Question for my brother regarding your field of Optometry

[pinipig523]

My brother is interested in optometry after I told him about it.

I used to be part of a pre-optometry club back in undergrad before I decided to do medicine and eventually become an ER resident.

I've been away from the field of optometry that I need a quick refresher from you guys.

1. How is the compensation and what is the yearly graph of it look like? Is it on the increase or is it declining?
2. How is your practice in general? Is there a lot of red tape to deal with?
3. How do you guys deal with midlevels like techs? Are they getting legislation to be able to administer eye exams?

Thanks much, fellas!

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[pinipig523]

There's gotta be someone with the info I need.

 

[RTM]

Don't really know what you're going for here, but I'll give it a whirl. . .

As far as the compensation goes, ODs can do quite well. I think some don't do as well as others, but doesn't that go with almost every profession? I would say that the economy is at least a partial driver for most ODs. I would guess that compensation goes as the economy goes, at least in part.
The practice in general can range fairly widely. Anywhere from a hospital to a mall or in a free standing building. Depends on the preferences of the doc. I would say there is certainly red tape. Every profession has its own brand of red tape.
In my practice, techs are techs. They work up patients and that's it. All doctor work is done by doctors in my practice. Haven't heard of any legislation regarding technicians.

Hope that helps.

 

[pinipig523]

Thanks RTM!

So ballpark compensation? Has it gone down since say 2004 secondary to the recession?

How is the job market and is it just as easy to find a job now vs 4-5 years ago?

 

[Penguin2012]

Before you start hearing anecdotes about compensation. I think it's best to check out the websites like the Bureau of labor statistics regarding salary - especially as it can vary greatly from state to state.

For instance someone in Hawaii or California can expect to make 90-100k. Whereas someone in Vermont and Louisiana can expect 140-150K. Quite a drastic range!

 

[pinipig523]

Before you start hearing anecdotes about compensation. I think it's best to check out the websites like the Bureau of labor statistics regarding salary - especially as it can vary greatly from state to state.

For instance someone in Hawaii or California can expect to make 90-100k. Whereas someone in Vermont and Louisiana can expect 140-150K. Quite a drastic range!

I understand the drastic range - it's the same as with MDs.

I guess let me be clearer with my question because this is not something I can get from labor statistics since I'm looking for up-to-the-minute data.

Since the recession, has the salary gone up or gone down and has the job market been as good or not as good?

And because of the recession, I had heard through the grapevine that commercial entities are trying to push for techs to refract - is this true?

Basically, it boils down to this:
- Is optometry still a lucrative field now in the midst of recession or would you have reconsidered the field (against it)?

 

[RTM]

Salaries are going to vary. Tell your brother not to do it for the money. If he wants to be an OD, then he should be.
Technicians refract in many offices both OD and MD alike. Optical prescriptions are not valid without an authorized signature.
Another issue is saturation. Saturation drives down compensation and job opportunities.
You being exposed to medicine, I think you will find that many of the same rules apply.

Peace.

 

[RTM]

Here, read this. . . Maybe this will help.

http://forums.studentdoctor.net/showthread.php?t=455712

Peace.

 

[pinipig523]

RTM,

Thanks very much for the info... helped quite a bit.

Thanks!

J

 

[optsuker]

What I tell interested students now:

I still love coming to work every day after 15 years. I work short, flexible hours and make enough to be in the highest tax bracket (good thing?).

Getting what I have now, however, is more difficult. The cost of school has outpaced the income, an oversupply of new graduates and the rise of corporately controlled settings (Walmart, Lenscrafters) makes it more likely that you'll be working for a big corp with more night & weekend hours with a decent, but flat pay scale.

Still a great career, just with more obstacles.

 

[IndianaOD]

My brother is interested in optometry after I told him about it.

I used to be part of a pre-optometry club back in undergrad before I decided to do medicine and eventually become an ER resident.

I've been away from the field of optometry that I need a quick refresher from you guys.

1. How is the compensation and what is the yearly graph of it look like? Is it on the increase or is it declining?
2. How is your practice in general? Is there a lot of red tape to deal with?
3. How do you guys deal with midlevels like techs? Are they getting legislation to be able to administer eye exams?

Thanks much, fellas!

IMHO, tell your brother to quietly walk (or run) away from optometry. You want job security and good income go dentistry. Why not medicine?

Any student going into optometry really needs to take a hard look at the oversupply (especially with the new schools), commercial practice penetration, medical insurance discrimination, and constant political battles to be allowed to do what you are trained to do.

 

[pinipig523]

IMHO, tell your brother to quietly walk (or run) away from optometry. You want job security and good income go dentistry. Why not medicine?

Any student going into optometry really needs to take a hard look at the oversupply (especially with the new schools), commercial practice penetration, medical insurance discrimination, and constant political battles to be allowed to do what you are trained to do.

That's so sad man... this was the post I was afraid to see.

Thanks guys..

 

[JAZZEYE]

IMHO, tell your brother to quietly walk (or run) away from optometry. You want job security and good income go dentistry. Why not medicine?

Any student going into optometry really needs to take a hard look at the oversupply (especially with the new schools), commercial practice penetration, medical insurance discrimination, and constant political battles to be allowed to do what you are trained to do.

Soooo lame...same blah blah blah.

 

[Commando303]

IMHO, tell your brother to quietly walk (or run) away from optometry. You want job security and good income go dentistry. Why not medicine?

Any student going into optometry really needs to take a hard look at the oversupply (especially with the new schools), commercial practice penetration, medical insurance discrimination, and constant political battles to be allowed to do what you are trained to do.

 

[Ryan_eyeball]

Soooo lame...same blah blah blah.

LOL always out of the mouth of a student. Wait til you get in the field and see how utterly hard and frustrating it is.

Vision Plans are the worst, and driving headaches between patients and doctors.

Scenario A: Patient diabetic with Eyemed and Aetna. Patient just saw retinal specialist two weeks earlier, and wants new glasses. The patient declines dilation b/c it was just done with OMD, but has a with history of laser PRP and reduced vision. Pt states, "OMD said I was fine, and that I was to return in 4 months." Patient is confused between higher co-pay with Aetna vs "free" exam for glases with Eyemed. Patient states that only his Eyemed should be billed b/c he wants glasses.

The patient then has a detachment 1 week later, and then turns to Light Perception in good eye. The other eye is 20/400 lazy eye. Do you know who the lawyers will go after first? The OD for failure to dilate to make sure the retina wasn't starting to detach between his visit with the OMD and OD.

OD Eyemed "Exam" $40-48 dollars
OMD Aetna Exam probably over $130 + patient out of pocket for 92015 refraction.

Medical Liability between OD vs OMD = Same.

My goal is to take zero vision plans in 2 years. Luckily my example was not my patient.

 

[alferec]

LOL always out of the mouth of a student. Wait til you get in the field and see how utterly hard and frustrating it is.

Vision Plans are the worst, and driving headaches between patients and doctors.

Scenario A: Patient diabetic with Eyemed and Aetna. Patient just saw retinal specialist two weeks earlier, and wants new glasses. The patient declines dilation b/c it was just done with OMD, but has a with history of laser PRP and reduced vision. Pt states, "OMD said I was fine, and that I was to return in 4 months." Patient is confused between higher co-pay with Aetna vs "free" exam for glases with Eyemed. Patient states that only his Eyemed should be billed b/c he wants glasses.

The patient then has a detachment 1 week later, and then turns to Light Perception in good eye. The other eye is 20/400 lazy eye. Do you know who the lawyers will go after first? The OD for failure to dilate to make sure the retina wasn't starting to detach between his visit with the OMD and OD.

OD Eyemed "Exam" $40-48 dollars
OMD Aetna Exam probably over $130 + patient out of pocket for 92015 refraction.

Medical Liability between OD vs OMD = Same.

My goal is to take zero vision plans in 2 years. Luckily my example was not my patient.

Oh man, tell me this really didn't happen. Also, can't you cover your butt by saying something like "it would be best if you were dilated today to make sure that there are no problems inside your eye given your history" or something like that?

 

[JAZZEYE]

...never mind

 

[pinipig523]

I didn't know you guys had to deal with the same medical legal bs we (MDs) have to deal with.

 

[OD4eyes]

LOL always out of the mouth of a student. Wait til you get in the field and see how utterly hard and frustrating it is.

Vision Plans are the worst, and driving headaches between patients and doctors.

Scenario A: Patient diabetic with Eyemed and Aetna. Patient just saw retinal specialist two weeks earlier, and wants new glasses. The patient declines dilation b/c it was just done with OMD, but has a with history of laser PRP and reduced vision. Pt states, "OMD said I was fine, and that I was to return in 4 months." Patient is confused between higher co-pay with Aetna vs "free" exam for glases with Eyemed. Patient states that only his Eyemed should be billed b/c he wants glasses.

The patient then has a detachment 1 week later, and then turns to Light Perception in good eye. The other eye is 20/400 lazy eye. Do you know who the lawyers will go after first? The OD for failure to dilate to make sure the retina wasn't starting to detach between his visit with the OMD and OD.

OD Eyemed "Exam" $40-48 dollars
OMD Aetna Exam probably over $130 + patient out of pocket for 92015 refraction.

Medical Liability between OD vs OMD = Same.

My goal is to take zero vision plans in 2 years. Luckily my example was not my patient.

When patients refuse to give me their aetna number, i tell them that it is to find their eyemed benefits, which true because eyemed cards only have the group #. If a patient has a problem with their aetna copay vs eyemed copay then we accept the eyemed copay and submit to aetna... 130 is still better than 40. Yes, patients will still refuse services because they just want glasses and recently saw their OMD. Vision plans are the worst and just one of the headaches in optometry. Still love the profession but you really need to explore before jumping right in.

 

[Ryan_eyeball]

Oh man, tell me this really didn't happen. Also, can't you cover your butt by saying something like "it would be best if you were dilated today to make sure that there are no problems inside your eye given your history" or something like that?

It was just a hypothetical situation. I try to explain the need of a DFE regardless if they just saw their retinal specialist. I also doubt a signed document explaining risks vs benefits of having a dilation is useless if a patient refuses. In my mind, an informed consent needs 24 hrs for a patient to consider if this was to go to court. I think the OD would probably win in the end if proper documentation of refusal by the patient in the chart. But legal costs, and publicity are a nightmare.

Patients are very confused about medical vs vision insurance. I enjoy providing care to patients but I have tried to eliminate vision insurances as soon as possible. Some insurances such as Aetna and UHC have a preventative exam covered if you do the work and call the ins. company.

Vision insurances should cover vision therapy if they were true to their name.

There are many days I love this profession, but there are aspects I hate about it.

 

[Ryan_eyeball]

Part A: When patients refuse to give me their aetna number, i tell them that it is to find their eyemed benefits, which true because eyemed cards only have the group #.

PART B: If a patient has a problem with their aetna copay vs eyemed copay then we accept the eyemed copay and submit to aetna... 130 is still better than 40.

PART A I agree with this statement.

PART B Students this is considered fraud.You must collect the appropriate copay if the exam is medical based.

 

[IndianaOD]

PART A I agree with this statement.

PART B Students this is considered fraud.You must collect the appropriate copay if the exam is medical based.

Yes, it is fraud.

 

[IndianaOD]

Soooo lame...same blah blah blah.

Ask the ODs in British Columbia how its going.

I'm offering honesty. You are offering....um ..... nothing!

I'm not starving or hating life because of optometry, but if I cared about my brother I'd put the profession low on the list.

 

[Meibomian SxN]

...Patients are very confused about medical vs vision insurance.....

Here's my typical scenario: Px comes in with known diabetes, HTN & dry eye syndrome. Refuses to use AETNA and after it is explained to the Px this is a medical exam, they throw a hissy-fit at the front desk over their co-pay. When I get them in the room to do a "vision exam only", they start with compaints of headaches, floaters, and dry eyes! And they know which "samples" they are expecting to walk out the office with!

When patients refuse to give me their aetna number, i tell them that it is to find their eyemed benefits, which true because eyemed cards only have the group #. If a patient has a problem with their aetna copay vs eyemed copay then we accept the eyemed copay and submit to aetna... 130 is still better than 40. Yes, patients will still refuse services because they just want glasses and recently saw their OMD. Vision plans are the worst and just one of the headaches in optometry. Still love the profession but you really need to explore before jumping right in.

The patient will bring that AETNA bill to your office complaining that you billed the wrong insurnace even though they didn't have to pay any copay! Then they will call AETNA on you....

 

[Meibomian SxN]

Oh man, tell me this really didn't happen. Also, can't you cover your butt by saying something like "it would be best if you were dilated today to make sure that there are no problems inside your eye given your history" or something like that?

This is where exceptional/detailed notes will save you, although there's still a greater chance the lawyers may try to settle out.

One thing I learned from OD school was you can never write enough on the chart. ie: Px is non-adherent with meds, Px is educated to continue medical eye care through previous eye physician, Px visual complaints were resolved with trial frame vision, etc....

Better to get Carpal-Tunnel Syndrome than to be staring at the chart kicking yourself on why you did not write enough...

I didn't know you guys had to deal with the same medical legal bs we (MDs) have to deal with.

In a court of law an OD is considered a doctor and yes they will sue without blinking an eye (no pun intended)!