Too many ODs??

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Toothless hillbilly was meant to be a term of endearment....

AS far as fee raising is concerned, it is my belief that this must be done on a regular basis(preferably yearly, but at least every two years). It is amazing what an extra $10-$20 per patient can do for your bottom line. Believe it or not, most patients dont seem to complain or notice the fee increase. Dont just look at your exam fee either. Every year I pull up the regional Medicare clearing house fee schedule and review the changes to fees for all services and procedures. You should AT LEAST have your fees set in line with these numbers(dont decrease your fees if these numbers go down). Also, in doing this each year, I am reminded of procedure codes that I should use more often but either forget or get too lazy to use; You dont want to leave too much money on the table if you can help it. You might also benefit from getting a copy of the fee schedule of your local friendly OMD(I realize this may not be possible) and see what they charge. You would be more than surprised to see what these folks are charging for the same routine services you are providing.

Posner

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keep it up, amigo. $6/month x 1 year.

yeah.... that would completely outprice my market. My exam fees are already higher than almost anyone else in the area. Think I'll stick to every year ;)

Although, funnily... now that I've gone up.. I've notice a lot of other area docs are going up too. ;)
 
Although, funnily... now that I've gone up.. I've notice a lot of other area docs are going up too. ;)

Better known as the "Butterfly Effect" :thumbup:
 
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dear dr posner,

how many patient's do you yourself see? about how long do you see each patient (on average?) do your patients feel rushed? do you have a lot of refferals/repeat patients? is most of your income from the dispensary? how large is your dispensary? how many employees do you have? what's the turnover like at your place?

thanks so much:)
 
Although, funnily... now that I've gone up.. I've notice a lot of other area docs are going up too. ;)

careful now. this could potentially be more contagious than EKC.
a condition also known as "hey - those 8 years of school should make my services worth perhaps just a little more than a haircut at costcutters and although im probably still $150 too low on my exam fee but hopefully someday i'll get it up there-atitis"

treated abruptly and effectively so far with "walmartomanagerprolol", dosed po qd, including saturdays and sundays. maybe there will someday be a new resistant strain.
 
dear dr posner,

how many patient's do you yourself see? about how long do you see each patient (on average?) do your patients feel rushed? do you have a lot of refferals/repeat patients? is most of your income from the dispensary? how large is your dispensary? how many employees do you have? what's the turnover like at your place?

thanks so much:)

I myself see between 23 and 32 patients per day depending on which office I am in(today I was in my smaller office and I had 4 reschedules and 3 no shows so I only saw 15 patients:mad: ). As I mentioned before in earlier posts, I try not to see more than 12-13 complete eye examinations in a day. I fill the rest of my slots with IOP checks, glaucoma checks, retinal checks, cl checks/cl evals, dry eye evals/workups,walk in/urgent care, etc, etc. In my smaller office I have 5-6 employees depending on the day(for example on tuesdays our offices open at 7am and close at 6:30pm; my associate works from 7-1:30 and I work from 11:30 to 6:30. We need the extra body on this day) I have a front office person, 2dispensary people, a pretester/cl tech, back office person, and another person to float in the front office to check patients out and to do special testing(OCT, 30-2 etc.) The dispensary in our smaller office is what I would call moderate in size. We have about 350 frames or so. THe entire office is only 1480sq ft. I find that I am able to spend 10-15 minutes with most patients. This greatly exceeds what most patients are used to. IN our smaller office we see about 15-20% new patients each month and the rest are repeat patients. At least 2 or 3 times per day do I hear a new patinet remark they have never experienced the comprehensive care we provide before. I am lucky to have a busy practice with many referrals.

In my other office which is roughly twice the size, we have about 10-11 employees depending on the day. 3-4 full timers in the dispensary, a full time biller for both offices, 2 front office girls, and 4-5 ancillary people to work up patients and perform special testing, etc. In the big office we have doulbe doctors every day but one(when we have the OMDs in the office). On double doctor days me and my partner see 50-60 patients. We see 20% new patients here as well. This is also a healthy referral practice. The dispensary here is almost twice the size and we stock about 550-600 frames or so. We have been lucky with employee turnover. We have a few employees that have been with the office for 8-10years plus. Several that are in their 4th or 5th year and a few newer ones. If you dont already know, you will find staff management to be the single most difficult aspect of private practice(the headache increases exponentially with each additional staff memeber)

It is my philosophy to try and make our income from at least 60% services and 40% from the dispensary. I have been successful with this as has my partner. Our associates are more 50/50 for some reason. As far as staffing goes, we are planning to get rid of 2 bodies here by the beginning of the year. We just switched to the EMR which has really cut down on not only the cost of forms,paper, etc but it has really streamlined our operation. By march we should be able to eliminate one more position but we shall see. I hope this is what you were looking for.

Posner
 
... Bodies...

Let me guess..... Your term of endearment for: Staff, Team Players, Little People, Hillbillies??

... I myself see between 23 and 32 patients per day...

That answers my question about the little people or as you would say; "bodies."


... we are planning to get rid of 2 bodies here by the beginning of the year. .....By march we should be able to eliminate one more position but we shall see.

So out of the 4 bodies that work for you, you are planning to get rid of 2-3 bodies, correct? You'll only have one body working for you and we all know equiptment breaks down all the time. This one body left will probably really croak by April.

Do your 4 current bodies know they are on a game of "Eliminate" ... It must be a cut throat environment you've created.

Well gotta go... unlike some people who see 30 patients a day and have all day to hang out at the student forums .... I'm actually busy.

I'm not flaming, I'm simply pointing out where the root of the problems in Optometry emerge from.
 
Let me guess..... Your term of endearment for: Staff, Team Players, Little People, Hillbillies??



That answers my question about the little people or as you would say; "bodies."




So out of the 4 bodies that work for you, you are planning to get rid of 2-3 bodies, correct? You'll only have one body working for you and we all know equiptment breaks down all the time. This one body left will probably really croak by April.

Do your 4 current bodies know they are on a game of "Eliminate" ... It must be a cut throat environment you've created.

Well gotta go... unlike some people who see 30 patients a day and have all day to hang out at the student forums .... I'm actually busy.

Your response hardly dignifies a reply, but I cant resist. When I say I am getting rid of 2-3 bodies, I am referring to my entire corporation that consists ay 17 employees(not including doctors). As I mentioned we swithched to Electronic records and we no longer have the need for all the manpower. eliminating employees is never fun, but it must be done at times for the greater good of the business. My post was intended to be helpful to another poster that specifically inquired about my practice. Perhaps you should mind your own business? Especially if you continue to choose to behave like a toddler.

Posner
 
Whaa, Whaa

Bodies = Staff

Got it. :laugh:
 
Has this idea ever occured to any of you optometry graduates that there are currently too many ODs in the job market? Do you think optometry schools are pumping out an overflowing number of ODs -- messing up the ideal supply and demand of optometric profession? As a result, there is more competitions among ODs and the job availability is also lowered.

Do anyone of you agree with me that all optometry schools should raise their admission standards and limit the number of new students entering every year?


Have you seen the latest admissions stats from opted.org? 4-5 years ago, when I researched applying for OD school, average gpas to get into opt schools was about a 3.2-3.3. And the only school that had a <3.0 mean gpa was PR, and they too are above a 3.0 now. Now 3/4 of all the schools have gpas in the 3.4-3.5. I think opt schools have raised their standards. Undergrad grade inflation also plays a small factor.
 
As I mentioned we swithched to Electronic records and we no longer have the need for all the manpower. eliminating employees is never fun, but it must be done at times for the greater good of the business. Posner

he is using efficiency, and he has no choice due to optometric under-demand. unfortunately the termination of those office employees would not have been necessary had there been more of a patient share left over after the masses have been through the cattle mills found in shopping malls and wally world. so actually the CRUEL termination of those employees could be looked at as an indirect result of corporate optometry + the massive optometric oversupply.

i have many correlations regarding oversupply when given the opportunity.
 
32 patients a day = cattle mills :laugh:
 
Have you seen the latest admissions stats from opted.org? 4-5 years ago, when I researched applying for OD school, average gpas to get into opt schools was about a 3.2-3.3. And the only school that had a <3.0 mean gpa was PR, and they too are above a 3.0 now. Now 3/4 of all the schools have gpas in the 3.4-3.5. I think opt schools have raised their standards. Undergrad grade inflation also plays a small factor.

The average GPA for a student entering optometry school in the US this year was a 3.41, with nearly 40% of schools having entering classes with a GPA at or above 3.5. Two schools, UAB and N. Eastern State had GPAs above a 3.6. That’s not too shabby if you ask me. Of course it could always be better, but the entering students aren't exactly majoring in underwater basket weaving either.
 
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The average GPA for a student entering optometry school in the US this year was a 3.41, with nearly 40% of schools having entering classes with a GPA at or above 3.5. Two schools, UAB and N. Eastern State had GPAs above a 3.6. That’s not too shabby if you ask me. Of course it could always be better, but the entering students aren't exactly majoring in underwater basket weaving either.

Same thing going on here at Pacific. Our class had an entering GPA of 3.55 and 345 on all sections of the OAT. The professors say we are a bunch of overachievers.:cool: :rolleyes:

As UABopt says, it can always be better, but it is good to know that standards aren't dropping to get warm bodies in the seats.
 
I myself see between 23 and 32 patients per day depending on which office I am in(today I was in my smaller office and I had 4 reschedules and 3 no shows so I only saw 15 patients:mad: ). As I mentioned before in earlier posts, I try not to see more than 12-13 complete eye examinations in a day. I fill the rest of my slots with IOP checks, glaucoma checks, retinal checks, cl checks/cl evals, dry eye evals/workups,walk in/urgent care, etc, etc. In my smaller office I have 5-6 employees depending on the day(for example on tuesdays our offices open at 7am and close at 6:30pm; my associate works from 7-1:30 and I work from 11:30 to 6:30. We need the extra body on this day) I have a front office person, 2dispensary people, a pretester/cl tech, back office person, and another person to float in the front office to check patients out and to do special testing(OCT, 30-2 etc.) The dispensary in our smaller office is what I would call moderate in size. We have about 350 frames or so. THe entire office is only 1480sq ft. I find that I am able to spend 10-15 minutes with most patients. This greatly exceeds what most patients are used to. IN our smaller office we see about 15-20% new patients each month and the rest are repeat patients. At least 2 or 3 times per day do I hear a new patinet remark they have never experienced the comprehensive care we provide before. I am lucky to have a busy practice with many referrals.

In my other office which is roughly twice the size, we have about 10-11 employees depending on the day. 3-4 full timers in the dispensary, a full time biller for both offices, 2 front office girls, and 4-5 ancillary people to work up patients and perform special testing, etc. In the big office we have doulbe doctors every day but one(when we have the OMDs in the office). On double doctor days me and my partner see 50-60 patients. We see 20% new patients here as well. This is also a healthy referral practice. The dispensary here is almost twice the size and we stock about 550-600 frames or so. We have been lucky with employee turnover. We have a few employees that have been with the office for 8-10years plus. Several that are in their 4th or 5th year and a few newer ones. If you dont already know, you will find staff management to be the single most difficult aspect of private practice(the headache increases exponentially with each additional staff memeber)

It is my philosophy to try and make our income from at least 60% services and 40% from the dispensary. I have been successful with this as has my partner. Our associates are more 50/50 for some reason. As far as staffing goes, we are planning to get rid of 2 bodies here by the beginning of the year. We just switched to the EMR which has really cut down on not only the cost of forms,paper, etc but it has really streamlined our operation. By march we should be able to eliminate one more position but we shall see. I hope this is what you were looking for.

Posner


i hope you will give those employees plenty of notice. thanks for giving us all a peek into your practice. i plan to own my own place - so look out! just kidding:) i hoping for 1 full exam per hour with checks on the 1/2 hour (it's a mode of practice that i worked in as an optician that i really liked) - you have done amazing things with your practice and deserve all of the success that comes your way.
 
32 patients a day = cattle mills :laugh:

THose of us that have chosen to apply more than the few weeks of refraction we learned in school to our practices, understand that 32 patients although a hectic schedule is very reasonable. You think in terms of complete exams and glasses because you are a simpleton. 32 of these types of patients would not only be a cattle mill, but it would cause me to drink a glass of hemlock and end it all.

Efficient utilization of personnel not only allows for superior patient care, it allows one to see more patients(and I dont mean exam and glasses patients). The problem with many ODs is that they have fragile egos and they think only they can provide patient care. Watch your local OMD see a patient; he or she will get right down to the important stuff and have the staff dot the i's and cross the t's. If you are taking more than 10-15 minutes of your time on average per patient(of course there are exceptions) you need to rethink what you are doing. Automate your equipment and hire people to streamline things. It is because of your small minded thinking that guys like KHE may have a point about optometry going the way of pharmacy...not on my watch. By the way, the OMDs in our office see between 25 and 30 patients in the morning and another 25-30 in the afternoon.

Let me try to put this post into perspective for you...which paragraph above makes most sense to you...paragraph number one or paragraph number two...paragraph number one or paragraph number two?

Posner
 
i hope you will give those employees plenty of notice. thanks for giving us all a peek into your practice. i plan to own my own place - so look out! just kidding:) i hoping for 1 full exam per hour with checks on the 1/2 hour (it's a mode of practice that i worked in as an optician that i really liked) - you have done amazing things with your practice and deserve all of the success that comes your way.

Thanks for your well-wishing, I appreciate it. I appreciate your thoughts on your future schedule when you own your own place; It can be hard to imagine doing retinoscopy(or auto refractor) in 20secs and a refraction in less than 5 minutes, and a complete health assessment in 6-7 minutes(including BIO) but it will happen. There can be a fine line between providing a comprehensive examination and making your patient feel like he or she is wasting thier entire day at your office. I do know a few docs that practice the way you would like to and they are very content with their practice and they have a loyal patient base. Good luck to you.

Posner
 
Posner,
You will win more students to your cause if you speak with a little kindness, respect, and perhaps a little less ego.

Explain how you go about seeing 32 patients. I believe you said about half of them are complete exams. Do you, yourself, refract them or does a tech? Do you test binocular vision or simple refractions? Does your tech instill dilation drops prior to your seeing the patients? How long do you spend with a CVE? etc., and so on and so forth
 
I finally meet someone who does not bash "Lenscrafters". I am so glad there are ODs out there who do not think "where you practice" affects "how you practice". Like you said, many private practices are "glorified" glasses dispensers. Optometry is in a unique profession where we do sell what we prescribed. The question is, do we prescribed what "profits" us the most? We have always been retail minded due to glasses and contacts. What we need to keep in mind is why we recommended a particular products or procedures? As long as we all do what we took oath for, which is to "enhance the quality of life through protecting God's most precious gift, which is vision". I hope all of us never forget that when we become too sucessful in our practices. Money brings greed. Greed makes us forget what Optometry is all about. I practiced at LENSCRAFTERS. I participated in charities program. We give free eye exams and free eyeglasses. I been on missions for the needys and poor. How many of you in private practices do that? Ask not what Optometry has given you but ask what you have given back to Optometry.
 
Posner,
You will win more students to your cause if you speak with a little kindness, respect, and perhaps a little less ego.

Explain how you go about seeing 32 patients. I believe you said about half of them are complete exams. Do you, yourself, refract them or does a tech? Do you test binocular vision or simple refractions? Does your tech instill dilation drops prior to your seeing the patients? How long do you spend with a CVE? etc., and so on and so forth

If you look back at this post, I believe I was originally trying to comment in a constructive way before I was made out to be a money hungry optometrist who performs illegal procedures in dark corners on his patients. Naturally, I took exception to this and what has resulted has turned out to be ridiculous.

On to your request....AS I mentioned I have alot of staff that work for me to make my office run smoothly. We have worked and reworked our office forms for max efficiency. My front office checks patients in. I have a pretester who goes through case history, cover test, color vision, pupils, EOMS, lensometry, blood pressure, etc. Each patient then gets screening visual field, near and far acuities. If they are contact lens patients, the techs do a spherocylinder over refraction, flips lids, remove cls, and so on. We have a light system in each room so that everyone knows whats up. Every single patient over the age of 14, gets a drop of paramyd before I come in. I review chart, address any problems, etc. I perform the refraction, do slit lamp, 90D lens, and then grab a BIO with a 28D lens. I document my findings, chat it up with the patients for a bit, answer questions, buzz my staff who then comes in and uses the Rev eyes. If patients need additional testing I either bring them back or if time permits, we do it then. My staff knows if there are any "red flags" they come get me. If we need to use 1%mydriacyl and 2.5 phenyl we do it. If I have to scleral depress or throw on a gonio or other contact lens, I do that as well. If in depth phorometry is indicated it is also done, etc, etc. 32 patients is 15 minutes per patient..that is an eternity. When is the last time you got 15 minutes of your PCPs time?

In my smaller office, a full schedule is 23 patinets(fewer staff and less space). To my knowledge, I dont have patients that say they feel rushed. Since they keep coming back and referring their friends, I tend to believe them. Furthermore, I have a staff member who stays on top of recalls and follows up on patients that have not been in for 2 or more years. Patients that dont come back almost always have moved or have gotten pissed off at the staff or dispensary. My system is not perfect or the best thing going...but it has worked well for me in my situation. I wake up interested in my job and I usually learn something on a daily basis.

Posner
 
My front office checks patients in. I have a pretester who goes through case history, cover test, color vision, pupils, EOMS, lensometry, blood pressure, etc. Each patient then gets screening visual field, near and far acuities.

Posner

Admittedly, I don't have any idea how OD's bill, and the more post I read it becomes even more hazy. My question is how can you bill for a "screening visual field"? Don't you need a medical indication, ie elevated IOP, increased cup/disc, etc...? I know if I submit an HVF with no ICD-9 which corresponds to insurance they won't pay or will inquire.
 
Admittedly, I don't have any idea how OD's bill, and the more post I read it becomes even more hazy. My question is how can you bill for a "screening visual field"? Don't you need a medical indication, ie elevated IOP, increased cup/disc, etc...? I know if I submit an HVF with no ICD-9 which corresponds to insurance they won't pay or will inquire.

Many insurance plans (BC/BS of SC comes to mind at first) require what they call a "screening visual field" on any comprehensive exam. This is usually done manually by techs.

Of course, I could be wrong and posner is doing a HVF on every comp. exam. If that's true, I also would be curious to know how he codes for that.

I was brought in as an emergency temp insurance person at an OD office a few years back. The more I learned, the more confusing it got. I hate insurance so much...
 
Admittedly, I don't have any idea how OD's bill, and the more post I read it becomes even more hazy. My question is how can you bill for a "screening visual field"? Don't you need a medical indication, ie elevated IOP, increased cup/disc, etc...? I know if I submit an HVF with no ICD-9 which corresponds to insurance they won't pay or will inquire.

He's not billing seperate for the screening fields (correct me pos if im wrong). Hes probably referring to counting fingers or confrontation fields, or maybe an automated screener (fdt) which his tech performs as pretest. If we bill medical, then we bill exactly like OMD (although you guys often have a certified biller doing the paperwork) Posner probably does too, I wish I did. No insurance will allow seperate payment for routine vf. The haziness you've seen in these threads come from ODs who dont deal with medical insurance on a regular basis. There are many of them out there. I once heard of an OMD who didnt take any medical and billed something like 5 grand for CE! Now thats your shangri-la. Too bad cats did not get lumped in with spectacle correction in terms of medical necessity, you guys would be rolling in it now.
 
again, Posner is using efficiency. we do the same thing. i can only pay my docs to be efficient. for comprehensives:
our techs do a case history, blood pressure, autorefr/wavefront mapping, NCT, FDT screener, VAs sc and c dist and near, eoms, pupils, CVFs, stereo, color, amps/npc, refraction, angles, dilation pending angles assessment.
a doctor comes in and reviews Hx, verifies refraction, and does health assessment.

YOU CANNOT TELL ME THAT THE OD OR OMD PRESSING THE BUTTON ON THE AUTOMATED MACHINES WILL GET A MORE ACCURATE RESULT THAN A TECH. INFORMATION GATHERING BY A CAPABLE INDIVIDUAL RESULTS IN REPEATABLE, ACCURATE, AND PRECISE MEASUREMENT.

our surgeons have the techs do most of their workup on consults as well (just not as much as they only do consults).

our techs also adminster GDx, OCT, OBFA, A-scan via immersion, photos, and when they are not busy they scribe.

here comes a good dose of ego, or logic, depending on how you look at it:
why would i pay a doctor $65/hour to press buttons when i can hire an ophthalmic tech $22/hour to do the same thing and achieve the same result?
 
here comes a good dose of ego, or logic, depending on how you look at it:why would i pay a doctor $65/hour to press buttons when i can hire an ophthalmic tech $22/hour to do the same thing and achieve the same result?

I don't think anyone is saying this. I think the discussion refers to what mode of practice - volume vs. "individualized-care" is more attractive to the patient. Another point of disagreement would be what does the OD need to see from the patient rather than read from the chart. That's how I see this discussion although the questions are implicit.

I have a request for Posner and drgregory, could you please stop yelling at us. All caps and belittling language is really not necessary. Just tell us what you think and let us go over it on our own. The tone of your posts really makes it difficult to buy into your position even though I agree with most of what you say.
 
Admittedly, I don't have any idea how OD's bill, and the more post I read it becomes even more hazy. My question is how can you bill for a "screening visual field"? Don't you need a medical indication, ie elevated IOP, increased cup/disc, etc...? I know if I submit an HVF with no ICD-9 which corresponds to insurance they won't pay or will inquire.

I include a humphrey screener as part of ANY comprehensive examination. I could do confrontations if I chose, but it is just something our practice had always done when I got there. Again, for any of my patients that have presenting medical complaints, well we work them up appropriately including visual fields if indicated. If I need to bring them back for a 30-2 or threshold 10 field, then we do it and bill for it. The ODs that understand the game bill the same as the OMDs. in most cases.

Posner
 
i think the reason my post seemed that way was because i needed to define why and how one could be thorough and see 32 patients/day.
and i felt the need to discuss how it is unlikely to see the same amount of patients in a corporate environment, likely without an educated ancillary staff and automated medical equipment, whilst maintaining thoroughness. the concept of seeing that number of patients may be confusing to one who has not physically observed how it can be done in a professional environment.

i tried to explain the above without sarcasm and ego, and upon re-reading it, it seems i have failed.
 
luckfool,
first of all i read it in the newspaper. second of all, my friends are hiring these young guys and they make about 120,000 first year out.the people in finance and traders make plenty of money. I want to let you know that you dont have to go into $150,000 of debt to make $100,000 . just so you know i dont have 1 friend that makes under $100,000. (that works full time) and my poorest friends are optoms.here is a list of what some of my friends do and there pay.
1. 37 y.o.investment banker 500,000
2. 37 yo sales 125,000
3. 37 yo oncologist 300,000
4. 42 yo lawyer 250,000
5. banker 1,000,000
6.designer 1,000,000
7. trader 1,200,000
and i have plenty more a pt. of mine told me that he has a 26y.o making 700,000.
I know what finance people make these r my friends and my pts. and i cant believe what the make. forgot one works for a hedge fund 1 million plus bonus
 
i just had to post more salaries b/c I'm still shocked.
pt. does sales for my designer friend 250,000 shes 27.
manager at best buy.(its not best buy but something very close) 85,000.
district manager 250,000. and he's 29.
and employed optoms make about 120,000 thats including benefits.
private school (pre k) in new york. 20,000.
private school in new jersey (again pre k) 10,000
If you dont live in a good area and you have to send your kid to private school in nj 20,000 to 25,000. if you live in a good area then your real estate taxes will be 15,000 to 25,000 (thats my town). so either way i'm screwed.
 
luckfool,
first of all i read it in the newspaper. second of all, my friends are hiring these young guys and they make about 120,000 first year out.the people in finance and traders make plenty of money. I want to let you know that you dont have to go into $150,000 of debt to make $100,000 . just so you know i dont have 1 friend that makes under $100,000. (that works full time) and my poorest friends are optoms.here is a list of what some of my friends do and there pay.
1. 37 y.o.investment banker 500,000
2. 37 yo sales 125,000
3. 37 yo oncologist 300,000
4. 42 yo lawyer 250,000
5. banker 1,000,000
6.designer 1,000,000
7. trader 1,200,000
and i have plenty more a pt. of mine told me that he has a 26y.o making 700,000.
I know what finance people make these r my friends and my pts. and i cant believe what the make. forgot one works for a hedge fund 1 million plus bonus

You know...I am always dubious of these posts. Who the **** goes around telling people what they make. I also have lots of close friend but except for 1, I have NO IDEA what they make and they do not know what I make. I can guesstimate, but to post such numbers really seems unbelievable in the sense they would share with you something so personal as their income.

BTW posner, I used to respect your posts, but now, you just seem to get your jollies implying how much you make, how wealthy you are, and how great you are...gets old.
 
luckfool,
first of all i read it in the newspaper. second of all, my friends are hiring these young guys and they make about 120,000 first year out.the people in finance and traders make plenty of money. I want to let you know that you dont have to go into $150,000 of debt to make $100,000 . just so you know i dont have 1 friend that makes under $100,000. (that works full time) and my poorest friends are optoms.here is a list of what some of my friends do and there pay.
1. 37 y.o.investment banker 500,000
2. 37 yo sales 125,000
3. 37 yo oncologist 300,000
4. 42 yo lawyer 250,000
5. banker 1,000,000
6.designer 1,000,000
7. trader 1,200,000
and i have plenty more a pt. of mine told me that he has a 26y.o making 700,000.
I know what finance people make these r my friends and my pts. and i cant believe what the make. forgot one works for a hedge fund 1 million plus bonus

These numbers are obviously scary but I highly doubt they're real/or the guys are telling you the truth. First of all, new graduate bankers don't make anywhere close to a million dollars per year. This is extremely far fetched. Professions like investment banker, sales, oncologist (MD!) always make that much. Lawyer (they, too, if successful. I've seen bankrupted lawyers). Trader (? depends on what kind of trade? obviously you got 1 extremely successful trader for a friend, but can this be generalized for all traders in the US?). And lastly, designer??? (they only make the amount you mentioned if they are truly good and unique, and very experienced. Average designers or inexperienced would wish they make past 30k/yr. And it's fact)
 
Most of my friends are in positions of power (i'm sure yours are too) getting starting salaries is easy. investment bankers make about 120,000. how I know what my other friends make comes up in conversation. and when some of these guys build 2 to 3 million dollar homes I know there making more than 150,000. I also have pts. in the same fields, and wifes talk. Listen I'm not saying i'm making this kind of money, i'm just saying some of my friends do. Here is a perfect example friend of mine told me he has to cut back he's starting a new company. he told me his salary was going to be 175,000.(his last company did 110 million.)
 
again, Posner is using efficiency. we do the same thing. i can only pay my docs to be efficient. for comprehensives:
our techs do a case history, blood pressure, autorefr/wavefront mapping, NCT, FDT screener, VAs sc and c dist and near, eoms, pupils, CVFs, stereo, color, amps/npc, refraction, angles, dilation pending angles assessment.
a doctor comes in and reviews Hx, verifies refraction, and does health assessment.

YOU CANNOT TELL ME THAT THE OD OR OMD PRESSING THE BUTTON ON THE AUTOMATED MACHINES WILL GET A MORE ACCURATE RESULT THAN A TECH. INFORMATION GATHERING BY A CAPABLE INDIVIDUAL RESULTS IN REPEATABLE, ACCURATE, AND PRECISE MEASUREMENT.

our surgeons have the techs do most of their workup on consults as well (just not as much as they only do consults).

our techs also adminster GDx, OCT, OBFA, A-scan via immersion, photos, and when they are not busy they scribe.

here comes a good dose of ego, or logic, depending on how you look at it:
why would i pay a doctor $65/hour to press buttons when i can hire an ophthalmic tech $22/hour to do the same thing and achieve the same result?


I don't think there's a problem with your techs doing any of that.... well, ok that's not true. I think one of the things that, in my mind, separates ODs from MDs is a really great refraction. That is the number 1 reason why I don't just go to the MD I worked for and ask for a quick check up once a year.

But, business-wise I can easily understand why you do it. I do have one question though. I could be wrong, but did you say that your refraction fee is something quite higher than the average ($90-ish)? How do you justify a fee that high when a tech does it?
 
I could be wrong, but did you say that your refraction fee is something quite higher than the average ($90-ish)? How do you justify a fee that high when a tech does it?

$97 now for 92015. my wife gets a haircut, which takes about 15 minutes of actual work from a non-educated individual (well maybe 8 weeks max) - she pays consistantly $65. with wavefront and the possibility of me double checking the refraction, thats where i the now tiny looking $97.
when i can pluck an eyelash and get $80, and the chance of complications are quite low, and it takes me 1/10 the time as the refraction, that makes me think about raising the refraction price.
and when my wife throws in a coloring at the "salon", you better count on another $115 on top of the $65.
or, another comparison - bring your car down to a mechanic. it'll run you about $90 to "have it put on the machine for diagnostics". that machine costs about 1/12 of what my wavefront costs and my cost to pay the ophthalmic tech.
 
luckfool,
first of all i read it in the newspaper. second of all, my friends are hiring these young guys and they make about 120,000 first year out.the people in finance and traders make plenty of money. I want to let you know that you dont have to go into $150,000 of debt to make $100,000 . just so you know i dont have 1 friend that makes under $100,000. (that works full time) and my poorest friends are optoms.here is a list of what some of my friends do and there pay.
1. 37 y.o.investment banker 500,000
2. 37 yo sales 125,000
3. 37 yo oncologist 300,000
4. 42 yo lawyer 250,000
5. banker 1,000,000
6.designer 1,000,000
7. trader 1,200,000
and i have plenty more a pt. of mine told me that he has a 26y.o making 700,000.
I know what finance people make these r my friends and my pts. and i cant believe what the make. forgot one works for a hedge fund 1 million plus bonus


Looking at your list, I have to wonder what the lifestyle of each of these professionals is. If I had to work 80 hrs a week or be a complete stranger to my family, those numbers aren't worth it. Particularly the Best Buy manager position... I would rather have my eyeballs plucked out than work a manager position in retail. You have to manage snotty 16 years working their first job ever, you are at the whim of district managers, and you have to deal with the cranky general public at holiday time. No thank you.

Hollywood - I get a sense of negativity and generally unhappy feeling from you about your chosen profession. Are you happy what you're doing? If you aren't, why don't you change careers?
 
"Bodies," "belly aching masses," "toothless hillbillies" ...and "I have X# of sea side acers of land more than you do" ... this mentality is what really rubs me the wrong way here... this verbal abusing towards others doesn't work in today's optometry (that's very "old school"). Everyone in this thread is educated or soon will be in a few years, some in this thread may have loans but will get out of it and eventually see the rewards in the future. Assuming we are simpletons doen't fly.
 
Well Most Do Work More Than 40 Hrs. I Would Say On Ave. Most Of My Friends Work About 12hrs/day. The Investment Bankers That I Was Talking About Work About 80hrs/week.
And Yes I Am Happy With Optometry I Just Hate The Insurance Part Of It. And It Can Get Boring At Times.
I Think It Is Very Important That You And All Other Od Students Understand That Most Of You Will Be Working For Or At A Commercial Place. (not That Its Bad, But The Schools Dont Tell You That)
Again In My Class Of 80 Only 5 Of Us Where In Private Practice. The Rest Where Working For Wal Mart And Sams Club. And The Numbers Were'nt That Diffrent For The Class Above Me And Below.
I Just Want You To Know What You Are Getting Yourself Into. I Don't Know Why More People Dont Join Together And Open Up Their Own Practices.(group Practice)
 
$97 now for 92015. my wife gets a haircut, which takes about 15 minutes of actual work from a non-educated individual (well maybe 8 weeks max) - she pays consistantly $65. with wavefront and the possibility of me double checking the refraction, thats where i the now tiny looking $97.
when i can pluck an eyelash and get $80, and the chance of complications are quite low, and it takes me 1/10 the time as the refraction, that makes me think about raising the refraction price.
and when my wife throws in a coloring at the "salon", you better count on another $115 on top of the $65.
or, another comparison - bring your car down to a mechanic. it'll run you about $90 to "have it put on the machine for diagnostics". that machine costs about 1/12 of what my wavefront costs and my cost to pay the ophthalmic tech.

I'd say your wife needs to find a new hairdresser. I pay about $20 for a haircut. My girlfriend pays about $70 as well, but usually for about an hour of time. If a refraction took 30 minutes, you might have me sold. Actually, now that I think on it... maybe a tiered system is the way to go. A 20-something myope like myself versus someone with binocular vision problems.

My mechanic does the diagnostic work for free. Granted I've been using the same guy for the 10 years I've been driving, but you get the idea.

I doubt we'll ever agree on this, but there it is.
 
I Think It Is Very Important That You And All Other Od Students Understand That Most Of You Will Be Working For Or At A Commercial Place. (not That Its Bad, But The Schools Dont Tell You That)


Thanks for your response. However, considering you don't know me personally, nor do you know most of the students who participate on this forum, I would say that a blanket prediction that we WILL end up in corporate is wrong. Will I end up working corporate for a while... maybe... but it will hopefully be during the same time our practice (meaning my husband and I) has just opened and we are supplementing our income. Pacific has a great clinical dean who has made it his life's work (among other things) to beat into our heads to start networking NOW, as in first year. We all started at GWCO this year, meeting doctors from states we want to practice in and handing out our business cards. It is a small step, but still one in the right direction, I hope. The nay sayers (spelling?) will jump in and say that optometry is going to be like pharmacy, we will all be corporate, ya da ya da. Maybe, but all I am in control of is myself and my actions. I know that what I do now is going to affect my future (and the future of my husband and family). Thus, I am starting now to make sure I end up where I want to be... with the practice of my dreams with my hubby. :)
 
You know...I am always dubious of these posts. Who the **** goes around telling people what they make. I also have lots of close friend but except for 1, I have NO IDEA what they make and they do not know what I make. I can guesstimate, but to post such numbers really seems unbelievable in the sense they would share with you something so personal as their income.

BTW posner, I used to respect your posts, but now, you just seem to get your jollies implying how much you make, how wealthy you are, and how great you are...gets old.

I agree with you, I can only estimate what some of my friends make. However I do have a few friends/family making well over 500k, they are all working in the "market". If you ask me its a sophmoric fraternity that makes way too much money IMHO. Posner does have a bit of a power trip, but in the OD community, hes doing very well.
 
I'm Just Giving You The Facts. Most Od's Want To Be In Private Practice. But Most Are Not. Out Of Every Od That Has Worked For Me In The Last 10 Yrs. I've Had 1 Go Out And Try To Make It On His Own. And My Father Who Has Been In Practice For 40 Yrs.(we Don't Work Together) Will Tell You Pretty Much The Same Thing. I Think Its Great That You And Your Hubby Want To Start A Practice Together. I Did The Same With My Wife. Anyway Good Luck .if I Can Help You Let Me Know.
 
You know...I am always dubious of these posts. Who the **** goes around telling people what they make. I also have lots of close friend but except for 1, I have NO IDEA what they make and they do not know what I make. I can guesstimate, but to post such numbers really seems unbelievable in the sense they would share with you something so personal as their income.

BTW posner, I used to respect your posts, but now, you just seem to get your jollies implying how much you make, how wealthy you are, and how great you are...gets old.

Your point is well taken. As I have looked back on my posts I can see where I have come accross a bit arrogant. That was not my intention, and for that I do apologize to the board at large. That being said, I have never thought I was "great". I feel that I have alot to offer in the way of experience and knowledge in regards to optometry and private practice. I am eager to pass on what I can and to learn from others. I hope to get back to construcitve discussions.

As far as the previous bogus post, I have to agree. I have a number of friends that earn significant incomes, but I could not tell you exactly what any of them make. I may know what their practice grosses or what they bill out for their services(attorneys, contractors, engineers, etc) but I havent a clue as to what they earn nor do they know what I earn.

POsner
 
You guys make me not want to be an optometrist. That makes me sad.

Look BabyTurtle,
Don't be sad, just look at it as an opportunity to get out while you can and find a real satisfying profession to get into. After all, you very well may live to be 150 years old, and that is too long to be an optometrist. :D
 
Posner,
Got a full set of teeth (one is an implant though). Hey some of those double wides ain't bad, especially with my new LCD and huge satellite dish in the front yard. Hey, trust me I am not saying anyone does unnecessary procedures. There is alot of room for discretion. I remember years ago (about 20) in upstate NY a very respectable local ophth charged $25 for flipping through the color plates as part of an itemized routine exam, this was only for checking color vision. Geez this is as much as some OD's now charge for full exams.

The cost of living is rather high on the west coast (CAlifornia especially). AS long as you are happy where you live good for you. I However, prefer my 6 acre ocean view estate instead of banjo playing toothless hillbillies with run down cars in front of their double wides.... It is personal preference.Posner
 
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