optoblog.com

Okay, so how did your practices do this firework season? In my previous practice as an Indian Health Service optometrist in Browning, MT, I would see 2-3 injuries in June-July.

I left town for the 4th thinking I would escape having to deal with fireworks injuries, but guess what! I still saw a woman who got hit with a bottle rocket. Sure it’s two days after it happened. Her chief complaint? She needed new glasses, since the bottle rocket made her old ones have a permanent black cloud on them.

Luckily, this woman doesn’t have any damage to her eyes other than singed cilia. The scary thing is she was holding her kid while her husband lit off bottle rockets, so that firework could have just as easily hit a poor baby without any eye protection. He had a bottle, but this errant one was launched from being stuck in the ground instead of in the bottle.

My family traveled to another state where bottle rockets are also outlawed. My kids and I watched some legal, colorful fireworks, but when the person broke out the bottle rockets, I took my kids kicking and screaming into the house (yes, literally). I told them they could look at it through the window. Scary thing…the firework lighter was also just planting them in the ground instead of using a bottle.

So, I’m glad I didn’t let my kids be around bottle rockets. The TV news in my area has been reporting about organizations that would like to ban consumer fireworks, mostly citing the wild fire issues. To date 5 states have outlawed consumer fireworks. I am almost ready to agree, but I still dislike having my freedoms being infringed on. The nearest parallel I can think of to the fireworks issue are firearms.

People misusing firearms cause lots of problems just like people who misuse fireworks. Maybe instead of an all out ban, fireworks could be regulated like the gun industry. Maybe people should be required to pass a fireworks safety class and obtain a permit to light consumer fireworks. Maybe no one should be allowed to light off fireworks except under the direct, on site supervision of a fireworks permit holder.

The negative? Fireworks would become too expensive to (legally) buy since demand would go down and government taxes would go up to cover the cost of firework regulation. Fireworks could only be cheaply purchased from gangsters. Lots of otherwise good kids would get a juvi record. But perhaps there would be less impact from banning fireworks, than say alcohol, since no one really thinks about lighting fireworks except on Independence Day and Christmas.

People shoot guns and light off fireworks safely all the time- except guns and the shooting of guns are heavily regulated while fireworks are not. I am still not for the all out ban of fireworks. I would rather have common sense prevail instead of expensive government regulation, but if fireworks injury cases are any indication, it appears that self regulation isn’t effective, at least anecdotally. We need John Lott to commission a study about how pervasive this whole firework injury problem is and whether government regulation would be cost effective.

For the mean time, I’m not allowing my kids near bottle rockets.

Ahh, yes. The smell of fireworks will soon be in the air. Dia Del Diablo in Guatemala is worse, but still, you have to admit there’s a distinctive aroma to fireworks and punks.

Or maybe I should say that punks with fireworks stink. Seriously, irrisponsible use of fireworks have made bottle rockets and firecrackers get a bad name. Prevent Blindness America and many eye doctors support the ban of consumer fireworks.

I grew up in Wyoming and day dreamed about fireworks as soon as the snow melted. I spend weeks in preparation for the 4th of July. Army men needed firecrackers strapped to them. Paper air planes needed bottle-rockets taped to them. Log cabins made of Popsicle sticks needed an M-80 placed inside them. Christmas wrapping paper needed to be thrown away so I could use the cardboard tube to make a bottle-rocket launcher.

Yup, I was the American Academy of Ophthalmology’s worst nightmare.

But I’m much older and wiser now. More to the point, I live in a state that outlaws bottle rockets and firecrackers, and I won’t do anything illegal because I don’t want my gun rights taken away.

So this 4th of July, make it a safe and sane holiday. Instead of whining to the government to outlaw consumer fireworks, lets sell stylish protective eyewear for everyone to wear in case they get caught as the innocent bystander to an errant firework.

And by the way, Prevent Blindness America, give me a break about that girl who lost her eye sight do to a firecracker getting tossed into a crowd. If you toss a pocket knife into a crowd you could poke an eye out, but no one is trying to outlaw pocket knives. Charge the perps- don’t take away my rights.

See another optoblog entry about fireworks.

Ah, yes. Summer is in the air. Bar-b-cues, baseball games, blockbuster movies. Those are some things I’ve been able to enjoy so far. Not on the list is camping, traveling, and outside summer fun. You see, I’m an optometrist. I spend all day inside until about 7:00 PM. I do this six days a week.

I planned on becoming an optometrist because I had observed that they work Monday through Friday, 9-5. Not so in today’s market place. Today’s eyecare consumer demands Saturday and evening appointments so as not to interfere with their work. Sure, if they have to schedule a physical with their PCP, that might be worthy enough to take off work, but the eye doctor…nope.

Some background on my situation. I left a great Indian Health Service career to pursue my whimsical fantasy of private practice. You see, I wanted to live near extended family, but there weren’t any openings available with IHS. I had the belief system that corporate optometry is the devil, so I had to open a private practice.

Before being able to open my private practice doors, I had to work commercial while the loans and build-out fell into place. I learned too late the corporate isn’t the devil. It’s only individual optometrists who don’t practice to their potential that make a bad name for corporate. Of course, this is true for private as well.

Now, since my private practice didn’t take off for me like I was expecting, I work commercial 4 days a week and my private practice 2 1/2 days a week. No, I don’t have a ton of money. In fact, I’m up to my eyeballs in debt. My private practice is losing money and my corporate income barely covers the losses. My wife wonders if we’ll ever be able to move out of an apartment and into a house.

The only people winning is this scenario are the frame vendors, the labs, the contact lens companies, the equipment vendors, and the financing companies. Everybody but the optometrist.

My message on this Father’s Day is: “Mamas, don’t let your babies grow up to be [optometrists].” For those of you who have already committed to oppie school, I would suggest that if you for some strange reason pursue the open-cold-private-practice nightmare dream, go small. Bootstrap instead of going big because that leads to one thing: going broke.

My boy watches Thomas and Friends about these trains that need to be “really useful engines.” Well, I’ve come across an optometry blog that is really useful. The Optometry Blog by ClearView Training is based in the U.K. From what I can gather, they appear to be a consulting company that helps you be a better eye doctor. What the heck is going on? I thought that all optometry consultants were like a pyramid marketing scheme- you give them money for the promise of a hope that you will make more money. Here is a firm that actually continues your training! Amazing!

What caught my eye was this useful little tidbit about asymmetric phorias on a cover test.

I just got an e-mail invitation to join a Yahoo Group called, and I quote, “optometrysucks.” The body of the e-mail only says:

optometrysucks@yahoo.com has invited you to join the optometrysucks group!

Tell us about your experiences as an optometrist

First of all, I don’t hate optometry, and I definitely don’t think it sucks. Second, I wouldn’t even join a Yahoo Group called “Optometry Rules” or even “Optometry is okay” because I don’t like the closed door approach. That’s why I don’t participate in ODwire.com. I post my thoughts on my blog for everyone to see, not just select people.

Optometry as a profession can provide excellent eye healthcare delivery, and even in private practice, still provides excellent value in healthcare fees. We do much good. We perform all eye-related healthcare except surgery. We are making a difference in people’s lives every day. Today, I just saved a guy from getting LASIK because he’d never heard of Focus Night and Day lenses.

On the flip side, I think students considering optometry school should be more aware of what they can realistically expect for income in different modes of practice. I wish the general public understood our profession better. I wish more M.D.s respected what we do.

Sure, there are challenges in optometry, but it doesn’t suck.

Rob Lynch, President and CEO of VSP, started a blog the other day. (Hat tip to Contact Lens Today e-mail newsletter: how come you don’t make an RSS feed?)

But Mr. Lynch does have a site feed, and He states,

I’m excited to launch our VSP blog and have even more direct two-way conversations with our members, clients, doctors…

I hope he’s prepared for the backlash that’s about to hit him. I mean, has he even read the stuff at ODwire.com? Seriously, I’ve heard people say his company is responsible for the mess that the profession of optometry is in today.

I say that VSP is probably a positive force in private practice optometry. They effectively ensure that their beneficiaries can’t go to the big box optical (although there is an out-of-network reimbursement loophole). I like how their beneficiaries do a search for their nearest VSP network doctor by entering their zip code on the VSP website. I also think they reimburse for exams a lot better than most vision plans, and that’s why I like VSP.

The second they lower my reimbursement is the second they get on my poop list, though.

What do you think of this?

I think it’s awesome. I’d heard it was coming when I heard Melton and Thomas at the AAO meeting in Denver December 2006. Most people’s co-pay is more than that for a one month supply, and this $20 two-pack is now on the shelf at Sam’s Club in Logan, Utah.

Now maybe people will actually get the medication I recommend.

I just found out about EyeCodeRight, a web-based practice management software and electronic health record solution. This looks cool for many reasons, but I’m most excited about the optometrist’s hardware savings. If all you need is a web browser, then think how much you could save!

I currently have officemate, but I had to buy a $2500 server with Windows 2003 server, and I bought Dell computers with Windows XP. If I would have gone with ECR4.0, then I wouldn’t have had to buy an expensive server, and I could assemble my own inexpensive desktops with a free Linux OS and use FireFox web browser to use the eyecoderight service. Nice.

I didn’t see anything about equipment integration, but I notice you can upload photos and stuff, so that might be sufficient for most people.

I also read in their online brochure how patients can enter their demographic info online! Integration with your practice website is pretty sweet.

If anyone is using this, how do you like it vs. other PMS/EHRs that you have used?

I originally wrote my lamentation on how few optometrist bloggers are out there are back in November 2006. I’ve since been made aware that there are a few more that I didn’t know about.
For example, there is a community of bloggers at eyecoderight.com. (You can subscribe to all of them with this feed.)

There is also Dr. Richard Hom’s blog.

I also heard about the Optcom list. Monty Vickers says,

Are you on the Optcom list? No. I prefer my whine with cheese.

In fairness, it seems all optometrist web boards turn into griping sessions about the profession. Again, my big beef with web boards is that they are not completely open for everyone to read. They are great if you need a specific question answered, but I would rather read commentary from blogs.

See my Bloglines feed subscriptions under the section of “Optometrist Feeds” for more optometry-related sites that I track.

Now, how many eye-related podcasts are out there? I’m talking about ones directed toward other optometrists/ophthalmologists, not patients.

• As Seen From Here
• eyecoderight

Any others that you listen to? (Leave a comment for everyone to see.)

I saw this ad in the paper, and I thought maybe the world was coming to an end.

I’m sure he is conveniently located near the ShopKo pharmacy. 😉

Even if this isn’t one of the signs of the apocalypse, it certainly can’t be a good sign for private practice doctors (physicians, dentists, optometrists, etc) in general. It looks like we are all going the way of the pharmacist.

Update: Just a little Google search found a news release revealing this type of arrangement has been in the works since May 2006. It also says he can spiffily zoom the Rx’s electronically to the pharmacy.

How soon until Wal-Mart follows suite?