked him a few times but he never spoke. I believe he was semi-******ed. I visited a few more ODs and they were like mind-numbed robots which I didn't know at the time is what happens to ALL ODs after 20 years of refracting nimrods.
Remember, there was NO OTHER WAY TO INVESTIGATE THE PRACTICE OF OPTOMETRY BACK THEN. No internet. No you-tube. No studentdoctor.org. No Optometrysucks.org. No AOA website. Nothing. Just an old guy in an old office that grunted at you if you asked a question.
I envy you guys. I would have given ANYTHING to have the access to real life doctors to give me the Gods-honest truth. I'm not making any of this stuff up. I have a decent practice. But it's getting harder and harder each and every year. Not because I have suddenly forgot how to run a practice or forgot how to be an good OD. But because ALL reimbursement are going down and ALL bills are going up. Doesn't take a rocket scientist to plot that graph.
You guys are very fortunate. So all I ask is that you come back on this site 5 years after you graduate and tell me I'm all wrong then. Until then, maybe you could just say "thanks". No, that will never happen. Because I'm crushing your dreams. And peope don't like hearing what they don't want to hear. Sorry to be the bearing of bad news. But............IT IS WHAT IT IS. 😳
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👍
August 5th, 2011 is my 5 yr anniversary of being an OD. I wish I had all this accessible to me in college. I would not become an optometrist again.
I know there is a a lot of discontent on this site about income and job in optometry etc.. but I will just throw in this fact to add a little perspective. The starting salary for a pediatrician in Washington D.C at Childrens Hospital is between 65-70K. It tops out at about 115K. Now a pediatric subspecialist starts at 85K and tops at about 150K. For the pediatrician that is 4 years med school, 3 years residency. For the specialist add two more years on top of that. There are worse situations in the medical world...
the oral surgeons also do a residency for 4 years after that. It isn't just 2 more years after dental school...Its 2 years to get the MD and then 4 years of residency or a total of 6 years after dental school. Not sure how you thought it takes two extra years after dental school to train a surgeon.
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Any reference for this other than "a friend told me this"? BTW, for pediatric specialists it's three years after residency for virtually all fellowships, not two.
Regardless, nationally (meaning everywhere outside of a 10-20 mile radius of 2 or three large Children's Hospitals on the East Coast), these are unquestionably not even close to representative numbers. Neonatologists, for example, typically, make more than twice what you've indicated, almost everywhere in the country, including the Washington DC area, and I know this from direct personal salary negotiations.....or something like that.😉
General pediatricians in most of the country start at much more than what you listed as well, although there are a few low paying jobs out there if you want one badly enough.
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My reference is my sister who is a pediatrician at Childrens in D.C. Mistake on the fellowship..but I think in major cities pediatricians starting under 100K is par for the course. Childrens in D.C is probably the worst I know. One of my friends who is a gastroenterologist interviewed at Columbia for aposition and the starting salary there was 125K but you get the "honor" of being at Columbia. I know from practices in peds and her job search 65=70 was lower end but top end was 150 max (middle of nowhere) with a top out of around 175. I think neonatologists are on the higher paid spectrum out of specialists from what I undestand...
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No. Unless you only define 3 cities in America as "major". But this is off-topic and we'll leave it at this as this isn't the place to argue pediatric salaries. Many pediatric specialists make over $200,000/year throughout the US.
Probably for most of us 'malcontent' ODs, it's not about working conditions or salaries really. It's simply about patient demand (which directly affects everything else).
A decent pediatrician will have a waiting list of patients within a few years of opening. Same with an internist. Same for a dentist. Certainly for a retinal ophthalmologist and most other health care providers. Our two local retinal OMDs are so busy they can barely take a day off. 3 month wait for anything non-emergent.
Every OD in town will be happy to see you as a walk-in so they dust off the slit lamp and make $50 (okay slight exageration there). Optometrists simply don't have the demand. After 12 years of opening, I'm still only about 50% booked most days. I still have to recall pts aggressively just to get them to come in. If I didn't have a dedicated person sending recall cards, then a second recall card, and then calling the patients (bordering on harrassment probably), I would have some very slow days. Same with most every OD I visit. Empty parking lots most time.
I like to believe I'm not a complete idiot either (make your own judgement : ) I've had articles printed in optometry journals, I've completed the written and oral requirements to attain my fellowship in the Academy of Optometry. I teach an eye course to nurses at a local university. I have a nice free standing professional office with the latest equipment and friendly great staff. I don't advertise and get all patients by good word-of-mouth. (Yellow page ads about around $1,000/month if you didn't know). I've done alot. Worked like a dog for the past 10 years building my practice ( moonlighted in nursing homes, prisons, OMDs office, commercial office, the VA hospital, visiting and sucking up to everyone) until I sorta gave up and began to realized I have hit the 'optometric celiing'. There is nowhere to go from here. It's the bed I've made and I'm lying in it. No problem. I'll be fine. I just don't want to see others be highly disappointed with their choice since tuition has probaby doubled since I graduted in the last 90's. Being a slave to debt is no fun.
The lack of patient demand is tough. Psychological, this beats you down. It's not just me. Most (90%?) of my colleagues deal with this. Hell our national journals constantly do stories on how to get patients to come in. We tell them they need a 'yearly' eye exam which is totally unnecessary for most people. But the bills have to be paid.
So while we all (health care providers) have the same problems of poor insurance reimbursment, staff problems, high tuition...........at least the others have the all-important 'patient demand'. Without that, we are little more than the car salemen on t.v. trying to get customers into the office in hopes we can talk them into a second pair of glasses (another big idea of our brilliant industry consultants) to increase income. Suck more money from each patient.
So I guess I can say your success as an OD depends on how well you can 'recuit' people......... and if your that good you might do well in Amway or something similiar. No I take that back. I wouldn't wish that on anyone. Those cult people are crazy. 🙂
A decent pediatrician will have a waiting list of patients within a few years of opening. Same with an internist. Same for a dentist. Certainly for a retinal ophthalmologist and most other health care providers. Our two local retinal OMDs are so busy they can barely take a day off. 3 month wait for anything non-emergent.
Every OD in town will be happy to see you as a walk-in so they dust off the slit lamp and make $50 (okay slight exageration there). Optometrists simply don't have the demand. After 12 years of opening, I'm still only about 50% booked most days. I still have to recall pts aggressively just to get them to come in. If I didn't have a dedicated person sending recall cards, then a second recall card, and then calling the patients (bordering on harrassment probably), I would have some very slow days. Same with most every OD I visit. Empty parking lots most time.
I like to believe I'm not a complete idiot either (make your own judgement : ) I've had articles printed in optometry journals, I've completed the written and oral requirements to attain my fellowship in the Academy of Optometry. I teach an eye course to nurses at a local university. I have a nice free standing professional office with the latest equipment and friendly great staff. I don't advertise and get all patients by good word-of-mouth. (Yellow page ads about around $1,000/month if you didn't know). I've done alot. Worked like a dog for the past 10 years building my practice ( moonlighted in nursing homes, prisons, OMDs office, commercial office, the VA hospital, visiting and sucking up to everyone) until I sorta gave up and began to realized I have hit the 'optometric celiing'. There is nowhere to go from here. It's the bed I've made and I'm lying in it. No problem. I'll be fine. I just don't want to see others be highly disappointed with their choice since tuition has probaby doubled since I graduted in the last 90's. Being a slave to debt is no fun.
The lack of patient demand is tough. Psychological, this beats you down. It's not just me. Most (90%?) of my colleagues deal with this. Hell our national journals constantly do stories on how to get patients to come in. We tell them they need a 'yearly' eye exam which is totally unnecessary for most people. But the bills have to be paid.
So while we all (health care providers) have the same problems of poor insurance reimbursment, staff problems, high tuition...........at least the others have the all-important 'patient demand'. Without that, we are little more than the car salemen on t.v. trying to get customers into the office in hopes we can talk them into a second pair of glasses (another big idea of our brilliant industry consultants) to increase income. Suck more money from each patient.
So I guess I can say your success as an OD depends on how well you can 'recuit' people......... and if your that good you might do well in Amway or something similiar. No I take that back. I wouldn't wish that on anyone. Those cult people are crazy. 🙂
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Could also take the 4 year route,essentially 4 years after dental school, skip the MD and just earn a masters on the road to becoming an oral surgeon. There are 4 or 6 yr routes-just throwing that out there..
Remember, I'm just the messenger and I have not verfied this yet.
Quote from another OD:
"I received a denied EOB from Tricare because I coded a level 4, 99214.
I contacted Tricare to inquire and the rep stated as of 4/1/11, 'Optometrists' are no longer allowed to code above a level 3.
Has anyone else heard of this?"
Quote from another OD:
"I received a denied EOB from Tricare because I coded a level 4, 99214.
I contacted Tricare to inquire and the rep stated as of 4/1/11, 'Optometrists' are no longer allowed to code above a level 3.
Has anyone else heard of this?"
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wow had no idea it got this bad.. Why is it that the AOA keeps pumping out new grads without limiting the spots? You would think its in their best interest to keep the supply down to bolster the demand. Every other medical subspecialty tries to do that aggressively.
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I would try another rep because that definitely doesn't make sense. Now If you get that same answer thrice, then "Houston, we have a problem...."
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For all you future optometrists out there: Don't worry, Optomerry is alive and well! The bitter sounding optometrists on this thread are just trying to discourage more optometrists so they can compete less and bring in fatter paychecks. All my friends had no problem finding jobs all over the country right out of school for around 100K per year. Great profession, and excellent pay! Go for it!
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The irony of it is that discouraging students from going into optometry school will not bring competition down. It will only bring down the average stats of optometry students. The number of graduating students will still remain ALMOST (lower stats might prevent a few individuals from passing the boards) the same.
Yep. Golly Gee Wiz........you all are on to us now. Every unsatisfied OD that has ever posted on studentdoctor and ODwire.org and Optometrysucks and everywhere else is just trying to limit competition so we can buy an even bigger catamaran and a second beach house in the Caymans. 🙄
Has nothing to do with:
- decreasing insurance reimbursments across the board.
- Your esteemed colleagues down the street trying to steal your patients by offering $40 eye exams.
- Insurances refusing to pay ODs but will pay OMDs for the same service.
- More and more insurances refusing to pay for refractions and forbidding billing it to patients.
- Nothing to do with having to sit on hold for hours with an insurance company because heaven-forbid, you don't know exactly what your patient's insurance covers. Yes they will demand you understand their program or they will go somewhere else who does (one of the other 30 ODs nearby sitting around salivating at the propect of another patient walking into his office).
- More and more patients buying from 1-800 contacts without an Rx (illegal yes. Enforced. No.) Just had a pt yesterday that hasn't been seen in 7 years but reguarly gets her CLs on-line.
- Most citys in the country adding 2-3 ODs per year with no increase in population.
- A new OD school opening each year despite reliable data showing we have a glut of ODs for the next 1000 years.
- Education debts up to $200,000 ballooning to $1/2 million by payoff.
- New grads forced to work in refraction mills or as subservent semi-slaves in OMD or OD offices.
- On-line company selling decent glasses for $39 (less then your cost again when you factor in everything).
- Rediculously increasing equipment cost to maintain a current office (OCT is $50,000 by itself).
- Seeing 3/4 empty parking lots from every local ODs office I come across.
- Lenscrafters offering a continual 50% off sale.
- Having your patients chronically no-show and knowing there isn't a damn thing you can do about it. Staff still has to get paid.
- Walmart offering CLs to patients CHEAPER than you can buy them from the manufacter making a profit from Contact lenses impossible any more.
-VSP, the # 1 vision insurance company, founded by and for ODs, has finally succumbed to giving up on private practice and letting commerical places in.......all the while dropping their reimbursement which was already 50% less than what Medicare ( a gov't discount plan) allows.
- Nothing to do with the other crappy vision plans which are even worse then VSP. Some pay $35 for a full exam. If you don't take it, the OD down the block from you will.
- Having signs on the Walmart shopping cart parking lot corrals advertising 2 pairs of glasses for $79.
-Vision plans knowing there is a glut of ODs and that they can offer as little as they want and plenty of ODs will jump at their offer.
- Insurance companies suddenly cut the fee for scanning laser (OCT, HRT) in half! Still cost the same to purchase and use. But Medicare decided and every insurance followed that they would just cut it in half.
- Insurance being so complicated that it takes someone with 3 PhDs and an MBA to figure it all out since the insurance companies themselve don't know how their own plan works.
- Has nothing to do with seeing our patients leave our office because we CAN'T take their insurance.
- Has nothing to do with patients leaving our office because their family doc, or Aunt Joan or the drunk on the corner told them they need to see an OMD to get checked for cataracts.
- Has nothing to do with having to see three times as many patients to make what we did on one patient years ago.
- Has nothing to do with dealing with staff on the low-end of the payscale since you can't pay them more than you make.
- Has nothing to do with any of this.
Yep. We just get together and drink martinis and laugh and laugh and laugh at how we are trying to sweeten the pot for ourselves.
Has nothing to do with trying to reach one............at least one person, who might consider doing something else. Something better. Something more far-reaching. Or at least showing that it's not all "one or two. Thank you. Now pick out your new $600 glasses and pay the girl up front".
On the upside, it's a GREAT time to be an eyecare or eyewear consumer. You can get an exam, contact lenses and 2 pair of glasses for probably less then $100 at some places.......with a sweating, grumpy ODs somewhere in back flipping that phorotor dial so fast it's probably smoking.
Has nothing to do with:
- decreasing insurance reimbursments across the board.
- Your esteemed colleagues down the street trying to steal your patients by offering $40 eye exams.
- Insurances refusing to pay ODs but will pay OMDs for the same service.
- More and more insurances refusing to pay for refractions and forbidding billing it to patients.
- Nothing to do with having to sit on hold for hours with an insurance company because heaven-forbid, you don't know exactly what your patient's insurance covers. Yes they will demand you understand their program or they will go somewhere else who does (one of the other 30 ODs nearby sitting around salivating at the propect of another patient walking into his office).
- More and more patients buying from 1-800 contacts without an Rx (illegal yes. Enforced. No.) Just had a pt yesterday that hasn't been seen in 7 years but reguarly gets her CLs on-line.
- Most citys in the country adding 2-3 ODs per year with no increase in population.
- A new OD school opening each year despite reliable data showing we have a glut of ODs for the next 1000 years.
- Education debts up to $200,000 ballooning to $1/2 million by payoff.
- New grads forced to work in refraction mills or as subservent semi-slaves in OMD or OD offices.
- On-line company selling decent glasses for $39 (less then your cost again when you factor in everything).
- Rediculously increasing equipment cost to maintain a current office (OCT is $50,000 by itself).
- Seeing 3/4 empty parking lots from every local ODs office I come across.
- Lenscrafters offering a continual 50% off sale.
- Having your patients chronically no-show and knowing there isn't a damn thing you can do about it. Staff still has to get paid.
- Walmart offering CLs to patients CHEAPER than you can buy them from the manufacter making a profit from Contact lenses impossible any more.
-VSP, the # 1 vision insurance company, founded by and for ODs, has finally succumbed to giving up on private practice and letting commerical places in.......all the while dropping their reimbursement which was already 50% less than what Medicare ( a gov't discount plan) allows.
- Nothing to do with the other crappy vision plans which are even worse then VSP. Some pay $35 for a full exam. If you don't take it, the OD down the block from you will.
- Having signs on the Walmart shopping cart parking lot corrals advertising 2 pairs of glasses for $79.
-Vision plans knowing there is a glut of ODs and that they can offer as little as they want and plenty of ODs will jump at their offer.
- Insurance companies suddenly cut the fee for scanning laser (OCT, HRT) in half! Still cost the same to purchase and use. But Medicare decided and every insurance followed that they would just cut it in half.
- Insurance being so complicated that it takes someone with 3 PhDs and an MBA to figure it all out since the insurance companies themselve don't know how their own plan works.
- Has nothing to do with seeing our patients leave our office because we CAN'T take their insurance.
- Has nothing to do with patients leaving our office because their family doc, or Aunt Joan or the drunk on the corner told them they need to see an OMD to get checked for cataracts.
- Has nothing to do with having to see three times as many patients to make what we did on one patient years ago.
- Has nothing to do with dealing with staff on the low-end of the payscale since you can't pay them more than you make.
- Has nothing to do with any of this.
Yep. We just get together and drink martinis and laugh and laugh and laugh at how we are trying to sweeten the pot for ourselves.
Has nothing to do with trying to reach one............at least one person, who might consider doing something else. Something better. Something more far-reaching. Or at least showing that it's not all "one or two. Thank you. Now pick out your new $600 glasses and pay the girl up front".
On the upside, it's a GREAT time to be an eyecare or eyewear consumer. You can get an exam, contact lenses and 2 pair of glasses for probably less then $100 at some places.......with a sweating, grumpy ODs somewhere in back flipping that phorotor dial so fast it's probably smoking.
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avg day at work?
😀 Unfortunately it is for an increasing number of ODs. I'm wondering if they are now making students buy an oil gun so that they can periodically lub that smoking phoropter. 😳
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Holy smokes! You are definitely in the wrong line of business. You should leave the eye care to those of us that love what we do. By the way, I've been out of school for 3 months, I make a ton of money, the hours are great, and I LOVE what I do. Even if I were just scraping by, I wouldn't change my career choice for anything in the world. Yes, there are some undesirable aspect to it but it doesn't change the way I feel. It looks like you have a lot of free time on your hands. Maybe you should spend more time fighting the system, and less time crying about your "horrible career choice".
Yep. I was SUPER motived when I first got out of school too. I quickly optained by FAAO. I stated a practice cold and built it up very quickly. I paid off all my loans and my home. I got involved in my state association. I wrote optometric magazine stories. I'm fine. It's the future guys/gals like you I"m concerned about.
I was a super gung-ho newbie.......just like you. Then a decade later, reality began to kick in. It will likley kick in for you too one day. Until then, carry-on young-gun. Fight the battles. Fight the system. Maybe you will make a difference and change the profession for the better.
I'm rooting for you you!
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Don't be concerned about me, I'm doing great. If I am ever at the point where I am not doing great then I will do something else. It's not too late for you. Do something else with your life. I'm sure someone would love to take your place in the eye care business.
[FONT=Arial, Helvetica, sans-serif]r. Volume 11, No. 30 Monday July 25, 2011.
Off the Cuff: Reality Bites
Last week's editorial about online spectacle sales generated a massive number of comments – so much so that I still haven't been able to get through all of them. I also followed the discussion generated by this issue on several fronts.
First, let me tell you what will not save your practice: hiding frame-markings behind price or inventory labels, asking patients not to use smart phones to scan or image frames or anything that reeks more of merchant than professional. Do this, and I can guarantee that you will damage existing patient relationships — the ones that might actually keep you afloat.
Another thing: don't keep trying to convince yourself that people won't purchase eyeglasses online. It's hogwash. I have friends who have purchased Porsche 911's online. And please, no more suit analogies. Yes, I know people like to try on suits, but oddly, clothiers have done a better job convincing their customers that suits are a custom experience than we have with eye care. Besides, millions of suits — including very expensive ones — are sold online each year.
How about opening your own online shop? Companies like Essilor and VSP are offering a variety of e-commerce solutions. Some are better than others, but realize that without intense marketing support, you will likely be competing with your own brick-and-mortar self. If you think you are going to effectively compete with 1-800; Wal-Mart; or the myriad frame, lens and discount eyecare vendors, I wish you luck.
Some have proposed climbing up the ladder by offering premium product, top-notch service coupled with state-of-the-art technology. Add in obviously caring about patients (what we used to call bedside manner) and this becomes an excellent strategy; however, don't place too much weight on trying to preserve profit by selling premium frame lines. Online vendors will be competing among themselves and they will be aggressively targeting this segment. That said, there will always be room at the top for a few smart survivors.
So is there a best solution? It is likely the one you heard during optometry school from a wise old instructor. Most of us were told to sell services and not to try to profit on the hardware. Trust that I know just how unlikely that seemed then and how impossible it seems now, but the only thing we have that no one can really compete with is our knowledge, our skills and our ability to change people's lives for the better. We are in the midst of a tsunami of change. The sooner we realize it, the better. More to come.
Arthur B. Epstein, OD, FAAO
Chief Medical Editor
Chief Medical Editor
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