Naive OD Students

[CaribbeanEye]

Yes it can have a disaterous impact on the job market. The schools will easily increase the graduation rate 15% or more. It is easy supply and demand. The current trend is incresing supply and flat demand.

I would agree but it is not "flat demand." Demand for service is expected to increase for all medical fields over the next 20 years because of the aging baby boomers. You can check the link I gave above. I really think that it is unknown at this point how this is going to pan out, but looking at the numbers, it looks more positive than negative.

anyways, even if we JUST TALK ABOUT COST, the patient who walks in a mall will see Pearl on his right for $29, and Dr. Joe OD on his left for $89. he might also see a nice pair of shoes for $60. doing the quick mental calculation, he needs an eye exam, but if he goes to Pearl, he can also get that pair of shoes, for the cost it would be to see Dr. Joe OD. i think Dr Joe has a tough sell.

i believe in market forces, and honestly, no matter how hard "we try", i don't think optometry really can do anything about it.

I disagree there are things we can do. This all comes down to educating everyone, most importantly aspiring Opt students, of the current situation. Universities need to get their hand out of the corporate cookie jar and start counseling and educating students away from corporate practice.

I also believe that private practices will never disappear completely as long as there are private practices willing to give better care and service to their patients. If you prove to the public that paying a little bit extra for good eye care is worth it, you take customers away from the wal-marts. The profession needs good OD's and good PR. The message needs to get out that eye care from a good OD is just as important as any other health concern. That is the message that is not getting out.

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[KHE]

First of all, let me reiterate that I am not saying there is no oversupply and I am definitely not saying there is a shortage. I won't say there is an oversupply either. I have yet to see conclusive data to prove either position. I assume, Indiana, that this is where you got the 57%, and I appreciate you comming up with the source. Unfortunately, I believe you have misquoted the data from the AOA's salary survey. I also find it funny that those that feel there is an oversupply always say the salary data is skewed when someone talks about the increasing salary result (I believe DocWatson was the last one to make this claim), but it is totally accurate when it shows 57% capacity.

While I believe that there is an oversupply in general, it is probably true that the oversupply in optometry doesn't rise up to the definition of "oversupply" that an economist would use. If it were true oversupply, we would see ODs unemployed, or defaulting on their student loans and we really don't see that.

However, I think the long term effect of oversupply vis a vis the ease of getting an appointment speaks to the notion that we have more capacity to perform exams than is currently needed as opposed to most other health professions in which getting an appointment for a non-emergent routine matter on the same day you call is a virtual impossibility. Adding more schools and therefore graduates to the mix isn't going to help that situation. I also don't think that new graduates are needed to replace retiring ones because many ODs work well into their 70s or even their 80s, and if it is true that they are seeing a relatively small number of patients, then it should be very easy to absorb those patients into already existing practices.

As we have more capacity to perform exams going unused, I think we will start to see a greater reduction in fees, a greater increase in the amount of low ball vision plan usage, and stagnant of declining incomes. Perhaps not to the point that you are going to see ODs on the bread lines, but to the point that many prospective students are simply not going to be attracted to the field and it will be harder and harder to attract the best and brightest young minds to the profession.

 

[KHE]

I would agree but it is not "flat demand." Demand for service is expected to increase for all medical fields over the next 20 years because of the aging baby boomers. You can check the link I gave above. I really think that it is unknown at this point how this is going to pan out, but looking at the numbers, it looks more positive than negative.

This is one of the biggest falacies out there. (IMHO) The fact is that the baby boomers have been presbyopic for years and are already "in the pipeline" with respect to optometric services. Most of the increase in ocular pathology that they are expected to aquire (cataracts, macular degeneration, CRVOs NAIONs, etc. etc) are things that ODs don't treat anyways. Yeah, we might get a few more glaucoma patients out of that cohort but the idea that babyboomers are going to cause a flood of demand for optometric services is, in my opinion a non starter.

I disagree there are things we can do. This all comes down to educating everyone, most importantly aspiring Opt students, of the current situation. Universities need to get their hand out of the corporate cookie jar and start counseling and educating students away from corporate practice.

I also believe that private practices will never disappear completely as long as there are private practices willing to give better care and service to their patients. If you prove to the public that paying a little bit extra for good eye care is worth it, you take customers away from the wal-marts. The profession needs good OD's and good PR. The message needs to get out that eye care from a good OD is just as important as any other health concern. That is the message that is not getting out.

This would be true if the average commercial practice was providing sub par care and the average private practice was providing above par care but IMHO, there isn't enough of a difference in the quality of care between the two modalities to have a large impact on the public's perception.

Yes, in my private practice and in every other private practice I have been in before I bought this one, I see patients frequently who claim they got a bad exam at Walmart, or they didn't like the doctor.

But during my tenure in commercial practice, I saw just as many patients who were in the commercial location because their private doctor badgered them into buying expensive spectacles from them, or gave them a hard time about releasing their contact lens prescription, or had an office that looked like it came out of the Eisenhower administration. I think it is tough to make the argument that a Lenscrafters in an upscale shopping center projects less of a positive image for optometry than the small private practice which is nothing more than an optical shop with an exam lane in the back located between the nail salon and the pizzeria.

IndianaOD loves to bash bash bash away at commercial practice, and yea it might make him feel a bit better but I almost start to wonder if it's not a case of "the lady doth protest too much." He might want to try to spend a few days seeing patients in a commercial location, if for no other reason than to scout the competition because right now, all the bashing is tedious and it's coming from someone who by his own admission has never worked in a commercial establishment. (I know, I know....I have many friends who do and I have talked to many people who blah blah blah blah blah blah blah) But his rants are almost becoming like listening to a 3 year old complain about eating broccoli. They've never had it, but they are convinced they don't like it.

 

[Ben Chudner]

While I believe that there is an oversupply in general, it is probably true that the oversupply in optometry doesn't rise up to the definition of "oversupply" that an economist would use. If it were true oversupply, we would see ODs unemployed, or defaulting on their student loans and we really don't see that.

Finally, a rational view of the situation.

However, I think the long term effect of oversupply vis a vis the ease of getting an appointment speaks to the notion that we have more capacity to perform exams than is currently needed as opposed to most other health professions in which getting an appointment for a non-emergent routine matter on the same day you call is a virtual impossibility.

Yes, in my opinion, which contrary to some people's idea does not make it fact, there should be some concern for the future.

Adding more schools and therefore graduates to the mix isn't going to help that situation. I also don't think that new graduates are needed to replace retiring ones because many ODs work well into their 70s or even their 80s, and if it is true that they are seeing a relatively small number of patients, then it should be very easy to absorb those patients into already existing practices.

I think technology has created some of this issue as well. The number of patients we have he aibility to see per hour has risen much faster than the number of patients. That doesn't mean we aren't seeing as many patients as before, just that we can see more than we could before.

As we have more capacity to perform exams going unused, I think we will start to see a greater reduction in fees, a greater increase in the amount of low ball vision plan usage, and stagnant of declining incomes. Perhaps not to the point that you are going to see ODs on the bread lines, but to the point that many prospective students are simply not going to be attracted to the field and it will be harder and harder to attract the best and brightest young minds to the profession.

Something to definitely watch.

 

[Ben Chudner]

can someone explain to me what is all the fuss about if an additional Optometry school or two opens up in a few years? Whether it is in California or Texas why the negativity of opening another school and giving more potential applicants a chance? Will it really impact our current job market?
Please explain to me.

Warning....this may come off as harsh. First of all, my concern is not the impact on the current job market. In fact, the more OD's that graduate, the less I will have to pay a new grad to work for me so I should be happy there are going to be more schools. My concern is the quality of the students that get into optometry school. It my not be PC to say this, but I don't think everyone is entitled to a chance to get into graduate school. I don't care about why someone didn't perform in undergrad. The fact is they didn't perform well, and that should factor into admission. I've heard all the sob stories, but at the end of the day, I want OD's to be the best and the brightest, not people that had extenuating circumstances that justify poor academic performance. Until our current schools are turning away significant numbers of very qualified applicants, adding more schools will just allow more sub-par applicants to become OD's.

 

[CaribbeanEye]

This is one of the biggest falacies out there. (IMHO) The fact is that the baby boomers have been presbyopic for years and are already "in the pipeline" with respect to optometric services. Most of the increase in ocular pathology that they are expected to aquire (cataracts, macular degeneration, CRVOs NAIONs, etc. etc) are things that ODs don't treat anyways. Yeah, we might get a few more glaucoma patients out of that cohort but the idea that babyboomers are going to cause a flood of demand for optometric services is, in my opinion a non starter

I always appreciate your objective point of view KHE, it is refreshing. Although I believe there will be an increase in demand for services, I don't expect floods of new patients because of the baby boomers either. Nonetheless we agree that the outlook is not as negative as others constantly trump.

But during my tenure in commercial practice, I saw just as many patients who were in the commercial location because their private doctor badgered them into buying expensive spectacles from them, or gave them a hard time about releasing their contact lens prescription, or had an office that looked like it came out of the Eisenhower administration.

You bring up some very important points here. OD's that have offices such as those you describe simply do not use common sense when it comes to running a business. The fact is not all private practices give the best care or service. You can find good or bad care either commercial or private. In fact I met a real good Optometrist that works at Wal-mart.

So it brings up this question: In your estimation KHE, Do you usually find better care and service at a private practice? My perception is that you find better service at private locations.

 

[IndianaOD]

Warning....this may came off as harsh. First of all, my concern is not the impact on the current job market. In fact, the more OD's that graduate, the less I will have to pay a new grad to work for me so I should be happy there are going to be more schools. My concern is the quality of the students that get into optometry school. It my not be PC to say this, but I don't think everyone is entitled to a chance to get into graduate school. I don't care about why someone didn't perform in undergrad. The fact is they didn't perform well, and that should factor into admission. I've heard all the sob stories, but at the end of the day, I want OD's to be the best and the brightest, not people that had extenuating circumstances that justify poor academic performance. Until our current schools are turning away significant numbers of very qualified applicants, adding more schools will just allow more sub-par applicants to become OD's.

Ahh ha, A point that I completely agree with!! Well put.

Also, it doesn't matter how good of care a commercial doc provides. The very nature of the setting and the fees are the degrading factor.

Is there any way to set up a poll in these forums.

I want to poll:

If commercial practice (Walmart, lenscrafters, american's best) was all that was available would you still choose optometry?

I'm needing to pick up the slack over here since KHE is becoming soft. His rantings were legendary on ODwire.

There are now rumors of a possible 5 new schools! Someone stop the bleeding.

1. Southern California
2. Texas
3. Arizona
4. Colorado
5. Carribean

 

[IndianaOD]

Okay, had a no show... have to get hopping, have 9 back to back after this.

To our students out there: What do you think a 8+ year medical professional SHOULD make?

Do you believe an eye exam should cost less than a haircut?

I also wanted to remind others that 100k working commercial does not equal 100k in private practice.

A private practicioner can write off a lot of taxes. A commercial OD has to pay ALL their taxes including 100% social security. A commercial OD does not build value in their practice. If he/she gets outed because a new grad will work for less or see more patients you have nothing.

Would you rather have your son/daughter say "daddy/mommy" works at walmart or "daddy/mommy" is an eye doctor.

 

[Ben Chudner]

Ahh ha, A point that I completely agree with!! Well put.

I knew we would find common ground eventually.

 

[KHE]

I always appreciate your objective point of view KHE, it is refreshing. Although I believe there will be an increase in demand for services, I don't expect floods of new patients because of the baby boomers either. Nonetheless we agree that the outlook is not as negative as others constantly trump.



You bring up some very important points here. OD's that have offices such as those you describe simply do not use common sense when it comes to running a business. The fact is not all private practices give the best care or service. You can find good or bad care either commercial or private. In fact I met a real good Optometrist that works at Wal-mart.

So it brings up this question: In your estimation KHE, Do you usually find better care and service at a private practice? My perception is that you find better service at private locations.

It depends on what you define as "better service." I think that in general, private practices have more technology in them and can offer more "one stop shopping" for all of your eye and vision needs. And because it's the doctors name on the door, they are more likely to care about their reputation as opposed to someone who is working in a commercial setting. However, commercial practices do not in general provide faulty care or sub par products. Lenscrafters isn't a multi-billion dollar company because they provide crappy products and services.

 

[KHE]

I also wanted to remind others that 100k working commercial does not equal 100k in private practice.

A private practicioner can write off a lot of taxes. A commercial OD has to pay ALL their taxes including 100% social security.

Can you explain that? What taxes can a private practitioners write off that a commercial practitioner can't?

 

[docwatson]

Can you explain that? What taxes can a private practitioners write off that a commercial practitioner can't?

Come on, you know what he means. You're a private doc, you have lots of equipment, employees, a building, etc. Sure, the commercial doc is just as eligible to right things off, but is that really the point?

The private doc has a lot more overhead and he has to pay a lot more taxes.

 

[qwopty99]

1. Southern California
2. Texas
3. Arizona
4. Colorado
5. Carribean

i've heard of the first three. do u have links for the following two?

and my understanding of the first three, is that they are all VERY UNDERWAY, with SoCal leading the pack. texas has apparently had quite a bit of coverage, but i've heard from insiders (from ODwire, anyway) that arizona is actually secretly way ahead of them.

SoCal and Texas are on public record for wanting to open for 2009.

 

[Ben Chudner]

I also wanted to remind others that 100k working commercial does not equal 100k in private practice.

Completely true, unless you are an independent contractor in a private practice. But the bottom line is you have to produce almost 300K in private practice to earn 100k, wheras you only have to produce about 140K in commercial. That 140K by the way, would include a little extra to cover the additional employment taxes.

 

[IndianaOD]

Completely true, unless you are an independent contractor in a private practice. But the bottom line is you have to produce almost 300K in private practice to earn 100k, wheras you only have to produce about 140K in commercial. That 140K by the way, would include a little extra to cover the additional employment taxes.

That is very misleading considering you usually have very low exam fees and get no income from glasses and contact lenses. There is a reason commercial docs make considerable less on average.

Also, most "indepent contractor" setups by commercial are illegal. They don't qualify under the IRS definition. You do not have the ability to set your own hours or control your exam fees.

 

[Ben Chudner]

That is very misleading considering you usually have very low exam fees and get no income from glasses and contact lenses. There is a reason commercial docs make considerable less on average.

Also, most "indepent contractor" setups by commercial are illegal. They don't qualify under the IRS definition. You do not have the ability to set your own hours or control your exam fees.

You are right in that it takes a lot more effort to produce 140K in a commercial setting than it does to produce 300K in a private practice setting.

Also, there are a couple of setups in commercial practice that I believe are illegal. Paying 20% of your gross collections and calling it rent or a lease payment is definitely shady. That being said, there are plenty of stories about private practice docs paying their associates as IC's to avoid paying employment taxes. There are very few cases in which an associate would actually qualify as an IC, which makes those arrangements illegal as well.

 

[hello07]

thank you all for your responses to my question. Some points that were brought up I have to disagree. Indiana OD states "more OD's equals less patients per OD." Where? In what state are we talking about? Cities or rural America? "More schools means less qualified applicants have a chance to get in." Is that a fact or you would like to believe it is a fact? I'm sorry, but I beg to differ with you on this one. What makes you believe that more OD schools will admit less qualified applicants? In fact, Optometry school in the past is or was more harder / keen to get in than dental school. You said the opposite. You really believe the caliber of students admitted to optometry school the past 15 years has been top notch? I don't believe so or at least not across the board.
Ben Chudner states "the more OD's that graduate , the less i will have to pay a new graduate to work for me." This in my opinion is a fallacy. How do you come up with this? How much considerably less are you going to pay a new grad compared with one that is out 14 years ? I'm sorry to say this, but your arguments do not hold validity on my account.

 

[IndianaOD]

thank you all for your responses to my question. Some points that were brought up I have to disagree. Indiana OD states "more OD's equals less patients per OD." Where? In what state are we talking about? Cities or rural America?

More ODs equals less patients per OD. This is first grade math. Do 8000 patients magically appear each time an OD graduates?

"More schools means less qualified applicants have a chance to get in." Is that a fact or you would like to believe it is a fact? I'm sorry, but I beg to differ with you on this one.

Uhh, OD schools (at least IU, which I did some student interviews) ranks students by GPA and OAT. The more qualified get in. If there were twice as many openings, all those who didn't qualify would be in. How could the average entering GPA not go down? Canada has only 1 english speaking OD school. Very low supply, very high demand. The average entering GPA is through the roof.

What makes you believe that more OD schools will admit less qualified applicants? In fact, Optometry school in the past is or was more harder / keen to get in than dental school.

Past is the key word, you are making my point for me.

You said the opposite. You really believe the caliber of students admitted to optometry school the past 15 years has been top notch? I don't believe so or at least not across the board.
Ben Chudner states "the more OD's that graduate , the less i will have to pay a new graduate to work for me."

Because an oversupply of ODs will lower the wages of all optometrists.

This in my opinion is a fallacy. How do you come up with this? How much considerably less are you going to pay a new grad compared with one that is out 14 years ? I'm sorry to say this, but your arguments do not hold validity on my account.

What the heck are you saying, I can't follow your thoughts?

 

[eyestrain]

thank you all for your responses to my question. Some points that were brought up I have to disagree. Indiana OD states "more OD's equals less patients per OD." Where? In what state are we talking about? Cities or rural America? "More schools means less qualified applicants have a chance to get in." Is that a fact or you would like to believe it is a fact? I'm sorry, but I beg to differ with you on this one. What makes you believe that more OD schools will admit less qualified applicants? In fact, Optometry school in the past is or was more harder / keen to get in than dental school. You said the opposite. You really believe the caliber of students admitted to optometry school the past 15 years has been top notch? I don't believe so or at least not across the board.
Ben Chudner states "the more OD's that graduate , the less i will have to pay a new graduate to work for me." This in my opinion is a fallacy. How do you come up with this? How much considerably less are you going to pay a new grad compared with one that is out 14 years ? I'm sorry to say this, but your arguments do not hold validity on my account.

I'm not sure I get this either. Like IndianaOD said, most of this is first grade math.

 

[IndianaOD]

Okay, I'm taking a break from the forum. It eating up too much of my time trying to help shine a light through the fog.

I encourange all pre opts to do some research. I love optometry but am very discouraged by what I see.

In is my OPINION that the schools and AOA will not give you a truthful picture of the current state of Optometry. The schools want to make money so will always tell you things are great. The AOA predicted oversupply years ago but doesn't do a thing.

I can't do anything but ask you to think. Go talk to plenty of ODs (commercial and private) before making the plunge.

Know whatever you do affects all the others in your profession.

I'll check back in around a week to see more of the same nonsense.

GO MAKE IT A GREAT PROFESSION AND DON'T LET IT GO DOWN THE CRAPPER.

 

[hello07]

First grade math....okay, again are we talking about rural America setting up shop in the mountains of Wyoming or Nebraska or in big cities such as NY, California and Chicago? So I guess your logic dictates more MD's equals less patients per MD or more DDS equals less petients per DDS. Totally inaccurate. Why do you bring up Canada? Don't you live in the USA? So you believe higher GPA's and OAT scores will make one a much more clinically competent OD? than one with lesser scores? wrong again. higher GPA's and OAT's are not a significant correlation how good clinically competent one will be. "oversupply of OD's will lower the wages of all OD's.? Indiana OD, no disrespect to you b/c you are a colleague of mine but are you on drugs? Where do you come up with this one? please don't tell me supply and demand again. More optometrists out there, and few jobs the salary is going to be lower. has your salary decreased the past 3,4 5 or 10 years? Although, it might not have gone up much depending on how or where you practice, salaries don't go down b/c of oversupply. Tell your argument to the physicians or dentists or lawyers. Common man, please. Be sharper than that!

 

[qwopty99]

thank you all for your responses to my question. Some points that were brought up I have to disagree. Indiana OD states "more OD's equals less patients per OD." Where? In what state are we talking about? Cities or rural America? "More schools means less qualified applicants have a chance to get in." Is that a fact or you would like to believe it is a fact? I'm sorry, but I beg to differ with you on this one. What makes you believe that more OD schools will admit less qualified applicants? In fact, Optometry school in the past is or was more harder / keen to get in than dental school. You said the opposite. You really believe the caliber of students admitted to optometry school the past 15 years has been top notch? I don't believe so or at least not across the board.
Ben Chudner states "the more OD's that graduate , the less i will have to pay a new graduate to work for me." This in my opinion is a fallacy. How do you come up with this? How much considerably less are you going to pay a new grad compared with one that is out 14 years ? I'm sorry to say this, but your arguments do not hold validity on my account.

sorry - admittedly, a lot of this thinking is bunk. like really...

most of what u say is that supply/demand doesn't matter. it does.

yes, some new grads from new schools will go to under-serviced areas. most will continue to practice in the same rural/urban ratio that they they practice now.

UW optom in Canada has gone from admitting 60 to 90 students. the avg entering gpa/oat has gone down. UT pharmacy has gone from admitting 120 to 240 studnets, again, the entering gpa of the class has gone down, and SPECIFICALLY, the #240th ranked person to get in is quantitatively WEAKER than the #120th ranked person who got in in the old days.

what about we use OPTOMETRY schools and look at the numbers. the larger schools (NECO, PCO, ICO, etc.) in general, have more spots and lower admission standards. when u have a bigger entering class to fill, u have to be less picky about who u choose.

medicine (for instance) might be "competitive" enough and have enough applicants to be able to open a handful MORE med schools now without diminishing their overall entering avg, but let's say they opened three-times more med schools as they have now, chances are, standard would fall.

as for more grads for Ben. sure. he's from a town that has 3 new incoming grads for the one job he's offering. they're clamoring for it. chances are, he doesn't have to do much recruiting, and that includes, offering an enticing starting salary with bonuses.

 

[qwopty99]

First grade math....okay, again are we talking about rural America setting up shop in the mountains of Wyoming or Nebraska or in big cities such as NY, California and Chicago? So I guess your logic dictates more MD's equals less patients per MD or more DDS equals less petients per DDS. Totally inaccurate.

How so? edit: oh i think i got it. difference, is MD and DDS are in a relative undersupply state. whether ODs are in the same state or not, we certainly are not as "undersupplied" as MD/DDS, if in fact we are.

Why do you bring up Canada?

because there's only one school there, and admission is comparatively through the roof.

Don't you live in the USA? So you believe higher GPA's and OAT scores will make one a much more clinically competent OD? than one with lesser scores? wrong again. higher GPA's and OAT's are not a significant correlation how good clinically competent one will be.

sure as hell matters if that person doesn't pass through OD school. they won't graduate. now extrapolate.
(ok ok, this one is controversial. however:

why do schools admit the students with the highest GPA/oats, if none of this mattered?
why do residencies look at your GPA/NBEO scores for admission purposes?
sure, "smarts" don't "correlate" with "beside manner", but maybe that C-student didn't learn or forgot the systemic associations of (oh i don't know) recurrent scleritis? that patient would be S.O.L.

i think there is a small, positive correlation with smarts and optom ability. and there is probably a small correlation of smarts and grades. so grades would have a small positive correlation with optom ability.

"oversupply of OD's will lower the wages of all OD's.? Indiana OD, no disrespect to you b/c you are a colleague of mine but are you on drugs? Where do you come up with this one? please don't tell me supply and demand again. More optometrists out there, and few jobs the salary is going to be lower. has your salary decreased the past 3,4 5 or 10 years? Although, it might not have gone up much depending on how or where you practice, salaries don't go down b/c of oversupply.

probably not go down, per se. but certainly, do not rise as quickly as they could if there was less competition.

here's a Q for u. who is likely to make more?

the OD in a rural city who's the only gig in town.
the OD in an urban city who has 5 ODs in a 1 mile radius, and one OD who set up shop across the street from him?

Tell your argument to the physicians or dentists or lawyers. Common man, please. Be sharper than that!

not enough docs. some claim to avg 400K/year.
not enough dents. some claim to avg 200K/year.
too many lawyers. many don't even practice law. the good ones get paid well, but the bad ones can't get a job and leave the profession.


why do some health professionals think they exist in economic bubbles? Adam Smith economic theory from 400 years ago applies in many areas. i went on the pharmacy forums at one point, and told them an unfavourable supply/demand would hurt their salaries. some naive-pharm students (haha) replied Economics 101 theory doesn't apply to them. and now, an OD is suggesting it doesn't apply to us either? why not?


Be Evidence-based. Prove to me why you are right. Don't hold unfounded beliefs that fly in the face of statistics. Show me the evidence. Most importantly: PRACTICE EVIDENCE-BASED MEDICINE (i.e. optometry).

 

[VA Hopeful Dr]

Okay, had a no show... have to get hopping, have 9 back to back after this.

To our students out there: What do you think a 8+ year medical professional SHOULD make?

Do you believe an eye exam should cost less than a haircut?

Ok, this last part is something I see all the damn time on ODWire and it frustrates me to no end.

I pay $20 for a haircut, usually takes about 10-15 minutes total. That amount of doctor time (looks like about the time of a comp. exam, assuming tech refraction) would run me $100+ (much more if I were cash pay).

Obviously the ladies out there will likely pay more for haircuts, but I suspect they also spend more time doing it. I dated a girl once who paid $80 for a haircut, which seemed ridiculous to me into I realized that she would spend 45+ minutes in there. For almost an hour of a doctor's time.... well hell, I don't even know what that would run but I guarantee that you guys bring in more than $80 an hour.

 

[qwopty99]

Ok, this last part is something I see all the damn time on ODWire and it frustrates me to no end.

the folks on ODwire aren't evidenced base.

they base their opinions on personal biases and anecdotes. for instance, someone yesterday posted:

"Too many refractionists saying come back when you need new glasses or contacts.

We need more medical optometrists (optometric physicians) providing medical care, making medical decisions and charging medical fees for the service!"

who says we "need" this? can he prove it? where is the data? who says moving more medically (and away from bread/butter refraction) leads to more income? i'm not trying to be a proponent of this or that, but if you're going to make claims, show that they are actually true.

things like strab doesn't go away. but just cause we emphasize BV less and medicine more, doesn't mean the prevalence of BV goes down. it just simply goes undetected. when this happens, we open the door for other practitioners to enter and claim that as part of their scope.

 

[KHE]

the folks on ODwire aren't evidenced base.

they base their opinions on personal biases and anecdotes. for instance, someone yesterday posted:

"Too many refractionists saying come back when you need new glasses or contacts.

We need more medical optometrists (optometric physicians) providing medical care, making medical decisions and charging medical fees for the service!"

who says we "need" this? can he prove it? where is the data? who says moving more medically (and away from bread/butter refraction) leads to more income? i'm not trying to be a proponent of this or that, but if you're going to make claims, show that they are actually true.

It is true that ODwire is predominantly a "bitch fest" but for many practitioners you can substitute "personal biases and anecdotes" with "years of experience."

And anecdotaly, I will say that after having worked in "refraction only" type practices and practices that are more heavy into medical billing, the income of the practitioners is the medical practices blows the other ones out of the water.

 

[docwatson]

It is true that ODwire is predominantly a "bitch fest" but for many practitioners you can substitute "personal biases and anecdotes" with "years of experience."

And anecdotaly, I will say that after having worked in "refraction only" type practices and practices that are more heavy into medical billing, the income of the practitioners is the medical practices blows the other ones out of the water.

Completely agree.

 

[docwatson]

who says moving more medically (and away from bread/butter refraction) leads to more income? i'm not trying to be a proponent of this or that, but if you're going to make claims, show that they are actually true.

things like strab doesn't go away. but just cause we emphasize BV less and medicine more, doesn't mean the prevalence of BV goes down. it just simply goes undetected. when this happens, we open the door for other practitioners to enter and claim that as part of their scope.

Let's see... If you get reimbursed twice as much, you take additional photos and other tests which also bring in more income, and you bill for additional needed follow up appointments, AND you also send the patient to the optical just as you would even if the patient didn't have a medical issue, why wouldn't an OD make more money? Do you need a study to figure this out?

The other issue is binocular vision. I agree that it's an important issue but we don't get paid much for this as you know. So you can go out on your own and try to develop a practice in this area but it will be an uphill climb.

 

[Ben Chudner]

Let's see... If you get reimbursed twice as much, you take additional photos and other tests which also bring in more income, and you bill for additional needed follow up appointments, AND you also send the patient to the optical just as you would even if the patient didn't have a medical issue, why wouldn't an OD make more money?

Wow, Keith we can finally agree on something.

 

[docwatson]

Wow, Keith we can finaly agree on something and then...you end up comming off like an ass.

It was a joke... See the -->>>

 

[qwopty99]

i was giving a hypothetical.

the point is, data. show the data.

"years of practice experience", in lieu, in some instances is acceptable. so i acknowledge the point above.

the bottom line is: be evidence based.


edit: to clarify my point:

bad things happen when people in positions of control, make decisions based on their personal whims. for instance:

- schools deciding to open optometry schools when there is no data to show they are needed.

- countries that go to war, when there is no (non-fabricated) evidence of WMD, etc.

 

[broadway]

It is true that ODwire is predominantly a "bitch fest" but for many practitioners you can substitute "personal biases and anecdotes" with "years of experience."

And anecdotaly, I will say that after having worked in "refraction only" type practices and practices that are more heavy into medical billing, the income of the practitioners is the medical practices blows the other ones out of the water.

I haven't seen that. In my practice most of my income comes from the optical. I bill medically whatever I can. My exam fee is $110 but my sales can average about $550. my highest sale was $2200. ( 2200 was for multiple pairs)

 

[cpw]

...you end up comming off like an ass.

let's refrain from the name calling, please.

There are some great constructive arguments on this thread. Let's try to go back to those.

 

[hello07]

I beg to differ with qwopty99. Can you show me evidence based criteria that opeing another Optometry school or two will negatively impact our profession and salaries? You talk about evidence based medicine and facts, why don't you show me facts about what you ramble about. You say NECO, PCO and ICO have more seats to fill and therefore lower their admission standards. How do you know this? And if so, so what? You think graduates form U Berkeley or Ohio state end up being much better clinicians than those from the big schools? I question your logic with some of your statements. lawyers you say the bad ones can get a job and leave the profession? where do come up with this buddy? and your examples of MD and DDS salaries where competition is less for them. Again, YOU SHOW ME EVIDENCE BASED CRITERIA for your erroneous statements. Your salaries argument is worthless and the amount of OD's out there working or not.

 

[IndianaOD]

I beg to differ with qwopty99. Can you show me evidence based criteria that opeing another Optometry school or two will negatively impact our profession and salaries? You talk about evidence based medicine and facts, why don't you show me facts about what you ramble about. You say NECO, PCO and ICO have more seats to fill and therefore lower their admission standards. How do you know this? And if so, so what? You think graduates form U Berkeley or Ohio state end up being much better clinicians than those from the big schools? I question your logic with some of your statements. lawyers you say the bad ones can get a job and leave the profession? where do come up with this buddy? and your examples of MD and DDS salaries where competition is less for them. Again, YOU SHOW ME EVIDENCE BASED CRITERIA for your erroneous statements. Your salaries argument is worthless and the amount of OD's out there working or not.

You offer no evidence for your side either.

 

[Ben Chudner]

I beg to differ with qwopty99. Can you show me evidence based criteria that opeing another Optometry school or two will negatively impact our profession and salaries? You talk about evidence based medicine and facts, why don't you show me facts about what you ramble about. You say NECO, PCO and ICO have more seats to fill and therefore lower their admission standards. How do you know this? And if so, so what? You think graduates form U Berkeley or Ohio state end up being much better clinicians than those from the big schools? I question your logic with some of your statements. lawyers you say the bad ones can get a job and leave the profession? where do come up with this buddy? and your examples of MD and DDS salaries where competition is less for them. Again, YOU SHOW ME EVIDENCE BASED CRITERIA for your erroneous statements. Your salaries argument is worthless and the amount of OD's out there working or not.

Personally, I don't think another school will impact my salary. It MIGHT impact the salary of new grads once it is open. If there are 100 job openings every year (just a random number for the sake of illustration), and there are 75 graduates to fill those jobs then the graduates will be in high demand. Employers will have to come up with enticing offers to get a grad to take the job. If you add 2 more schools so that the number of graduates is now 125, but the number of jobs is still 100, then the jobs will be in higher demand and the employers may not have to make the offers as enticing. This is a theory of course, but based on proven economic principles. It may not really happen, but if it does, there is no going back. The new schools won't close, and some of us don't want to take that chance.

As for admission standards, the same principle applies. If there are 100 spots and 150 applicants, the schools can choose the most qualified students to fill their spots with. If the number of spots increases to 200 and the number of applicants stays the same, then the schools will have to take less qualified applicants to fill their spots. Again, this may not happen, but it's a realistic concern. We could say, "Let's take a chance and see what happens." I feel the risk is too great, and since we can't turn back once we make the decision to have more schools, I just don't think it's worth it.

 

[qwopty99]

I beg to differ with qwopty99. Can you show me evidence based criteria that opeing another Optometry school or two will negatively impact our profession and salaries?

read an earlier post. i compared our situation to that of pharmacy school. it affected them. i think it will affect us in the same way.

i showed how optometry practices are closing without buyers. that must affect income doesn't it? what have you shown?


You talk about evidence based medicine and facts, why don't you show me facts about what you ramble about. You say NECO, PCO and ICO have more seats to fill and therefore lower their admission standards. How do you know this?

you pretend this information is not easily found online. whatever the numbers are, the numbers are verifiable. it is either the case that marks from NECO PCO ICO > UCB, OSU. OR UCB, OSU > NECO PCO ICO. i'll choose the later as being true. u can choose the former but i'm sure u would be wrong.

And if so, so what? You think graduates form U Berkeley or Ohio state end up being much better clinicians than those from the big schools? I question your logic with some of your statements.

i said above i think marks have a small correlation with ability. i explain why, above. this is my opinion. now your turn (my answers are in parenthesis. if u disagree with them, tell me why):

1. will someone who fails out of optometry school make a good clinician?
(a definite no.)
2. will someone who didn't learn the systemic associations of recurrent scleritis be a better clinician than someone who did?
(probably not. definitely not in the case of the student who failed out.)
3. which of the two students will likely get a better score on the NBEO?
(probably the one who learned about recurrent scleritis. definitely not the student who failed out.)

OAT and GPA have been shown to predict grades in optometry school. as such, the TREND would be that the person who failed out PROBABLY had a lower entering OAT and GPA than the person who passed through. so marks CAN matter in general (this is extrapolation), and in specific (as explained here).


lawyers you say the bad ones can get a job and leave the profession? where do come up with this buddy? and your examples of MD and DDS salaries where competition is less for them. Again, YOU SHOW ME EVIDENCE BASED CRITERIA for your erroneous statements.

it is said 50% of lawyers don't practice law 5 years out of graduation. perhaps not exactly "fact", but thereabouts. more lawyers graduate than are law jobs available to them. probably "fact"

Your salaries argument is worthless and the amount of OD's out there working or not.

supply and demand is a phenomenon the way natural selection is too. in fact, S/D has existed as a theory for over 4 hundred years. u can pretend it doesn't happen, but it does. ignore at your peril.

why so bitter in your posts? why r u disagreeing just for the sake of disagreeing? such as disagreeing that marks across the private schools are lower (they are) than at public schools?

 

[IndianaOD]

Okay, I'll make a quick post since I'm waiting for my wife to get ready to go to a wedding.

I appreciate everyone's input in this discussion. I feel that it is critical that these issues be discussed. While these problems may affect older practicioner's a little, they will affect new grads the most.

While pharmacy used to be a very respected profession (and still should) I think perceptions have changed greatly. Honestly who doesn't think of them at the local commercial pharmacy counting pills? They go through too much education to be thought of this way. Its my feeling that we must keep optometry from a similar fate. Realistically it is up to the new grads (the most educated ODs to ever graduate) to keep this from happening. Why would you be satisfied that patients think an OD just does glasses and contacts? (You can train anyone to collect data, it takes a doctor to solve the patients problems and address the entire visual system).

Despite disagreements its always important to review why you have YOUR specific opinion. Use the differing opinions to start your own investigation into the facts. I try to be completely honest, but how could you know that? How do you even know if anyone on here is an OD or MD etc? Don't take the words of the AOA, optometry schools, commercial interests, or me for fact. I too was skeptical of the OD doomsdayers at first, but I've done a lot of research and talked to A LOT of ODs to come to my conclusions.

Personally, I also believe that disagreements should not "close" threads. Its ridiculous and us "adults" need to work out our differences.

 

[hello07]

I might have gone a little bit over the top didn't mean to come across as bitter but couldn't help it. Let each and every potential applicant to Optometry school decide if it is worth it for them or not. I will not argue my points any more. The only thing I would like to say is for those who are against another school or two opening up they should welcome the challenge for more colleagues of our coming into the pprofession and not be intimadated for whatever reason. I'm done arguing on to other posts.

 

[362.04]

'...

1. Southern California
2. Texas
3. Arizona
4. Colorado
5. Carribean

1. Western University in Pomona
2. University of the Incarnate Word
3. Midwestern University, Glendale, AZ
4. Rocky Vista Univrsity, Aurora CO
5. ?

 

[IndianaOD]

Okay,

Lets expand this discussion a little. People say there is too much commercial bashing so I'd like to hear from the other side.

How does commercial optometry positively affect the profession? I'm not talking personally as in its the laziest way to make a living and I couldn't feed my family without it (which if is true optometry is in worse shape than even my pessimistic tendencies can envision).

While docwatson, steve, myself and others complain....we do it for a reason. We care about the profession.

While we also may be beating a dead horse, there are new people around every day. On the other hand these cranky private docs offer the most helpful advice in other threads not related to oversupply and commercial practice.

Where are our super successful commercial ODs???

 

[drbizzaro]

Okay,

Lets expand this discussion a little. People say there is too much commercial bashing so I'd like to hear from the other side.

How does commercial optometry positively affect the profession? I'm not talking personally as in its the laziest way to make a living and I couldn't feed my family without it (which if is true optometry is in worse shape than even my pessimistic tendencies can envision).

While docwatson, steve, myself and others complain....we do it for a reason. We care about the profession.

While we also may be beating a dead horse, there are new people around every day. On the other hand these cranky private docs offer the most helpful advice in other threads not related to oversupply and commercial practice.

Where are our super successful commercial ODs???

i'm doing commerical, and so is a good friend of mine

we both make 3000+ a week (before taxes of course)... i'm not going to say the company, but you can make huge profits from bonuses

 

[IndianaOD]

i'm doing commerical, and so is a good friend of mine

we both make 3000+ a week (before taxes of course)... i'm not going to say the company, but you can make huge profits from bonuses

How is that helping optometry? How many days a week? What is the exam fee? Do you only lease one space or skim off of new grads?

 

[docwatson]

How is that helping optometry? How many days a week? What is the exam fee? Do you only lease one space or skim off of new grads?

How much do you pay your employer to "rent" your space?

 

[IndianaOD]

i'm doing commerical, and so is a good friend of mine

we both make 3000+ a week (before taxes of course)... i'm not going to say the company, but you can make huge profits from bonuses

Probably best not to say where you work. Some greedy product of OD oversupply might take your spot overnight.

 

[IndianaOD]

I had a thought today (scary I know!)

Why do commercial docs charge soooo much less on average than private docs? Yes there are some awful private goobers out there as well. Commercial docs always say they are "independent" and thus LEGALLY can charge what they choose.

For example. Why do the local private docs in town charge $95 for a new exam while the local optical and wally charge around $40? Why not charge $75 and still be the low ball? You'd still get the price shoppers.

Is this too close to the point that the commercial docs can't compete with private if the prices are anywhere near each other?

My only thoughts are:
1. The docs aren't independent and are illegally controlled by the commercial entity that wants the most exams to sell the most glasses.
or
2. Commercial docs can't compete with private if the prices are remotely similar.

Any thoughts?

 

[Dr Gump]

I had a thought today (scary I know!)

Why do commercial docs charge soooo much less on average than private docs? Yes there are some awful private goobers out there as well. Commercial docs always say they are "independent" and thus LEGALLY can charge what they choose.

For example. Why do the local private docs in town charge $95 for a new exam while the local optical and wally charge around $40? Why not charge $75 and still be the low ball? You'd still get the price shoppers.

Is this too close to the point that the commercial docs can't compete with private if the prices are anywhere near each other?

My only thoughts are:
1. The docs aren't independent and are illegally controlled by the commercial entity that wants the most exams to sell the most glasses.
or
2. Commercial docs can't compete with private if the prices are remotely similar.

Any thoughts?

Most commercial docs are "entitled" to the vision insurance that the corporate entity forces upon them. They may be "independent doctors of Optometry" but they are force fed the corporate exam prices.

Back my day of corporate drudgery, Eyemasters had a vision plan that each "independent doctor" had to take. I think they reimbursed $39 per exam (even with pathology). The Optometrist who I filled in for use to work 8 hours on Saturdays and see about 65 patients. You can imagine the type of exam those patients got.

 

[IndianaOD]

Not one current corporate doc has stepped up to the plate. I really do want to understand.

 

[qwopty99]

i don't know if any corporate docs think corporate helps optometry, but that won't necessarily stop them from going down that path.

 

[drbizzaro]

I had a thought today (scary I know!)

Why do commercial docs charge soooo much less on average than private docs? Yes there are some awful private goobers out there as well. Commercial docs always say they are "independent" and thus LEGALLY can charge what they choose.

For example. Why do the local private docs in town charge $95 for a new exam while the local optical and wally charge around $40? Why not charge $75 and still be the low ball? You'd still get the price shoppers.

Is this too close to the point that the commercial docs can't compete with private if the prices are anywhere near each other?

My only thoughts are:
1. The docs aren't independent and are illegally controlled by the commercial entity that wants the most exams to sell the most glasses.
or
2. Commercial docs can't compete with private if the prices are remotely similar.

Any thoughts?

i'm in commerical, and the companies DO in fact set prices.... they want #1....

i'd be happy if we set up enough people to take over the prices/hours/etc of commerical establishments (just like how OD's sued walmart to do that exact same thing)

currently, i'm content in commerical practice... i do good eye exams, and get paid well... (but that is only relative to other commerical docs)... compared to private practice docs i get paid bad...

how did i negotiate such a high salary compared to fellow commerical docs? well it all comes down to initial meetings/negotiations/interviews.... i'm only a new grad, and i negotiated a huge amount compared to some of my classmates...

the way it works is like this:

certain company - which we shall call AMERICAS NEST... (notice the word NEST, and not some other word such you might be thinking of)... they MAY tell you they are paying all new grads 95K, but that is a huge lie... you only need to tell the people hiring that you will accept nothing short of 110K and they'll take it... but say you have been offered a higher offer... it's that simple... there are people in my class that took 94K for a year, which is horrible...

anyways, that's my reply to this message and the previous ones above... and my warning to new grads - ask for more money, and say you have higher offers, and they WILL give you more.... especially companies like AMERICAS NEST!!!! i guarantee you....

there are some people sent out to hire you, such as:

CHRISTIAN SCHULTZ.... he'll lie to you about the money people are making... in order to get you to sign for 94 or 95K.... they can afford much more... they make a killing off of you...

dont settle for less than 110!