optoblog.com

The topic of today’s post is the most searched term that brings people to my little blog, so I thought I would directly answer the question, “How do I become an optometrist.”

Here are the steps as I see them:

1. Go to college and major in any field you want. You will be required to take prerequisite courses before entering optometry school, and most of these courses are taken during a biology-type major. But, you can major in statistics or Spanish, but it will take extra time to graduate AND get all the optometry school prereqs. Don’t let that put you off because if you don’t get into optometry school, you will want a degree that you can use to do something you love. About the only thing you can do with a biology degree besides work for the federal government is work at McDonalds.
2. The summer after your second or third year of college, take the OAT and score well. Make sure you check the option to have your scores released to all the optometry schools that you are considering.
3. As part of your optometry school application, you have to observe a few optometrists in different practice settings (private, government, research/academic, commercial) for around 30 hours. This takes time, so schedule ahead before your application becomes due. It’s also very important because you may discover that being an optometrist is not for you. That’s a good lesson to learn before you spend huge amounts of money becoming one.
4. If you still want to be an optometrist, get your application together and send it in when your fourth year of college starts. There are usually essay questions and a personal statement. Try not to write anything naive. You’ll also need to round up all your official college transcripts. Hopefully you are a fine human being and have cultivated outstanding personal, academic, and work references. I threw in a clergy reference as well. Each optometry school might have a slightly difference process, so please read their website like the careful, well-educated person you are.
5. Interested schools will call you up and schedule an interview usually starting around January. You will have to pay your own travel, food, and accomodations, so if you get a lot of interview requests, you may want to prioritize them if you don’t have unlimited funds and time. By the way, do well at the interview.
6. Wait for all the offers to pile in, and accept the one you want. I would pray about it. It’s a big decision.
7. Spend big money to attend optometry school and pay attention because there is a test later. Spend some more money on your own optometry equipment and reference books.
8. Work with a professor that you respect to plan, execute, and write a thesis project during your second year of optometry school.
9. Pay your money to take the NBEO 3-part testing and do well.
10. During your fourth year of optometry school, you will travel around to different preceptorship sites. You can focus on the type of settings you would like to work in, or better yet, experience several different settings to give you more experience if your preferred setting doesn’t work out right out of school.
11. If interested in specializing, you can do an optional optometry residency. During your fourth year you will apply and then be invited to interview for residencies. They are preferred for several modes of practice like government, academia, and LASIK centers. You’ll learn more about this and be able to make an informed decision after being in optometry school.
12. Graduate from optometry school
13. Apply for optometry licenses in the state(s) you wish to practice in.

Congrats, you would then be a practicing optometrist. For those of you counting at home, that was a minimum eight years of your life after graduating high school. I wish you luck in your quest to find a job and be happy with your career.

Before you can start working, you will need spend money on a license, malpractice insurance, perhaps a DEA number, and apply for all the insurance panels you want to take. If you decide to work for yourself instead of someone else, you’ll need to take care of a whole bunch of business related stuff that is beyond the scope of this post.

Don’t forget you will need to spend a whole bunch of money every year in the racket known as continuing education conventions.

For you optometry students trying to make up numbers for your business plan, here are some percentages from my average Walmart practice:

In 2007 and 2008 I didn’t track the percentage of patients using insurance because I didn’t have to bill very much back then.

For more interesting stats to help you make your business plan, the OBA-CE has compiled these:

• Revenue Per Exam
• Complete Exams per OD Hour
• Annual Revenue Growth Rate
• Internet Site Penetration
• Contact Lens Usage by Lens Type
• Recall System Independent of Vision Center
• Walk-in Ratio
• Contact Lens Exams Percent of Total Exams
• Medical Eye Care Visits as Percent of Total Visits
• Exams Percent of Active Patients
• Professional Fee Income Percent of Total Location Revenue
• Performance Metrics by Years at Location
• "Elite” Practice Metrics
• Performance Metrics for Walmart and Sam’s Club Locations

I’m instituting a new feature: Hate Comments. You know, the comments that don’t get published because they fail my unapologetically arbitrary moderation process.

It turns out there could be gems of literary wisdom for the ages in some of these unpublished comments. Let’s read the nuggets and gems just pouring out of this deleted comment:

Author : Johnny (IP: 66.142.***.*** , adsl-66-142-***-***.dsl.crchtx.swbell.net)
E-mail : forgetyou19@hotmail.com
URL :
Comment:
first of all, David Langford is a sore loser in optometric field…..”happily rents a place in Wal-Mart” ????……after 8 years of school (maybe more for you, who knows), and works “happily” in the cubicle of Wal-Mart ??!!!…you’re embrassing !!!!……having opticians watching your every move and determining your working hour ??!!!….take title OD off of your last name Langford….biggest loser like you don’t deserve it…..if you can’t encourage people into OD career, then don’t lead them to your sorry ending ways.

Wow. First, I didn’t lose in the optometric field. It was private practice. And if a bright, nice guy like me can fail in opening cold, you young pups coming out of optometry school could also. It should give you pause because while I don’t think I’m any better than you, why would you assume you are better than me? Your O.D. degree doesn’t guarantee anything. And that loss was just a single battle in my life. I’m winning everywhere else (family, church, hobbies, current job, etc), so I don’t think you can fairly call me a loser.

Second, Johnny, look in your local phone book and see how many commercial vs. private practice optometrists there are. Your comments are disparaging almost 1/3 of the optometrists in the nation. Your use of cubicle is interesting because almost 99% of all optometrists work in a room about 11’x13′ (and in the dark half the time). You don’t even know that I set my own hours. What’s embarrassing is your spelling of the word embarrassing.

Let me address who I think Johnny is. His IP address from Southwestern Bell indicates he’s probably in the states of Arkansas, Kansas, Missouri, Oklahoma, or Texas. So, it’s possible that he could be an optometry student in Houston, Tahlequah, or St. Louis. Judging by the maturity and knowledge revealed by his writings, I would guess that it’s more likely he’s an undergrad, possibly high school student, planning on becoming a private practice optometrist.

Johnny, I would say that you should go for it. Go big or go home. I’m sure you can do it, Johnny, because I have faith in your ability to communicate and win friends and influence people.

To the rest of you undergrads that are asking yourself, “Should I be an optometrist?” Let me ask you some questions:

1. Do you like sitting in the dark half the day?
2. Do you like explaining the same thing over and over and over again to everyone you meet?
3. Do you like to wear slacks and collared shirts all day, everyday?
4. Do you like to work Saturdays? (More and more private practices are now in addition to commercial.)
5. Do you want to pay more in school loans than it’s worth to be in said profession?
6. Do you have a favorite town you want to settle in? Because I’ll bet it’s already saturated with eye doctors.
7. Do you like having shortened lunch time because the last patient went long?
8. Do you like getting scowled at whenever you run a few minutes behind?
9. Do you like knowing you could be sued and maybe your career over if you mess up even once? (Not that you will, but it’s possible.)
10. Do you like to whine at ODwire.org? (But seriously, check out this link for more considerations in choosing optometry as a career.)

Apparently there was a video contest, and Marc Schmitt at PUCO submitted a great entry. I recognized three professors in it: Dr. Hannu Laukkanen, Dr. Dennis Smith, and Dr. Lorne Yudcovitch.

H/T to Dr. Maino.

Kevin, M.D. says that

The retail clinic era is over, and … pharmacy-based clinics are doomed to fail.
Corporations are finding out what primary care doctors already know: it’s hard to make money only doing office visits.

Ophthalmologists make bank doing procedures. I guess the problem with the retail medical clinic is that the doctor is paid so much. I guess optical shops are lucky that optometrists aren’t as high up on the whole pay scale totem pole.

I have to wonder about the optometric profession, though. The student loan debt percentage delta outpaces optometrist’s pre-tax net percentage delta. How much longer will anybody want to apply for optometry school?

I guess we need Obama to bailout the optometry schools. Socialized medicine, here we come. Thanks for reading, comrades.

I saw this list over at PookieMD’s blog, and I think you should add it to your list of considerations before applying for optometry school, because many of the challenges facing PCPs also relate to optometrists.

Any readers of this blog entry entitled “The Perks of an Optometry Career” need to read my “Do Not Become an Optometrist” entry or my “Should YOU Open a Private Practice?” entry.

How does the perk of working every Saturday sound? How do you like getting home many nights at 8:00 PM, (just in time to tuck your kids into bed)?

Unless an optometrist is employed by a big chain or there is some extreme emergency, hours are generally restricted to Monday through Friday with no on-call duty needed.

That’s not true in today’s market. Only government workers get Saturdays off now. More and more private practices offer extended hours and Saturday hours to stay competitive in today’s market. People don’t take time off work anymore just for routine eyecare (but of course they’ll do it for the dentist, but not you…a lowly optometrist).

Oh, and other doctors don’t have to worry about their scope of practice being legislated away.

And how do you like having a cap on potential income? You can only see so many patients a day. Get rich selling an unlimited number of widgets that everyone wants. Only become an optometrist because you love it…but, that begs the question how do you find out that you love optometry without going to expensive optometry school? By the way, when I went to optometry school (PUCO 2003), it cost about $22,000 per year for tuition, including fourth year when you’re not even at school because you are on preceptorship. Last I heard it’s up to $27,000 per year.

So my question is, at what price point does optometry school become unfeasible?

I keep hearing this type of comment: “I don’t understand you. I’ve read your blog when you were in private practice versus now. I don’t think you know what you want out of life.”

They seem to be saying that I’m a flip flopper and must be some unhappy individual who is lost. You can’t discredit me because I’ve experienced three major forms of practice. Someone who has experienced government, private, and various flavors of commercial is not a lost soul, but rather he is an experienced voice.

I implore all students and new O.D.s to listen to my words. If you would like the security of government work and don’t mind living in remote locations, then by all means be a government optometrist. If you want to be able to live in more populated areas, than choose commercial practice over private and choose Wal-Mart over all other commercial options.

In my previous posts advocating private practice and demonizing commercial, I had been drinking the private practice cool-aid that I’d been served since optometry school. Some of the disparaging remarks against commercial hold true for many brands of opticals, but not Wal-Mart.

Private practice is too risky. Sure, you know or have at least heard about successful private practice businesses, but you can’t assume that things would go well for you if you were to hang up a shingle. The money it takes now days to start cold could be better invested in Vegas. It’s a crapshoot, heavy on the crap because the frame vendors, the lens suppliers, ophthalmic equipment companies, the financing company, the advertising people, the landlords, the employees and more all get their money from you. But when do you get paid? Paying all of those people doesn’t automatically bring patients in the door. And when will you actually get enough patients to break even? That could be never, you know. You may just have to close shop when the money dries up, like I did.

Wal-Mart makes it risk free. There will always be patients coming to your door. Your success is only limited by the number of hours you are willing to work. That’s why if you want to be rich, make and sell widgets. If you want to do eyecare, work for the government or Wal-Mart, depending on where you want to live.

Anyway, just because I’m giving advice from my experience doesn’t mean I’m somehow lost or unhappy. I have family, religion, and a great job inside a Wal-Mart Vision Center. Of course I’m happy.