Oversupply: I finally get it!!

[IndianaOD]

For the record, I believe every OD has the opportunity to have a million dollar practice, but not every OD has the ability to. I hate to say it, but not all OD's have all of the skills necessary to become that successful, and I am not talking about clinical skills. Your point about how I feel about the new schools is inaccurate. I believe opening NEW schools is dangerous. Doing so, IMHO will lead to oversupply, but that does not necessarily translate to oversupply today. I think the number of new grads each year is not that out of line. I have been looking for data to see how much the number of OD's has grown in relation to the US population. If the number of Americans per OD has not decreased significantly over the past 20 years, we may not be graduating too many OD's, but adding more schools would change that.

Coincindentally, I am in Chicago this weekend for our semi-annual meeting. Our group was brought together by Cleinman Performance Network because of our practice size. We left to go out on our own, and we rarely add people to the group. You would have to know someone in the group that knows your practice really well that could recomend you. We do not advertise for new members. We are scattered around the country, so that no one competes with anyone else in the group. We are all very concerned with the future of the profession, and in fact 2 AOA trustees are in our group. What we don't do is complain about how the current oversupply situation and the number of corporate docs is causing us to make less money.

Ben, Your statements on here do not support this. What if one morning you woke up and you were working a Walmart gig. Lets say all your savings from private practice are gone. Would you still get the same satisfaction out of Optometry? Would you still have chosen Optometry if that was all there was?

If a new school opened up a mile from your practice would you be happy?

It is clear from the AOAs goals for the next year that they are near worthless. The AOA PAC is the only thing worthwhile.

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[Ben Chudner]

Ben, Your statements on here do not support this. What if one morning you woke up and you were working a Walmart gig. Lets say all your savings from private practice are gone. Would you still get the same satisfaction out of Optometry? Would you still have chosen Optometry if that was all there was?

If a new school opened up a mile from your practice would you be happy?

It is clear from the AOAs goals for the next year that they are near worthless. The AOA PAC is the only thing worthwhile.

Please explain how my statements on here do not support the text you highlighed. Two of our members are very involved with the AOA. You may not agree with the AOA, but that does not mean that those 2 OD's care any less for our profession. In fact, I could argue that they care more since they have told us they got involved on the national level because they were not happy with where the AOA was heading. Since they are relatively new to the board, it will take time to see a difference. At least they have put their money where there mouth is rather than simply complaining on forums.

As for your hypotheticals, I am not sure where you are going with that, other than to say that the AOA isn't addressing those issues. All I can say is if you don't like the way our AOA works, put up or shut up.

 

[docwatson]

At least they have put their money where there mouth is rather than simply complaining on forums.

...

All I can say is if you don't like the way our AOA works, put up or shut up.

Ben...

I think it would help considerably since you are a leader on this forum to refrain from saying posters only complain on the forums. No one is complaining. That implies that you don't care what anyone says. This is a discussion forum where we discuss issues about optometry good or bad.

As far as the second part... I don't think this statement helps either. Telling someone that their dialogue is not wanted is also not good policy. I believe that is what you are implying since it sounds like "stop talking about it and do something".

Even if you don't like what a person says, let the poster have his/her say. Please, debate the merits of the statements only. Remember: This is a discussion forum.

As far as acting on behalf of our profession and the AOA, we members of ODwire and POP are doing something. If you want to make a difference then join these forums and speak out. I've heard IndianaOD many times and I know he is supporting the profession. We believe that the AOA is an old, good ol' boys, bureaucratic organization which seems to only care about "now" and doesn't do enough to prepare for the future. There have been no statements in regards to the issues that concern ODs the most. That doesn't sound like an organization that responds to its members.

I invite your two AOA Trustee members to talk about these issues on ODwire. Please tell them that we would love to have them discuss what they are going to do to make a difference.

 

[IndianaOD]

Please explain how my statements on here do not support the text you highlighed. Two of our members are very involved with the AOA. You may not agree with the AOA, but that does not mean that those 2 OD's care any less for our profession. In fact, I could argue that they care more since they have told us they got involved on the national level because they were not happy with where the AOA was heading. Since they are relatively new to the board, it will take time to see a difference. At least they have put their money where there mouth is rather than simply complaining on forums.

As for your hypotheticals, I am not sure where you are going with that, other than to say that the AOA isn't addressing those issues. All I can say is if you don't like the way our AOA works, put up or shut up.

Ben, did you see what I'm doing for optometry on the other thread. Pretty good for a young OD I'd say.

The hypotheticals are relative b/c that's what might be left of optometry if no one gives a crap.

Sounds like you are a card carying member of the good-ole boys club. I don't expect you to realize or care about the problems that young grads may face.

 

[Ben Chudner]

Ben...

I think it would help considerably since you are a leader on this forum to refrain from saying posters only complain on the forums. No one is complaining. That implies that you don't care what anyone says. This is a discussion forum where we discuss issues about optometry good or bad.

As far as the second part... I don't think this statement helps either. Telling someone that their dialogue is not wanted is also not good policy. I believe that is what you are implying since it sounds like "stop talking about it and do something".

Even if you don't like what a person says, let the poster have his/her say. Please, debate the merits of the statements only. Remember: This is a discussion forum.

I would appreciate it you would stop telling me what I can and cannot post. This is not the first time you have tried to censor me, and I find that funny because you are essentially telling me to let people have their say when you refuse to allow me the same courtesy. As for the complaining, you are probably right. The people on this forum don't need me to point out the obvious. A quick review of the posts from you and Indiana would be sufficient to see that. And my pointing out your obvious behavior does not imply that I do not care what other people say. Once again, this is not the first time you have stated that, and not only is it incorrect, but I don't appreciate it.

I invite your two AOA Trustee members to talk about these issues on ODwire. Please tell them that we would love to have them discuss what they are going to do to make a difference.

I have seen how ODwire treated Mike Cohen, and I have no desire to subject my friends to that. Furthermore, you know that they cannot post on a public forum as their comments could (and most likely would) be misinterpreted.

 

[Ben Chudner]

Ben, did you see what I'm doing for optometry on the other thread. Pretty good for a young OD I'd say.

The hypotheticals are relative b/c that's what might be left of optometry if no one gives a crap.

Sounds like you are a card carying member of the good-ole boys club. I don't expect you to realize or care about the problems that young grads may face.

Please do not assume anything about what organizations I support. I never said whether or not I support the AOA. I support my friends who have chosen to become trustees because they were not happy with what they saw within the AOA.

 

[docwatson]

I would appreciate it you would stop telling me what I can and cannot post. This is not the first time you have tried to censor me, and I find that funny because you are essentially telling me to let people have their say when you refuse to allow me the same courtesy. As for the complaining, you are probably right. The people on this forum don't need me to point out the obvious. A quick review of the posts from you and Indiana would be sufficient to see that. And my pointing out your obvious behavior does not imply that I do not care what other people say. Once again, this is not the first time you have stated that, and not only is it incorrect, but I don't appreciate it.I have seen how ODwire treated Mike Cohen, and I have no desire to subject my friends to that. Furthermore, you know that they cannot post on a public forum as their comments could (and most likely would) be misinterpreted.

What in the world are you talking about? I'm not trying to censor anything. I'm just asking that you respect others opinions. Is that so much to ask?

Do you ever admit anything? Go back and read what you are saying. You want IndianaOD to keep quiet: Stop talking, stop complaining. That's what you said. It's obvious who is trying to do the censoring here.

This is hilarious. You think AOA officials should not respond to their members!!! I'm paying the AOA thousands of dollars every year and it's expected that they should NOT respond to those who pay the organization???? Maybe they don't make any money from what they do, but they represent the organization who I pay! If they think like you do, this is outrageous. Please ask them if this is their policy since this would make great news on ODwire.

Should I drop my membership now?

 

[qwopty99]

nevermind...

i don't want to be involved in a flame war here.

 

[VA Hopeful Dr]

Do you ever admit anything? Go back and read what you are saying. You want IndianaOD to keep quiet: Stop talking, stop complaining. That's what you said. It's obvious who is trying to do the censoring here.

This is hilarious. You think AOA officials should not respond to their members!!! I'm paying the AOA thousands of dollars every year and it's expected that they should NOT respond to those who pay the organization???? Maybe they don't make any money from what they do, but they represent the organization who I pay! If they think like you do, this is outrageous. Please ask them if this is their policy since this would make great news on ODwire.

Should I drop my membership now?

I tend to agree with part of where Dr. Chudner is coming from. I have no problem with folks doing a little venting here and on ODWire. Its a good way to blow off some steam, and a fairly harmless way at that. However, when you have a near constant barrage of complaining about the same topic with no attempt to fix it... well, that's a different story.

I agree that the AOA should respond to its members, but I don't think that ODWire is the best place for that given the high anti-AOA sentiment running there. Dr. Cohen is an excellent example of why, were I in a position of power in the AOA, I wouldn't post over there either. If you want answers from the AOA, contact them. In fact, there's even a great meeting every June for just such a thing. Even better, get involved and try to fix things.

 

[docwatson]

I tend to agree with part of where Dr. Chudner is coming from. I have no problem with folks doing a little venting here and on ODWire. Its a good way to blow off some steam, and a fairly harmless way at that. However, when you have a near constant barrage of complaining about the same topic with no attempt to fix it... well, that's a different story.

I agree that the AOA should respond to its members, but I don't think that ODWire is the best place for that given the high anti-AOA sentiment running there. Dr. Cohen is an excellent example of why, were I in a position of power in the AOA, I wouldn't post over there either. If you want answers from the AOA, contact them. In fact, there's even a great meeting every June for just such a thing. Even better, get involved and try to fix things.

I didn't bring this up to start another war. I'm just asking for civility. Is that too much to ask?

Sorry, I just had to respond to the AOA thing because Ben thought that the AOA spokespeople should keep their mouths shut. It's rather odd to expect them to not respond to their members. Okay, I'll keep quiet about it. Clearly, my comments are not wanted...

 

[IndianaOD]

I didn't bring this up to start another war. I'm just asking for civility. Is that too much to ask?

Sorry, I just had to respond to the AOA thing because Ben thought that the AOA spokespeople should keep their mouths shut. It's rather odd to expect them to not respond to their members. Okay, I'll keep quiet about it. Clearly, my comments are not wanted...

Indeed, there appears to be a huge disconnect between the AOA and the joe public optometrist. Ben, if your trustee buddies are similar to you I don't think they are going to address some of the biggest problems facing optometry.

If you don't mind, what was it about the AOA that they didn't like? I would love to work my way up the AOA ladder eventually in an attempt to make as much difference as possible.

I think its preposterous that the AOA does not allow every single member to see where all the money is going. Even thought the AOA is terrible and pathetic compared to the ADA I support it because there is nothing else.

 

[stevemc1]

Ummm....are some of you folks here actually taking up for Mike Cohen? Go back and look at Mike's posting history on ODwire (go back at least a year, he's mellowed recently). IF you still feel he's being treated unjustly, let me know, but IMO, he's a Benedict Arnold and worthy of all manner of criticism.

As far as the AOA goes, if they're too scared to take some heat from their constituency (or future members), then they are unworthy of our dues. Keep your money until those sissies grow a pair. We need strong leaders in Optometry, not weak minded play-along-to-get-along politicians.

 

[Ben Chudner]

This is hilarious. You think AOA officials should not respond to their members!!! I'm paying the AOA thousands of dollars every year and it's expected that they should NOT respond to those who pay the organization???? Maybe they don't make any money from what they do, but they represent the organization who I pay! If they think like you do, this is outrageous. Please ask them if this is their policy since this would make great news on ODwire.

So, I post that they cannot post on a public internet forum for concern of being misinterpreted, and you misinterpret that to mean that they shouldn't listen to the membership and they should keep their mouth shut? This is exactly what I am talking about. ODwire is not the place for AOA trustess to post their opinion, but even according to Paul, there are AOA board members reading the posts. I think newer members of the AOA board are listening but I also believe that the majority of the board is out of touch. I am hoping that my friends will be able to recruit like minded individuls and make positive changes in the AOA. Off the record, I did have a discussion with one of them about the proposed new schools, and he says there are many on the AOA board against them. How that translates to action by the current AOA board, I don't know.

As for Mike Cohen, I do not agree where he has taken his career, but that is not the point of bringing him up. The posts on ODwire were far from civil. I can only imagine how AOA board members would fare.

It is obvious that I will not agree with Keith, Scott, and Steve about this issue. That's fine, as I believe dialogue is what will bring about changes in our profession, but we won't change each other's opinion. This thread has served its purpose - to show students both sides of the arguement. Maybe we'll run into each other at some meeting and we can continue this discussion over a beer.

 

[stevemc1]

I repeat...if AOA "leaders" are afraid of some public discourse, perhaps they should stick to tidly winks and horseshoes, and allow adults with backbone to lead our profession forward.

 

[Ben Chudner]

I repeat...if AOA "leaders" are afraid of some public discourse, perhaps they should stick to tidly winks and horseshoes, and allow adults with backbone to lead our profession forward.

I think this is a valid point. I will repeat however, that ODwire is not the appropriate forum for that public discourse. Posts are often misinterpreted, and the gang mentality sometimes seen on that site makes for a very confrontational exchange. Does the AOA allow members to address the board during the annual meeting? I have only gone to lecture at the AOA and have never attended the meetings. If the board is not accessible for discussion at that meeting, then something needs to be done about that. I also remember when the AOA was trying to pass board certification several years back, they sent board members to state meetings to discuss it with the membership. Do they still do that?

 

[IndianaOD]

I think this is a valid point. I will repeat however, that ODwire is not the appropriate forum for that public discourse. Posts are often misinterpreted, and the gang mentality sometimes seen on that site makes for a very confrontational exchange. Does the AOA allow members to address the board during the annual meeting? I have only gone to lecture at the AOA and have never attended the meetings. If the board is not accessible for discussion at that meeting, then something needs to be done about that. I also remember when the AOA was trying to pass board certification several years back, they sent board members to state meetings to discuss it with the membership. Do they still do that?

Ben, as far as I could tell in Boston, all the good "discussions" were behind closed doors not accessable to the rank and file. I think one of the main problems is that there is no open line to communicate through. The new "ask the AOA" thing on the website is a joke. They've only replied to 3 questions and the answers were pointlessly vague. I suggested they do another comprehensive manpower study and all I got back was "please be patient, sorry it has taken so long". That was well over a month ago.

I really do hope some changes get made, I think the AOA COULD be very helpfull to us all. Especially if we get sucked into socailized healthcare.

 

[IndianaOD]

Intesting income talk over on the dental forums.

http://www.forbes.com/2006/05/20/06w...obs_slide.html

Optometry is getting smoked by nearly eveyone. Though we already knew what was true. I have to say it: what seperates these professions from optometry: no oversupply and no commercial.

 

[Ben Chudner]

Ben, as far as I could tell in Boston, all the good "discussions" were behind closed doors not accessable to the rank and file. I think one of the main problems is that there is no open line to communicate through. The new "ask the AOA" thing on the website is a joke. They've only replied to 3 questions and the answers were pointlessly vague. I suggested they do another comprehensive manpower study and all I got back was "please be patient, sorry it has taken so long". That was well over a month ago.

I really do hope some changes get made, I think the AOA COULD be very helpfull to us all. Especially if we get sucked into socailized healthcare.

I don't believe any meetings should be behind closed doors so that's just pitiful. So Scott, I am going to suggest something very radical. Since you and I will never agree that this is an oversupply problem TODAY, let's move past this. I just wanted to show the students that not all of us think they are doomed when they graduate during the next 1-3 years. And while you think the oversupply problem is going to get worse over the next 10 years, I do believe if we continue down the current path of increased tuition, increased schools, decreased reimbursements, private OD's overestimating their practice worth, etc we are heading for a real problem. So let's stop wasting our time fighting about something neither of us can change and work together fighting for our future.

 

[Ben Chudner]

Intesting income talk over on the dental forums.

http://www.forbes.com/2006/05/20/06w...obs_slide.html

Optometry is getting smoked by nearly eveyone. Though we already knew what was true. I have to say it: what seperates these professions from optometry: no oversupply and no commercial.

For the record, I have commercial dentistry in my area. It's not in a Wal-Mart, but they are a chain of dental offices that are in strip malls...and they advertise "Walk-Ins Welcome"

Also for the record, one of the OD's that posts on both SDN and ODwire claims to net 30% from his $1MM practice before paying back his loans. I won't say who he is, but that's well over $300K in salary plus probably another $80K to pay back the practice note. Not everyone is getting smoked.

 

[KHE]

I don't believe any meetings should be behind closed doors so that's just pitiful. So Scott, I am going to suggest something very radical. Since you and I will never agree that this is an oversupply problem TODAY, let's move past this. I just wanted to show the students that not all of us think they are doomed when they graduate during the next 1-3 years. And while you think the oversupply problem is going to get worse over the next 10 years, I do believe if we continue down the current path of increased tuition, increased schools, decreased reimbursements, private OD's overestimating their practice worth, etc we are heading for a real problem. So let's stop wasting our time fighting about something neither of us can change and work together fighting for our future.

Students are not doomed.....but many of them are going to end up less than satisfied because a lot of what they have been told is essentially hooey and they are thinking about and worrying about the wrong things.

Throughout my tenure here and on other forums, I have been one of the more negative voices but again, I was never negative about the profession of optometry per se. The issue is that too many people are thinking about the wrong things when they enter the field.

I own my own practice now and I make way more money that what the AOA reports as average. In fact, I would say I make more money than I really know what to do with, which is why I'm mostly just paying off my practice aquisition loan. However, it took me years to find this opportunity, and even then I sort of fell into it. I wish I could say that it was some sort of brilliance on my part that makes me a high earning OD now, but I honestly can't with the exception that I think I had enough experience to recognize the good opportunity for what it was despite the high asking price. Many before me had looked at this practice and were scared off by the high asking price.

Many prospective optometry students view optometry as:

1) A "cool" job in which you get paid decent money to help people see better. Sounds good.
2) Little blood and guts, little death
3) Less schooling than needed to become a "real doctor."


What they don't have the foresight to be asking or thinking about are issues such as

1) To what extent is managed care going to affect my ability to see patients and get paid
2) The extent to which optometry is not integrated well into the health care delivery system and that it essentially operates "outside the circle".
3) The extent to which scope of practice varies widely between states
4) The relative difficulty of being able to move freely around the country for work or spousal commitments. ie: some state boards make it incredibly difficult for people to be able to obtain licensure in those states

Prospective optometry students worry about the wrong things....they worry about student debt loads, LASIK, and the number of ODs in a given town. These aren't the biggest issues facing the profession.....

 

[VA Hopeful Dr]

Intesting income talk over on the dental forums.

http://www.forbes.com/2006/05/20/06w...obs_slide.html

Optometry is getting smoked by nearly eveyone. Though we already knew what was true. I have to say it: what seperates these professions from optometry: no oversupply and no commercial.

I think a major reason why dentists make more, on average, than you guys is the procedure heavy nature of dentistry. From my last dental cleaning bill, they don't do that well on the exam end of things.

 

[Ben Chudner]

Students are not doomed.....but many of them are going to end up less than satisfied because a lot of what they have been told is essentially hooey and they are thinking about and worrying about the wrong things.

Throughout my tenure here and on other forums, I have been one of the more negative voices but again, I was never negative about the profession of optometry per se. The issue is that too many people are thinking about the wrong things when they enter the field.

I own my own practice now and I make way more money that what the AOA reports as average. In fact, I would say I make more money than I really know what to do with, which is why I'm mostly just paying off my practice aquisition loan. However, it took me years to find this opportunity, and even then I sort of fell into it. I wish I could say that it was some sort of brilliance on my part that makes me a high earning OD now, but I honestly can't with the exception that I think I had enough experience to recognize the good opportunity for what it was despite the high asking price. Many before me had looked at this practice and were scared off by the high asking price.

Many prospective optometry students view optometry as:

1) A "cool" job in which you get paid decent money to help people see better. Sounds good.
2) Little blood and guts, little death
3) Less schooling than needed to become a "real doctor."


What they don't have the foresight to be asking or thinking about are issues such as

1) To what extent is managed care going to affect my ability to see patients and get paid
2) The extent to which optometry is not integrated well into the health care delivery system and that it essentially operates "outside the circle".
3) The extent to which scope of practice varies widely between states
4) The relative difficulty of being able to move freely around the country for work or spousal commitments. ie: some state boards make it incredibly difficult for people to be able to obtain licensure in those states

Prospective optometry students worry about the wrong things....they worry about student debt loads, LASIK, and the number of ODs in a given town. These aren't the biggest issues facing the profession.....

As usual Ken, you and I agree.

 

[IndianaOD]

I think a major reason why dentists make more, on average, than you guys is the procedure heavy nature of dentistry. From my last dental cleaning bill, they don't do that well on the exam end of things.

Ahh, the beauty of no MD competition. Our level of training should allow procedures of equal invasiveness. I'm sure we can thank the ophthalmologists and their turf protecting for that.

Its not only that they charge an extravagant amount for procedures, its the fact that most of the time its private pay or decent paying insurance that can be balance billed. They have done an amazing job maintaining control of the profession. (dentists that is)

 

[IndianaOD]

I don't believe any meetings should be behind closed doors so that's just pitiful. So Scott, I am going to suggest something very radical. Since you and I will never agree that this is an oversupply problem TODAY, let's move past this. I just wanted to show the students that not all of us think they are doomed when they graduate during the next 1-3 years. And while you think the oversupply problem is going to get worse over the next 10 years, I do believe if we continue down the current path of increased tuition, increased schools, decreased reimbursements, private OD's overestimating their practice worth, etc we are heading for a real problem. So let's stop wasting our time fighting about something neither of us can change and work together fighting for our future.

Ben, I think the negative pressure does keep some young grads from selling out to commercial. That is a positive effect of our rantings. I couldn't agree more than OD students worry about all the wrong things.

I mean really, dentists make much more money and are in higher demand, but as far as I know there are more OD schools opening up. There is a post from a reliable doc on ODwire stating that the new school in CA is purely for profit. The OD students will be thrown into class sizes of 450 with dentists, podiatrists, med students, and PA students. Their only goal is to teach the boards and make money.

That is simply ridiculous and the reason I will never support private OD mills.

 

[Ben Chudner]

Ben, I think the negative pressure does keep some young grads from selling out to commercial. That is a positive effect of our rantings. I couldn't agree more than OD students worry about all the wrong things.

I mean really, dentists make much more money and are in higher demand, but as far as I know there are more OD schools opening up. There is a post from a reliable doc on ODwire stating that the new school in CA is purely for profit. The OD students will be thrown into class sizes of 450 with dentists, podiatrists, med students, and PA students. Their only goal is to teach the boards and make money.

That is simply ridiculous and the reason I will never support private OD mills.

I believe all of the proposed new OD schools are for profit, and even if they weren't I wouldn't support them.

 

[VA Hopeful Dr]

Ahh, the beauty of no MD competition. Our level of training should allow procedures of equal invasiveness. I'm sure we can thank the ophthalmologists and their turf protecting for that.

Its not only that they charge an extravagant amount for procedures, its the fact that most of the time its private pay or decent paying insurance that can be balance billed. They have done an amazing job maintaining control of the profession. (dentists that is)

I disagree to both of those points. As I understand it now (if I'm wrong, please correct me as I haven't graduated from an optometry school), OD school doesn't spend all that much time on procedures outside what is allowed in at least some states. I'm not saying your knowledge isn't sufficient to do such things, merely that I didn't think your schooling gave you that much exposure to things like YAGs or the like.

My insurance from the dentist back in July paid out around $200. This was cleaning, exam, and X-rays. Medicare (which pays less than what I have) for an established comp. eye exam with photos and refraction (92285 in this case for a photo, I'm a bit rusty on my optometric coding so I hope that's reasonable - also assume $25 for refraction since Medicare doesn't cover) would net an OD $160. I don't think it unreasonable to tack on $30 to compensate for BCBS paying better than Medicare, which brings us up to $190. Not much of a difference there.

 

[IndianaOD]

I disagree to both of those points. As I understand it now (if I'm wrong, please correct me as I haven't graduated from an optometry school), OD school doesn't spend all that much time on procedures outside what is allowed in at least some states. I'm not saying your knowledge isn't sufficient to do such things, merely that I didn't think your schooling gave you that much exposure to things like YAGs or the like.

My insurance from the dentist back in July paid out around $200. This was cleaning, exam, and X-rays. Medicare (which pays less than what I have) for an established comp. eye exam with photos and refraction (92285 in this case for a photo, I'm a bit rusty on my optometric coding so I hope that's reasonable - also assume $25 for refraction since Medicare doesn't cover) would net an OD $160. I don't think it unreasonable to tack on $30 to compensate for BCBS paying better than Medicare, which brings us up to $190. Not much of a difference there.

You're math is incorrect. You are comparing a routing dental exam with a higher level eye exam. Photos can only be billed to insurance when a reason exists. These "reasons" are very rare. We probably average around $65 for insurance concerning a routine exam and refraction.

I was taught IV and sub-conj injections in school. Nope can't do them. All I really want is the ability to do NLDO probes, remove and inject chalazion etc, and if the future of eyecare relies upon it, intravitreal injections. A local OMD was saying how he had never done any until the recent ARMD boom. Said it was easy and never had a complication.

There is the difference. We can't just up and do something we've never done. We have to lobby for years to do it and have twice the training. Sorry I degress.

 

[VA Hopeful Dr]

You're math is incorrect. You are comparing a routing dental exam with a higher level eye exam. Photos can only be billed to insurance when a reason exists. These "reasons" are very rare. We probably average around $65 for insurance concerning a routine exam and refraction.

I was taught IV and sub-conj injections in school. Nope can't do them. All I really want is the ability to do NLDO probes, remove and inject chalazion etc, and if the future of eyecare relies upon it, intravitreal injections. A local OMD was saying how he had never done any until the recent ARMD boom. Said it was easy and never had a complication.

There is the difference. We can't just up and do something we've never done. We have to lobby for years to do it and have twice the training. Sorry I degress.

Not at all, I'm comparing my twice yearly dental exam with my yearly eye exam. I'll agree to drop the photo, so that widens the gap to more like $50. You guys just need to get insurance to cover photos of the retina like it covers dental xrays. As for $65 for a yearly exam w/ refraction - you make an excellent point. I'd forgotten that many medical plans won't cover annual check-ups except with separate vision plans... ignoring those, y'alls exam fees are not that different from dentistry (if we ignore x-rays).

Oddly enough, in my state you can do NLDO probes. I don't know enough to comment on the other things you would like to do. If you did a reasonable number in school, I probably wouldn't mind you guys doing them.

Your last part actually hits on the exact reason why I didn't go into optometry. The idea of having to go to the legislature every time some new drug/technology comes out didn't appeal to me at all.

 

[Ben Chudner]

There is the difference. We can't just up and do something we've never done. We have to lobby for years to do it and have twice the training. Sorry I degress.

Just for clarification, you mean twice the training necessary to perform the procedure and not twice the training compared to any other level of provider.

 

[IndianaOD]

Just for clarification, you mean twice the training necessary to perform the procedure and not twice the training compared to any other level of provider.

yes

 

[docwatson]

Your last part actually hits on the exact reason why I didn't go into optometry. The idea of having to go to the legislature every time some new drug/technology comes out didn't appeal to me at all.

That's not really the case. Not every state has to jump through a bunch of hoops. The key is to get set up right in the first place. If a state is set up so that ODs can prescribe all orals, well, any revolutionary oral drug that comes along means we can use it.

I believe North Carolina got their drug law set up 30 years ago and I don't believe they have had to make many changes. I think they just added injections recently.

None the less, the states have been catching up to each other. It's only a matter of time before every state is practicing at the same high level.

Despite what I've been saying, I think optometry is a great profession (it may not translate this way to the rest of you). I just don't know how long it's going to last if there are too many of us.