While I understand your concern about your ability to repay your debt obligations upon graduation, I would strongly urge you to get into a private/group practice setting. Not only will you have greater autonomy, you will doing your part to break the cycle. There are opportunities if you look hard enough...start now if you can.
Again, at the root of this problem is optometry schools turning out too many new graduates each year(with admission criteria that are too low) and strapping them with a large debt load, thus, leaving them no choice but to sell out to a doc in the box to make a living. Again, this makes me sick.
Posner
While it certainly is fun to bash bash bash away at commercial optometry, I am not prepared to lay optometry's problems at the feet of commercial practice.
In fact, I lay it squarely at the feet of private practice. For many many years, it was PRIVATE practices that were responsible for the whole "free eye exam if you get your glasses from me" situation. In fact, it is exactly this that gave BIRTH to commercial optometry. Commercial interests looked at the massive profit margin on ophthalmic materials and said "YES! We are getting in on this deal." If only those private practitioners of yesteryear had the foresight to charge heavily for their exams and mark up their materials minimally, commercial optometry would have never existed.
But that horse has long since left the barn. There is no point in crying over it because there is no going back. However, what has private practice done in the last 20-30 years to differentiate itself from the commercial locations. I would submit, very very little.
I have said this multiple times: Most private optometric practices are essentially eyeglass stores with exam lanes in the back. And most of them are located in strip mall locations in between the pizzeria and the nail salon. A collegue of mine from Los Angeles told me that he looked at a "private practice" that was located next to a store that sells adult novelties and clothing.
Obviously thats an extreme example, but can anyone out there honestly say that a Lenscrafters in an upscale mall projects a less positive image of optometry than a private practice next to a chinese take out place? Lets be serious now.
I worked in plenty of private offices and plenty of commercial places during my tenure in optometry. I saw just as many dusty BIOs in private offices as I did in commercial. I saw just as many uveitis patients referred out in private offices as I did in commercial. I saw just as much 7 and 4 and out the door in private offices than I did in commercial. (in fact, probably more so in private on that last one) I saw way more "doctors only" lenses in private offices.
People don't view optometry negatively because of Lenscrafters. They view optometry negatively because the overwhelming majority of ODs offices that they have been to have essentially been eyeglass stores. Can you blame them?
While there are a few scattered practices here and there that are starting to emphasize the service over materials paradigm, it is my opinion that that is not happening nearly as often, and certainly not nearly fast enough to stop the commercial take over of optometry. And it is because of this trend that I still believe optometry is destined to end up like pharmacy.
