retail aspect of optometry

[Optoed]

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Hi, I'd like to hear from current students/ practicing ODs. How important is the retail aspect of Optometry. I'm pretty bad at convincing others to buy stuff...so the thought of practicing beside an Optical chain is comforting. I'm aware that about 2/3 of money comes from glasses/contacts, so if I were to open up my own store, is it realistic to hire an optical dispenser and get him/her to do the sales for me?

 

[namams]

I've volunteered with quite a few optometrists and none of them dealt with the sales of glasses. Have you volunteered with any optometrists? The office staff usually handles sales while the optometrist conducts eye examinations.

I don't mean to be harsh but please don't say you are opening up a 'store' if you want to be an optometrist - you will be opening a clinic/office/practice. Spectacle and c/lens sales should be provided as an ancillary service to your patients. Yes, it's a large part of your income but you should place a greater emphasis on your services as an optometrist.

If you just want to open a store, become an optician and hire someone to do the sales while you manage the lab.

 

[KHE]

Hi, I'd like to hear from current students/ practicing ODs. How important is the retail aspect of Optometry. I'm pretty bad at convincing others to buy stuff...so the thought of practicing beside an Optical chain is comforting. I'm aware that about 2/3 of money comes from glasses/contacts, so if I were to open up my own store, is it realistic to hire an optical dispenser and get him/her to do the sales for me?

You don't have to "convince" anyone to get anything. You recommend the stuff that people need, which is why they come to you. You know.....just like a "real doctor" does.

The best part of optometry though is that unlike the rest of those real doctors, you get to reap the financial reward of it.

 

[Commando303]

You don't have to "convince" anyone to get anything. You recommend the stuff that people need, which is why they come to you. You know.....just like a "real doctor" does.

The best part of optometry though is that unlike the rest of those real doctors, you get to reap the financial reward of it.

Yeah, but doesn't your having such a large stake in reaping that financial reward taint your objectivity in recommending, and even in evaluating, what the patient "needs"?

 

[Shnurek]

Yeah, but doesn't your having such a large stake in reaping that financial reward taint your objectivity in recommending, and even in evaluating, what the patient "needs"?

Ah, the classic conflict of interest that plagues all professions 🙂

That's why government stepped in with regulation of healthcare aka CMS.

 

[KHE]

Yeah, but doesn't your having such a large stake in reaping that financial reward taint your objectivity in recommending, and even in evaluating, what the patient "needs"?

No, not at all.

I think that this is something that prospective students need to get over and in fact should embrace.

In ANY field of health care, there is plenty of opportunity to act in an unethical manner to financially enrich yourself, whether it's recommending unneeded procedures, tests, or products. I would say that in 99.9% of the time, it's not necessary to do so. You can make plenty of money in an honest, ethical manner.

For whatever reason, in medicine, or optometry or whatever any discussion of money is regarded as just this side of gauche. It's considered unseemly.

I would tell everyone that there is absolutely no reason that thoughts of money shouldn't enter your mind. From a business standpoint, it does not benefit your patients if your practice is teetering on the brink of insolvency because you don't pay attention to the money part of it because of some misguided notion that doing so is somehow "undoctorly."

Don't kid yourself for one millisecond by thinking that all those MBAs who work for Aetna and Cigna and Kaiser and VSP etc. etc. aren't worried about money. Why shouldn't you be too?

And the retail aspect of optometry is actually DESIRABLE because it allows you to offer products and services that for most of your patients ARE NOT COVERED BY INSURANCE. Believe you me, that's a good thing!

Why do you think many ophthalmologists are starting to add optical? Why is it that every time my wife sees her dermatologist she's offered an assortment of various creams and lotions and skin peels?

 

[Shnurek]

'

 

[mclem222]

Why should we not be concerned with money? Because once we do...it can definitely taint our thoughts as to what is good for the patient. When my brother was in med school he went to a local OD for a pair of glasses (he was 24). The guy gave him an Rx that was +0.25 -0.25 x 90 ou with a +25 add. You are telling me that guy wasn't thinking about financial gain? That being said, a large part of my practice is glasses. That is what most patients who come to me are in interested in. I provide a service but I try to do what is best for the patient. Just recommending every patient to get an Rx and trying to maximize their optical bill is not a good practice as a doctor. Our specialty and relatively recently OMDs have had experience with that. The only difference between having patients do unecessary procedures vs getting unecessary glasses is that you don't get sued for an uncessary pair of glasses but doing uncessary cataract surgery or hip replacement can lead to a huge lawsuit. There are situations where the profit of optical does affect me but I try hard to not let it. It is a large portion of my profit for the year. My brother who is an OMD has an optical but it represents about 20% of his income. He just does it for conveniece. Just thought I would plug in my experience. Just saying we should be into money because lawyers and insurance business people are is not a justification. Lawyers are super sleazy so does that mean we should be?

 

[Commando303]

Lawyers are super sleazy so does that mean we should be?

That's pretty unfair...

 

[Optoed]

Awesome response. Thanks so much for sharing your experience! When you're faced with a lot of overhead cost, tons of loans and mortgage, it's not going to be easy to have patients' best interest in mind 100% of the time. I've made a switch of career form another health care field that does involve quite a bit of retailing..if you will. So I want to make sure not to make the same mistake. I do not mind the managing a clinic/store at all..it's just the retail side that concerns me.
The last time I got my eyes checked at Wal-Mart, the optometrist did a pretty good job at getting me to wear daily contacts from monthly ones.

Any other thoughts?

Why should we not be concerned with money? Because once we do...it can definitely taint our thoughts as to what is good for the patient. When my brother was in med school he went to a local OD for a pair of glasses (he was 24). The guy gave him an Rx that was +0.25 -0.25 x 90 ou with a +25 add. You are telling me that guy wasn't thinking about financial gain? That being said, a large part of my practice is glasses. That is what most patients who come to me are in interested in. I provide a service but I try to do what is best for the patient. Just recommending every patient to get an Rx and trying to maximize their optical bill is not a good practice as a doctor. Our specialty and relatively recently OMDs have had experience with that. The only difference between having patients do unecessary procedures vs getting unecessary glasses is that you don't get sued for an uncessary pair of glasses but doing uncessary cataract surgery or hip replacement can lead to a huge lawsuit. There are situations where the profit of optical does affect me but I try hard to not let it. It is a large portion of my profit for the year. My brother who is an OMD has an optical but it represents about 20% of his income. He just does it for conveniece. Just thought I would plug in my experience. Just saying we should be into money because lawyers and insurance business people are is not a justification. Lawyers are super sleazy so does that mean we should be?

 

[KHE]

Why should we not be concerned with money? Because once we do...it can definitely taint our thoughts as to what is good for the patient. When my brother was in med school he went to a local OD for a pair of glasses (he was 24). The guy gave him an Rx that was +0.25 -0.25 x 90 ou with a +25 add.

I know of no lab in the world that would make a +0.25 add. However, I've known tons of college students to have benefited from low powered reading glasses so it is entirely conceivable that a nearpoint Rx with a total spherical power of +0.50 was given without financial motivation in mind.

But IF that story is factual and assuming for a second that that doctor was only looking for money, that optometrist is only hurting himself long term because yes, you won't get sued over a bad pair of glasses but it won't take the patient more than 6 seconds of wearing them to realize that that prescription they spent a couple hundred bucks on is doing nothing.

You are telling me that guy wasn't thinking about financial gain? That being said, a large part of my practice is glasses. That is what most patients who come to me are in interested in.

If your practice is mostly optical, that's a problem with your business model.

I provide a service but I try to do what is best for the patient. Just recommending every patient to get an Rx and trying to maximize their optical bill is not a good practice as a doctor.

I've never seen that everyone is recommended an Rx in any practice in all my 11 years in both private and commercial practice.

Our specialty and relatively recently OMDs have had experience with that. The only difference between having patients do unecessary procedures vs getting unecessary glasses is that you don't get sued for an uncessary pair of glasses but doing uncessary cataract surgery or hip replacement can lead to a huge lawsuit. There are situations where the profit of optical does affect me but I try hard to not let it. It is a large portion of my profit for the year. My brother who is an OMD has an optical but it represents about 20% of his income. He just does it for conveniece. Just thought I would plug in my experience. Just saying we should be into money because lawyers and insurance business people are is not a justification. Lawyers are super sleazy so does that mean we should be?

That is a problem with your own ethics then, sir. I am here to tell the OP and anyone else reading this who has concerns about the retail aspect of optometry that there is no reason in optometry to have to "convince" anyone to buy anything. You can make plenty of money practicing in an ethical manner.

 

[KHE]

Awesome response. Thanks so much for sharing your experience! When you're faced with a lot of overhead cost, tons of loans and mortgage, it's not going to be easy to have patients' best interest in mind 100% of the time. I've made a switch of career form another health care field that does involve quite a bit of retailing..if you will. So I want to make sure not to make the same mistake. I do not mind the managing a clinic/store at all..it's just the retail side that concerns me.
The last time I got my eyes checked at Wal-Mart, the optometrist did a pretty good job at getting me to wear daily contacts from monthly ones.

Any other thoughts?

It's VERY easy to keep patients best interests at heart.

Again, there are no reason that you can't make a good deal of money in this field in an honest, ethical manner even if you have loans and overhead costs.

 

[Visionary]

In ANY field of health care, there is plenty of opportunity to act in an unethical manner to financially enrich yourself, whether it's recommending unneeded procedures, tests, or products. I would say that in 99.9% of the time, it's not necessary to do so. You can make plenty of money in an honest, ethical manner.

Very well said. The fact is that, though we are all public servants in a sense, we (at least those of us in private practice) are also small business owners. You can provide ethical care and be profitable without abusing the health care system or purposely gouging the patient. There are and always will be those who abuse it, however. That's why the old fee-for-service model disappeared.

 

[Shnurek]

That is a problem with your own ethics then, sir. I am here to tell the OP and anyone else reading this who has concerns about the retail aspect of optometry that there is no reason in optometry to have to "convince" anyone to buy anything. You can make plenty of money practicing in an ethical manner.

He/she works in a commercial setting so maybe the higher ups are trying to instill their own ethics.

 

[KHE]

He/she works in a commercial setting so maybe the higher ups are trying to instill their own ethics.

They probably do but that shouldn't matter to the doctor. Again....there is ample opportunity to make plenty of money in this business without having to compromise ethics. Students should embrace that. There's nothing wrong with it.

 

[mclem222]

I double checked the glasses myself.. When you say it is a bad practice pattern and after a short while the patient will realize this I can see your point...however the placebo effect can also have a strong effect which is not to be underestimated. I think it depends where you practice what people do...in big cities I feel people are much more aggressive about prescribing Rxs and if the new Rx has changed only a slight amount 20/20-2 to 20/20 people still tell the patient to get the new glasses etc... I was just being honest as a doctor on not having it affect my judgement. I don't write those type of Rxs or give everyone glasses but part of our practice involves patients who may have questions about AR coating, transitional etc...There is a retail component to our work...can't get away from it...and honestly I don't want to.There is a book called Blink by Malcolm Gladwell...same guy who wrote the tipping point. It shows how things subconciously affect us even when we don't realize it. So to say that we just choose to ignore the profit component from glasses from clouding our judgement and those who admit that it affects them are unethical is not really correct. It may affect you without even knowing it...

 

[KHE]

I double checked the glasses myself.. When you say it is a bad practice pattern and after a short while the patient will realize this I can see your point...however the placebo effect can also have a strong effect which is not to be underestimated. I think it depends where you practice what people do...in big cities I feel people are much more aggressive about prescribing Rxs and if the new Rx has changed only a slight amount 20/20-2 to 20/20 people still tell the patient to get the new glasses etc...

I've practiced in New York City, the Mecca of s***** practitioner behavior from all types of providers and I've never seen anyone with 20/20- told to get glasses.

I was just being honest as a doctor on not having it affect my judgement. I don't write those type of Rxs or give everyone glasses but part of our practice involves patients who may have questions about AR coating, transitional etc...There is a retail component to our work...can't get away from it...and honestly I don't want to.

So then, what's the problem?

There is a book called Blink by Malcolm Gladwell...same guy who wrote the tipping point. It shows how things subconciously affect us even when we don't realize it. So to say that we just choose to ignore the profit component from glasses from clouding our judgement and those who admit that it affects them are unethical is not really correct. It may affect you without even knowing it...

I don't ignore the profit component. I aggressively pursue profit. But I never, ever EVER suggest or have suggested that people get products or tests or purchase things that I think they don't need.

 

[mclem222]

Hey...its not a personal attack on you. I have seen people given Rxs who have 20/20-2 vision for sure.... I am not saying that you give unnessary stuff but I definitely have seen that done. Just what can happen when retail component is in a field thus the need to really check oneself when in a field such as this.