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Thread: Purchasing an existing optical with no OD

  1. #51
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    I'm curious BayouSpectacle-do either of you perform refractometry? Refractometry is not the same as a refraction, which only a doctor finalizes; refractometry was part of my training and is what a tech will do to divine the patient's Rx for an ophthalmologist. I'm a Licensed Dispensing Optician and before that, a Certified Ophthalmic Technician in ophthalmology for 20 years-and we performed refractometry for the MD"s-the supposition that the intimate details and machinations of what a patient had for an Rx and what Rx is in their present glasses and what their new Rx is, I believe, will result in a ton of re-dos for unhappy patients from shops that didn't know how complicated getting the "right" Rx is-and outsourcing the refraction to a outside location is begging for problems. I have an OD come in and I charge her no rent and she makes my patients very happy with very little re-dos, which can kill a new business. Best of luck to you both-we need more independent ECP's!

  2. #52
    OptiBoardaholic CNG's Avatar
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    I think that a good remote refracting system needs to be able of performing objective and subjective refraction. Without the subjective part it would fall outside of the standard of care. Now as for stand alone refraction it is perfectly legal in most states when performed by an ophthalmologist because refraction and the manufacturing of eyeglasses are not medical acts. These exception were put by optometry and opticianry when they legislated their professions. So in essence an ophthalmologist can supervise a non medical act such as refraction and not be held liable because it is not a medical act.

    CNG

  3. #53
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    What exactly does the doc do when they 'finalize' a refraction? And why?

    B

  4. #54
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    Kittyeyes

    Neither my wife nor I will perform refractometry or refraction. A technician that is working under the direction of an ophthalmologist will perform the refractometry or refraction (I'd ask my wife the difference between the two, but she is sleeping and Google was no help). The exam consists of a questionnaire for medical history, an auto lensmeter is used to read prior prescription, and then an objective exam which is followed by a subjective exam. If you are interested, there are several locations in New York that are currently using the technology. There are several in Florida (where my wife and I visited) that are using the technology. There will be one in Louisiana using the technology very soon and we would welcome you down here anytime. I cook a mean crawfish etoufee.

    I am sorry, but I am not sure what you mean by the "right" prescription. It appears from what you listed the features of the system we will be using - "what a patient had for an Rx and what Rx is in their present glasses and what their new Rx is" so I assume you are familiar with it. What did you do as a Certified Ophthalmic Technician for that ensured you got the prescription right? Do you feel you could not have gotten it "right" had you not been standing in the room with the person who's eye were being examined? Did your exam really require a physical presence? Why? I am truly interested in your experiences and hope to gain some insight as to what potential problems you think could occur.

    My wife, the optician, will do her job as an optician. The OD that I was lucky enough to find will come in every Monday and every other Saturday (until I am able to generate enough patients to pull her away from XXXXXXX) will do her job. In the meantime, I have an OMD will do his/her job as an OMD, although it will be performed remotely.
    Last edited by BayouSpectacle; 02-26-2016 at 01:04 AM.

  5. #55
    Ophthalmic Optician
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    Quote Originally Posted by Barry Santini View Post
    What exactly does the doc do when they 'finalize' a refraction? And why?

    B
    Signature? Take responsibility for it?

    Just guessing.
    Ophthalmic Optician, Society to Advance Opticianry

  6. #56
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Quote Originally Posted by Johns View Post
    Signature? Take responsibility for it?

    Just guessing.
    I think what they do is very misunderstood by opticians and optical techs.

    B

  7. #57
    OptiBoardaholic CNG's Avatar
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    Quote Originally Posted by Barry Santini View Post
    I think what they do is very misunderstood by opticians and optical techs.

    B
    Generalizations...you always seem to speak in riddles. I guess that is a sign of superior intellect. :)

  8. #58
    OptiBoardaholic CNG's Avatar
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    The beauty of digital refraction systems is the technology behind them. The fact that at the end it will demonstrate the old Rx vs the new one creates a wow effect. if I'm reading this correctly this system probably is in 60 to 70 k which makes it possibly an investment that the average shop could not afford. What he is describing is not a computer based refraction but a real refraction. In top of that is done with equipment that is FDA approved so if necessary it could be billed to insurance if they find a way to do fundus exam. It maybe possible for the patient to even get reimbursed for the refraction in some wellness plans.

    CNG

  9. #59
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    CNG,

    That is my point, it is a real refraction. And it is done with FDA approved equipment, not equipment that you purchase at the ATT store. It is the latest in high end equipment that is found in OD/OMD offices. And yes, the purchase price you listed is extremely accurate . In fact, there is an option to expand the equipment purchase to include everything needed for a complete, insurance reimbursed, exam. But I am waiting before making the jump.

    There are a number of reasons I have not chosen to go with the expanded equipment purchase:

    1. Foremost, I want to see how well received remote refraction is in my area. I do understand the this is something new so before going all in, I want to test the waters. There are customers that will not be good candidates for remote refraction because of age or eye health reasons, so I want to have a good feel for my customer base before any additional investment.

    2. I am testing the relationship with a vendor that is new to me. I am relying on their staff to be ready when my walk-in customers are ready. I am also relying on their staff to provide accurate exams. So again, testing those waters. Worse case, if the relationship does not turn out well, I have the latest optical exam equipment on the market for my doctor to use.

    3. I was trying not to get into the money aspect, but I am opening a startup. Nobody is interested in loaning money at the moment, so I have just over $100,000 invested. Add the $60,000 to $70,000 equipment purchase and I am at $170,000 or so. Before I add the additional equipment that provides an insurance reimbursable comprehensive exam, which would put me well above $200,000, I think it prudent I perform both 1 and 2.

  10. #60
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    Oh, and reason 4. I found a boat I am interested in....

  11. #61
    Master OptiBoarder optical24/7's Avatar
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    Bayou, I mean this with the deepest respect, but if I had that kind of money to invest, I would open a pizzeria. New start-up's in optical take a lot of time to build up, even if you were an OD, and even that is no guarantee of success. But I do wish you the absolute best of luck! Please keep us posted.

  12. #62
    OptiBoardaholic CNG's Avatar
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    I think you have covered all angles. Please excuse some of us for being ignorant about such system because it is all new to us. The ones that I would be leery about would be the totally online refractions. Not being able to have a real subjective makes its results unkown until after you purchase the glasses and frankly is scary when a human really is not involve. Just make sure that you always do the right thing when things don't go right. Be very open with refunds and really do not push your glasses down the throat of your customers ...let them decide based on quality and service. I personally know of a fellow licensed optician who also is doing online eye exams at his office and trial framing the results for a fraction of the cost...time will tell. The online refractions does not do subjective like your equipment does.

    CNG

  13. #63
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    Quote Originally Posted by Barry Santini View Post
    What exactly does the doc do when they 'finalize' a refraction? And why?

    B
    I can't speak for everyone, but in my case it means I look at the autorefraction, then I look at the subjective refraction and best visual acuities, and if I did a cyclo, the cycloplegic refraction. Then I look at the existing Rx next to my "tentative Rx" which is the same as the subjective refraction result, usually. Then I look at the patient's distance, near and intermediate vision needs and at their accommodative and convergence functions. Finally, I use my experience and judgement and the patient's complaints if any, to come up with an Rx or multiple Rxs with suggestions on lens types which I think are appropriate for their needs.

    Sometimes these "final Rxs' are the same as the manifest refractions, but more often than not, they are not the same.

    Oh and why do I do this? It helps the patients see better and it results in fewer remakes. It also results in multiple pairs being provided.
    Last edited by Dr. Bill Stacy; 02-26-2016 at 11:40 AM.

  14. #64
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    Quote Originally Posted by optical24/7 View Post
    Bayou, I mean this with the deepest respect, but if I had that kind of money to invest, I would open a pizzeria. New start-up's in optical take a lot of time to build up, even if you were an OD, and even that is no guarantee of success. But I do wish you the absolute best of luck! Please keep us posted.
    NOW you tell me.....

    Actually, I do understand it takes time to build a new optical. I did not inherit the cash reserves I have on hand, it was accumulated through years of being wise with it. Are there "easier" investments? Perhaps, but I think I have a unique opportunity in the city I am in.

    But a pizza shop is still a possibility...

  15. #65
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    Quote Originally Posted by optical24/7 View Post
    Bayou, I mean this with the deepest respect, but if I had that kind of money to invest, I would open a pizzeria. New start-up's in optical take a lot of time to build up, even if you were an OD, and even that is no guarantee of success. But I do wish you the absolute best of luck! Please keep us posted.
    You, Fezz, and I have all had the same conversation, and it was one of the few times we were all serious. I think we all agreed also; another first.

    Optical has been very good to us, but I would be putting pizza boxes together, or filling the soft serve machine before I'd start from scratch again. Having said that, nobody appreciates dreams more than I do.
    Ophthalmic Optician, Society to Advance Opticianry

  16. #66
    Master OptiBoarder optical24/7's Avatar
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    Quote Originally Posted by Johns View Post
    You, Fezz, and I have all had the same conversation, and it was one of the few times we were all serious. I think we all agreed also; another first.

    Optical has been very good to us, but I would be putting pizza boxes together, or filling the soft serve machine before I'd start from scratch again. Having said that, nobody appreciates dreams more than I do.
    That's why I mentioned the pizzeria!

  17. #67
    Master OptiBoarder optical24/7's Avatar
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    Oh, also, we couldn't use your name on the business, Papa John's is already taken...Maybe Papa Fezz 24/7!!

  18. #68
    Master OptiBoarder OptiBoard Silver Supporter Java99's Avatar
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    Quote Originally Posted by observatory8 View Post
    Greetings all, I am trying some due diligence before diving in with bare feet.
    There is a tiny office/optical available in a terrific, high density area. However, there is no OD or MD in the same building or same street. The overhead is ridiculously low and the clientele are high end. What do you think this business would look like in a year?
    In another line of thought: I have been paying attention to the evolution of telemedicine and see that remote refraction are available in Florida. 2 part question. Where do you all see remote refraction heading? Does it take off? And secondly, how do you think being a board certified optician that fits soft contacts would add to a business? Especially in a highly transient, tourist area.
    Thanks in advance for the thoughts!
    1. Only take advice from people who have done what you are doing or something very, very similar.
    2. Opticians can operate just fine with no one refracting in the office. There is more proof of this every day.
    3. If it's the Finley's office, buy it. They are selling below market and they make money. They aren't my friends and I've never met them, but they are doing it right.
    4. What the business looks like in a year is entirely dependent upon what the new owner puts into it. There are no crystal balls. Write a business plan.
    5. I think remote refraction is the future and if I was in Florida and ready to expand into a 2nd location, I would buy it.

  19. #69
    OptiBoard Moron newguyaroundhere's Avatar
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    Quote Originally Posted by optical24/7 View Post
    Oh, also, we couldn't use your name on the business, Papa John's is already taken...Maybe Papa Fezz 24/7!!
    So this means you would be open 24 hours a day, 7 days a week? Yikes
    Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity

  20. #70
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    Open 24/7 is the best way to catch those late night people that are having difficulty with sudden double vision problems....

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