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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.

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Here is the scenario. One doctor can own a Wal-Mart contract (or a Sam’s Club contract for that manner) for more than one location at the same time. Wal-Mart usually decides to do this if the locations are struggling with volume and/or having a hard time finding someone to fill the location.

Can the doctor physically be at two places at once or work eight days a week? No, so he hires someone. Let’s call the multi-contract owner Dr. Fingers and the two doctors who work for the contract owner we’ll call Drs. Desperate and Disgruntled. Wal-Mart needs three locations filled: Bountiful, Ghetto, and Rough Diamond.

So let’s say Dr. Fingers works Bountiful and hires Dr. Desperate at the Ghetto location and Dr. Disgruntled at Rough Diamond. The contract is similar to “I’ll pay you 70% of your gross receipts.” Dr. Desperate says fine because she just needs a job and doesn’t care about a long term commitment because she’s willing to relocate in a moments notice. Dr. Disgruntled is in a bind because he really wants to live in the city of Rough Diamond forever, but he doesn’t want to pay Dr. Fingers 30% of his gross receipts, especially when he finds out that Dr. Fingers is only paying Wal-Mart 10% or if the contract is some ridiculously low flat fee not even based on receipts.

So what happens? Usually Dr. Disgruntled will leave and try to find his next best ideal location. Dr. Fingers will probably have to funnel in and out doctors every couple years. The vision centers stagnate and never grow because the doctors who work there have no vested interest in growing the practice since they know they won’t be there long term since Dr. Fingers takes so much of their money.

I believe that it is a mistake for Wal-Mart to give any doctor a contract for more than one location just so he can suck cash from other doctors for no reason other than, “Hey, I own the contract.”

Now, I can see how some of you might say, “But what if you had a multi-doctor parnership share multiple locations equitably?” Well, you’d still have the problem of the last location not growing because the doctors rotate every day, and then which of the doctor partners would volunteer to work at the last location on its poor performing days?

It’s better for the vision centers, the doctors, and even the community to have each doctor own the contract for the vision center that they work in.

“But what about vacation days?” you say. Well, wouldn’t it be cool if each area could have it own full time fill-in person? Maybe the fill in person could always keep 100% of his receipts and not have to pay rent to subsidize the days when there isn’t an opportunity to work? I don’t know, I’m just thinking out loud here. Or you can probably find a private practice doctor who needs supplemental income to work for you.

“But our store needs someone, and we can’t find anyone, so thank Heaven for Dr. Fingers,” you say. Well, that’s a short term solution that defeats you in the long run. None of your sub-contracted doctors would be motivated to grow the practice (an thus increase vision center sales) like a contracted doctor would. This scenario will just stagnate you at mediocrity. If you must hire Doctor Fingers, I think the terms should explicitly say that Wal-Mart has the option to not renew Dr. Fingers contract at the satellite location if they can find a permanent doctor when the contract expires in three years. I don’t care if Dr. Fingers is taking a “risk.” He has three years to recoup his “risk.” Take it or leave it, Fingers.

But let me restate. Multi-location contracts for a lone doctor who invariably gets greedy and pockets cash for not doing any work: BAD. Allowing a doctor to own the contract where he actually works in order to change it from slow to crazy-busy: GOOD.

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Ouch. This hurts.
It makes me want to cry.
But seriously, didn’t I say that optometrists have a PR problem? Sure, you could argue the cartoon itself is fun and games, but the reader comments about it are not.

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Brian Rowley was in the class above me in optometry school, and I just saw him at the UOA Meeting. It seems he is in the newspaper as a karmic baseball fan.

He also was interviewed for KSL TV, and they showed it on SportsBeat Sunday which you can view completely here on their SportsBeat iCast. On Saturday they showed this teaser:

I’d say that’s a pretty good practice builder for an up and coming optometrist. At the Park City meeting, he told me that his practice will soon need a new building with more exam lanes. Dr. Rowley had to work commercial optometry for a while before taking over his current thriving practice. So you see, optometry students, it is possible to make a successful solo private practice…if you are willing to roll the dice, take the gamble, spin the wheel, bet the farm, etc.

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I always wanted to do a podcast, but I’ve never gotten around to it because who wants to hear me ramble? I can say things more succinctly by writing them. I think a podcast is interesting when it’s a small group discussion or an interview with interesting people. I’ve never gotten around to recording either scenario, so I never published a podcast…until now.

In a previous post I linked to a YouTube snippet of the CEO of 1-800 CONTACTS, Jonathan Coon, giving a speech to Wal-Mart optometrists. Posting the entire video from the DVD would take too much bandwidth, but I managed to scrape the audio to share with you. So it’s not really my podcast, but it is a step in the right direction.

Again, if I get a legal letter from 1-800 or Wal-Mart demanding that I remove the content, I will of course comply; however, they did send this DVD to every Wal-Mart optometrist, and some of those optometrists also work in private practice settings. Also, this presentation defends 1-800 CONTACTS and Wal-Mart’s partnership better than anything I’ve heard. So, I think you will agree that every optometrist who is interested should listen to this talk (or watch it if you can borrow it from your nearest Wal-Mart Vision Center).

Enjoy. (Click the player below or download manually or subscribe to it in iTunes or subscribe to Optoblog’s site feed or podcast feed to automatically get it in your favorite podcatcher.)

 

 1-800 CONTACTS and WAL-MART DVD audio [46:43m]: Play Now | Play in Popup | Download (114)

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The Utah Optometric Association held their annual meeting in Park City at the Canyons Resort last week. The whole thing was a four day meeting, Thursday-Sunday, which is puzzling since the total CE hours offered was a mere twenty-three. The first two days only offered four hours and the last two days offered seven and then eight.

So why did the first two days only offer four hours? Well, of course you have to have the golf tournament which I overheard the same people win every year so they have to change the scoring rules to give others a chance. Then there’s all the luncheons, vendor fairs, dinners, parties, receptions, and association business meetings that take up more time.

Personally, I wish they would do all that other stuff on one day so that I could skip that day and still get all the CEs I need in just 2-3 days instead of four. I especially dislike having to go to CE on Sunday when I should be going to church instead. I mean, we live in Utah for Heaven’s sake! More than half the optometrists at the meeting are LDS church goers who normally wouldn’t work on Sundays, so you’d think someone could change the schedule to allow for more CE on Friday and Saturday and then I could skip out on the partying on Thursday and Sunday.

The Canyons is a nice resort. In the winter, it looks like you could ski out of your hotel onto the lift. But hey, all resorts in Park City are nice. The Canyons staff took good care of the conference room set-up, and there was plenty of pop, water, food, and hot chocolate.

Park City is great, but May is the off season. It’s neither winter nor summer, so you can’t ski and you can’t ride the alpine slide. Part of me would like to see the conference done in either the summer or winter when a lot more is available for the family to do; however, that would only serve to increase the rates of the convention and its hotel stay, so maybe it’s just fine in late May.

Really, it’s a great meeting, but the time lost in an extra day away from the office and the whole disrupting my Sunday routine has me thinking I might go to the NROC, SECO or AAO next time.

I’m sure I’ll still go to the UOA Park City conference occasionally in the future because it’s great to talk with other O.D.s in the state, but I’m never going to stay for a Sunday CE lecture again.

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