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"side-by-side" in commercial practice?

Discussion in 'Optometry' started by r_salis, Jun 22, 2002.

  1. r_salis

    r_salis SDN Supa-Mod Emmetrope
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    Optometrist
    Do all commercial optometry practices operate as "side-by-side" businesses? Is there a legal/ethical/liability-avoidance reason for operating this way? What is the benefit of this, or is there one? What happens when the optometrist is also the owner of the dispensing-end of the business -- are they still considered or operated as separate businesses?
     
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  3. Caffeinated

    Caffeinated Army Strong

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    In some states, an OD can only be employed himself or herself, another OD, or an MD. Thus, the "side-by-side" where the chain owns the optical fabrication and dispensing, and the doctor collects the fees for exam, and usually for contact lens sales. There are some establishments where the corporate side is owned by an OD, so the subordinate OD's work directly inside the practice, without the side-by-side arrangement. But the impetus for the side-by-side is state regulation of the profession.
     
  4. r_salis

    r_salis SDN Supa-Mod Emmetrope
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    Thanks, Caff.

    I found some more information about the regulation of optometry in an article by Deborah Haas-Wilson at the Cato Institute (I love Google) -- <a href="http://www.cato.org/pubs/regulation/reg15n4d.html" target="_blank">The Regulation of Health Care Professionals Other Than Physicians</a> It's kinda long-winded, but the author's gist is that state regulation of non-physician providers (optometrists, dentists, chiropractors, etc.) is thought to provide better care and value to consumers but instead raises costs and makes no difference to the quality of care provided.

    Here are the paragraphs that describe some of the side-by-side thing (which is basically exactly what Caff said):
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> State-by-state self-regulation of optometrists has also resulted in a wide variation in the type of commercial practice restrictions placed on optometrists. In 1980 thirty-seven states restricted the employment of optometrists by nonprofessional firms, twenty-eight states restricted the permissible locations of optometrists' offices, twenty-two states restricted the number of branch offices per optometrist, and thirty-eight states restricted the use of trade names by lay-employed optometrists. Before 1977, the year of the Bates decision eliminating bans on truthful advertising, many states restricted advertising of ophthalmic goods and services; thirty-five states prohibited optometrists from advertising discounts or premiums.

    Employment restrictions prohibit unlicensed persons and firms from hiring optometrists. Such restrictions prevent nonprofessional firms from selling eye examinations and eyeglass or contact lens prescriptions so that they cannot offer the one-stop service provided by dispensing ophthalmologists or optometrists. To the extent that there are economies of scope in providing eye examinations and eyeglasses or contact lenses, the employment restrictions force nonprofessional optical firms to incur the higher cost of producing eyeglasses and contact lenses alone. The National Association of Optometrists and Opticians estimates that state laws that require optometrists and vision care firms "to practice in a side-by-side configuration increase the construction cost of such offices as much as $20,000 per office and the operating cost at least another $10,000 per office every year.'' </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">
     
  5. Jubileee

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    Not all corporate opticals operate on a side by side basis. The majority do as was stated earlier because of state regulations limiting who can employ medical professionals. In the case of ODs it is a matter of professional ethics. The legislature was concerned about ODs being told what to prescribe by non medical professionals.

    You will also find that there are side by sides and wholey owned offices in the same company. Such as Lenscrafters who operates side by side in most states except California where the ODs are employees of the company and operate under Exam2000.

    Other restrictions are in some states such as TN the OD has to have an entrance to the office that doesn't require the patient to go through the dispensary.

    There is pros and cons to the side by side. The company can limit its liability for anything the doc does since they are a "seperate" business. They sublet the space so they can collect rent, advertising fees, and other misc expenses. They aren't responsible for staffing issues either. The cons for the company are that they do not have absolute control over the office. While they can hold the lease agreement over your head, they still have to let you have some slack in how you want to run your business. Things such as work hours, what products you recommend, if you want to do pre and post op care, who will handle contact sales, etc...

    If the optometrist is the owner of the dispensary, he/she can employ other doctors, opticians, COTs, are whomever they desire. In stattes the require a licensed optician, they should have one for every 3-5 unlicensed (apprentice opticians) and the doc or the license
    holder must be present during working hours.
    They must also follow any local laws regarding the number of entrances, releasing rxs, and all that fun stuff. They are normally considered one and the same business unless it is a partnership with an optician or they took special care to seperate the two...

    Cassandra
     

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