Wal-Mart...

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Just out of curiosity, how much do Wal-Mart optometrists tend to gross (as in, what they personally take home)? I've heard eye-exam figures quoted in this thread ranging from $29-to-$49-per exam. I chose a number within that range -- $39 -- and did some simple calculations. At a minimum of 15 patients per day, that's $585/day. If you work 5 (?) days a week, that's $2,925/week. With four weeks in a month, that's $11,700 per month, and with 12 months in a year, that amounts to a total yearly gross of $140,400. That doesn't sound bad, at all.

Of course, I'm sure I'm totally wrong in how all of this works, so please excuse my ignorance.

So, what are some low, middle and high-range figures for a Wal-Mart, Sams, etc. optometrist?

Henry, it's more complicated than that. There's payroll, rent, and other misc bills. It's probably safe to say that WM ODs can net around 70%.

Some other variables/add-ons are: Contact lens fees(extra $50 to $80), Visual fields(extra $10-$20), Dilated fundus exams (extra $10-$20, this is a cheesey add on, most docs in private practice include it in the exam fee), billing for medical exams and testing (highly variable fee reimbursement). My best guess is that full time WM docs make anywhere from $60,000 to $250,000 (rare but doable)/year. Average probably around $100,000 or so.

Docs that work at WM are not highly thought of within the profession, generally, and they're usually so far in denial they refuse to realize it. The money is good, but it could best be characterized as blood money, since most ODs in these settings give up control to an evil corporation solely interested in profits, and drive the image of the profession into the ground.

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Texas OD sues WalMart...... and wins. Finally, an OD with some back bone.

MEMORANDUM


DATE:

February 5, 2007


SUBJECT:

Texas Federal Court Case: Aaron v. Wal-Mart Stores, Inc. (Eastern
District
of Texas, December 28, 2006, Settlement Agreement)


TO:

Affiliate Presidents, Presidents-Elect, State Executive Directors


FROM:

Lance R. Plunkett




BACKGROUND:

Optometrist Brad Aaron, O.D., of Texas, sued Wal-Mart in federal court
in
Texas for violations of the Texas Optometry Act -- specifically,
provisions
of that law that make it illegal for retailers of optical goods to
control
or attempt to control the professional judgment, manner of practice, or
the
practice of an optometrist. Texas is unique among states in that it has
very
specific laws on this subject that spell out specific private remedies
and
specific penalties for violations by entities like Wal-Mart. The matter
in
controversy exceeded $75,000 and, since Wal-Mart is incorporated in the
state of Delaware, the case satisfied the threshold diversity of
citizenship
requirements to enable the case to be brought in federal rather than
state
court in Texas. On December 28, 2006, Wal-Mart entered into a
settlement
agreement with Dr. Aaron to end the case. The amount paid in the
settlement
agreement was stipulated to be confidential and has not been disclosed
by
the parties. Dr. Aaron is not a member of the American Optometric
Association.


PROBLEM OR ISSUE TO BE ADDRESSED:

What does this case mean for optometry nationally?

This case is important in that it demonstrates that state legislation
protecting the professional medical judgment of optometrists can be
effective. Dr. Aaron was able to allege in his court complaint that
Wal-Mart
had violated the Texas Optometry Act [which, in making it illegal to
control
the professional judgment, manner of practice, or practice of an
optometrist, also forbids the following activities by a retailer like
Wal-Mart: 1) setting or attempting to influence the professional fees
or
office hours of an optometrist; 2) restricting or attempting to
restrict an
optometrist's freedom to see a patient by appointment; 3) terminating
or
threatening to terminate an agreement, including a lease, or other
relationship in an attempt to control the professional judgment, manner
of
practice, or practice of an optometrist; 4) providing, hiring, or
sharing
employees, business services, or similar items to or with an
optometrist;
and 5) making or guaranteeing a loan to an optometrist in excess of the
value of the collateral securing the loan.] Dr. Aaron was also able to
claim
that Wal-Mart had violated the Texas Deceptive Trade Practices Act
based on
the same conduct. Wal-Mart settled the case with Dr. Aaron on December
28,
2006, paying an undisclosed sum of money to end the case.

The basic issue in the case was Wal-Mart's demanding over several years
that
Dr. Aaron keep increasing his working hours or be threatened with
termination of his lease to the Wal-Mart premises that housed his
optometric
practice. Ultimately, Dr. Aaron terminated his lease with Wal-Mart. Dr.
Aaron subsequently brought the lawsuit to recover statutory penalties
allowed under Texas law, lost wages and earnings, capital costs of
having to
open a new optometry practice, damages for mental anguish, court costs,
attorneys' fees, and interest as allowed by law on any judgment.
Because the
settlement sum remains confidential, it is not known exactly what
claims in
the case Dr. Aaron recovered what sums of money for.

At the present time, the Texas settlement agreement has limited
applicability to other states because: 1) it is just a settlement
agreement
and is not an actual decision by the court; and 2) only Texas has a law
that
sets out specific remedies and penalties that grant an optometrist a
clear
private right to sue a retailer like Wal-Mart for violations of that
law.
Tennessee is the only other state with a similar law, but the Tennessee
law
does not carry specific remedies and penalties enforceable by private
parties like the Texas law.

States may want to consider adopting provisions of law similar to those
in
Texas to protect the professional medical judgment of optometrists and
to
allow optometrists to individually enforce their rights against
entities
like Wal-Mart. In the absence of clear statutory authority, courts will
likely not accept private lawsuits to enforce such restrictions on
commercial entities. Most state laws instead reserve any enforcement
rights
to the state attorney general or another government official.

A copy of the Texas court case
<http://www.magnetmail1.net/ls.cfm?r=14696207&sid=1878502&m=268078&u=AOA_&s=
http://www.magnetmail.net/images/clients/AOA_/attach/TXODwinsLawsuitAgainstW
alMart.pdf> , with an explanation of the case by the attorney who
handled
the matter, is attached to this memorandum.
 
I went to the new Super Wal-Mart last night that just opened up two weeks ago near me, and I glanced at the Optometry "department." A complete eye exam starts at $55, and a contact lens exam starts at $89. How are these figures contrasted in the context of what a private practice would charge?

I have to admit, the OD area looked pretty damn nice -- a definite step-up from what I've typically seen in Wal-Mart. It almost "looked" like the private practice optometrist I go to (although, he is highly focused on selling glasses/contacts).
 
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I went to the new Super Wal-Mart last night that just opened up two weeks ago near me, and I glanced at the Optometry "department." A complete eye exam starts at $55, and a contact lens exam starts at $89. How are these figures contrasted in the context of what a private practice would charge?

I have to admit, the OD area looked pretty damn nice -- a definite step-up from what I've typically seen in Wal-Mart. It almost "looked" like the private practice optometrist I go to (although, he is highly focused on selling glasses/contacts).


The $55 routine eye exam fee is higher than I've seen, around here all WM docs charge $39, but I kow regional vatiations exist. The $89 CL eval is standard but remember, that INCLUDES the routine portion as well. Let 99% of these ODs try and raise their fees, and see how long before WM exercises the 30 day out clause and the OD is out on the street.

One of the biggest problems I have with WM docs is the complete lack of autonomy. In Texas it is illegal for a corporation to control the hours, scheduling, and fees on an Optometrist. In WMs, ODs give up control of these things, and essentially sign illegal contracts. If the store or district manger aren't happy with the optical sales, good chance the OD will be "fired". So as you can see, a conflict of interest exists. The difference between a private doc selling materials, and a corporate optical influencing ODs so the Optical can sell the materials is that we as health care professionals should have the patient interests above all. Corporations have the stock holder interests first, patient be damned.

The other problem I have is the poor image being a "doc in the box" portrays to the public and other health care professionals. No matter what, professionals affillated with the biggest discount mega store in the world is very cheesey and in poor taste. There are many commercial docs that will challenge me on this, but they are delusional, plain and simple.
 
I went to the new Super Wal-Mart last night that just opened up two weeks ago near me, and I glanced at the Optometry "department." A complete eye exam starts at $55, and a contact lens exam starts at $89. How are these figures contrasted in the context of what a private practice would charge?

I have to admit, the OD area looked pretty damn nice -- a definite step-up from what I've typically seen in Wal-Mart. It almost "looked" like the private practice optometrist I go to (although, he is highly focused on selling glasses/contacts).

I know a local optometrist who charges (without insurance) $ 129 for an eye exam and $ 149 for a first time basic CL exam and plus 10-30 more if complicated, etc. Plenty of patients and optical sales without pressure either.
The eye clinic at my school's student health center (privately owned but integrated into the system) charges 55 bucks for an eye exam (by very competent optometrists as well). The mandatory undergraduate insurance (unless you have another insurance plan through spouse or sibling, etc.) plan brings that down to $ 5.00!
 
Texas OD sues WalMart...... and wins. Finally, an OD with some back bone. .............................................................................

Nice to see an OD with back bone. The schools do such a good job of taking your backbone away from you. Anyone with an opinion will get chewed down, so once out in the real world, new ODs have been so brain washed into submissing they wouldn't normally do something like this. Dr. Aaron needs to run for president of something or other, I'd vote for him.

.....................Dr. Aaron is not a member of the American Optometric
Association.

Money well saved.


:)
 
Agreed.....aaannnnd......agreed.
 
I don't know if it made the news in the US, but recently in Medicine Hat, Alberta, Canada, Wal-Mart announced plans to launch a pilot-project where they would get rid of their OD and have an optician "sight test" with the Eyelogic system. After considerable opposition, they decided to postpone things. This should worry ODs working in commercial settings.
I wondered when that would start happening. They wouldn't have to pay opticians as much as optoms and if, as seems to be the case, WM is only interested in having their eye people do refractions so they can sell glasses and contact lenses, then why have ODs at all?

Unfortunatley, Walmarts and the like degrade our image and make it very easy for the public to confuse us with opticians. If we want to become integrated into the sphere of health care we need to get the hell out of Walmart. I own a private practice and gets lots of referrals from MDs, and will soon be doing call at the local hospital. What MD is going to refer a patient to Walmart??? Not many. Will opticians beable to refract without Dr. supervision? I think probably....in BC, though not legal, it is a common practice. In short, it's time for an OD image change. It's our responsibility.
I've seen a lot of the veteran ODs on these boards saying similar stuff, ie that working in commercial locations is degrading the profession to the point that ODs are just seen as glorified opticians. I don't know what's to be done about that though....new OD grads are in debt, making setting up their own practices a dicey proposition right out of school. If they're not hired into established practices by older ODs then the only option is to work commercial.

I think if ODs are willing to gain more business sense, there is a great oppurtunity to be able to start your own practice with lots of support. One of the student organizations needs to teach marketing principles. And this would also be a great workshop at a forum. If ODs really got involved in the community it would be much easier. Things like adopting a school. Free clinics at local churches. This could rack in many patients. Wal-Mart is becoming evil. Indoor malls are becoming obsolete. Even partnering with MDs or Dentists would be a smart move.
There does seem to be a need for more focus on how to run a private practice. The school at which I was accepted (Waterloo) I think has only one course on practice management, and that's in third year. Checking curricula at other optom schools yields similar results. Schools don't seem to care what happens to grads after they get the degree.
 
Docs that work at WM are not highly thought of within the profession, generally, and they're usually so far in denial they refuse to realize it. The money is good, but it could best be characterized as blood money, since most ODs in these settings give up control to an evil corporation solely interested in profits, and drive the image of the profession into the ground.

Does the fact that they work at Walmart matter, or is it that they're in a corporate setting in general? You could characterize anyone working in that situation (like say a pharmacist at Walgreens or Shoppers DrugMart) as giving up control to an 'evil' corporation solely interested in profits. It might be 'blood' money, but it's good money, and good money talks....
 
Does the fact that they work at Walmart matter, or is it that they're in a corporate setting in general? You could characterize anyone working in that situation (like say a pharmacist at Walgreens or Shoppers DrugMart) as giving up control to an 'evil' corporation solely interested in profits. It might be 'blood' money, but it's good money, and good money talks....


Hey, as long as you're paid "good money" to hell with the profession.:rolleyes: Free country man, but if I'm selling out, it's for more than WM money.
 
How much is Walmart money?

Not enough to embarass yourself and your entire profession, IMO. But OD's come cheap now a days.

To answer your question, the average WM OD probably nets around $100,000. I've heard of a select few making $200,000, and some make $50,000. In some areas, they're trying to put a Walmart on every corner, they'll be canibalizing themselves sooner than later.
 
How does Wal-Mart pay its OD's? Is it purely off of exams, hourly, or salary? How much commission (if any) do they take from optical/cl sales? So when you guys say an OD might make about 100k at Wal-Mart, what kind of hours are we talking? 40 hrs a week?

What other options are there for new graduates? I understand that some rent an exam room at an existing office and pay a percentage. What other ways can an OD get paid without his own practice?

Thanks ya'll.
 
How does Wal-Mart pay its OD's? Is it purely off of exams, hourly, or salary? How much commission (if any) do they take from optical/cl sales? So when you guys say an OD might make about 100k at Wal-Mart, what kind of hours are we talking? 40 hrs a week?

What other options are there for new graduates? I understand that some rent an exam room at an existing office and pay a percentage. What other ways can an OD get paid without his own practice?

Thanks ya'll.
Wal-Mart does not pay OD's, they are independent contractors (at least in WA). Wal-Mart takes 10% off of the daily gross receipts if you hire your own receptionist and handle your own billing. They take 20% if they pay the receptionist and handle the billing.
 
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Yes a lot of ODs say that a commercial job is just "for a little while". Thing is if ODs didn't sell thier souls in the first place there would be lots of private practice opportunities. Thing is I never hear first or second year students dreaming of working at Wally. They all say "I'm going to do private practice." Then guess what, they sell out their own dreams and the dreams of upcoming ODs. I don't care what you say, commerical practice is BAD for optometry. Repeat BAD, BAD, BAD!

I graduated at the top of my pre-med class and chose Optometry over all other medical professions. Please stop pissing on my profession by practicing in an unprofessional setting. I don't want my son saying "My daddy works at walmart" :oops:
 
Has anyone else heard about Ciba's deal with Wal-Mart on the Focus Dailies 90pk? Wal-Mart is selling these contacts for less than the cost optometrists (at least the one I work for) are paying for them. This doesn't seem like a very smart move on Ciba's part....
 
Hey, as long as you're paid "good money" to hell with the profession.:rolleyes: Free country man, but if I'm selling out, it's for more than WM money.

I cant stand it any longer, I am emmerging from my self imposed exile:eek: . It is so refreshing to see more voices of reason. I had all but given up on this board...if it werent for an accidental slip while trying to load another web page from my history, I wouldnt have ended up here.

Nevertheless, after seeing the topics at the top of the thread list(specifically Wal Mart) I felt a surge that prompted a response. Honestly, I expected to see nothing but posts from snivelling, spineless, blue-vest sympathizers. Steve(and the rest of you that seem to have the smallest of inklings) you made my night. Thanks.

Posner
 
Posner, the enemy is no longer WalMart. I'm done wasting my energy talking about ODs that exhibit profound loss of vision, pardon the pun. Medicine is our professional enemy. Their goal is, and I quote, "... the extinction of Optometry" and to "Drive Optometrists into the sea"

It's time we put our differences aside and unite to battle this strong determined enemy.

Medicines goals:

Attack your revenue streams. Accomplished by getting ODs kicked off of medical panels, backing refracting optician legislation, and backing legislation that makes it illegal to sell what you prescribe.

There goes all revenue streams. Medical exams, vision exam, and materials sales. Left is Vision therapy, and low vision.

Now is the time to unite and support your state and national PACs.

As an aside. In the event of medicines success in making Optometry "extinct", I would advise any and all displaced ODs to go to law school. Then specialize in medical tort cases. Thousands, maybe 10's of thousands, bright, young, pissed off, anti medicine attorneys flooding the market will serve up medicines just rewards.

BTW, I've talked with attorneys about this. Attorneys with health care backgrounds are highly sought after and very well compensated.
 
... the extinction of Optometry"
..........
Attack your revenue streams.

Left is Vision therapy, and low vision.
I agree with this, the revenue streams are obviously under attack and winning... but don't you think even the "specialties" are covered?
For example: Paraoptometrics, NCLE (for specialty CL & partially sighted), and COVTs, Orthoptists, and Low Vision Assistants.... An M.D. can hire one or two of these, the Optician, and then be completely covered? It's something to think about.

And another thing I've noticed, while Optometrists are always fighting/throwing low punches/bickering with each other. All the ophthalmologists I have dealt with have been very, VERY, nice with me in person, (it's much easier to get a LOR from an O.M.D. than from an O.D. in my experience) it has made me think I just should remove myself from optometrists' arena all together and go work for an O.M.D. They have been really cool with me and always give me the most accurate and informative information when I'm looking for an answer to a question. On the other hand O.D.s are always grumpy don't/won't give me an answer to something I have been wondering about regarding eye care, LORs, etc.... As KHE once said the "lone wolf mentality" very much applies with O.D.s.
 
... the extinction of Optometry"
..........
Attack your revenue streams.

Left is Vision therapy, and low vision.
I agree with this, the revenue streams are obviously under attack and winning... but don't you think even the "specialties" are covered?
For example: Paraoptometrics, NCLE (for specialty CL & partially sighted), and COVTs, Orthoptists, and Low Vision Assistants.... An M.D. can hire one or two of these, the Optician, and then be completely covered? It's something to think about.

And another thing I've noticed, while Optometrists are always fighting/throwing low punches/bickering with each other. All the ophthalmologists I have dealt with have been very, VERY, nice with me, (it's much easier to get a LOR from an M.D. than from an O.D. in my experience) it has made me think I just should remove myself from optometrists' arena all together and go work for an O.M.D. They have been really cool with me and always give me the most accurate and informative information when I'm looking for an answer to a question. On the other hand O.D.s are always grumpy don't or won't give me an answer to something I have been wondering about regarding eye care, LORs, etc....


Most Ophthalmologists will be nice to your face but stab ODs in the back from the shadows. They are nice because they want referrals. I agree though ODs need to help and refer to other ODs.
 
It seems to me this SDN site is promoting the demise of optometry. At the bottom there is an ad for $20 eye exam at Cohens. Guys, the bottom line is the profession is doomed, jump on the mercantile gravy train and ride it to the coast. Pray your kids choose another profession.

I cant stand it any longer, I am emmerging from my self imposed exile:eek: . It is so refreshing to see more voices of reason. I had all but given up on this board...if it werent for an accidental slip while trying to load another web page from my history, I wouldnt have ended up here.

Nevertheless, after seeing the topics at the top of the thread list(specifically Wal Mart) I felt a surge that prompted a response. Honestly, I expected to see nothing but posts from snivelling, spineless, blue-vest sympathizers. Steve(and the rest of you that seem to have the smallest of inklings) you made my night. Thanks.

Posner
 
It seems to me this SDN site is promoting the demise of optometry. At the bottom there is an ad for $20 eye exam at Cohens. Guys, the bottom line is the profession is doomed, jump on the mercantile gravy train and ride it to the coast. Pray your kids choose another profession.


If this is true I'm screwed:rolleyes: . I've been out of school for 5 years now and I'm about to open up my second PRIVATE practice, this one right next door to a WM. I'm going to seriously punk the WM OD that goes in there, count on it.:smuggrin:
 
Posner, the enemy is no longer WalMart. I'm done wasting my energy talking about ODs that exhibit profound loss of vision, pardon the pun. Medicine is our professional enemy. Their goal is, and I quote, "... the extinction of Optometry" and to "Drive Optometrists into the sea"

It's time we put our differences aside and unite to battle this strong determined enemy.

Medicines goals:

Attack your revenue streams. Accomplished by getting ODs kicked off of medical panels, backing refracting optician legislation, and backing legislation that makes it illegal to sell what you prescribe.

There goes all revenue streams. Medical exams, vision exam, and materials sales. Left is Vision therapy, and low vision.

Now is the time to unite and support your state and national PACs.

As an aside. In the event of medicines success in making Optometry "extinct", I would advise any and all displaced ODs to go to law school. Then specialize in medical tort cases. Thousands, maybe 10's of thousands, bright, young, pissed off, anti medicine attorneys flooding the market will serve up medicines just rewards.

BTW, I've talked with attorneys about this. Attorneys with health care backgrounds are highly sought after and very well compensated.


:sleep: You lost me here dude. Medicine need not worry about optometry, ODs will be responsible in the end if optometry becomes extinct(see my numerous retorts regarding the "walmartization" of optometry). I believe that the minority of MDs share the views you expressed above...much like I believe the minority of ODs truly want full surgical scope expansions.

You make very important points when you mention supporting PACs..I agree 100% with this.

posner
 
:sleep: You lost me here dude. Medicine need not worry about optometry, ODs will be responsible in the end if optometry becomes extinct(see my numerous retorts regarding the "walmartization" of optometry). I believe that the minority of MDs share the views you expressed above...much like I believe the minority of ODs truly want full surgical scope expansions.

You make very important points when you mention supporting PACs..I agree 100% with this.

posner

I wonder how well New Mexico ODs are sleeping now, since they lost their minor surgical privileges last week (FB removal, plugs, D&I). WalMart didn't do that...that was due to an ophthalmologist on the Medicare advisory panel for their local carrier. I can compete with WM, and crush 'em. Medicine money in government is much tougher.
 
I wonder how well New Mexico ODs are sleeping now, since they lost their minor surgical privileges last week (FB removal, plugs, D&I). WalMart didn't do that...that was due to an ophthalmologist on the Medicare advisory panel for their local carrier. I can compete with WM, and crush 'em. Medicine money in government is much tougher.

I agree attacking our revenue streams is the underlying enemy.

Crushing WM with what little is left for us to do should still be a fun endeavor :)

Having a $200,000 debt looming over one's head is stressfull, I understand why O.D.s have to sell out.
O.D.s should get rid of that "lone wolf" mentality and partner up or hire more associates. O.D.s are doing it to themselves.
 
I wonder how well New Mexico ODs are sleeping now, since they lost their minor surgical privileges last week (FB removal, plugs, D&I). WalMart didn't do that...that was due to an ophthalmologist on the Medicare advisory panel for their local carrier. I can compete with WM, and crush 'em. Medicine money in government is much tougher.

:eek: Very scary indeed if this is in fact the case. Again, I implore those of you who really want to have a profession to get involved at the local and national levels when you can and support your PACs.

Posner
 
I wonder how well New Mexico ODs are sleeping now, since they lost their minor surgical privileges last week (FB removal, plugs, D&I). WalMart didn't do that...that was due to an ophthalmologist on the Medicare advisory panel for their local carrier. I can compete with WM, and crush 'em. Medicine money in government is much tougher.

The thought of losing those techniques is depressing, considering how I am a student learning how to do all of those currently (literally... this week!). If that trend continues, what a waste of time and money being professionally trained to perform those procedures.
 
The thought of losing those techniques is depressing, considering how I am a student learning how to do all of those currently (literally... this week!). If that trend continues, what a waste of time and money being professionally trained to perform those procedures.

It is also a waste of time and money being professionaly trained to perform those procedures if an insurance company will deny you payment for them upon your graduation simply because you happen to be an OD.

I noticed with a wee bit of depression that the view/post ratio on this thread is very very high as it is on threads that center around OMD/OD bickering and commercial vs private offices and a ridiculous thread about whether an OD should lend a hand in a medical emergency or not yet the threads in which insurance issues are discussed has a much lower ratio.

This is dangerous business guys and one that is going to have a tremendous impact on your careers. I understand that most of you are students or prospective students so you may not feel its critical right now and that its something that you will deal with "later" but I'm swearing to you right now in front of God and everyone that you better start thinking about it before you put your head down on the pillow tonight.
 
KHE as usual, makes some good points. But it isn't really all that depressing. You can still make a good living in Optometry. Here's an abbreviated list of what I think are the events/traits that are the most important in determining success in modern Optometry. BTW, I will never define succes as working in a commercial environment:thumbdown: . Remember, this is just my opinion.

In order of importance.

1) Location-medical plans allow ODs on panel?
2) Location-public need for eye care in a specific area?
3) Location-not full of cheap ass redneck demographic that worships WM (I can get away with this, I'm a redneck;) )
4) Business savvy (notice I haven't mentioned Optometric skill yet)
5) Deep pockets (Grandma willed you some money is always helpful)
6) Hard working
7) Diligence
8) Perserverence
9) Luck (I strongly considered moving this up the scale)
10) Finally.......professional skill (frankly, we're all very well trained)

If these things fall in place for you, you can make as much money as ANYONE in the healthcare field. In comparison, however, most people in other medical fields do not have to try nearly as hard to make a very good living.
 
KHE as usual, makes some good points. But it isn't really all that depressing. You can still make a good living in Optometry. Here's an abbreviated list of what I think are the events/traits that are the most important in determining success in modern Optometry. BTW, I will never define succes as working in a commercial environment:thumbdown: . Remember, this is just my opinion.

In order of importance.

1) Location-medical plans allow ODs on panel?
2) Location-public need for eye care in a specific area?
3) Location-not full of cheap ass redneck demographic that worships WM (I can get away with this, I'm a redneck;) )
4) Business savvy (notice I haven't mentioned Optometric skill yet)
5) Deep pockets (Grandma willed you some money is always helpful)
6) Hard working
7) Diligence
8) Perserverence
9) Luck (I strongly considered moving this up the scale)
10) Finally.......professional skill (frankly, we're all very well trained)

If these things fall in place for you, you can make as much money as ANYONE in the healthcare field. In comparison, however, most people in other medical fields do not have to try nearly as hard to make a very good living.

Now this is a good post. Let me be the first to thank you for......Did you just call me fukin redneck?????? wtf? You gonna do some prayin' boy. You sure got a perty mouth.:laugh: :laugh:
 
Students and prosepctive students:

If someone were to ask you what the qualities of a successful optometrist are, you would probably all respond with things like intelligence, a strong clinical acumen, good bed(chair)side manner, and other such noble qualities.

I would bet however that none of you would think of the ability to be accepted onto insurance panels.

However....what I have been harping on for years now?
What is at the top of Steve's list here?

Notice any similarities....?????

Steve is right....you will always make decent money as an OD. I believe that I have specifically gone out of my way multiple times to say that. You will always make above the national average in terms of income. You will not default on your student loans. You will not eat out of a dumpster.

However, for the vast majority of you the ability to be professionally satisfied is going to be predicated to a large extent on you being able to take care of your patients to the extent that you are trained and that's why this issue is paramount.


KHE as usual, makes some good points. But it isn't really all that depressing. You can still make a good living in Optometry. Here's an abbreviated list of what I think are the events/traits that are the most important in determining success in modern Optometry. BTW, I will never define succes as working in a commercial environment:thumbdown: . Remember, this is just my opinion.

In order of importance.

1) Location-medical plans allow ODs on panel?
2) Location-public need for eye care in a specific area?
3) Location-not full of cheap ass redneck demographic that worships WM (I can get away with this, I'm a redneck;) )
4) Business savvy (notice I haven't mentioned Optometric skill yet)
5) Deep pockets (Grandma willed you some money is always helpful)
6) Hard working
7) Diligence
8) Perserverence
9) Luck (I strongly considered moving this up the scale)
10) Finally.......professional skill (frankly, we're all very well trained)

If these things fall in place for you, you can make as much money as ANYONE in the healthcare field. In comparison, however, most people in other medical fields do not have to try nearly as hard to make a very good living.
 
I have been watching this message board for a short while now, and I find the vitriolic rhetoric against doctors who lease space from Wal-Mart quite surprising. If this message board is really a forum, I hope its users will read this entire post and retort with arguments instead of flames.

1. Ideally, optometrists should be wholly independent of glasses and contact sales. Optometrists should use their training to treat eye-related conditions and complement eye-care provided by ophthalmologists. Presently, most optometrists spend their time refracting—a task a trained optician can do. We fought hard for the right to provide medical care, let’s provide it. Get on medical insurance panels, take Medicare, and provide G-treatment. Over time, I am sure the public can be convinced an optometrist is a better medical alternative than a general practice M.D. or a second-year ER resident, both of whom receive limited training on the eye.

2. Private-practice optometrists hurt public perception more than optometrist affiliated with commercial retailers. (I can only assume that Wal-Mart is more hated than Eye-Masters or Pearle Vision because of Wal-Mart’s greater presence.) Nobody can argue that most private-practice optometrists make the bulk of their income from glasses and contact sales. A 70/30 split in favor of such sales is not an unreasonable figure. Because of this, many private-practice optometrists are primarily retailers and only secondarily medical providers. Resultantly, the glasses become the shopped for item, and the medical care becomes irrelevant.

In fact, there is a strong conflict-of-interest issue when O.D.’s make more money from sales than treatment. Consider an M.D. that owns a pharmacy to which she refers her patients. This M.D. now has a strong financial incentive to over-prescribe her patients. I am not implying that private practice O.D.’s are unethical, I am simply pointing out that there is a conflict that cannot be ignored.

Most private-practice optometrists appear angry at Wal-Mart because of the retail impact, not the medical impact. The posted arguments do not allege Wal-Mart doctors provide a lesser quality of medical care, they simply argue such doctors are sleeping with the enemy. Wal-Mart is not an “enemy” to medical providers, only retailers. An M.D. or D.D.S. that leases space from Wal-Mart is not traitor to her profession. Neither is an O.D. who does the same.

3. Free market dictates why Wal-Mart doctors can and will charge less. Specifically, without the risk of capital expenditures necessary to establish an office, commercially-affiliated doctors can charge lower prices while still making the same net income.

Ultimately, only after glasses sales are separated completely from the medical service will the quality of medical care dictate which doctors can charge more. I think that Wal-Mart doctors are too closely linked with glasses sales, but they are a heck of a lot better than private practice optometrists with optical sales.
 
1. Ideally, optometrists should be wholly independent of glasses and contact sales. Optometrists should use their training to treat eye-related conditions and complement eye-care provided by ophthalmologists. Presently, most optometrists spend their time refracting&#8212;a task a trained optician can do. .

Agreed, mostly. Disagree on the refraction thingy. But Optometry IS historically the profession that provided these materials. Distancing ourselves from our roots will be difficult, and not really in the patients best interest.

Private-practice optometrists hurt public perception more than optometrist affiliated with commercial retailers. (I can only assume that Wal-Mart is more hated than Eye-Masters or Pearle Vision because of Wal-Mart's greater presence.) Nobody can argue that most private-practice optometrists make the bulk of their income from glasses and contact sales. A 70/30 split in favor of such sales is not an unreasonable figure. Because of this, many private-practice optometrists are primarily retailers and only secondarily medical providers. Resultantly, the glasses become the shopped for item, and the medical care becomes irrelevant.

I'm going to try and be nice about that statement, but it will be hard. The first sentence indicates either you are truly ignorant, you are a WM doc, or both. It's so far out of the realm of saneness I can't even venture a response.

The reason WM is the biggest target is they are the worst offender when it comes to removing any semblence of independance from the profession of Optometry( set fees *illegal*, set hours *illegal*, set schedule*illegal*). On top of that they are a sh**ty company bent on ruling the world, but that's another story. The 70/30 fraction is a common ratio I've heard commercial ODs use to justify their dumb choice to sell their future to the highest bidder. Most 21st century private practices are probably closer to 50/50, but of course I wouldn't expect a WM doc to understand that. A private doc nowadays trying to convince a WM doc that their ways are cursed would be like what Copernicus must have felt 500 years ago lecturing the Poles that the Sun is the center of the solar system.

In fact, there is a strong conflict-of-interest issue when O.D.'s make more money from sales than treatment. Consider an M.D. that owns a pharmacy to which she refers her patients. This M.D. now has a strong financial incentive to over-prescribe her patients. I am not implying that private practice O.D.'s are unethical, I am simply pointing out that there is a conflict that cannot be ignored.
In some states, Florida for sure, MDs can own a pharmacy. How does your analogy hold up for hospital owned pharmacies? I don't necessarily disagree about the conflict of interest, but it does not solely pertain to ODs.


Most private-practice optometrists appear angry at Wal-Mart because of the retail impact, not the medical impact. The posted arguments do not allege Wal-Mart doctors provide a lesser quality of medical care, they simply argue such doctors are sleeping with the enemy. Wal-Mart is not an "enemy" to medical providers, only retailers. An M.D. or D.D.S. that leases space from Wal-Mart is not traitor to her profession. Neither is an O.D. who does the same.

TOTALLY wrong. ODs are mad at WM ODs because they make us look like discount store docs. It's demeaning. It has much more to do with our PROFESSIONAL(medical) image than our RETAIL image. If you haven't heard allegations that WM docs are performing at a lower level than private docs, let me be the first to make the allegation.

Free market dictates why Wal-Mart doctors can and will charge less. Specifically, without the risk of capital expenditures necessary to establish an office, commercially-affiliated doctors can charge lower prices while still making the same net income
.

The law also says (in most states) that WM can not dictate professional control over the Optometrist. Setting their fees (directly or indirectly) is illegal. The free market setting fees vs illegal corporate practices of an evil corporation establishing the fees on an "independant" PROFESSION are not the same thing. WM docs DO NOT SET THEIR FEES. WM establishes the fees, independant of free market pressures.

Ultimately, only after glasses sales are separated completely from the medical service will the quality of medical care dictate which doctors can charge more. I think that Wal-Mart doctors are too closely linked with glasses sales, but they are a heck of a lot better than private practice optometrists with optical sales
.

Separating materials sales from Optometrists will do nothing. NOTHING, but increase the stock price of large corporations that sell ocular goods. Overall it will not reduce price to the consumer (probably increase it if Luxotica has anything to say about it), will not result in higher number of quality goods, or make anyone a better Dr (your statement above was weird). What it will do is reduce supply (increasing demand and price) and decrease convenience (throwing our patients to the wolves by sendig them to the malls and 1800 contacts of the world).

Overall, patients are MUCH better off purchasing their eyewear and contact lenses from a PROFESSIONAL that has taken an oath to hold the patients best interest first and foremost. Instead of a corporation whose motto is f*** 'em every chance you get. The above poster brings up some interesting points, but uses faulty logic and exhibits a profound lack of broad industry knowledge. Try getting out a bit more, heh.
 
On the topic of conflict of interest. I want to make it clear that leasing from an optical is a huge conflict of interest, even more that owning your own optical.

Consider the lease. Most leases are structured so that the landlord can let you go with 30 days notice, often for no reason, depending on state laws. The main reasons commercial opticals exercise the 30 day out clause is because they aren't selling enough glasses. Add to this the fact that optical managers are imploring ODs to "sell from the chair" in an attempt to increase lens addons and sell premium products. So, what do you think happens to your precious lease if the optical isn't hitting their sales quotas? Bada Bing You're gone. So what do you do? What do you do? Lose your lease or over prescribe? What do you do..........?

In a private practice, docs have a choice. They can be unethical and prescribe unnecessarily, or they can do the right thing, like the vast majority do. They choose. A licensed, professional, oath taking, human being decides in a private practice who gets an rx and what lens options to recommend. We won't fire ourselves if the optical numbers are a bit down. Unlike corporate docs taking orders from a GED having, corporate monkey in a blue vest looking out for his bonus, salary raises, and stock options.

If you really want to get rid of the conflict of interest (and I'm betting you don't Chubbs), ODs leasing from Opticals should be outlawed, period. As it is obvious to all, the affilliation is patient and consumer unfriendly, and puts patients into a system where they are quided by professionals (albeit working in a very unprofessional environment) to purchase glasses whether they need 'em or not. Let's work together to ban these unethical affiliations wrought with conflicts of interest. WHO'S WITH ME?:p
 
1. Ideally, optometrists should be wholly independent of glasses and contact sales. Optometrists should use their training to treat eye-related conditions and complement eye-care provided by ophthalmologists. Presently, most optometrists spend their time refracting—a task a trained optician can do. We fought hard for the right to provide medical care, let’s provide it. Get on medical insurance panels, take Medicare, and provide G-treatment. Over time, I am sure the public can be convinced an optometrist is a better medical alternative than a general practice M.D. or a second-year ER resident, both of whom receive limited training on the eye.

2. Private-practice optometrists hurt public perception more than optometrist affiliated with commercial retailers. (I can only assume that Wal-Mart is more hated than Eye-Masters or Pearle Vision because of Wal-Mart’s greater presence.) Nobody can argue that most private-practice optometrists make the bulk of their income from glasses and contact sales. A 70/30 split in favor of such sales is not an unreasonable figure. Because of this, many private-practice optometrists are primarily retailers and only secondarily medical providers. Resultantly, the glasses become the shopped for item, and the medical care becomes irrelevant.

In fact, there is a strong conflict-of-interest issue when O.D.’s make more money from sales than treatment. Consider an M.D. that owns a pharmacy to which she refers her patients. This M.D. now has a strong financial incentive to over-prescribe her patients. I am not implying that private practice O.D.’s are unethical, I am simply pointing out that there is a conflict that cannot be ignored.

Most private-practice optometrists appear angry at Wal-Mart because of the retail impact, not the medical impact. The posted arguments do not allege Wal-Mart doctors provide a lesser quality of medical care, they simply argue such doctors are sleeping with the enemy. Wal-Mart is not an “enemy” to medical providers, only retailers. An M.D. or D.D.S. that leases space from Wal-Mart is not traitor to her profession. Neither is an O.D. who does the same.

3. Free market dictates why Wal-Mart doctors can and will charge less. Specifically, without the risk of capital expenditures necessary to establish an office, commercially-affiliated doctors can charge lower prices while still making the same net income.

Ultimately, only after glasses sales are separated completely from the medical service will the quality of medical care dictate which doctors can charge more. I think that Wal-Mart doctors are too closely linked with glasses sales, but they are a heck of a lot better than private practice optometrists with optical sales.

I would still consider myself a recent grad, and I have filled in at walmart at times.

Wow, I can understand your thinking, but would disagree with you on almost all of your points. Are you a practicing optometrist? Optician? In school?

1. Optometry's strength is in providing most of what patients need related to eyecare. The desire to reduce refraction to a delegated task is fraught with danger, and the implication that it is less important because it involves optical sales is just misguided.

2. There are a lot of optometrists that are more optical in nature, but thats fine. I have a hard time ever believing the local private OD is doing more harm than a commercial guy openly advertising ridiculously low exam fees. Think of the public perception of just one walmart in comparision to 10 private offices. Which has more of an impact?

I don't believe there is any more conflict of interest than an ophthalmologist seeing a patient, diagnosing cataracts, and then "selling" the patient on surgical removal, or up-selling the patient on an advanced IOL design. Or any surgeon profiting from their own recommendations for surgery. No conflict there. No conflict with providing a specialized medical device to patients. And, I am led to believe more and more each day that I am saving patients from the vultures out there that only care about profit from sales and have little to no professionalism.

There are plenty of reasons walmart sucks for ODs. I personally see it as a mistake to work in such an arena try to build a medical practice. It makes no sense. The only positive is patient flow. You will never be able to charge what your services are worth, and only drag down reimbursement for others in the community. The liability risk of seeing those "medical" patients is not worth the vastly reduced fees you are "forced" to provide. Its a loss for patient care, a loss for the surrounding docs, and most importantly a loss for the walmart doc.

Walmart promoting medical is purely an attempt to keep recent medically-minded, non-entrepreneurial-minded, shortsighted recent grads interested in running their refraction mills.

It unfortunate there seems to be a feeling amongst students that optical services are beneath them. When you graduate, this will be where the vast majority of your experience and time is exerted. Most ODs will always earn the majority of their income from optical sales and exams related to nonmedical issues (ie, refractive). THERE IS NOTHING WRONG WITH THIS. Sure, there will be those working in specialized settings, but the majority of ODs work in private practice in a primary setting. I think its a mistake that somehow this is less important than diagnosing a red eye or detecting a cataract. Our value to the public is still in good Vision, which requires optics and health.

I'll go even further, I think those that do open a private practice and neglect the optical side really do a disservice to themselves and their patients. Its bad from a business standpoint as well. Open a practice and only care about the medical aspects and patients will want to leave and buy the crap that walmart (or whoever) sells. If you really believe what you provide is the same as walmart, you need to spend some more time relearning your optics.

I hope to not be spiteful, but I seriously wonder what types of garbage is being dispensed in these schools of optometry.
 
Copernicus came with facts, and was refuted with dogmatic assertions and uninformed biases. I am not always right, and I will concede a point if proven otherwise. But simply asserting hyperbole as fact will not convince me.

Even you conceded that, at best, a private practice optometrist is as much a retailer as she is a medical professional. At no point are glasses sales ever simply just an accoutrement to medical services. Such sales are a substantial, if not primary, revue stream. No other medical profession is similar. Even if, in Florida, MD’s are permitted to own pharmacies, I highly doubt that Florida MD’s generate 50% or more of their revenue from drug sales. When viewed as a whole, they are doctors first and apothecaries second. If you can convince me that private-practice optometrists make more than 70% of their income from medical services, then you will have a point. Until then, I think you and I can stipulate that private-practice OD’s are substantially retail focused.

As long as people perceive that OD’s are retailers--and not medical providers--people will always think of OD’s as salesmen and not doctors. Many patients wrongly believe that Wal-Mart OD’s get a cut from the glasses sales. This misperception is a function of private practice retailers. Even you agree that the ideal optometrist would primarily sell medical services as opposed to medical devices. Such a transition may be difficult, but Wal-Mart doctors are closer to this ideal than most private-practice OD’s.

You argument that patient care benefits from optometrists selling glasses is unsupported. Professions always evolve, and historical duration is not justification for disparaging change. Do optometrists cut lenses better? The quality of the glasses is a function of the retail establishment. Wal-Mart may be a lesser-quality retail establishment, but private practice does not necessarily equate to better care. Let the market decide. If Wal-Mart glasses are poor quality, then people will not buy them. Again, your dispute with Wal-Mart is founded in retail concerns, not medical concerns.

You prove my point that in that private practice OD’s attack Wal-Mart doctors because they are “sleeping with the enemy” and not providing poor medical care. MD’s leasing space in Wal-Mart, by your analysis, cheapen the medical profession. Moreover, this MD, because of his affiliation with Wal-Mart, must be a lesser quality doctor, by your analysis. Medical care is about providing services to people who need them. If Wal-Mart is where the people are, then medical services should follow. Wal-Mart doctors should be judged individually by the services they provide—not by where they are located. Moreover, if it makes more economic sense for OD’s to partner with Wal-Mart, then why shouldn’t they.

Wal-Mart has every right to negotiate with doctors to get the most favorable lease terms. If one doctor is willing to pay more rent than another and be open for longer than another, why should Wal-Mart not have the right to pick the most symbiotic doctor. If Wal-Mart pushes too hard, then doctors will not sign on. Adam Smith’s invisible hand will prevail. I agree that, in some cases, Wal-Mart may get too involved in managing the OD’s practice. However, if they just asked for competitive bids (simply sent out blank leases to doctors who would wholly set the terms), I think the net result would be the same. The problem is in the process, and not the outcome. In other words, Wal-Mart may not be following the letter of the law (which is unacceptable), but this malfeasance does not change the economic fundamentals: If there is market saturation, eye-exam prices will go down. Wal-Mart does not change this. Wal-Mart only changes the retail dynamic.

People are always resistant to change. From the immigration of the Irish, to the globalization of industry, those who are less suited for the change shout that the change is unfair. Indeed, less-qualified ophthalmologists raised bloody hell when optometrists began providing medical treatment. We fought hard to be medical providers. I think that Wal-Mart doctors are still too close to the retail side. However, they are further away from retail than private practice optometrists.

Wal-Mart will not be around forever. Already, market forces are stagnating Wal-Mart sales, Wal-Mart’s stock has not gained, while Target’s stock has. Change happens, get used to it.
 
Copernicus came with facts, and was refuted with dogmatic assertions and uninformed biases. I am not always right, and I will concede a point if proven otherwise. But simply asserting hyperbole as fact will not convince me.

Even you conceded that, at best, a private practice optometrist is as much a retailer as she is a medical professional. At no point are glasses sales ever simply just an accoutrement to medical services. Such sales are a substantial, if not primary, revue stream. No other medical profession is similar. Even if, in Florida, MD’s are permitted to own pharmacies, I highly doubt that Florida MD’s generate 50% or more of their revenue from drug sales. When viewed as a whole, they are doctors first and apothecaries second. If you can convince me that private-practice optometrists make more than 70% of their income from medical services, then you will have a point. Until then, I think you and I can stipulate that private-practice OD’s are substantially retail focused.

As long as people perceive that OD’s are retailers--and not medical providers--people will always think of OD’s as salesmen and not doctors. Many patients wrongly believe that Wal-Mart OD’s get a cut from the glasses sales. This misperception is a function of private practice retailers. Even you agree that the ideal optometrist would primarily sell medical services as opposed to medical devices. Such a transition may be difficult, but Wal-Mart doctors are closer to this ideal than most private-practice OD’s.

You argument that patient care benefits from optometrists selling glasses is unsupported. Professions always evolve, and historical duration is not justification for disparaging change. Do optometrists cut lenses better? The quality of the glasses is a function of the retail establishment. Wal-Mart may be a lesser-quality retail establishment, but private practice does not necessarily equate to better care. Let the market decide. If Wal-Mart glasses are poor quality, then people will not buy them. Again, your dispute with Wal-Mart is founded in retail concerns, not medical concerns.

You prove my point that in that private practice OD’s attack Wal-Mart doctors because they are “sleeping with the enemy” and not providing poor medical care. MD’s leasing space in Wal-Mart, by your analysis, cheapen the medical profession. Moreover, this MD, because of his affiliation with Wal-Mart, must be a lesser quality doctor, by your analysis. Medical care is about providing services to people who need them. If Wal-Mart is where the people are, then medical services should follow. Wal-Mart doctors should be judged individually by the services they provide—not by where they are located. Moreover, if it makes more economic sense for OD’s to partner with Wal-Mart, then why shouldn’t they.

Wal-Mart has every right to negotiate with doctors to get the most favorable lease terms. If one doctor is willing to pay more rent than another and be open for longer than another, why should Wal-Mart not have the right to pick the most symbiotic doctor. If Wal-Mart pushes too hard, then doctors will not sign on. Adam Smith’s invisible hand will prevail. I agree that, in some cases, Wal-Mart may get too involved in managing the OD’s practice. However, if they just asked for competitive bids (simply sent out blank leases to doctors who would wholly set the terms), I think the net result would be the same. The problem is in the process, and not the outcome. In other words, Wal-Mart may not be following the letter of the law (which is unacceptable), but this malfeasance does not change the economic fundamentals: If there is market saturation, eye-exam prices will go down. Wal-Mart does not change this. Wal-Mart only changes the retail dynamic.

People are always resistant to change. From the immigration of the Irish, to the globalization of industry, those who are less suited for the change shout that the change is unfair. Indeed, less-qualified ophthalmologists raised bloody hell when optometrists began providing medical treatment. We fought hard to be medical providers. I think that Wal-Mart doctors are still too close to the retail side. However, they are further away from retail than private practice optometrists.

Wal-Mart will not be around forever. Already, market forces are stagnating Wal-Mart sales, Wal-Mart’s stock has not gained, while Target’s stock has. Change happens, get used to it.

I'm not sure who you are responding to. But here's a few more points.

Have you ever seen a prescription from walmart? One of the worst parts about working there is that 99% of people end up buying glasses at walmart. The quality sucks, ask anyone who works in the industry. Sure, there may be some premium products, but the quality of the lab people making the final product is suspect at best. I've seen crazy stuff passed off as finished. When I was there, I'd say at least 75-95% of the remakes were from wrong PD measurements, poorly fitting PALs, or just plain incompetence in the manufacture of the lenses. In a private practice, if something is wrong you change labs.

Walmart is and always will be about low cost. I actually think most walmart ODs are striving for a quality presentation and service. But they do not get paid for it. They get paid for the most basic of eyecare services, bottom of the barrel. Not everyone wants this, luckily. I think there is a danger in giving this stuff away.

I don't think private ODs are perfect, or even great in a lot of cases. But on an individual basis, private ODs tend to be much better off from a financial and mental standpoint. There is a huge difference in being a "fake" employee and owning your own business. Its hard to really compare the two.

I mentioned entrepreneurial spirit because I think that is a factor. There are a lot of unknown variables. But walmart overplays how difficult it is to new grads and how difficult the market is. Truth is, despite the oversupply, I believe a good number of ODs could cold start and be successful provided you had a sound business plan and found a good location. But walmart is sooo much easier in so many aspects.

When I worked at walmart I had patients coming in all the time with Diabetes. I could only charge $39, but a comp consult reimbursement is in the $170s. Why would you knowingly work and openly try to convince other docs and students this is a good thing for all of us?
 
Who sold you guys on the fact that this is purely a medical profession? We are doctors of optometry. What does that mean?

My point is that I think its a disservice to students and prospective students to somehow suggest that magically in a few years we will all be spending the majority of our time as ODs treating medical patients. Its even more absurd to think that ODs will be better off when walmart decides to get us all on the medical/medicare bandwagon in that neck of the woods.

If walmart does succeed in this, I can see the headlines now at the AMA meetings, "spawned by the acceptance of medical care in walmart by patients and optometrists, walmart now looks to add surgical suites to all super centers" You think they hate us now???

My opinion. Keep walmarts, lux stores, etc as refractive as possible. I was never comfortable diagnosing glaucoma in a walmart, because we did not maintain standard of care. If we did, we couldn't bill their medical. If they did not have medical, patients wouldn't pay out of pocket and wouldn't have the procedures done. Or the services were priced so low that cash paying patients could afford it, but there is a much higher percentage of patients visiting walmart that wouldn't pay $2 for a VF or $0.50 for pachymetry. I've seen lots of commercial guys go out on their own and buy digital cameras, pachymeters, etc and then not really be able to charge much at all for their use.

That does nothing but harm to our profession. So, not only are we not getting paid, not getting respected, etc. etc. we are also facing increased liability in those situations. It all added up to not being worth it in my opinion.

I don't think its worth it to try to be a great doctor (adequate, thorough, yes) in walmart and change patient's opinions of me (and optometry in general) one patient at a time, when everything else in the industry tells them otherwise.. It could be done, but why in the *ell not do it in your own office that you can benefit from and have some type of job security and have something to be proud of? Otherwise, all that sweat and hard work you put in to it is really only making more money for Arkansas, imo.

Its not about qualifications, or about market economics to me. Its not about whos a better professional, or whats more ethical necessarily. I just thinks its extremely stupid and silly to waste a good license on efforts that do not primarily benefit me.
 
Lets talk about this some more:

Ethics about dispensing. I personally believe its a mistake to somehow feel commercial ODs are more ethical because they do not profit from materials. I believed this at one point, but no longer hold this belief.

We'd all agree its not ethical to up-sell patients into products that do not benefit them. How about products that cost more and provide inferior results, IE luxottica stores selling almost exclusively polycarb. Or those places that use an outdated PAL because patients believe "all progressives are the same."

The point here is about control. The truth is, despite our move away from optics and its theory, I still believe optometrists are 10x better suited to understand the intricacies of good optical care. I think the fact that youner ODs feel less comfortable around optics is partly due to the extremely vast amount of knowledge required to know everything. But believe me, you guys still know and understand way more than the average worker at walmart or lux. Most of them are hired just because they can sell.

Private opticians know better, or should. Private ODs should as well. My point of all of this is to highlight the importance of the finished product in what we do. There is a difference in the quality of frames at walmart in comparision to the vast majority of OD/optician's offices. There are also differences in frame warranties, coatings, etc. There really are. Do you really want your patients to end up with junk? Or perhaps the quality is ok but they paid 3x what they should have?

I think its easier to believe that patients just want the cheapest than it is to take it upon yourself to truly fill all the needs of your patient, from opening history form to the finished optical product. There could be an argument that patients really can't tell a difference in some cases, but I think its much more likely that they have never really seen the other side and what benefits those other products offer.

Education is a key role in all of this, but by default walmart ODs are saying the only thing that matters is the little numbers I write on this piece of paper and I'm done, anything will work. Despite what some may believe, this isn't some ethical, utopian optometry nirvana that will make us all appear more like health professionals.

Rather, its a poor replacement for the quality in eye care that patients deserve and ultimately results in the professional being taken out of both the technical and financial loop. We are all worse off for it. The only winners are in Arkansas.
 
Copernicus came with facts, and was refuted with dogmatic assertions and uninformed biases. I am not always right, and I will concede a point if proven otherwise. But simply asserting hyperbole as fact will not convince me.

Even you conceded that, at best, a private practice optometrist is as much a retailer as she is a medical professional. At no point are glasses sales ever simply just an accoutrement to medical services. Such sales are a substantial, if not primary, revue stream. No other medical profession is similar. Even if, in Florida, MD’s are permitted to own pharmacies, I highly doubt that Florida MD’s generate 50% or more of their revenue from drug sales. When viewed as a whole, they are doctors first and apothecaries second. If you can convince me that private-practice optometrists make more than 70% of their income from medical services, then you will have a point. Until then, I think you and I can stipulate that private-practice OD’s are substantially retail focused.

As long as people perceive that OD’s are retailers--and not medical providers--people will always think of OD’s as salesmen and not doctors. Many patients wrongly believe that Wal-Mart OD’s get a cut from the glasses sales. This misperception is a function of private practice retailers. Even you agree that the ideal optometrist would primarily sell medical services as opposed to medical devices. Such a transition may be difficult, but Wal-Mart doctors are closer to this ideal than most private-practice OD’s.

You argument that patient care benefits from optometrists selling glasses is unsupported. Professions always evolve, and historical duration is not justification for disparaging change. Do optometrists cut lenses better? The quality of the glasses is a function of the retail establishment. Wal-Mart may be a lesser-quality retail establishment, but private practice does not necessarily equate to better care. Let the market decide. If Wal-Mart glasses are poor quality, then people will not buy them. Again, your dispute with Wal-Mart is founded in retail concerns, not medical concerns.

You prove my point that in that private practice OD’s attack Wal-Mart doctors because they are “sleeping with the enemy” and not providing poor medical care. MD’s leasing space in Wal-Mart, by your analysis, cheapen the medical profession. Moreover, this MD, because of his affiliation with Wal-Mart, must be a lesser quality doctor, by your analysis. Medical care is about providing services to people who need them. If Wal-Mart is where the people are, then medical services should follow. Wal-Mart doctors should be judged individually by the services they provide—not by where they are located. Moreover, if it makes more economic sense for OD’s to partner with Wal-Mart, then why shouldn’t they.

Wal-Mart has every right to negotiate with doctors to get the most favorable lease terms. If one doctor is willing to pay more rent than another and be open for longer than another, why should Wal-Mart not have the right to pick the most symbiotic doctor. If Wal-Mart pushes too hard, then doctors will not sign on. Adam Smith’s invisible hand will prevail. I agree that, in some cases, Wal-Mart may get too involved in managing the OD’s practice. However, if they just asked for competitive bids (simply sent out blank leases to doctors who would wholly set the terms), I think the net result would be the same. The problem is in the process, and not the outcome. In other words, Wal-Mart may not be following the letter of the law (which is unacceptable), but this malfeasance does not change the economic fundamentals: If there is market saturation, eye-exam prices will go down. Wal-Mart does not change this. Wal-Mart only changes the retail dynamic.

People are always resistant to change. From the immigration of the Irish, to the globalization of industry, those who are less suited for the change shout that the change is unfair. Indeed, less-qualified ophthalmologists raised bloody hell when optometrists began providing medical treatment. We fought hard to be medical providers. I think that Wal-Mart doctors are still too close to the retail side. However, they are further away from retail than private practice optometrists.

Wal-Mart will not be around forever. Already, market forces are stagnating Wal-Mart sales, Wal-Mart’s stock has not gained, while Target’s stock has. Change happens, get used to it.

If you really think that there is no conflict of interest in selling materials for WM docs, I challenge every WM doc out there to cut the number of spectacle prescriptions written in half for a two month period. Then let's get together and see how many of you still have a lease. It is implied, in a very obvious manner, that a WM docs job security is tied to the profittability of the optical. Now I don't necessarily have a problem with that, but don't give me a song-and-dance routine about how ethical it is to NOT sell optical materials. Smoke and mirrors, and these aren't the droids you're looking for etc, etc.

As far as WM having every right to negotiate the most favorable lease terms, according to most state laws that is simply not true. The laws were written to protect the public from unscrupulous corporations that may strong arm licensed health care professionals to perform unethically. I'm not saying some private practice docs don't behave poorly, but compared to the way WM and most other large opticals behave, we're a bunch of choir boys.

You may consider much of what I say hyperbole and anecdotal...maybe, but take a look at your own statements and show me the unadulterated facts.

The fact that all large optical corporations are involved with illegal and unethical activity, as well as manipulate the judgement of independant licensed health care professionals for their own financial game is a matter of fact. And it pisses me off.
 
I would like to add something else. I would have a lot less problem with this if commercial docs were actually employed by the opticals, like they are in some states. This is the way it should be, because as most of us know this is the reality of the situation. In this situation, it should be illegal to use the designation "Independant Doctor of Optometry". A true independant doctor would have full control of the experience, from appointment to optical goods dispensed, to responsibility and liability for the entire process. The fact that commercial docs shun a significant portion of their responsibilites is negligent in my opinion.

That way the public would have a clear choice....go to the employee at WM, or see the true independant optometrist down the road. No more delusional commercial docs, no more law breaking opticals, better educated patients. Make it a clear delineation.
 
Around here we are a tad more politically correct...I prefer to be know as an Appalachian American:)

3) Location-not full of cheap ass redneck demographic that worships WM (I can get away with this, I'm a redneck;) )
 
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