Too Many ODs?

[docwatson]

I don't know at what point this subject might have been addressed and it would be hard to tell anyway since it could be embedded in any of a thousand threads...

I'm curious to know from the students on the optometry forum what they think of our profession. Are there too many optometrists working today? Are we graduating too many leading to an even bigger problem? What is the future going to be like? Are we simply feeding the commercial interests? Do we need more schools?

I'd like to hear some comments on these questions since these are truly the big subjects in optometry today.

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[Schroder79]

Quite honestly I think I am probably one of the more political and opinionative people on this forum so you'll have to take my comments with a grain of salt. I honestly think enough of optometry that I believe there can be more OD's than there are now. Now I know everyone is struggling to get more patients as my brother is and that is something we need to pay of school loans and make a living, but I don't think that it is right to fault the profession for not having a healthy supply of patients. Insurance policies will always be what they are, trying to get the best deal for lowest wages but that is a part of general business. I was quite suprised last summer when I did some research and found out that most people feel it is cheaper to pay out of pocket than to take insurance. In other words, people aren't trusting insurance as much as they used to. What % of your patient population would you say doesn't carry insurance?
I must admit that I didn't fully understand optometry when entered grad school, but I have no regrets. We are a commercial institution, but we are also a medical one as well. I really think that if optometrists were properly used by the public, we would be doing all the primary care and then refer the patients to appropriate specialists for any other needed care. It's a business world out there and everyone is looking for the MD initials when they get hurt, much more frequrently than needed. My PA friend asked me if we could treat a corneal ulcer; unfortunately some states don't allow that (California) but we definately have the right training. I don't get why I-pods are selling so well being pure entertainment value, when we help people to see. I think the nation needs more optometrists, more schools, and that we need to take a perspective that patients should see us first when there is anything wrong with their eyes or any part of seeing.

 

[KHE]

It is absolutely inconceivable to me that anyone could argue that there is an undersupply of ODs and this posting is full of contradictions that I don't understand.

The poster acknowledges that everyone is struggling for patients (including his own brother) and yet later on in the post, he advocates for MORE ODs and MORE schools. I just can't reconcile those two thoughts in my head.

This poster than claims that we should be advocating patients "see ODs first when anything is wrong with their eye" yet in the same breath acknowledges that there are areas of the country where ODs can't handle even the most simple of cases. From the patients perspective, why would they want to see an OD in these parts of the country?

And how is this not the "fault of the profession" that patients have this view of optometry or that optometry has such archaic scope of practice laws in many parts of the country or lack of access to medical insurance plans? In spite of all this, we need more schools and more ODs?

I'm really trying to understand this post. Please clarify it for me because I really think I must be missing the point.

I have said this dozens of times, both here and on other forums. If this doesn't prove to you that there is not an OVERsupply of ODs, then nothing will.

Open up your phone book and phone 10 ophthalmologists and ask for an appointment for a non-urgent matter. A "routine eye exam" if you will. I would bet $100 that it will take you at least 4 weeks to get an appointment with 9 out of 10 of them, and at least half will be at least a 6 week wait.

Then phone 10 ODs out of the same phonebook (after noting how many of them have large yellow page ads that proudly annouce "walk-ins welcome") and ask for an appointment for a non-urgent matter. I would bet $100 that you can get an appointment with 9 out of 10 of them within two days, and I would bet that you can get it for less than $60 with at least half of them.

Quite honestly I think I am probably one of the more political and opinionative people on this forum so you'll have to take my comments with a grain of salt. I honestly think enough of optometry that I believe there can be more OD's than there are now. Now I know everyone is struggling to get more patients as my brother is and that is something we need to pay of school loans and make a living, but I don't think that it is right to fault the profession for not having a healthy supply of patients. Insurance policies will always be what they are, trying to get the best deal for lowest wages but that is a part of general business. I was quite suprised last summer when I did some research and found out that most people feel it is cheaper to pay out of pocket than to take insurance. In other words, people aren't trusting insurance as much as they used to. What % of your patient population would you say doesn't carry insurance?
I must admit that I didn't fully understand optometry when entered grad school, but I have no regrets. We are a commercial institution, but we are also a medical one as well. I really think that if optometrists were properly used by the public, we would be doing all the primary care and then refer the patients to appropriate specialists for any other needed care. It's a business world out there and everyone is looking for the MD initials when they get hurt, much more frequrently than needed. My PA friend asked me if we could treat a corneal ulcer; unfortunately some states don't allow that (California) but we definately have the right training. I don't get why I-pods are selling so well being pure entertainment value, when we help people to see. I think the nation needs more optometrists, more schools, and that we need to take a perspective that patients should see us first when there is anything wrong with their eyes or any part of seeing.

 

[pfstar]

does this mean that the future of optometry is bad?

 

[prettygreeneyes]

does this mean that the future of optometry is bad?

No. All it means is that some people have slightly more negative view of the future of optometry.

Is the profession perfect?

NO!!!

Is there room for improvement?

YES!!!

Is it the right profession for you?

No one can answer that but you.

 

[drgregory]

Then phone 10 ODs out of the same phonebook (after noting how many of them have large yellow page ads that proudly annouce "walk-ins welcome") and ask for an appointment for a non-urgent matter. I would bet $100 that you can get an appointment with 9 out of 10 of them within two days, and I would bet that you can get it for less than $60 with at least half of them.

he is absolutely, 100%, entirely correct. and i'll take this opportunity to jump up to the microphone and say that giving away eye exams at wally world for $29 and churning patients through like cattle doesnt help the problem.

 

[Ben Chudner]

It is absolutely inconceivable to me that anyone could argue that there is an undersupply of ODs and this posting is full of contradictions that I don't understand.

The poster acknowledges that everyone is struggling for patients (including his own brother) and yet later on in the post, he advocates for MORE ODs and MORE schools. I just can't reconcile those two thoughts in my head.

This poster than claims that we should be advocating patients "see ODs first when anything is wrong with their eye" yet in the same breath acknowledges that there are areas of the country where ODs can't handle even the most simple of cases. From the patients perspective, why would they want to see an OD in these parts of the country?

And how is this not the "fault of the profession" that patients have this view of optometry or that optometry has such archaic scope of practice laws in many parts of the country or lack of access to medical insurance plans? In spite of all this, we need more schools and more ODs?

I'm really trying to understand this post. Please clarify it for me because I really think I must be missing the point.

I have said this dozens of times, both here and on other forums. If this doesn't prove to you that there is not an OVERsupply of ODs, then nothing will.

Open up your phone book and phone 10 ophthalmologists and ask for an appointment for a non-urgent matter. A "routine eye exam" if you will. I would bet $100 that it will take you at least 4 weeks to get an appointment with 9 out of 10 of them, and at least half will be at least a 6 week wait.

Then phone 10 ODs out of the same phonebook (after noting how many of them have large yellow page ads that proudly annouce "walk-ins welcome") and ask for an appointment for a non-urgent matter. I would bet $100 that you can get an appointment with 9 out of 10 of them within two days, and I would bet that you can get it for less than $60 with at least half of them.

Ken, it's like you are reading my mind.

 

[KHE]

does this mean that the future of optometry is bad?

It depends on what your definition of "good" is.

I believe that the future of optometry is going to mirror that of pharmacy. You will see the vast majority of ODs working retail hours in retail locations. The pay will still be very much above average for the foreseeable future. You will not starve. You will not default on your student loans. But you will be doing routine care in retail settings.

The small private OD office will become like the small independant pharmacy. Virtually non-existant.

I do not see anything on the horizen to disuade me from this opinion, but it is just that...my opinion.

 

[KHE]

Ken, it's like you are reading my mind.

I guess great minds really do think alike.

 

[Schroder79]

****Note:
Before I continue this email I want to first say that many optometrists have built a beautiful profession that is very dynamic. I don't wish to offend as I'm sure no one here does but I do wish to review my points because they were misunderstood and mis stated.

KHE,

I suppose most of my stances were hard to understand, but its hard for me to understand why you are in a profession you don't believe in. Or are you really an optometrist? Maybe I don't understand your response very well either.

First, my brother isn't an optometrist, I never said he was. He is a chiropracter and that means he is with us in the health professions community trying to help but still trying to make a living. (You really shouldn't have assumed that.) I think that anyone who opens up a business cold should expect only a few customers at first and as trust develops and skills are proven, the business will succeed.

Secondly, the idea that optometrists are unable to treat some occular conditions in my opinion isn't from lack of knowledge or experience, its from lack of legislative power. I think they are quite able to treat most eye conditions. Under the current circumstances some people trust MD's with "whatever power they deem necessary to keep them alive" being that in theory MD's are the most capable people on the planet to do so. Others don't think that way. MD's only do procedures that they read about in a book somewhere that has been proven to be effective anyway.

Finally, you owe me $100. I worked for an optometrist who could rarely schedule someone the same week for a CVE. I scheduled a VT exam at PUCO and was told the wait is not just 6 weeks, but 8 weeks. I think you are only referring to private practices when you say you could get an appointment within two days, am I correct? Perhaps in another thread the idea of supporting group practices could be discussed. An optometric version of Kaiser would be interesting to think about. Oh there are Lenscrafters and Binyons, but the schools are one of the only places I know where people go because they know they will get a complete exam. (I know we could argue why they would need a complete exam and cost/benefit analysis, lets save that one though.) By the way, out of curiosity how many patients have you seen because an ophthalmalogist screwed up? I haven't seen patients too long and I'm already counting.

 

[Schroder79]

Let me add sometings. I think that optometry should be more interested in the medical side of the profession rather than the business side. I think there are way too many people with low reading abilities (you know the statistics) and we should take that personally. I think its our job to bring that up. No one else will.

 

[Schroder79]

does this mean that the future of optometry is bad?

pfstar,

Don't be afraid of arguments like these. It's through these arguments that optometry becomes defined for what it really is rather than a group of professionals carrying a title that doesn't relate them in any way. It is the individuals within the group that defines it, not the title.
Ask yourself, how can a profession be bad that is designed to help people learn and grow and become better?

 

[PBEA]

pfstar,

Don't be afraid of arguments like these. It's through these arguments that optometry becomes defined for what it really is rather than a group of professionals carrying a title that doesn't relate them in any way. It is the individuals within the group that defines it, not the title.
Ask yourself, how can a profession be bad that is designed to help people learn and grow and become better?

Take it easy schroder79, your points are heard. KHE is treating you like you've been in practice for awhile, KHE is not treating you like a student. While what KHE says is 99.9% true, KHE does not realize how little you actually understand how our marketplace works. This is not your fault, and you will become more familiar with how "things" work. Maybe KHE needs a vacation?

 

[Schroder79]

PBEA

Thanks for understanding, I am a little more passionate about this than I think I should be. It really took a lot for me to get here though and school is frustrating sometimes. I am definately not a top student in my class so sometimes I have to ask my self, am I really doing the right profession or wasting my time. I have a friend in the PA program asking himself the same question as well. I'm sorry if some of that came out. I have a lot of respect for OD's and like you said, I do have a lot to learn. I thought his response was a little direct and I tried to match it, I don't really have much experience with formal debates, but I do like a good argument every now and then. I think it can increase my understanding. Again, thanks for understanding and sorry if I offended.

 

[posner]

I suppose I should weigh in on this matter. I do think that most optometry schools do a great disservice to private practice. THey leave many new graduates so heavily indebted, that they have no choice but to run out to Wal MArt and start spinning dials to pay the bills. THis is one of the reasons why I will NEVER give one cent to my optometry school. I dont care how successful I have become in optometry, it is from the sweat of my own brow..if anything my optometry school stacked the odds against me with exorbitant tuition, red tape, deceit, and limited real world practice management education. They often neglect to paint the true picture, that many private practictioners leave school in debt only to initially make less money than their commercially employed conterparts. All the while they smile and raise tuition quarterly. If I had the chance I would take a dump on Les Walls desk tomorrow. I do however, highly recommend supporting heavily the AOA and your local/state optometric association.

Now that I have that off of my chest, I would like to opine on another matter. How many of you have ever heard a patient say, "man am I glad I had to wait 6 weeks to see my doctor....it makes me feel like he or she is really good! besides, I have nothing better to do than wait any way." This is another case of OD's feeling sorry for themselves and trying to draw parallels with ophthalmology. In our offices, I have found that 2-3 weeks is the perfect amount of time to be booked up in advance. It allows ample time to fill cancellations, while still allowing reasonable access to care for patients. ANy longer than this is an aggravation for patients and they have an easier time justifying looking for another doctor. In some cases on medical plans, they are limited in their choices so they stay in spite of their desire to have better access to care; this is the case in many MD practices and the MDs know this.

One of our locations is very busy(45-60 patients per day) and the other is moderately busy(22-30 patients per day because we only have two lanes in this office which only allows for one doctor). In the busy office I am usually booked 2.5-4 weeks in advance for any type of appointment except for emergencies, and in the other I am about 1-2.5 weeks out depending on the time of year. Without a doubt, I hear more complaints from patients in my busy office about having to wait to see me than I do in the other office. So my point is an over abundance of patients is a good problem to have, but there is a point where this can become a problem.

All this doom and gloom from others that see optometry going primarily to retail locations in the future is a waste. Let those people spin dials and complain their lives away...good riddance. These folks want you to share their self-loathing; deep down they dont want to see private practice succeed because it reaffirms their own insecurities. Because these folks chose to spin dials and sell their souls to corporations, they want you to do the same. For the rest of you that want to build a successful private practice, you should know it is possible. It may not be easy, but it is definitely possible. I am only 33, so I have another 16-18 years of practice left. I know that when I do retire or begin to plan for my retirement I will find the right person to take the reigns and I will make it possible for he or she to purchase my 1/2 of the practice.

Oh, and I almost forgot; there are not too many ODs. However, there are far too many OD's with limited personalities and social skills. Every convention I go to looks like a savant gathering...I keep waiting for someone to sit down at a piano and play a symphony by ear or to carry out Pi to a thousand places. These people take up real estate and keep patients from your offices. Furthermore, they represent your profession and help shape the public opinion of optometry. I think optometry schools should look for more well rounded applicants that can actually carry on an intelligent conversation instead of turbo nerds and social ******s. Let me just say, it is a damn good thing I am not in charge of admissions.

POsner

 

[VA Hopeful Dr]

Secondly, the idea that optometrists are unable to treat some occular conditions in my opinion isn't from lack of knowledge or experience, its from lack of legislative power.

That is exactly true, but until this is fixed, there are too many ODs in places with more restricted scope.

I think they are quite able to treat most eye conditions. Under the current circumstances some people trust MD's with "whatever power they deem necessary to keep them alive" being that in theory MD's are the most capable people on the planet to do so. Others don't think that way. MD's only do procedures that they read about in a book somewhere that has been proven to be effective anyway.

This part kinda confuses me. Would you mind explaining this again?

Finally, you owe me $100. I worked for an optometrist who could rarely schedule someone the same week for a CVE. I scheduled a VT exam at PUCO and was told the wait is not just 6 weeks, but 8 weeks. I think you are only referring to private practices when you say you could get an appointment within two days, am I correct?

Anecdotal evidence doesn't make something true. So you have 2 examples of ODs that schedule way in advance, and one of them is school. Well, let's exclude schools since there are only a handful of them out there (compared to the number of practices). I think that, for private and commercial, KHE is right.

You've got fire, that's good... use it for something useful. When you're done with school, join your state association and fight to make things better.

 

[KHE]

KHE,

I suppose most of my stances were hard to understand, but its hard for me to understand why you are in a profession you don't believe in. Or are you really an optometrist? Maybe I don't understand your response very well either.

First, my brother isn't an optometrist, I never said he was. He is a chiropracter and that means he is with us in the health professions community trying to help but still trying to make a living. (You really shouldn't have assumed that.) I think that anyone who opens up a business cold should expect only a few customers at first and as trust develops and skills are proven, the business will succeed.

Secondly, the idea that optometrists are unable to treat some occular conditions in my opinion isn't from lack of knowledge or experience, its from lack of legislative power.

Finally, you owe me $100. I worked for an optometrist who could rarely schedule someone the same week for a CVE. I scheduled a VT exam at PUCO and was told the wait is not just 6 weeks, but 8 weeks. I think you are only referring to private practices when you say you could get an appointment within two days, am I correct? Perhaps in another thread the idea of supporting group practices could be discussed. By the way, out of curiosity how many patients have you seen because an ophthalmalogist screwed up? I haven't seen patients too long and I'm already counting.

I graduated in 2000 and worked full time in various commercial and private locations. Right now, I practice only part time in private practices.

My apologies for thinking your brother was an OD, but after rereading your posting, I think that given the discussion, and the forum that anyone reading it would have made the connection that your brother was also an OD.

I agree with your point about lack of legislation to some extent. However, I believe that in most locations, it is not lack of "legislation" per se. It is lack of acceptance onto medical plans. But whatever the reason for that problem is does not mean that we need either more ODs or more schools.

Also I don't think you can make the leap that because the PUCO VT clinic is booked far in advance that there is an undersupply of ODs. I think that most people who enter optometry do not envision themselves working at the PUCO VT clinic. They envision working in and/or owning a private practice. Is that possible? Of course. But at the rate we are producing graduates (and schools, it would seem) I would suggest that that is only going to get more and more difficult as time goes on.

 

[KHE]

I suppose I should weigh in on this matter. I do think that most optometry schools do a great disservice to private practice. THey leave many new graduates so heavily indebted, that they have no choice but to run out to Wal MArt and start spinning dials to pay the bills. THis is one of the reasons why I will NEVER give one cent to my optometry school. I dont care how successful I have become in optometry, it is from the sweat of my own brow..if anything my optometry school stacked the odds against me with exorbitant tuition, red tape, deceit, and limited real world practice management education. They often neglect to paint the true picture, that many private practictioners leave school in debt only to initially make less money than their commercially employed conterparts. All the while they smile and raise tuition quarterly. If I had the chance I would take a dump on Les Walls desk tomorrow. I do however, highly recommend supporting heavily the AOA and your local/state optometric association.

Now that I have that off of my chest, I would like to opine on another matter. How many of you have ever heard a patient say, "man am I glad I had to wait 6 weeks to see my doctor....it makes me feel like he or she is really good! besides, I have nothing better to do than wait any way." This is another case of OD's feeling sorry for themselves and trying to draw parallels with ophthalmology. In our offices, I have found that 2-3 weeks is the perfect amount of time to be booked up in advance. It allows ample time to fill cancellations, while still allowing reasonable access to care for patients. ANy longer than this is an aggravation for patients and they have an easier time justifying looking for another doctor. In some cases on medical plans, they are limited in their choices so they stay in spite of their desire to have better access to care; this is the case in many MD practices and the MDs know this.

One of our locations is very busy(45-60 patients per day) and the other is moderately busy(22-30 patients per day because we only have two lanes in this office which only allows for one doctor). In the busy office I am usually booked 2.5-4 weeks in advance for any type of appointment except for emergencies, and in the other I am about 1-2.5 weeks out depending on the time of year. Without a doubt, I hear more complaints from patients in my busy office about having to wait to see me than I do in the other office. So my point is an over abundance of patients is a good problem to have, but there is a point where this can become a problem.

All this doom and gloom from others that see optometry going primarily to retail locations in the future is a waste. Let those people spin dials and complain their lives away...good riddance. These folks want you to share their self-loathing; deep down they dont want to see private practice succeed because it reaffirms their own insecurities. Because these folks chose to spin dials and sell their souls to corporations, they want you to do the same. For the rest of you that want to build a successful private practice, you should know it is possible. It may not be easy, but it is definitely possible. I am only 33, so I have another 16-18 years of practice left. I know that when I do retire or begin to plan for my retirement I will find the right person to take the reigns and I will make it possible for he or she to purchase my 1/2 of the practice.

Oh, and I almost forgot; there are not too many ODs. However, there are far too many OD's with limited personalities and social skills. Every convention I go to looks like a savant gathering...I keep waiting for someone to sit down at a piano and play a symphony by ear or to carry out Pi to a thousand places. These people take up real estate and keep patients from your offices. Furthermore, they represent your profession and help shape the public opinion of optometry. I think optometry schools should look for more well rounded applicants that can actually carry on an intelligent conversation instead of turbo nerds and social ******s. Let me just say, it is a damn good thing I am not in charge of admissions.

POsner

No one is saying that patients are happy about waiting 6 weeks to see an ophthalmologist but just the fact that it happens while the majority of ODs are taking walk ins should be a sign that we don't need more ODs.

Your assertion about ODs having limited personalities may well be true but ophthalmologists are generally much worse and yet they don't seem to be suffering from any shortage of patients. You are right. Too many patients can create a problem, but when you have the majority of optometric practices out there able to accommodate same day or walk in appointments, that should pretty much be a sign that we don't need more ODs.

If your coment about doom and gloom was directed at me, rest assured that I am not in commercial practice. I have not sold my soul to corporate interests, nor do I spin dials all day. I practice limited part time in only private practices. But I stand by the opinion that optometry is going to end up like pharmacy because as it stands right now, the vast majority of private optometric practices out there are essentially optical stores with exam lanes in the back. It is only a matter of time, IMHO before commercial interestes completely swallow this part of the eye care market up and there are not nearly enough ODs making livings from professional services to keep private offices afloat. Where is that going to leave the ODs? Doing routine eye exams in retail locations.

You can make the argument that we may be admitting the wrong types of students and that may be valid. But to say that we need "more ODs" or "more schools" is sheer lunacy because there is not one shred of evidence that these schools are not going to produce "more of the same." Is that what anyone wants?

 

[cpw]

Let me add sometings. I think that optometry should be more interested in the medical side of the profession rather than the business side. I think there are way too many people with low reading abilities (you know the statistics) and we should take that personally. I think its our job to bring that up. No one else will.

I hate to break it to you but.. optometry.. IS.A.BUSINESS.

And no, they don't do a great job of teaching you this in school. there are quarterly tax payments, payroll, accountants, lawyers, insurance panels... and I only employ MYSELF. Don't worry... I'm just bitter I had to spend half my day off at my accountant's yesterday.

No matter how good I am.. patients with low reading abilities (and equally low incomes) aren't going to stomp their way into my office unless I take their insurance, give them an exam "for the same price as VisionWorks", or take them as a charity case.

 

[xmattODx]

...I take their insurance, give them an exam "for the same price as VisionWorks", or take them as a charity case.

Why do all y'all keep using VisionWorks as the example of what's wrong with optometry. You're giving me a complex!

 

[Ben Chudner]

I hate to break it to you but.. optometry.. IS.A.BUSINESS.

 

[Schroder79]

I hate to break it to you but.. optometry.. IS.A.BUSINESS.

And no, they don't do a great job of teaching you this in school. there are quarterly tax payments, payroll, accountants, lawyers, insurance panels... and I only employ MYSELF. Don't worry... I'm just bitter I had to spend half my day off at my accountant's yesterday.

No matter how good I am.. patients with low reading abilities (and equally low incomes) aren't going to stomp their way into my office unless I take their insurance, give them an exam "for the same price as VisionWorks", or take them as a charity case.

I think this is also a big point that KHE has been using as well. Its unfortunate like you said that business training is really limited. I have a minor from undergrad in business so hopefully that helps. I do wonder however with the usage of computers now days if reading will become more of a demand than it used to be. (I guess all the other jobs that don't require reading are still there though.)
Thinking on this, there is a fine line between visionary thinking and wishful thinking. Out of curiosity I looked at some previous entries KHE put in and I think I understand his point better now. Red tape and paperwork, if only computers could make that go away now!!

 

[Schroder79]

I graduated in 2000 and worked full time in various commercial and private locations. Right now, I practice only part time in private practices.

Also I don't think you can make the leap that because the PUCO VT clinic is booked far in advance that there is an undersupply of ODs. I think that most people who enter optometry do not envision themselves working at the PUCO VT clinic. They envision working in and/or owning a private practice. Is that possible? Of course. But at the rate we are producing graduates (and schools, it would seem) I would suggest that that is only going to get more and more difficult as time goes on.

Thanks for responding to my entry, I'm a blue personality and red (I guess that makes purple doesn't it?) Anyway, I agree with what you said. From my class and what the faculty says its interesting to know how many doctors plan to work in private practices and how many actually get there is different. I read some other threads you have commented on and I think I understand you're position better now. I should say that though I was never a part of a debate team I did argue the devils advocate in undergrad ethics class just to understand positions better and I think it changed my opinion in a lot of things.
I find myself often shooting for the stars and settling for the tree tops in that I make big plans that settle in to something much less. Example, I think that optometry could get more involved in societies education (schools are a mandatory need for kids) because there are many other needless things already there (in my opinion, again another thread.) My idea is that economically as more OD's graduate the practice will be forced to change and legislature will be forced to change the scope. I think my graduates will mean more trust in the title, more cash flow to AOA (hopefully) and more opportunities. Maybe this is a little naive and my experience can't tell me if thats true, but in theory it should work. I think sometimes OD's limit themselves by referring things they could treat, even if its within their scope (at least that's what I've been told.)

I guess the big thing for me to learn right now is that there is a big change from going on the sidelines (in school) to the field of play (practice.) Like many others have said on this thread, I really honestly think that it really depends on the optometrists in the area that will help define your practice.

Btw I will definately be looking at medical insurance as you said in this thread and others.

 

[Schroder79]

That is exactly true, but until this is fixed, there are too many ODs in places with more restricted scope.



This part kinda confuses me. Would you mind explaining this again?



Anecdotal evidence doesn't make something true. So you have 2 examples of ODs that schedule way in advance, and one of them is school. Well, let's exclude schools since there are only a handful of them out there (compared to the number of practices). I think that, for private and commercial, KHE is right.

You've got fire, that's good... use it for something useful. When you're done with school, join your state association and fight to make things better.

My little bit about the MD's is that I think we are just as trained as they are in dealing with eyes and its their title that people trust. Since a person holds the title MD they will often trust pretty much anything they say if it relates to health even when they realize MD's are human too and make mistakes. (They have with some of my friends.) I guess that part came out a little weird.

Secondly, like you said KHE is probably right, the first time I saw an optometrist was 5 years ago and I'm 27 right now. Not much to go on, but I can't disbelieve there is an oportunity right now. I appreciate KHE giving some of his history so I can understand and trust him a little more now. I mean you have to take most of the information you hear on the internet skeptically anyway so now it has some more value to me.

 

[Ben Chudner]

My little bit about the MD's is that I think we are just as trained as they are in dealing with eyes and its their title that people trust.

Let's see where this statement takes us.

 

[prettygreeneyes]

Let's see where this statement takes us.

Wait for it... wait for it....

 

[VA Hopeful Dr]

Let's see where this statement takes us.

Ah hell...

 

[nova2010]

WELL SAID!!! What is the value of sight? Ask someone who has lost it?

 

[Schroder79]

WELL SAID!!! What is the value of sight? Ask someone who has lost it?

????

 

[Schroder79]

Let's see where this statement takes us.

Alright guys, so I'm at odds with everyone. I'm not testifying under oath and I don't expect this forum to be the trial of my life. This is an educational opportunity isn't it, thats why its for students right?

I'm not comparing us to surgeons or specialists. And the context of the full statement should be taken into account. Okay, someone tell me where an ophalmalogical exam is superior to an optometric basic exam. Maybe I'm wrong but someone inform me how. We can treat (almost everywhere) anything affecting the anterior seg of the eye as long as it doesn't involve seidels sign right? We can also treat many posterior seg diseases. If there is something wrong with the vasculature (like diabetes) then we refer for systemic treatment. Isn't that the same thing an ophthalmalogist would do?

 

[Schroder79]

????

Do you think that I said patients shouldn't care about their sight? My statement about MD's was supposed to be generally speaking but applicable to the eyes.

 

[docwatson]

I think this is also a big point that KHE has been using as well. Its unfortunate like you said that business training is really limited. I have a minor from undergrad in business so hopefully that helps. I do wonder however with the usage of computers now days if reading will become more of a demand than it used to be. (I guess all the other jobs that don't require reading are still there though.)
Thinking on this, there is a fine line between visionary thinking and wishful thinking. Out of curiosity I looked at some previous entries KHE put in and I think I understand his point better now. Red tape and paperwork, if only computers could make that go away now!!

I'm really surprised that we haven't seen more comments from students. Come on people! We need your opinions!!!

 

[wrx04]

As a student, i can tell you the only education i get on the oversupply issue is from what i read on here and odwire. I really have no real world experience on how tough it is to find an area that will support a new practice, or even find an employed position for that matter. That being said, i have noticed that there are an insane amount of optometry practices (private and corporate) in the metro detroit area. This being the case, i can't imagine why more schools would be needed at all.

As far as private practice being a dying breed, i don't know. In my class, almost everyone is planning on going into private, BUT i'm sure that almost everyone plans on private and may end up working for DOC. However, I have a small class (35) with mostly in-state students, so our debtload won't be nearly as bad as some other schools. This will give us a better chance of following our goals of private practice. Our school is also very good at pushing towards private group practice.

I wanna know when and how I should start looking for a place to set up when i get out of school. Is 2nd year too early to start? How do i tell if a city will support a new practice? How do i know if i will be able to get on medical panels in that city? Is it better to buy out an existing practice or to start cold?

 

[Schroder79]

I wanna know when and how I should start looking for a place to set up when i get out of school. Is 2nd year too early to start? How do i tell if a city will support a new practice? How do i know if i will be able to get on medical panels in that city? Is it better to buy out an existing practice or to start cold?[/QUOTE]

Make sure you keep up with the literature in optometry. There was an article in Review of Optometry this last summer discussing buying out old practices. It discusses itemizing the equiptment and patient records (which feels a little morally iffy.) It can be good. Usually practices aren't sold like cars or houses though. The doctors want to know who is going to start taking care of their baby, their practice that they built.

 

[Schroder79]

I'm really surprised that we haven't seen more comments from students. Come on people! We need your opinions!!!

I think that some are really getting confused by this issue. PUCO has a theory don't use ophthalmologists for anything you can take care of yourself. Our clinic director from SCO seems a very similar opinion.

 

[bournehall]

The best decision you could make is to cut your losses and run. Apply to dental school, pharmacy school, heck go the RN route and become a CRNA. I have done OK by optometry in 23 years but, reality of the future is kinda bleak. With a pension from the military and a comfortable job with an ophth group no worries mate at this time. The CRNA doing blocks 4 days a week for the group makes over twice what the optometrists are paid. If Hiliary is elected and socialized medicine becomes a reality and OD's are included and 367.1 is a medical diagnosis then times are good.

I think that some are really getting confused by this issue. PUCO has a theory don't use ophthalmologists for anything you can take care of yourself. Our clinic director from SCO seems a very similar opinion.

 

[KHE]

Alright guys, so I'm at odds with everyone. I'm not testifying under oath and I don't expect this forum to be the trial of my life. This is an educational opportunity isn't it, thats why its for students right?

We can treat (almost everywhere) anything affecting the anterior seg of the eye as long as it doesn't involve seidels sign right? We can also treat many posterior seg diseases. If there is something wrong with the vasculature (like diabetes) then we refer for systemic treatment. Isn't that the same thing an ophthalmalogist would do?

As far as private practice being a dying breed, i don't know. In my class, almost everyone is planning on going into private, BUT i'm sure that almost everyone plans on private and may end up working for DOC. However, I have a small class (35) with mostly in-state students, so our debtload won't be nearly as bad as some other schools. This will give us a better chance of following our goals of private practice. Our school is also very good at pushing towards private group practice.

I wanna know when and how I should start looking for a place to set up when i get out of school. Is 2nd year too early to start? How do i tell if a city will support a new practice? How do i know if i will be able to get on medical panels in that city? Is it better to buy out an existing practice or to start cold?

No. You are not at odds with anyone. You are doing the right thing to try and gather information and especially early on in your career. When I was in school, we did not have resources like SDN and ODWIRE.

I think however, from reading your posts that you are operating from a theoretical perspective, and its because you are still in school. In THEORY, ODs can treat most conditions. In THEORY, everyone should get their eyes examined every year. However, the reality of it is is that most private practices out there are essentially optical stores with exam lanes in the back that are NOT treating things for a variety of reasons. Some of them are lack of desire. Some of them from lack of access to medical plans. This is what happened to me. WHen I worked private practice, I essentially spinned and grinned exactly the same as in commercial practice because I couldn't get on medical plans. In fact, I would dare say that I saw more pathology in teh COMMERCIAL practices during that time because we saw a fair number of sick people with no insurance who couldn't afford ophthalmology care, or who hurt themselves on a saturday afternoon and the commercial joint was the only place open.

I would suggest finding an area that you want to practice in, find out what the top 5 MEDICAL plans in that area are (you can find this from the chamber of commerce or from your state insurnace regulatory body) and then phone up those plans and ask if they are currently credentialling NEW ODs to see MEDICAL cases. If you can't get access to at least 4 of them, I would consider practicing somewhere else.

That being said, that does not mean that you can't make good money having an optical store with an exam lane in the back. FOr me the issue was never money. I always made decent money and you can too. I just got tired of having to refer out even the most minor of medical cases because of lack of access to plans. This essentially left me retailing eyewear for a living and helping pre-teen girls decide of AQUA or TURQOISE looked better on them. Needless to say, that was not the future I wanted for myself. I would bet that you don't either.

Therefore...

You do not need access to medical plans to make a good, or even above average living, though I think it is much easier if you do have that access.

You DO however need access to medical plans if you want to have a stimulating career. Especially with the modern optometric training that you are receiving. Imagine sending out every single glaucoma suspect or diabetic that you see. Not a pleasant thought is it?

I would be interested to ask your opinion as to why you think that everyone starts off wanting to enter private practice at the start of optometry school and so few end up actually doing it once they are out.

 

[KHE]

The best decision you could make is to cut your losses and run. Apply to dental school, pharmacy school, heck go the RN route and become a CRNA. I have done OK by optometry in 23 years but, reality of the future is kinda bleak. With a pension from the military and a comfortable job with an ophth group no worries mate at this time. The CRNA doing blocks 4 days a week for the group makes over twice what the optometrists are paid. If Hiliary is elected and socialized medicine becomes a reality and OD's are included and 367.1 is a medical diagnosis then times are good.

I don't really agree with this because this above thought centers around money. Many people think success is defined by money. Obviously, money is nice and we would probably all like to make as much as we can. HOwever, the top 5 most successful ODs that I know are also the most miserable because even though they all make over 200k, its not enough. Well, let me tell you, unless you are Bill Gates, someone is ALWAYS going to have more money than you.

I think what is much more important is that you have a career that is professinally challenging. And sitting in 10 X 10 dark room all day increasing minus on teenagers and increasing adds on prebyopes is not going to do it for the vast majority of you out there. However, that is what the vast majority of optometry is in the vast majority of private and commercial practices out there. That doesn't mean you can't make good money doing it. However, how long before the routine of that burns you out?

I know that other posters on here disagree with this, but I stand by my assertion that optometry is going to end up like pharmacy because the vast majority of ODs get the vast majority of their income from retailing optical materials and the sad fact is that large corporations can do that faster, cheaper, and more efficiently than just about any private office out there and this fact makes optometry vulnerable to being swallowed up by commercial interests just like pharmacy has been because they money there is in the retailing of pills, not in the professional services. Same with optometry....the money is in retailing spectacles, not providing routine eye exams.

(And yea, I know I use the word "vast" a lot.)

 

[posner]

The past few responses are some of the most pathetic responses I have ever heard. I sincerely hope that prospective OD's dont heed the words of the underachieving masses on this board. This is the type of OD I refer to when I say that optometry selects the wrong types of students. I chose this profession for several reasons, not because I couldnt get into medical school like many ODs(I completed my first year at UC IRvine Medical school and was in the top 20 in my class before deciding not to go on) but because I felt I would enjoy the profession more than medicine. SO far I am having a pretty good time.I do get frustrated with some of the legislation issues that plague the profession, but such is life. I cant figure out why so many ODs think other professions have it so much better. My friend the cardiologist often remarks about the "same ol thing" routine of his practice; it doesnt matter what you do(unless you are a trauma surgeon) it is not always exciting. All of you whiners on this board seem to think that you are in competition directly with anyone or thing that is selling eyewear. If you create a perceived value of your services, patients will pay for your services(and your products). If you make your practice a dial spinning practice that is what it will be.

That being said, I have had about enough of this board. It brings me and everyone else down. You can all sulk if you want to but I am not going to be a part of it. I have met a couple prospective associates on this board, so hopefully that turns out to be good. So go back to all the negativity, I have patients to see.

Posner

 

[Ben Chudner]

I completed my first year at UC IRvine Medical school

Go 'eaters! UC Irvine class of 1992.

 

[Ben Chudner]

The past few responses are some of the most pathetic responses I have ever heard. I sincerely hope that prospective OD's dont heed the words of the underachieving masses on this board. This is the type of OD I refer to when I say that optometry selects the wrong types of students. I chose this profession for several reasons, not because I couldnt get into medical school like many ODs(I completed my first year at UC IRvine Medical school and was in the top 20 in my class before deciding not to go on) but because I felt I would enjoy the profession more than medicine. SO far I am having a pretty good time.I do get frustrated with some of the legislation issues that plague the profession, but such is life. I cant figure out why so many ODs think other professions have it so much better. My friend the cardiologist often remarks about the "same ol thing" routine of his practice; it doesnt matter what you do(unless you are a trauma surgeon) it is not always exciting. All of you whiners on this board seem to think that you are in competition directly with anyone or thing that is selling eyewear. If you create a perceived value of your services, patients will pay for your services(and your products). If you make your practice a dial spinning practice that is what it will be.

That being said, I have had about enough of this board. It brings me and everyone else down. You can all sulk if you want to but I am not going to be a part of it. I have met a couple prospective associates on this board, so hopefully that turns out to be good. So go back to all the negativity, I have patients to see.

Posner

Remember that the majority of people that post on this site are students. The doctors that post on this site generally fall into two categories. Those that really dislike the profession and want to vent about it, and those (like you and me) that really enjoy the profession and want everyone to know about how great it can be. If you leave, there will be one less of us and we can use all the help we can get.

If you are talking about KHE, he actually really likes the profession, but had some very bad experiences. He tries to share those with the students so that they know what they have to watch out for.

 

[rpie]

Remember that the majority of people that post on this site are students. The doctors that post on this site generally fall into two categories. Those that really dislike the profession and want to vent about it, and those (like you and me) that really enjoy the profession and want everyone to know about how great it can be. If you leave, there will be one less of us and we can use all the help we can get.

If you are talking about KHE, he actually really likes the profession, but had some very bad experiences. He tries to share those with the students so that they know what they have to watch out for.

Count me in as a person that enjoys Optometry!

 

[KHE]

Remember that the majority of people that post on this site are students. The doctors that post on this site generally fall into two categories. Those that really dislike the profession and want to vent about it, and those (like you and me) that really enjoy the profession and want everyone to know about how great it can be. If you leave, there will be one less of us and we can use all the help we can get.

If you are talking about KHE, he actually really likes the profession, but had some very bad experiences. He tries to share those with the students so that they know what they have to watch out for.

*sigh*

I don't know how much more clear I can be in my postings but I will try one more time.

I HAVE NEVER EVER EVER SAID THAT IT IS NOT POSSIBLE TO HAVE A CAREER IN OPTOMETRY THAT IS NOT FINANCIALLY AND PROFESSINALLY REWARDING.

However, I claim that in order to achieve that goal it requires much more careful planning than most students realize and it requires consideration of issues that most students are clueless about and do not even know exist until they graduate.

I have said many times that I would bet that the vast majority of optometry students and prospective optometry students dream of one day owning in, or being a partner in a large Guggenheim type optometry practice filled with designer merchandise that patients are falling over themselves to pay hundreds of dollars for and a waiting room filled with cool and interesting pathology cases.

Is this possible?? OF COURSE.

HOWEVER, it requires consideration of issues that most students are not conscious of. For example, most students are taught to look at areas where there is a relatively small number of ODs per population. My experience has been that this matters little. I know of thriving practices in areas saturated by ODs and know of dying practices in areas where they are the only game around for miles. However, the common theme in the THRIVING practices is ability to accept medical insurance plans. Most students have some vague notion that they need to learn how to "bill and code" but they make the assumption that accessing medical plans is a foregone conclusion. How wrong they are in that assumption.

Most students are taught that when they graduate, they will be able to find a benevolent older doctor who will take them on at their practice and if a "love-connection" is made, partnership will be offered, or the young doctor will be given the opportunity to slowly buy in while the senior OD slowly retires. My experience has been that most older doctors are merely interested in selling their tired old optical shops for 3 times what they are worth or the carrot of partnership will be dangled ad infinitum because the senior OD "isn't quite ready" which usually means that the wife isn't ready.
The optometric lexicon is filled with stories like these.

SO FOR THE LAST G-D DAMNED TIME STUDENTS....YOU CAN ACHIEVE SUCCESS IN OPTOMETRY. I HAVE COLLEGUES THAT LOVE OPTOMETRY SO MUCH THAT TO THEM, IT IS LIKE A DRUG. THEY CAN NOT WAIT TO GET UP EVERY SINGLE DAY AND MARCH INTO THEIR OFFICES AND SEE PATIENTS!

HOWEVER, I IMPLORE YOU TO CONSIDER THE RAMIFICATIONS OF NOT BEING ABLE TO ACCEPT MEDICAL INSURANCE PLANS.

I also continue to stand by my opinion that optometry is doomed to end up like pharmacy as long as private practices continue to make the bulk of their revenue from material sales. A study by the AOA found that more than 85% of private practices generate the majority of their revenue from the sale of spectacles and contact lenses. I stand by my assertion that those "doctors offices" or not really doctors offices. They are stores. And unless this trend substantially reverses itself in the near future, private optometrists will become about as common place as private pharmacists.

Do I hope I'm wrong? Absolutely. But I have not seen any current trend in optometry that has disuaded me from that opinon, and that is mostly why I practice on a very limited basis right now.

 

[wrx04]

I would be interested to ask your opinion as to why you think that everyone starts off wanting to enter private practice at the start of optometry school and so few end up actually doing it once they are out.[/QUOTE]

I think the big appeal of optometry is the fact that you are going to be your own boss. The problem is that loans are high and students feel overwhelmed by debt when they get out. If they try to start their own place, they get hit with another 100k and if they try and buy in, they end up getting low-balled. Maybe i don't share this thought with the majority, but there is no doubt why i chose the profession. I look at it from the business point of view. If you open a practice with the mindset of being a successful businessman, i don't see the problem.

It seems that the majority of optometry students aren't very business minded at all. I think there is plenty of potential to succeed. If Wall-Mart down the street is giving exams down the street for cheap, that's fine....make them look CHEAP. Raise your fees as they lower theirs. I think you will attract more people by having high fees. It will make you look like quality and them look like crap. Maybe it's wishful thinking, but i know i wouldn't use a
COUPON when it comes to my health, and i think other people think the same.

 

[Ben Chudner]

I HAVE NEVER EVER EVER SAID THAT IT IS NOT POSSIBLE TO HAVE A CAREER IN OPTOMETRY THAT IS NOT FINANCIALLY AND PROFESSINALLY REWARDING.

However, I claim that in order to achieve that goal it requires much more careful planning than most students realize and it requires consideration of issues that most students are clueless about and do not even know exist until they graduate.

Didn't I just say you are trying to let the students know what to watch out for, and that you are not one of those OD's that hates our profession?

 

[KHE]

Didn't I just say you are trying to let the students know what to watch out for, and that you are not one of those OD's that hates our profession?

Yes Dr. Chudner, and I thank you for your kind words. My exaspiration was not directed at you. I merely quoted your post because it was the last one of the thread at the time I posted.

 

[Ben Chudner]

Yes Dr. Chudner, and I thank you for your kind words. My exaspiration was not directed at you. I merely quoted your post because it was the last one of the thread at the time I posted.

I'd hate to lose that whole great minds thing, and please call me Ben. Remember, I am not a real doctor.

 

[prettygreeneyes]

SO FOR THE LAST G-D DAMNED TIME STUDENTS....YOU CAN ACHIEVE SUCCESS IN OPTOMETRY. I HAVE COLLEGUES THAT LOVE OPTOMETRY SO MUCH THAT TO THEM, IT IS LIKE A DRUG. THEY CAN NOT WAIT TO GET UP EVERY SINGLE DAY AND MARCH INTO THEIR OFFICES AND SEE PATIENTS!

HOWEVER, I IMPLORE YOU TO CONSIDER THE RAMIFICATIONS OF NOT BEING ABLE TO ACCEPT MEDICAL INSURANCE PLANS.

I also continue to stand by my opinion that optometry is doomed to end up like pharmacy as long as private practices continue to make the bulk of their revenue from material sales.

KHE,

Perhaps you could add the quoted section above to your signature. Might save some wear and tear on your keyboard...

I'm curious to know in this "pharmacy-like model" that you are predicting for optometry, where do you see speciality clinics like VT, peds, etc.? Completely extinct? Alongside the optical shop in Wally World? Still free standing private practices?

I appreciate you taking the time to share your experiences with us students. I've been around here for a little while, so I've heard your story. But, new posters might come in and see you as an incredibly negative optometrist, until they become more familiar with your posts. It is tough to work so hard to get into school, and through school, and find out that there are a lot of problems with your chosen profession. SDN and ODWire can be a slap in the face for the unprepared student...they sure were for me. The schools say nothing about what optometry is facing, but it is good that someone is.

 

[KHE]

KHE,

Perhaps you could add the quoted section above to your signature. Might save some wear and tear on your keyboard...

I'm curious to know in this "pharmacy-like model" that you are predicting for optometry, where do you see speciality clinics like VT, peds, etc.? Completely extinct? Alongside the optical shop in Wally World? Still free standing private practices?

I appreciate you taking the time to share your experiences with us students. I've been around here for a little while, so I've heard your story. But, new posters might come in and see you as an incredibly negative optometrist, until they become more familiar with your posts. It is tough to work so hard to get into school, and through school, and find out that there are a lot of problems with your chosen profession. SDN and ODWire can be a slap in the face for the unprepared student...they sure were for me. The schools say nothing about what optometry is facing, but it is good that someone is.

There are problems in every single profession out there. Each and every one. I don't think that because I have said some things that are "not positive" that that makes me an incredibly negative optometrist. I guess people might think that though because most students have only gotten the "rah rah" speech from their schools. People reading my posts should be able to see that I'm NOT suggesting that they NOT choose optometry. I'm just suggesting that they need to be aware of certain issues that they almost certainly are not or it is going to lead to unfulfilled expectations.

Most students and prospective students think that the negatives are "Walmart" and "fighting with ophthalmolgists." Neither of those things are particularly good, but they are really just minor annoyances in the grand scheme of things. They aren't true negatives, IMHO.

The biggest "negative" is not being able to treat your patients to the extent that you are trained. This makes optometry incredibly boring after a very short amount of time. At least, it did for me. THat does not mean that other people wouldn't be satisfied with it, or that you can't make good money at it. I have always tried to accentuate that you CAN make good money in optometry. But for me, money was never the issue. It was boredom at not being able to care for my patients because of the arbitrary policies of insurance companies.

Regarding peds, and VT and the future of optometry: I don't know of any true "pediatric" optometry practices, and I know of very few true VT only practices. Most VT practices are regular primary care optometry practices that also do some VT on the side. I believe that these practices will also be swallowed up unless they make the majority of their revenue from their VT services. If the bulk of their revenue comes from routine eye exams and retailing eyewear, I don't see a future for them.

For the practices that are exclusively VT, I do see a future for them although they tend to operate in a way that is so far removed from "mainstream" or "traditional" optometry that they are almost not functioning as optometrists. I don't mean that in a negative way. But even though they have the OD degree, they almost operate as a separate profession.

 

[Opii]

I have seen KHE refered to as the negative optometrist on this site on several occasions, I think it would be more appropriate to call him the realistic optometrist on this site. A little East Coast bluntness never hurt anyone.