Why Optometry instead of medicine?

[Tippytoe]

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Everyone knows that $45 is what insurance usually pays.

Not true at all. Medicare pays around $130. Tricare pays us about $125. VSP pays $65. Blue Cross/ Blue Shiled pays around $180 (some individual plans- unfortuately there are about 100 different BCBS plans we have to keep up with). United health care pays about $35.

So tells us what else you know.

What is true is that all these reimbursents are going down, down, down.......quickly. So $45 (or less) is what I predict all will be paying in 2020. Why would they pay more when ODs will certainly take less (in order to survive based on OD surplus)? Insurance companies certainly aren't going to pay us more out of the goodness of their hearts. Again, it's supply and demand.

As a matter of fact, I believe an insurance company could send out a plan paying $15 for an eye exam and they would get 50% of ODs sign up for it within 24 hours (just for the hope of having a 'body' in the office). That's how dog-eat-dog (and progressively pathetic) the profession is.

 

[q1we3]

Not true at all. Medicare pays around $130. Tricare pays us about $125. VSP pays $65. Blue Cross/ Blue Shiled pays around $180 (some individual plans- unfortuately there are about 100 different BCBS plans we have to keep up with). United health care pays about $35.

Thanks, that's better than I thought!

 

[Shnurek]

Its not that great getting paid $35 or something like that to examine somebodies eyes and rule out all possible pathology. If you miss one little thing its not fun to be getting served court papers months later. Like I mentioned before, misdiagnosis is the #1 way ODs get sued. I'm sure practicing ODs can back me up on this.

 

[Jason K]

Its not that great getting paid $35 or something like that to examine somebodies eyes and rule out all possible pathology. If you miss one little thing its not fun to be getting served court papers months later. Like I mentioned before, misdiagnosis is the #1 way ODs get sued. I'm sure practicing ODs can back me up on this.

If you don't like being underpaid for seeing a high volume of patients, you're entering the wrong profession. The $35 garbage can is what future ODs will be digging in because that's all that needs to be offered by insurance companies to get us to see patients. Don't worry that it will actually cost YOU about $40-50 dollars to see that patient (assuming you actually get reimbursed by the slimy insurance carrier), though, you can "make it up on volume."

 

[Tippytoe]

If you don't like being underpaid for seeing a high volume of patients, you're entering the wrong profession. The $35 garbage can is what future ODs will be digging in because that's all that needs to be offered by insurance companies to get us to see patients. Don't worry that it will actually cost YOU about $40-50 dollars to see that patient (assuming you actually get reimbursed by the slimy insurance carrier), though, you can "make it up on volume."

Once again, this it true. I've seen my insurance reimbursement cut about 30% in the past 10 years while expenses have gone up (at least) 20%. So I'm down 50% overall.

Extrapolate this out 10 more years and I will be working for free. A year after that and I'll be paying patients to come in to see me. If competition was going down, I'd think we had a chance. But since it's 180 degrees the opposite, I still contend we are screwed completely.

Reading about the genius politicians working on a Medicare fix doesn't make me feel warm and happy. Either way it ends up, doctors (all) will be taking it in the rear because we are all too rich. And it must be noted, that usually private insurance follows whatever Medicare does.

The backbone of optometry has always been private practices. This, of course, is over. Sad because with your own practice you have autonomy and freedom. From here on out, optometrist will be simply employees that will have to ask "how high" when told to jump. Sad. Sad. I surely won't let my children go to optometry school.

 

[319671]

If you don't like being underpaid for seeing a high volume of patients, you're entering the wrong profession. The $35 garbage can is what future ODs will be digging in because that's all that needs to be offered by insurance companies to get us to see patients. Don't worry that it will actually cost YOU about $40-50 dollars to see that patient (assuming you actually get reimbursed by the slimy insurance carrier), though, you can "make it up on volume."

how do you have so much time to post at all hours of the day if you're so busy seeing pts?

 

[Jason K]

how do you have so much time to post at all hours of the day if you're so busy seeing pts?

Not sure how this is so hard to grasp. Sorry if I think and type faster than you. Also, as I've stated before, Chuck often does my posts for me. He knows my thoughts.

 

[319671]

Not sure how this is so hard to grasp. Sorry if I think and type faster than you. Also, as I've stated before, Chuck often does my posts for me. He knows my thoughts.

Guess you have to bring a laptop/smartphone with you into the exam room....no wonder you have few pts

 

[Jason K]

Guess you have to bring a laptop/smartphone with you into the exam room....no wonder you have few pts

Right, have you forgotten that KHE posted just as much as I do on this thing? I suppose he brought a laptop into his exam room. You seem to forget that most ODs have a deficiency of patients due to the fact there are far too many of us given the population of eye care-seeking individuals. It leaves plenty of time for posting. You should be spending your time learning about the profession you're so confident in, not trying to poke holes in some online poster who knows a lot more than you do about the way things are. Go right ahead, though, keep trying. Maybe one of these days you'll come up with something.

 

[319671]

**Mommy Mommy, he did it so I can do it too**

 

[Jason K]

**Mommy Mommy, he did it so I can do it too**

Emily, you need to work on your burns. That was seriously lame.

 

[Tippytoe]

I'll post a reply on why some ODs have so much time to post here.

#1 is due to lack of patients.

# 2. Technology which is why we don't even need 50% of the ODs we currently have.

Let me explain further. In the old days, an OD had a receptionist, a slit lamp, a direct ophthalmoscope and a chair & stand and that was it. Total cost to open an office = about $5,000.

The receptionist (or him even) would answer the phone and schedule the pt. When the pt arrived, the OD would casually walk out to the reception area and call the pt back while chatting him/her up. He had little technology so he'd check acuity himself with/without glasses. He'd do retinoscopy and a 20 minute refraction with all the phoria, vergences, NRA/PRA and ever other possible test people made up back then to keep ODs busy.

Then he'd take a peek with the slit lamp and direct ophthalmoscope and escort the pt to his optical where he'd proceed to show her whatever glasses she wanted to by. She was a captive audience because there was no other places to buy glasses from except antother OD office or optician. From there, she was taken up to the receptionist to pay cash. THe OD sat down and read a book while waiting for the next pt to arrive.

So you see the OD pretty much did everything which makes for a hour long exam. But he was paid cash which made it worthwhile and he could easily make a good living seeing 8-10 pts per day. School loans were pretty much non-existent.

2012

Today ODs have a receptionist, 2-3 techs, 2-3 optician/frame stylists, 2-3 insurance people and an office manager (and maybe 1-2 on standby whenever the others are out playing sick, getting stoned, getting a tattoo, whatever).

And it goes like this:

1. The pt calls and says you are on their insurance list.

2. The receptionist gets their name and all other info and schedules an appt.

3. She then turns the info over to the insurance person who calls and stays on hold for 45 minutes to get the patients benefits info.

4. The insurance person calls the patient back to tell them that they have a $40 deductible.

5. The patient yells at the insurance lady and demands to speak to the manager/doctor.

6. After 2 days of back and forth with the patient and their insurance company ( you make no money for all this work so it probably cost you $20 before the pt even shows--if they show).

7. Say the pt shows and fought you down to a $20 copay (you eat the other $20 just to have a body in the chair).

8. The receptionist checks him in and the tech calls him back but has to wait until he finishes his cell phone call.

9. The tech does visual acuity, autorefracts/autokeratometry, takes history, measures glasses with the
autolensometer, take a retinal photos, and a screening visual field . All of this info is automatically zipped into the electronic medical record (making topographical mistakes almost non-existent). The tech takes pt to the exam room and refracts and does cover test and confrontation fields and may or may not dilate the pt.

10. Finally the OD comes in and peeks at the photo, maybe double check the refraction (if necessary), looks with slit lamp and BIO if necessary and makes an assessment and recommendation.

11. The pt asks for their Spectacle Rx (which the OD and OMD is supposed to by law give them without request).

12. The pt comes back 2 weeks later and complains about the glasses he got at a one-hour optical and demands a refund because he can't see and doesn't want to hear that his 'good deal' on progressive lens glasses are actually put in upside down (trained monkeys work at most commercial opticals). The optical employee explains this to him for 15 minutes (for no pay again) and sends him back to the optical wishing him good luck with the monkeys.

So you see, the OD actually does very little. The bulk of the exam is done by trained high school graduates. Actual OD time in the room is maybe 10 minutes if he goes slow and talks alot. (techs do all CLs insertion and training. OD just peeks with slit lamp for 15 seconds).

So if the OD only saw 10 pts per day, that would equal about 1 1/2 hours of actual work for which he would make less money than the old time OD seeing 10 pts and doing it all himself (due to staff cost, equipment cost and insurance).

So this, boys and girls, is why current ODs could easily see 3 times as many patients as we do today and why we have so much time to play on the internet and why income is dropping (increased staff costs, employee cost, increased taxes, equipment cost, CE costs, and insurance decreases.(And why more ODs are not needed and will struggle so much).

Good day.

 

[q1we3]

Tippy, I recommend hooking up a Xbox too and playing Grand theft auto. Take that frustration out by killing everyone in the virtual world......Anyways, how many patients are you averaging? what type of practice are you in?

 

[Tippytoe]

Tippy, I recommend hooking up a Xbox too and playing Grand theft auto. Take that frustration out by killing everyone in the virtual world......Anyways, how many patients are you averaging? what type of practice are you in?

I don't play video games. I have kids to entertain me. I own one of the few private practices left in my city.

 

[Shnurek]

7. Say the pt shows and fought you down to a $20 copay (you eat the other $20 just to have a body in the chair).

You shouldn't do this..you give positive reinforcement to a person that uses disorderly tactics. Then when they go to the next doc they'll do the same thing and the cycle continues. That is why I do not give money to panhandlers in NYC and tell all my friends not to. If they bother you...then do not reinforce their behavior.

I don't play video games. I have kids to entertain me. I own one of the few private practices left in my city.

Keyword: city - Cities are just a clusterf*ck of people that don't give a crap about each other. Can't wait to move out to country where your circadian rhythm is actually influenced by the sun, your kids have lower chances of developing myopia, the air is cleaner, the taxes are lower, the cost of living is lower... I can keep going and going. Everyone knows there is a maldistribution of doctors and schools should focus on admitting more outdoorsy people rather than the 3.8 GPA people to raise their stats.

 

[319671]

what school did you attend tippytoe? where do you practice now? how much do you make?

 

[Tippytoe]

what school did you attend tippytoe? where do you practice now? how much do you make?

Are you writing a book?

 

[Tippytoe]

You shouldn't do this..you give positive reinforcement to a person that uses disorderly tactics. Then when they go to the next doc they'll do the same thing and the cycle continues. That is why I do not give money to panhandlers in NYC and tell all my friends not to. If they bother you...then do not reinforce their behavior.

Not only do I not do this, but it is illegal. But with most ODs charging $40 for an eye exam, they really don't need to give discounts. But if I've learned nothing else in the past 15 years, it's that you can't control what other ODs do. They WILL do what's best for them no matter what that means (ie. steal your patients, stab you in the back, lie, etc......)
There is NO brotherhood in optometry (like there should be).

Unions and any organized collusion is illegal giving us absolutely no bargaining power (ie. 2 or more ODs can't get together and decide what they will charge for an eye exam) ---thus insurance companies can pay us whatever our lowest common denominator accepts.

Keyword: city - Cities are just a clusterf*ck of people that don't give a crap about each other. Can't wait to move out to country where your circadian rhythm is actually influenced by the sun, your kids have lower chances of developing myopia, the air is cleaner, the taxes are lower, the cost of living is lower... I can keep going and going. Everyone knows there is a maldistribution of doctors and schools should focus on admitting more outdoorsy people rather than the 3.8 GPA people to raise their stats.

This is a rumor. There is no need for ODs in rural areas either. There may have been 40 years ago but there is an OD now in every small town and incorporated area in the country except for a few border towns (I hear).

The fantasy of being able to succeed better in a rural area is just that......a fantasy. Well, there may be 1 or 2 places left in the US that could use an OD. I just don't know where that would be.

P.S. I gladly give money to any panhandler that will lick my Lexus tires clean with their tounge. I figure if I have to work for my money, so can they. Is that wrong? Turns out their "will work for food" signs are not true. I always wonder why they think cleaning my tires is not worth having food to eat. Ha, ha, ha.

 

[319671]

tippytoe, I figured because you referr to your experience and your background so much, you'd actually like to share it.

 

[Tippytoe]

tippytoe, I figured because you referr to your experience and your background so much, you'd actually like to share it.

No, not particularly. Can't see where it's relevant to the discussion. But for the record I am an above average OD (hey, what else am I supposed to say) in an average city (pop ~ 200,000) with a mix of patients and a high tech, well-equiped private free-standing office building with all the latest eye toys.

I've filled in at commercial, OMD, optical locations and a VA hospital on occasion early in my career.

 

[acetabulum7]

U.S. POPULATION PROJECTIONS
[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular][FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]2010 US population ~310,233,000 *..

[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular][FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]2020 US population ~ 341,387,000*.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]2030.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]373,504,000.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]32%.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]2040.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]405,655,000. [FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]44%.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]2050.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]439,010,000.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]55%.0.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]10%.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]2020.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]341,387,000.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]21%.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]2030.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]373,504,000.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]32%.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]2040.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]405,655,000. [FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]44%.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]2050.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]439,010,000.[FONT=Arial,Helvetica,Geneva,Swiss,SunSans-Regular]55%.
Source: U.S. Census Bureau

The old rule of thumb for optometrist-to-population ratio varies from 1:5,000 to 1:8,000 in urban area to 1:25,000 to 1:40,000 in rural areas. Source: Business Aspect of Optometry, John Classe. 1997

As we can see, based on the projected numbers, there will be roughly 1 OD for every 7,000 patients in the US (IF EVERY SINGLE PERSON GOT AN EYE EXAM). But as I said, this ratio is greatly outdated because it doesn't account for the fact that ODs are much more efficient (thanks to advanced instrumentation and lowering reimbursements) And it doesn't take into account ophthalmologist population. So it's more accurate to simply count ECP (eye care providers) per area and divide by local population.

My area has gone from 30 ODs in 1998 to 50 in 2011. Population has gone from 290,000 to 310 ,000 during this time. We have 20 Ophthalmologists.

Oh yea, for the record (and from the same book I highly recommend), average income for a new grad in 1994 was $47,300. Average school debt was $40,00-$60,000. So it was basically one years salary to pay off your debt.

Nowadays the avg new income is about $75,000 and school debt is $200,000.......so it's 2.5 times as much now. And again, this is still in the 'good ole days'. None of this takes into account 500 additional OD gradutates each year. Which means 10 new additional ODs per state, per year......for ever?? In 5 years, each state will have (at least) 50 additional ODs than they have now (that is plus the roughly 1,100 or 22 per state that currently graduate each year). So now each state will have to absorb 77 newly minted optometrists per every single year! There is, on average, 800 ODs per state currently. So 77 + 77 + 77 + 77 +77 +77 + 77.......see where it's all going. And ODs typically work until they are 95 years old and propped up beside the phoropter with a cane.

Where will they all go? THAT is the question. There simply isn't enough Walmarts currently. But maybe they are planning on building 10 news one in each state every year. That's a possiblity.😛

Your math in the bolded part is wrong.

22 new per state per year + 10 new per state per year = 32 new per state per year. NOT 77. You got 77 by adding 50 after FIVE years plus the 22 current per state per year.

 

[Tippytoe]

Your math in the bolded part is wrong.

22 new per state per year + 10 new per state per year = 32 new per state per year. NOT 77. You got 77 by adding 50 after FIVE years plus the 22 current per state per year.

True that. Let's say 32 new per state in year one and 77 per state in year 10 as each class size goes from 50 to 150 (don't doubt that).

But lets see how you feel with just 5 of those 32 wanting to come to practice beside you in your little town/city in a few years. Then 7 come to your town the next year. Then more the next year..... See the problem.

 

[cjensen20]

If we all had the stats to get into med school, why would you choose opt over med?

back to the original post...

in my opinion I would still choose Optometry over Medicine because:

• Medicine is a failing practice in the US (taking big hits from insurance companies and government regulations and the like) - the 'golden age' of medicine has passed.
• Optometrists have far less education commitment than do medical physicians. (after OD school...we are essentially done. whereas our counterparts in medicine must complete med school, internship, residency, possibly fellowship, and other specialty training)
• I never have wanted to perform surgery. Optometry provides that 'luxury' to me.
• Imo, I think that optometry is more business based than medicine. Its much easier to have your own private practice than many fields in medicine. I fully intend to have my own practice, so I am not dependent on an employer, but rather self-dependent.
• people typically like going to the eye doctor....as opposed to say their dentist, gastrointerologist, urologist, ER doctor, gynecologist, etc etc.. - there is typically a positive feeling regarding going to an eye doctor
• I'm not going to be on call. In my own opinion, there aren't "emergencies" in optometry that can't be and shouldn't be expedited to an OMD, or that can't wait until the next day in the office. ex "my glasses broke and I need them fixed..." or "I am suddenly blind at 3am, what do I do?"
• I can have a flexible schedule. I don't foresee myself working until all hours of the night everyday (even though I will have my own practice)
• because of the typical work hours, I intend to have regular quality family time.
• because optometry is a relatively new profession, it can be more easily shaped and redefined for the good (if need be)
• etc. etc..

the unfortunate parts of optometry to me are far less than the benefits

some of the cons I can think of off the top of my head are:

• high cost of education for the amount of income I expect to earn
• corporate "big box" conglomerations that don't value us as much as they should
• a three-way 'battle' between OMDs, ODs and opticians. OMDs should specialize in the surgical treatment of the eye and ODs should specialize in the medical treatment of the eye. Opticians should continue to work dispensing optical devices. Unfortunately there is a power struggle between OMDs and ODs and opticians are wanting to get in on the action too.
• I accept the fact that there may be a slight oversupply...that brings steep competition (I just wish the ones that are 👎 would go out of business already)

 

[Jason K]

• Medicine is a failing practice in the US (taking big hits from insurance companies and government regulations and the like) - the 'golden age' of medicine has passed.

• 
  
  Optometry is failing at a much greater pace and you'll start and finish with a much lower earning potential. Rest assured, medicine is struggling, but optometry is in a whole other world of difficulty compared to medicine. We bill for the same services and get paid less for what we do since we're ODs instead of MDs. The golden age of medicine and optometry may be over, but the future is more solid than for optometry.
  
  

  [*]Optometrists have far less education commitment than do medical physicians. (after OD school...we are essentially done. whereas our counterparts in medicine must complete med school, internship, residency, possibly fellowship, and other specialty training)

  
  Fair comparison, but you get what you pay for when it comes to the time requirements in this situation. The extra years you'll put into an MD/DO career will pay for themselves in both career options and earning potential afterwards. If you think an OD is a cakewalk, you're in for a surprise. I'd much rather put in an extra 3 years as an internal medicine resident to come out and have a future in something other than a Walmart, but that's just me.
  
  

  [*]Imo, I think that optometry is more business based than medicine. Its much easier to have your own private practice than many fields in medicine. I fully intend to have my own practice, so I am not dependent on an employer, but rather self-dependent.

  
  If you're referring to the retail component of optometry that medicine doesn't have, it's not going to last long. Optometry is converting over to the medical model because our ability to pay the bills by selling retail goods is vanishing before our eyes with online retailers and Sam's Club selling contacts for 38 cents a box. Medicine and optometry are both very business-based professions.
  
  
  

  [*]people typically like going to the eye doctor....as opposed to say their dentist, gastrointerologist, urologist, ER doctor, gynecologist, etc etc.. - there is typically a positive feeling regarding going to an eye doctor.

  
  This wears thin after about 3 months of seeing patients. I have a friend who is an orthodontist. His patients love to see him and he makes about 4x the average OD while doing a lot less work.
  
  

  [*]I'm not going to be on call. In my own opinion, there aren't "emergencies" in optometry that can't be and shouldn't be expedited to an OMD, or that can't wait until the next day in the office. ex "my glasses broke and I need them fixed..." or "I am suddenly blind at 3am, what do I do?"

  
  This may be your opinion, but it's not correct. If you wish to work in a private practice environment, whether yours or someone else's, you're going to have emergencies that will require you to come into the office. No, you're not going to be dealing with traumatic evulsions and penetrating traumas, but you'll have to take call unless you work in a retail environment.
  
  

  [*]I can have a flexible schedule. I don't foresee myself working until all hours of the night everyday (even though I will have my own practice)

  
  As an OD, especially right out of school, your schedule will depend on the place who's kind enough to hire you. You'll likely be working late at least twice per week and you'll be virtually guaranteed to work weekends. This is optometry - we're all having to meet the Sam's Clubs and the Costcos that are open Sat and Sun and have evening hours. Not so before, but true now. You may think you'll get out of school, grab the optometric world by the sack, and twist, but you're going to realize quickly that things are not as they seem.
  
  

  [*]because of the typical work hours, I intend to have regular quality family time.

  
  Ahhh, family time. I'd like to show this one to the friends I have who work 6 days per week so they can make their student loan payments. When you don't get paid enough to justify your degree, you have to make up the difference somehow. That 6th day helps. I wouldn't count on having a lot of extra family time.
  
  

  [*]because optometry is a relatively new profession, it can be more easily shaped and redefined for the good (if need be)

  
  Ok, now I'm starting to think this post was made to get a reaction from the ODs on here. Optometry is absolutely the last profession that can be easily shaped for the good. The "elite" at the AOA are, intentionally or otherwise, making sure that optometry's future lies solely in commercial and retail. If you think optometry can be easily shaped for the better, you're in for a surprise. It can be easily shaped, but make no mistake, the shape that's coming is in the form of a long, brown, log.
  
  
  

  the unfortunate parts of optometry to me are far less than the benefits

  
  That's only because you have yet to see what optometry actually is. You'll be there soon with the rest of us. Sorry, but you're in for the long haul now.
  
  
  

  some of the cons I can think of off the top of my head are:
  
  [*]I accept the fact that there may be a slight oversupply...that brings steep competition (I just wish the ones that are 👎 would go out of business already)

A slight oversupply? The oversupply problem is hardly slight. That's like saying that Hurricane Katrina left some slight damage in New Orleans. It's massive - not slight, and it's contributing to the downfall of the profession.

And when those 👎 practices go out of business, it will be the final nail in the coffin for private practice optometry, just like private pharmacies died after commercial pharmacy took over the profession. If you want to see the future of optometry, look to your nearest Walgreens for CVS pharmacy counters. That's where we're headed.

 

[cjensen20]

Jason K

let me get this straight?

you are going to criticize me on MY opinions?
wow. cheap shot their buddy.

oh well... thank heavens for the >>Ignore<< option

I should have done this a long time ago.
every time I see you dumb avatar I already know what garbage will follow.
Its the same message every time...the same melody to the same sad sad song.
never is it beneficial to read, it just makes me want to kill myself.

If you hate your career so much, why don't you find a new one? the rest of us could get along quite well without you.
if you hate your life so much, why don't you do something to make it better? why not go find religion or something?

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

>>IGNORE<<

ahh much better. Thanks SDN!

 

[Jason K]

Jason K

let me get this straight?

you are going to criticize me on MY opinions?
wow. cheap shot their buddy.

Cheap shot? Your opinions are based on fantasy. I wish someone had corrected me when I made a decision to pursue and OD based on many of the same assumptions. If you want to keep livin' the dream, just talk to some pre-optometry students. I'm sure they'll tell you what you want to hear.

oh well... thank heavens for the >>Ignore<< option

Yes, the head in the sand approach has been shown to be very effective across human history.

If you hate your career so much, why don't you find a new one? the rest of us could get along quite well without you.

You're right, one less OD in practice is definitely something that would benefit the situation. That's why I AM leaving the profession, along with many other ODs who have made the same choice. Don't worry, though, there will be plenty of room for you when you graduate......oh wait...no there won't.

if you hate your life so much, why don't you do something to make it better? why not go find religion or something?

Who said I hate my life and who said I am not religious? God, Generation Y really likes to make a lot of assumptions. That's going to bite you all in the collective arses very soon. Actually, it already has, you just fail to realize it.

Ahhhh....and yet you hit the IGNORE button.....I'm truly crushed. Welcome to the wonderful world of optometry, my friend. I'd try to get over the "If I don't like reality, I'll just ignore it.." attitude. It'll get you into a lot of trouble when you start fighting with insurance companies, competing with the other 4000 ODs in your area, and trying to convince yourself that you love the profession you wasted 200K on.

Be happy in your ignorance

 

[cjensen20]

did someone say something? 😕

>>Shrug<<

didn't think so 😉

 

[Jason K]

did someone say something? 😕

>>Shrug<<

didn't think so 😉

That's funny.....I thought you hit the "Ignore" button. Funny how it works when you ignore someone - you don't know when they actually say something. You need to work a little better getting your ignore function to actually work.

Hypothetical conversation taking place in front of a burning house:

Neighbor: Hey dude, your house is on fire....

Homeowner: No it's not - that would be terrible, therefore, my house is not burning down...my house is just fine and will be for years to come. Stop being so negative.

Neighbor: Dude, your house is a blazing inferno and there is smoke billowing out of every
window and door....your house is on fire, my friend.

Homeowner: No, it's not - stop being so pessimistic! Why can't you just accept the fact that my house might be a little warm, but it's not on fire.

Other neighbors: No way, chief, your house is definitely on fire - that guy is right. Your house is burning down like Charlie Sheen's career, right in front of all of us.

Fire Chief: Dude, your house is a gonner. We're just gonna stand here and watch it torch 'cause we ain't gettin' near that thing. Do you mind if we use our ladder to hover over it, though, and roast some marshmellows?

Homeowner: All of you are idiots. Obviously, if my home were burning down, that would be a terrible thing and as we all know, terrible things don't happen to generation Y'ers. Therefore, my house is fine, despite what all of you say. You're just bitter and negative. My house is fine.

Fire Chief: No it's not.

Homeowner: Yes it is.

Charlie Sheen: Winning!

Smokey The Bear: Dude...it's burning, even I can see it and I'm a freakin' bear.


See...just because something is bad, doesn't mean it isn't true. All of you want optometry to be exactly as you see it; a solid prospect with a great outlook. Unfortunately, the optometry that used to be just that, no longer is. It's gone. You just fail to see it and when other, more experienced people tell you as much, you just choose to ignore it.

Your house is burning....optometry is a declining profession...same difference. You'd ignore either situation. Enjoy the results. You'll be wishing I had tried harder in a few years.

 

[q1we3]

Smokey The Bear: Dude...it's burning, even I can see it and I'm a freakin' bear.

Lmao!

 

[dylennon]

I'm a pre-opt student and I see this discussion happening all over the place. I will admit that I take all online conversations with a grain of salt. I can accept that optometry may no longer be what it once was, but with that in mind, isn't there still a place for a successful career? My goal now is to complete school, get in to a residency (ocular disease, preferably), working a few years to gain experience and ultimately working in pre and post-op care for an OMD. I think it goes without saying that these positions aren't outrageously common but I don't think this is irrational thinking.

Or maybe it is. Perhaps the practicing OD's could shed some light on this. If the 1980's version of private practice optometry is dead, ok. Where do you see the success of optometry now and in the future?

 

[Jason K]

Or maybe it is. Perhaps the practicing OD's could shed some light on this. If the 1980's version of private practice optometry is dead, ok. Where do you see the success of optometry now and in the future?

Unfortunately, there is only one possible outcome, given what's happening. Organized optometry has had plenty of chances to pull itself out of the hole that it's fallen into, but it was not proactive enough to take the measures necessary to protect itself. It's been sold out to commercial and retail entities. As a result, it will take some time, but the profession will be swallowed up by commercial, just like pharmacy. Are there a few private pharmacies out there? Sure, but not many. Almost all are retail. Optometry, with its thousands of unneeded grads, will continue to feed the commercial animal, allowing it to grow larger than it is today. The result will be that the vast majority of new OD grads will find themselves in commercial employed positions. That's not what any of them intend to do, but that's where they're going. Sad, but very true. There will always be a handful of successful landing spots out there, but when 99% of grads end up in box somewhere, it really doesn't matter if there are a few that land "good" private practice opportunities. Anyone who argues that private practice optometry is not a dying entity in the profession simply doesn't understand what's happening in the profession.

 

[Tippytoe]

I'll take it a step forward from Jason.

The OD population is set to explode. The American Optometric Association (AOA) did their own study which showed we've had an over supply of optometrists at least back since1995 and projected it to get worse.

Here's the study:
http://www.ncbi.nlm.nih.gov/pubmed/10998943
RESULTS: Workforce projections suggest an excess supply of optometrists is likely over the next 20 years. Over the next five years, approximately 550 optometrists are expected to retire each year, while more than 1,100 optometrists enter practice annually. Patient encounter volume is projected to increase steadily, but the effects of this increase are largely offset by an anticipated decrease in optometrist time requirements for routine eye examinations.

Now this study was about 17 years ago. It was based on the current number of school at the time which I think was 15 maybe. Of course now we have 5+ NEW ones open or opening soon.

We also know from speaking with many new OD grads that many of them are having to piece together part-time jobs already.

Since the study done in 1995, our technology has advanced greatly. The average OD can probably see 3 patients in the time it took him to see one back then. There is only ONE conclusion from this and it's that there is an oversupply.

IF THE AOA (WHO HAS EVERY REASON TO BE BIAS) EVEN SHOWED AN OVERSUPPLY 17 YEARS AGO AND PREDICTED IT TO GET WORSE, WHAT COULD THE OPENING OF 5 MORE OPTOMETRY SCHOOLS POSSIBLY DO EXCEPT futher decrease the workplace opportunities, making many more applicants per position which will absolutely lower income. It's simple supply and demand economics.

 

[CL Doc]

wow... optometry is a nightmare. I've read this entire thread just now and basically, I see these things:

1. practicing optometrists that have actually been in the occupation are telling it like it is.

2. in order to get in to optometry school, you must not be required to shadow an optometrist for very long. I currently have over 150 hours shadowing sub specialists of internal medicine in a certain field that may or may not tend to deal with radioactive dye and arteries. I've talked a crap ton with them, and they definitely have no qualms recommending the field to me: one of the doc's just bought a lambo, the rest already have something similar.

3. pre-optometry students/optometry students think they know way more than they do.

4. I should get down on the floor and lay prostrate every night as I thank God he gave me the desire (and ability- that 4.0 this past semester helps lol) to go to med school and not make me delusional enough to want to attend optometry school.

5. Even if all I get is family practice, 180k+ is a gift from heaven compared to being a Walmart OD.

I know a lot of MDs and not one of them has a Lambo or anything even close. I wouldn't order your exotic car until you see how much debt you are going to have.

 

[CL Doc]

I guess none of them are middle aged and interventional cardiologists then... or cardiothoracic surgeons... or orthopedic surgeons...

Sorry but when your making upwards of 450 grand/year, even after ridiculous taxes you can afford a lambo, maserati or... even a black F430 (as i saw in the physician parking space in the attached parking garage at the hospital I shadow at). Yea, they are in their 40's, but you know what? that's fine. If it's the difference between having one in my 40's and never having one... well just lol. You do realize sub-specialists and surgeons can pay off their loans pretty quickly if they so choose? And you do realize not everyone graduates from med school with the SDN-hyped "300K" in debt, right?

And that's before the ophthalmologists that I've heard of that run cataract/lasik factories in a certain city, making upwards of 2 million/year. Corner the market and dominate. Or the spine surgeons....


A hefty price is paid for that 'family time' lol.


Psychiatrist I know of personally, has a 6000 sq. ft house and 2 brand new BMW's. He's out of residency by 7 years. Sure, he had debt, but you can pay it off. The people who talk about the hell of family practice and 137k/year jobs are wanting to live right on the east coast and stuff. Thats ridiculous... I actually understand supply/demand and have no problem staying in the midwest.. and I don't even want to do FM.

Sounds like you have a real obsession with material objects.

 

[ineed2stpsmurfn]

Sounds like you have a real obsession with material objects.

...OR, I was replying to your comment that MD's somehow can't afford crap. Don't get optometry and medicine confused.

 

[KHE]

I'm a pre-opt student and I see this discussion happening all over the place. I will admit that I take all online conversations with a grain of salt. I can accept that optometry may no longer be what it once was, but with that in mind, isn't there still a place for a successful career? My goal now is to complete school, get in to a residency (ocular disease, preferably), working a few years to gain experience and ultimately working in pre and post-op care for an OMD. I think it goes without saying that these positions aren't outrageously common but I don't think this is irrational thinking.

Or maybe it is. Perhaps the practicing OD's could shed some light on this. If the 1980's version of private practice optometry is dead, ok. Where do you see the success of optometry now and in the future?

If that's your goal, the optometry degree is probably not needed. You would be better off spending much less time and money becoming a certified ophthalmic tech or something like that.

 

[blazenmadison]

If that's your goal, the optometry degree is probably not needed. You would be better off spending much less time and money becoming a certified ophthalmic tech or something like that.

A COA/COT cannot prescribe medications, cannot write eyeglass prescriptions, and certainly cannot be reimbursed by medicare/medicaid without an MD seeing the patients. They are technicians and collect data. They do not interpret it. If your goal is to collect data for an OMD, then OD school is a waste of time and money.

 

[dylennon]

If your goal is to collect data for an OMD, then OD school is a waste of time and money.

This question may have been a bit premature. I'm shadowing an office here in Phoenix in a few months that has both OMDs and ODs (Southwestern Eye Center). I'm familiar with this office because my wife has Retinitis Pigmentosa and the care provided there is done by OMDs and ODs side by side. Most of her primary care was from an OMD, but the OD did her vision field test and some other tests, as well as a low vision specialist that would poke his head in from time to time. I know of another center here in Phoenix that does this (Barnet Dulaney Perkins) and I can only figure there are more both locally and nationwide. So perhaps I was unclear, but I'm certainly not interested in just collecting paperwork. What I'm wondering is if a situation like this is what the future of optometry looks like. I think the retail chains will be always be there... and I don't necessarily see that as a drawback.

I guess the short of what I'm trying to say is if I have a clear goal to finish OD school, finish a residency in ocular disease, get a few years experience and then either work in combined OMD/OD office and/or teach at an OD school... is that a pipe dream? I would think not because those experiences exist. I read on this site a lot about OD students having the wrong perception of the field and turning a blind eye (pun intended?) to the counsel they receive. I see my goal as realistic and attainable, but am I just another daydreaming student?

 

[percyeye]

I have been reading these negative posts and half not believing what I'm hearing, asking everyone's opinion is it mostly the coasts that are so saturated with OD's because I have to say being from Iowa I haven't seen any of this. There are many private practices here along with your Wal-Marts and Targets but the vibe is many people would rather go to a private place for their eye exams and during my under-grad when I was trying to find a job in Optometry offices I was told by more than a couple places they didn't have any tech jobs open but to get back to them after I graduated from OD school because of how busy they have been. I have been in 2 offices now both private practices and the doors are over flowing with pts with 3 ODs at each practice I was at and each saw anywhere from 22-30 people a day pretty regularly. One thing I noticed was the increasing amount of diabetic patients coming through for their yearly exam (we all know this problem is only going to get worse in this country) and now most schools are making it mandatory kids get an eye exam before kindergarten just like they make a hearing test mandatory which only makes sense. But the point of this was could the Midwest be shielded from this doom and gloom a little bit because I just haven't seen it? By the way the two practices I was at, which were in two seperate towns, all of the six doctor's wives didn't work because of how well their husbands did.

 

[Shnurek]

Its not optometry. Its that some people make bad decisions with the degree, like live in a saturated area and then they come online to b*tch about it. From the research I've done on health careers, optometry is the fastest growing scope of practice wise and numbers wise (by percentage) than any other healthcare profession out there.

 

[Jason K]

Its not optometry. Its that some people make bad decisions with the degree, like live in a saturated area and then they come online to b*tch about it. From the research I've done on health careers, optometry is the fastest growing scope of practice wise and numbers wise (by percentage) than any other healthcare profession out there.

Please don't listen to this absolutely clueless 1st year optometry student. If you're interested in optometry, be ok with working in a commercial setting. I say this because by the time you get out, the profession will be even more occupied by commercial entities. That IS where the profession is going. Pie in the sky 1st year OD students like to blow sunshine up each others' back doors, but that's the reality. There will be a few good "landing spots" for grads coming out in the years to come, but the vast majority of them will end up in a commercial mill somewhere, the numbers do not allow for any other outcome. A few years ago, we had 17 schools and there was a massive oversupply. Now we have 22 and counting. The schools are there to make money for investors and highly paid administrators, not to better the profession. Don't jump into a pit of quicksand because there's some guy in there saying "Hey, it's not all that bad in here."

If you pick optometry, be ready for what is to come. Most of all, do not assume that the successful ODs you see out there have something that will be attainable for future OD grads. That ship sailed decades ago and it will never return to port. The optometry you'll be signing up for is vastly different from the one you see in successful offices of today.

 

[percyeye]

Jason K my question wasn't answered by you, which you seem to know all but possibly could some areas perhaps not be hit at it because to a lot it may not be desirable but to someone like me its called home. Have had known two people to graduate and start in private practices and buy into them out of school but again it was in South Dakota and Nebraska. Like I said before the doors are over flowing here because of the outrageous number of diabetics, and the OMDs here seem to only care about cataracts, Lasik, AMD injections, botox etc etc and everything else is sent to the ODs which leaves a lot of patients. But not to go off on a tangent going back to my original questoin maybe some areas of the country are doing well?

 

[Jason K]

Jason K my question wasn't answered by you, which you seem to know all but possibly could some areas perhaps not be hit at it because to a lot it may not be desirable but to someone like me its called home. Have had known two people to graduate and start in private practices and buy into them out of school but again it was in South Dakota and Nebraska. Like I said before the doors are over flowing here because of the outrageous number of diabetics, and the OMDs here seem to only care about cataracts, Lasik, AMD injections, botox etc etc and everything else is sent to the ODs which leaves a lot of patients. But not to go off on a tangent going back to my original questoin maybe some areas of the country are doing well?

There were some nice deck chairs on the Titanic just before the whole ship sank. Look, chief, optometry is sinking - at least the private practice side of it. What will replace it will be commercial. The ill effects of oversupply, commercial invasion, and reimbursement decline are not limited to the more heavily saturated areas, although people would like to think that they are. It may take a little longer to bury those remote locations, but the effects will get there soon enough. I'm sure there were some great private pharmacies around before that entire profession was swallowed up by commercial. And for what it's worth, you're not going to get rich off a bunch of diabetics. The AOA and BLS seem to have convinced the nation that there will be some sort of mass apocalypse rooted in the fact that we'll be getting some more diabetics in the next few years. There won't be.

As I've said before, there will be a few "good" landing spots, for now. If you think you can find one of those spots, great, but don't be disappointed if you end up as one of the tens of thousands of "extra" ODs that end up filing into the commercial machine that is devouring the profession. You guys see what you want to see and ignore the rest. That's a great approach if you want to keep your dream alive so maybe it's the best thing for you.

Lastly, don't come on here and get sassy with someone who's giving you a warning that could save you from a serious mistake. If you think you can get an OD, find some dream practice in the middle of nowhere, and somehow avoid the realities that are coming, go for it, but when you realize it was all a pipe dream that was manufactured by the AOA and the schools, don't say someone didn't warn you.

 

[Shnurek]

Is Jason K going on about how optometry is dying and its all a big pipe dream and the entire profession is sinking? He's been saying that over and over and over. I wouldn't know because he is on my ignore list 🙂

 

[dylennon]

Lastly, don't come on here and get sassy with someone who's giving you a warning that could save you from a serious mistake. If you think you can get an OD, find some dream practice in the middle of nowhere, and somehow avoid the realities that are coming, go for it, but when you realize it was all a pipe dream that was manufactured by the AOA and the schools, don't say someone didn't warn you.

I appreciate your candor, and there's no way for me to write this without it looking like I'm being a smarta** (which I'm not), but why do you post on these boards? Maybe I'm mistaken, but I thought I saw you post something about IAU grads and you were helping them prepare for the boards. Between that and all your activity on here it would seem that you are still heavily involved in the industry, which makes for a great resource. But why bother with all of that? Is it an altruistic endeavor to save people from what you see as a mistake? Is it like a Holden Caulfield thing? I hate my current job and see the particular industry as priming itself for collapse. I doubt there are any message boards for people looking to get in to what I do, but if there were I wouldn't bother with them. I'd be honest if asked, but I don't think I'd seek it out.

Again, I know this might sound like I'm baiting you, but I'm just curious. I think it actually helps break down the wall a lot of pre-opt students might have built when they see the storm clouds in your assessment.

 

[Shnurek]

The LASIK practice I work for already told me, "When you graduate we'd love to hire you." And I'm only a first year and I never even asked them first. dylennon, just go out there and talk to doctors yourself. Go shadow them, go speak with them about the positives and the negatives of the profession. Speak with young Doctors especially. Do not rely on one obsessive opinionated person on anonymous internet forums. A lot of what Jason K does have some use because he warns about taking out $200,000 in unsubsidized government loans which may prevent you from taking your degree to the fullest potential for a number of years after graduation. But that is not optometry's fault. That is the fault of the people that chose to take out such great loans and for the government for making it so simple to do so that tuition costs have risen immensely across all professional schools to take advantage of this.

 

[dylennon]

The LASIK practice I work for already told me, "When you graduate we'd love to hire you." And I'm only a first year and I never even asked them first. dylennon, just go out there and talk to doctors yourself. Go shadow them, go speak with them about the positives and the negatives of the profession. Speak with young Doctors especially. Do not rely on one obsessive opinionated person on anonymous internet forums. A lot of what Jason K does have some use because he warns about taking out $200,000 in unsubsidized government loans which may prevent you from taking your degree to the fullest potential for a number of years after graduation. But that is not optometry's fault. That is the fault of the people that chose to take out such great loans and for the government for making it so simple to do so that tuition costs have risen immensely across all professional schools to take advantage of this.

Thanks, Shnurek. I look forward to the shadowing for that reason. My friend graduated from ICO 2 years ago, worked for America's Best for 2 months and then joined a private practice and has been there since. Is he more exception than rule? Even if I shadowed 100 new docs how could you really know for sure?

As I've said before, my goal is to do a residency and work in an office with OMDs and to co-manage care. But if that doesn't happen and I work retail... why is that the end of the world for people?

 

[Jason K]

But that is not optometry's fault. That is the fault of the people that chose to take out such great loans and for the government for making it so simple to do so that tuition costs have risen immensely across all professional schools to take advantage of this.

No Shnurek, as usual, you have it all wrong. It is the fault of the government lenders who created an unlimited supply of money for borrowers. That is what drove tuition costs up, not the borrowing itself - that was the response to the increase.

Secondly, did you get served a large helping of Kool-aide at the SUNY 1st year orientation? To make a comment as blindly faithful as the one you made above, it looks like the brainwashing has done its job.

But why bother with all of that? Is it an altruistic endeavor to save people from what you see as a mistake?

Why bother? Here's two good reasons:

1) Optometry has an amazing ability to hide its crap from applicants. I know of few other professions that do this to the extent that we do. The AOA blatantly lies to prospects. The BLS data are based on lies from the AOA. The schools lie to bait students into dropping obscene amounts of their future income into a profession that is being pushed out of existence, at least as we know it.

2) There are some people out there who actually have the ability to separate themselves from their vision of what optometry is and look at the situation objectively. Those are the people who PM me and say "Thanks, I read what you and others have written, and after asking some direct questions of quite a few ODs, it seems like you're right about the future."

Don't rely on what you hear from a bunch sunshine heros on this site. Don't rely on what I say or what any single poster or person says to you. Look, yourself, at the numbers. It's plainly obvious what's happening if you look at the data and they're right there for you to see if you look at them. I've worked with optometry students for a long time and I see the transofrmation from happy, motivated, usually clueless first years to more realistic, but still somewhat naive 4th years. Then I get to see tham after they graduate with big plans of starting, buying, or working in some amazing private office, only to see them come back with 4-5 PT positions strung together like a quilt.

If you think you can avoid that scenario, great. Good for you. I sincerely hope you're one of the few who gets a spot on the life boat. But if you're not, don't say you weren't warned. That's all I'm saying. If you don't like what you read, do what Shnurek does. Just claim you hit the "ignore" button, but then read everything I say.

 

[dylennon]

Thanks, Jason. Gives me good information to take with me when I shadow.

 

[CL Doc]

...OR, I was replying to your comment that MD's somehow can't afford crap. Don't get optometry and medicine confused.

Can't afford crap? Who said that? You think anything less than a Lambo is crap?


You're setting yourself up for a lifetime of disappointment.