Non-Affiliated Optical

[Chris Ryser]

Buy into the shop. Seems like the fairest, win/win solution. Pay her an agreed amount as buy-in, she gets a salary and benefits, split the profit that's left. Fewer headaches for you, she gets cash, and/but a lower percentage of more profit.

This would seem to a logical solution, the agreed buy in could from a percentage of the sales of customers you send. When reached, the part of the business you have agreed upon would be yours.

This way you would not have to cough up the cash and she would not have to pay you anything until you have fulfilled your obligation. It also could be of advantage to the optician because as your office grows so will hers.

A agreement like this could be beneficial because both would benefit at the end.

[shellrob]

I'm sorry DR, but it doesn't matter if I'm an employee or an owner to know that what you're expecting from that Optican is unreasonable. You should be ashamed of yourself for thinking that they owe you something because you're 1/2 million doallars in debt and that you will be "giving" them money for the referrels. Like all the other posts have said.....open your own shop or offer to buy into the shop. Anything else that you request from the Optican is ridiculous and they should laugh in your face. I almost cannot believe what I'm reading.

[drillmountmaster]

I don't see why you don't just invest in a good optician and do some dipensing....it would increase your net, and then you don't have to worry about the other guys....if you're so great then the other guy will go out of business.....or on the other hand they might go to war with you. If I were them I wouldn't play ball, especially if they have been there for a long time. And just because they don't seem to be busy all of the time dosn't mean they're not making money....just remeber if you spend 1/2 hour doing an exam you might make at the most $150 in fee's, while the Optician spends 1/2 hour with a patient and makes on the average $325......and someone made the point earlier that your office is bound to get bogged down with 3rd party crap.....anyway good luck!

[NC-OD]

I'm sorry DR, but it doesn't matter if I'm an employee or an owner to know that what you're expecting from that Optican is unreasonable. You should be ashamed of yourself for thinking that they owe you something because you're 1/2 million doallars in debt and that you will be "giving" them money for the referrels. Like all the other posts have said.....open your own shop or offer to buy into the shop. Anything else that you request from the Optican is ridiculous and they should laugh in your face. I almost cannot believe what I'm reading.

Alright, you guys win. I will put in an optical and put the little run down optical and the opticians out of business. That seems to be what many of you are suggesting (surprisingly).

So when I do it, it will not be half ***. There will be no stains on the carpet, old green equipment, dirty frame displays, and 1 week waits. I like to go first class. I will undersell and out perform them at every step. My way, their income would increase substantially for doing a little more work. Your way, they will be out of work hoping to get at job at Walmart or begging me for a $10/hr job.

It's amazing that you folks don't want to try to protect your colleagues. This is one of the last remaining independent opticals in our area. Your contributing to their extinction. :shiner:

[NC-OD]

I don't see why you don't just invest in a good optician and do some dipensing....it would increase your net, and then you don't have to worry about the other guys....if you're so great then the other guy will go out of business.....or on the other hand they might go to war with you. If I were them I wouldn't play ball, especially if they have been there for a long time. And just because they don't seem to be busy all of the time dosn't mean they're not making money....just remeber if you spend 1/2 hour doing an exam you might make at the most $150 in fee's, while the Optician spends 1/2 hour with a patient and makes on the average $325......and someone made the point earlier that your office is bound to get bogged down with 3rd party crap.....anyway good luck!

I only take a handful of medical insurances (MCR, MCD, BCBS, UNHC, workers comp and a few others). No vision plans. I'd dig ditches before I messed with the likes of VSP.....but that's another topic, I suppose:D

[For-Life]

Alright, you guys win. I will put in an optical and put the little run down optical and the opticians out of business. That seems to be what many of you are suggesting (surprisingly).

So when I do it, it will not be half ***. There will be no stains on the carpet, old green equipment, dirty frame displays, and 1 week waits. I like to go first class. I will undersell and out perform them at every step. My way, their income would increase substantially for doing a little more work. Your way, they will be out of work hoping to get at job at Walmart or begging me for a $10/hr job.

It's amazing that you folks don't want to try to protect your colleagues. This is one of the last remaining independent opticals in our area. Your contributing to their extinction. :shiner:

Your way you are taking money from other peoples work.

And if this place is so runned down then its business will probably not increase that much.

[shellrob]

Md, your additude from the beginning has been me, me , me, and now you want our support?????

I don't know much about where you're from, but unless the doctor has some type of ownership in the shop, they don't get anything from the sale of optical goods. Look at all the doctors that work for the chains, they don't get squat from the sale of glasses and contacts, so what makes you so different?

I'd be interested to hear what the other docs on here had to say.......

[NC-OD]

Md, your additude from the beginning has been me, me , me, and now you want our support?????

I don't know much about where you're from, but unless the doctor has some type of ownership in the shop, they don't get anything from the sale of optical goods. Look at all the doctors that work for the chains, they don't get squat from the sale of glasses and contacts, so what makes you so different?

I'd be interested to hear what the other docs on here had to say.......

This is very, very simple. The docs that work at the chains pay very little in overhead and have very, very little risk capital. They are hired refractionists. They can walk away at any time.

I think I mention earlier (maybe not) that I have spoken with 2 other opticans locally that "lease" office space to an OD and one to an OMD. Both give free office space AND a small percentage of the sales. Perhaps this is not common or is just their particular arrangement. But this is the largest private optical in my area. So maybe they understand the rules better.

Let me offer this analogy. A large vision plan comes to town and says, "we have 10,000 "souls" and we want you to be their optical provider but you will have to do it at a 20% discount off your normal fee". Many would probably jump at this. Why? They are not doing any work. They are getting money for nothing, right? What is different from this and me going to them and saying, I will be sending over 5 customers per day for glasses and would like a small piece of the action.

Hey, what if I give them a % of the exams they send over. Not sure of the leagalities but would this make anyone happy? Would that be fair?

[For-Life]

I do want to say something to NC-OD.

I know that you are doing this under the best intentions, and I do not want you to take my comments as anything really personal, becuase I know you are not trying to be an ogar.

A lot of my comments now have become more theoritical than practical, as many OD's do demand a percentage of sales; however, I do not agree that is correct. I understand that the practice beside you will benefit from the deal; however, would you chase every script that leaves your office for someone else? Again, if the office beside you sent over more patients than they received would you give them a percentage of sales?

It just seems like everyone wants to take a bigger chunk from the Opticians when the Opticians are just trying to make money like everyone else. It was the Optician's choice to become a dispenser, the OD's choice to become a refracter, and the MD's choice to become a surgeon. Somehow those have become blurred. OD's are dispensing and trying to get to the more surgerical side, MD's are doing are dispensing and doing refractions, and Opticians are now even refracting. Nevermind, the Internet will probably try to somehow do all three in the future.

[Aarlan]

.....But on the other hand, we all know that we can make as much money or more selling a moderately priced pair of glasses as I can doing a routine eye exam. The difference is, I have $100,000+ dollars worth of equipment (not to mention another $100,000 in school loans.......well......it's down to $70,000 now) to do it while this optican has maybe $5,000 in equipment and inventory.

So we are not talking apples to apples. I also advertise, speak and teach more to bring in new patients. I don't think you understand. Maybe you are an employee and not an owner. Maybe that makes a difference in our thinking.

.

If you are interested in opening this new practice, you should be doing it on the merits of its own profitability. Of course you are spending $100K +...That's par for the course to establish a new office. The fact that there happens to be an established optical shop next door should have little bearing on the situation. If you want a percentage of the optical profits, either open your own dispensary or purchase theirs. The fact that they may benefit from your decision to expand your office does not entitle you to any extra profit they may experience any more than they are entitled to any of your profits if they began to refer every one of their patients to you.

We have a large retail development going up down the road. The restaraunt next door is planning on making a killing due to the increased traffic this new project will bring...does the restaraunt owe any of it's increased revenue to the new development's landlords/owners? Why is it fair that the develpers have to spend $70 million, and this restaurant owner is going to make all of this extra money all because of them?

As unfair as it may seem to you that someone is benefitting from your hard work and financial investment, you stated that you didn't do a lot of dispensing at your original office, so I simply don't see how you are entitled to anything derived from the opticians next door. If they were across the street, would you feel equally entitled? How about 2 blocks away? My point is unless you have an ownership modality in their business (purchase it outright, or buy into a profit sharing agreement), or you open your own dispensary, you shouldn't expect to realize any money from their business.

That being said, they are only opticians... we're not always the brightest to be found in the human species...I'd try to get from them whatever you can...

Best of luck with your new endevour.

AA

[slaboff]

Hey, what if I give them a % of the exams they send over. Not sure of the leagalities but would this make anyone happy? Would that be fair?

It really doesnt matter what makes us happy... would it be fair that you would make a percentage profits from their work if they made the same percentage profits off of yours... I would say yes it would be fair if it worked both ways...

personally if i was in your postition i would attempt to buy them out and hire the optician working there... put a little money into the place to spruce it up and everyone should be happy, assuming the optician wants to sell...

[Aarlan]

Hey, what if I give them a % of the exams they send over.

I could have sworn kickbacks are illegal. I believe it works both ways.

You can be compensated for your effort and work, and they can be paid for theirs. You can have a mutually beneficial relationship for the both of you. Your patients have a great practice to go to next door, and they have a great doctor to refer all patients and CTL fits within a close proximity. This seems to be a good fit for everyone...
Incidentally, you had mentioned how much you are spending to open your new office there. Did you ever stop to think how much they have spent in equipment, displays, frames, improvements, processing costs, etc? They may have easily spent as much or more over the last few years than you are planning to. I know it's a pain to part with that much money to outfit your new establishment, but what would be the cost to establish a dispensary, maintain it, staff it, monitor it, update it, audit it, etc? And how much would it cost in poor relations with your new neighbor? Just let them keep what little extra income they may receive from your practice, and you keep whatever patients they send your way, and everyone goes home happy.



AA

[chip anderson]

I can once recall having a discussion with a friend who was a female O.B. (Obstetrician for those of you in Rio Linda). I asked why any ophthalmologist who could knock down from 1 to 5 million a year on ophthalmic medicine, exams and surgery lower himself to fool with the optical business?

Her reply: "Don't ever underestimate greed."

So why are we having all this fussing, we know the problem. We can modify the semantics to make each of our positions seem ethical and honorable. But the truth is: "Ain't neither of us gonna change."

For years the young inexperienced M.D. would move into town and the independent opticians would fill him up with referrals. The M.D.'s and independent opticians hated O.D.'s and vice-versa. Then later things changed when the doctor got booked up in advance, the local wholesaler put him a dispensary in "at little or no cost". The statements of what is ethical changed and medicine changed.

Now the M.D.'s like the O.D.'s and vice-versa. A poor little ignorant legally restricted optician isn't going to be a great source of cataracts, or refractive surgery and the O.D. can not only furnish these. They are now apparently qualified to do follow-up visits pre and post-surgery.

There is little point in our debating this, "ain't neither of us gonna change." and the world has changed.

Chip

[NC-OD]

I can once recall having a discussion with a friend who was a female O.B. (Obstetrician for those of you in Rio Linda). I asked why any ophthalmologist who could knock down from 1 to 5 million a year on ophthalmic medicine, exams and surgery lower himself to fool with the optical business?

Her reply: "Don't ever underestimate greed."
Chip

I don't disagree at all. I like Chip. I've never seen him but I picture him being a cross between Popeye with a stove-top pip and Pachino :D

I also agree: "It is what is is". It's not up to me to change the world. I've given up on that and simply play the cards I have. Speaking of GREED. I have a quick story.

Recently I was set to partner with a busy cataract/refractive Ophthalmologist that left his group and went out on his own. For 6 months, I worked at his temporary office out of town a few days per week. The story was: He would do the surgeries and I'd handle the routine exams, post-ops and diseases. We played along for half a year until he got into his new 16,000 sq ft, 21 exam lane office in town (with an optical despite me almost begging him not---my first hint of things to come). So we were to merge our practices. It got to the 11th hour when I finally tired of him delaying when I gave him a contract to sign. He studied it and come to the conclusion that I would be making too much money. He wouild make a couple of million a year as a busy Lasik OMD but was concerned that a few hundred thousand (for working my *** off) would be way out of line for an OD......SEE YA! I didn't look back. I learned a great deal about greed form this guy.

The real problem, in my opinion, (and I think most of us would agree), is that there is a huge oversupply of ECPs in most every place. This contributes to bringing out the worst in some good people.

[harry888]

I've really enjoyed this thread, it has brought out some good points. Myself, I'm an OD in private practice, but have also been in a side by side with an optician. So I can look at this from both sides.

In private practice with dispensing, I feel like an eyeglass peddler. Insurance companies don't give fair compensation for professional services because they expect you to make something off glasses. Patients view a recall card as "he just wants to sell another pair of specs".

I admire NC-OD for opening a non-dispensing practice.

But if you expect a cut on the glasses you send there, they should get a cut of the exams they send to you.

Think of them as an excellent referral source and free advertising. Send a basket of baked goods and they will be telling everyone how wonderful you are. They already have the client base.

Harry

[Dannyboy]

If the optical is that old and only has a 100 frames and it is an antique... Then maybe this optician is not as successful as to merit being around for 30 years. I tend to agree with u, put the optical on your own and hope for the best..I would leave the doors open in case the optician wishes to come on board... but it sounds that it maybe it is time for her to retire. It does happen. Do the business plan well...either invest in the optical or search for an LDO who can put your operation at ease....Maybe you can find an Optician partner who is out of school and interested in starting his own practice. Make sure that this optician practices to the fullest permitted by law.

Remeber the kickback rules...If u are not charging for rent...that is a kick back. Have the new independent optician pay commercial price rent. Your real estate is worth more because you are there and is a prescriber.

good luck

Dannyboy:shiner:

[drk]

NC,

I know you from another forum. Your dislike of optical is notorious, there. My OD to OD opinion:

1.) They will be getting a good deal with your sure-to-be-growing practice next door. They are lucky, here. As is, they don't owe you a thing.

2.) If you want to be involved in optical, be involved.
a.) The best bet would be to assess whether they are the type you want to do business with. If so, consider an equity business arrangement with them. They apparently need capital, and you could provide it. This is risky, but not if they're good people.

b.) If they are not worthy of partnership, set up your own optical. You would prosper and they would still be ahead.

2.) You may choose to stay with your passion, medical optometry. Don't let the siren song of $$$ influence you, then. Don't look back. If you're nervous about debt service, consider whether you've overdone it.

[hcjilson]

From Optician to NC_OD- nice to see you posting again, and this is a great thread with valid points all around.I think drk is on the right track. Sit down with the optical folks and see what you can work out. This could be a golden opportunity for both sides to gain.

As an aside, NC and I have had very different opinions in the past but to my knowledge he has not displayed a lack of respect or dislike of "optical". Its just not his bag.

[NC-OD]

From Optician to NC_OD- nice to see you posting again, and this is a great thread with valid points all around.I think drk is on the right track. Sit down with the optical folks and see what you can work out. This could be a golden opportunity for both sides to gain.

As an aside, NC and I have had very different opinions in the past but to my knowledge he has not displayed a lack of respect or dislike of "optical". Its just not his bag.

True, I don't hate optical. I don't really hate anything really. I just think opticians are the ones that should be handling the optical side. I can do it, but I have other interests...and frankly, I'm not that good at it. And I've learned that no one can truely be an expert at everything (but some people sure do try and they fool themselves and maybe even others :bbg: ).

I will be speaking to the opticians soon and I hope that we come to a win-win arrangement. I'll let you all know.

[drk]

As for the exam room, nothing personal against you or Drk, or any other OD, but I hate it when the OD talks about lens options in the fitting room.

Most OD's, and I am very sure this excludes you and Drk because you have proven that you want to be educationed, do not know as much about lenses as the opticians does. So now the OD is recommending this and that and is telling the patient information that may not be the best information. On top of that, the patient takes that as part of the prescription (especially if it is written on the script) and will discount anything a trained optician who specializes in lenses will tell them.

So I would just not go over that information in your office. If the patient asks tell them that a licenced optician is better to make those decisions for them, because they specialize in that field.

I think you are generally right, here. (Unfortunately, IMO) our profession is ceding the lens design to your profession. It's a great opportunity for your profession to take advantage of. More and more OD's are becoming like NC-OD: superb medical clinicians with less interest in vision care. I'm of the opinion that our profession will sub-divide into specialties in the near future.

In the purest of worlds, the MD's would do surgery-related care, OD's general medical and vision care, and Opticians would do the lens designing and optical services. In the real world, there is tremendous scope overlap, even to the degree where Dr. Ilan is going to know surgical to optical (if his brain doesn't explode, first:) ).

The overlap is necessary because we all can't get along and work together, I'd guess!

[drballen]

Tom,
I have not been on this site for several years, primarilly because of the strong anti-OD comments made. Your post on another site to review the posts on this one has brought me back as well. I am impressed with the dialogue ongoing on this thread, and I have to side with the majority of the opticians on this one. Without ownership you have no right to ask for a cut, and this is considered illegal where I practice. I have relocated one office right near another optical myself, but I put in my own optical , and still get referrals for exams. And before anyone asks, YES, i send them right back. I expect the same level of respect when I refer to an OMD(but dont always get it).
You want optical sales revenue: Put in an optical. If you do not want to have the hassles of an optical, hire a competent optician to manage it for you.
Finally, ya gotta drop the feel sorry for me with my 500K debt. I carry over 1M in debt and love it.
I think that OD"s can and generally do a superb job of running an optical, there are just some newer grads(did I just say that?) who would prefer not to. To be honost I once felt this way myself, but not anymore. The comment that OD's shouldn't discuss lens options in the exam room is way off, where should I discuss it? In the parking lot? It is expected by my patients(even those who get their glasses elsewhere) that I will discuss and make recomendations(which is all they ever are) if they are warranted. I would put my knowledge of optics and lenses up against the average optician any day. Notice I said average optician, because I realize that there are probably many who are way more knowlegable than I. I am also certain Tom could put his management of ocular disease up against the average OMD any day as well.
Brent (UW '95)

[ilanh]

Thought I wouldn't find this thread, huh? But I did.:hammer:

In the ideal world it would be nice if each one of us tried to stick to their own field and not interfere with the other. Unfortunately, in my case it was not possible. I have a very busy surgical practice and hire 2 OD's; however, I began to realize that my patients weren't always thrilled with the results of their refractions and contact lenses. I took an avid interest in refractions and contacts, read books, practiced on hundreds of patients, thought about optics for a while and eventually discovered that I could refract better than anyone in my practice. Now I have established guidelines for my optoms and they have to do it my way. The quality of the refractions have improved greatly. Should they have known this? Yup. Did they? Nope.

Same for opticianry. I used to have a very experienced optician and she retired. While she was in charge I never bothered to know a damn thing about the business. After she left I realized that it was a huge mistake and I had missed wonderful opportunities. I started to learn as much as I could and as fast as I could. We are now dispensing better product, at better prices to happier patients.

Do I like all this extra work? NO. Can I find anyone to do it better than me? I wish I could.

Ilan

[NC-OD]

Because I'm a bit confused and just out of curiosity, do any of you have an OD come into your place to work. How are your arrangements with them? A set dollar amount per sq feet? Does anyone offer free rent (or close to it) just to have them there to do exams? Or do you charge fair market value to rent the space? Any other incentives.

[Jim Stone]

You have plenty of room. Why don't you open your own optical and put this optician out of work. Maybe you can offer her a job in your new optical shop.

[For-Life]

Because I'm a bit confused and just out of curiosity, do any of you have an OD come into your place to work. How are your arrangements with them? A set dollar amount per sq feet? Does anyone offer free rent (or close to it) just to have them there to do exams? Or do you charge fair market value to rent the space? Any other incentives.

I have a doctor come in and do exams. No rent. He gets paid his fees, I get paid mine.

I would like to charge rent, but then he would have never come and worked for us.