Am I real? Yes. Maybe you could have read more than just one of the 340+ posts on my blog? Maybe you could have looked at the side bar and seen the link to my twitter feed and my practice website?

Do I hate optometry? Nope. I like it fine. Sure, I’d rather be a rock star, but that will have to wait for now.

Did I make a whole bunch of inflammatory blog posts? Yes. But I can’t please everybody. I like Walmart optometry more than private practice for numerous reasons, but not the least of which is I feel like less of a salesman and more like the doctor I was trained to be. I think you can get that in other settings too, but I don’t want to work for the government anymore. I’m not academic enough to be a professor, and I don’t want to be an OMD’s “super-tech.”

In private practice, everyone else got paid…except me. The frame reps, the contact lens distributors, and labs, the staff, the landlord, , the bank, the equipment vendors…they all get their money up front or first thing. You, the doctor, get paid last…if at all. Risky.

if you like taking risks, then why not take a better bet in a different profession selling or manufacturing widgets with less restriction on maximum possible income?

Undergrad, if you really want to be a private practice optometrist, go ahead. I won’t stop you. I would ask you why you would gamble so much when you could practice in a setting with MUCH less risk. It does work out well for lots of O.D.’s, but that doesn’t mean it will work well for you.

By the way, I don’t think pointing these things out should be labeled “negative.” It’s reality. There are pluses and minuses to every profession. Undergrad, I don’t want to sugarcoat your potential career choice. I once thought I was going to be an architect because I wanted to design houses. I actually talked with an architect and found out very few architects design houses because most people buy their plan from a catalog. Most architects design banks and rest-stop bathrooms and other utilitarian buildings. That’s not what I would be happy with, so I switched majors. I’m thankful that architect shot straight. If you don’t believe me, then I hope you talk with an optometrist that you can trust who will also shoot straight.

Now, knowing more of the risks and potential negatives, if you still want to be an optometrist, then at least you’re not going into this blind. You won’t be able to say, “Why didn’t anyone tell me it would be this way?”

Anyway, I’ve spoken enough about this subject. I need to get back to writing/selling the next great screenplay so I can have a retirement.

• 7-1-2011 Doctors will no longer get trials for O2Optix
• 1-1-2011 Product availability not guaranteed
• 7-1-2012 O2Optix lens discontinued.

Ciba has been pushing strongly the one month replacement modality which flies in the face of the two week replacement schedule philosophy of their competitor, Vistakon. Ciba’s recommended alternative for those who have been in O2Optix lenses is to have their doctor refit them in Air Optix Aqua.

AP09 is Walmart’s policy on dealing with shoplifters. A copy obtained by KSL shows employees are allowed to use “reasonable force” to limit movements of struggling suspects. If a weapon comes out, however, associates must “disengage” and “withdraw,” the policy states.

Imagine you have a Walmart employee who cares more about rules than their own life. In that exact moment, they hesitate because rule AP09 springs into their head. Their hesitation could cost them their life. I applaud these three men and one women. They acted reasonably and rationally. We should throw a parade in their honor.

The pansy lawyers in corporate who wrote AP09 should revise their documentation to say, “However, in a post 9/11 world, if you believe your life is in danger, you should fight like Joshua on the 7th day at Jericho so that your inaction won’t cost you your life and potentially others lives also.”

Agreed, no one thinks a pair of socks or a computer is worth anyone’s life trying to defend it. Criminals don’t care about your life. They kill kids to steal their Nike Air Jordan shoes! They kill to try to stay out of jail. You won’t know if they actually shoot or not until after the fact, but guess what! The very fact they pulled out a deadly weapon means that they are willing to use it! This isn’t about socks or computers anymore. We have to assume that if they pull a gun they are going to shoot! They are willing to…kill…you!

Walmart shouldn’t expect people to play dice with their own life. Those Fabulous Four didn’t allow chance or the crazed mind of a felon to determine whether they went home to their family that day.

Before September 11, 2001 popular belief was that if you give into the demands of evil people, then you would be okay. Apparently corporate Walmart never got the memo that the rest of us received on 9/12.

Walmart will sell out their existing stock of ClearCare, but won’t be reordering more. Here’s from the memo dated 1-24-2011:

• Jan 1, 2001 Ciba Vision has incorporated a substantial cost increase to their Clear Care items throughout the industry.
• We take any and all cost increases very seriously especially if the supplier is unable to justify the significant increase completely.
• In the interest of our customers, we will not carry Clear Care until this matter is resolved.

They go on to suggest that the V.C. associates can ask the Doctor Partners to recommend a suitable alternative product.

Isn’t this what happened to Rubbermaid?

Eye Exam Types

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

Nice logo, Walmart!

I intend to blog about my experience daily. As one of the few selected, I imagine there will be an occasion for me to express concerns and ask questions. If you have any comments or questions you would like me to consider voicing in Bentonville, then please write it in the comment section below. (Please be serious and civil.)

Here’s that e-mail:

Dear David Langford

Historically, the annual Doctor meeting was primarily focused around Optometry. As our health and wellness businesses continue to become more integrated, we seek to further expose the important work of health care professionals to the greater Walmart organization. We also want our senior leadership to better understand the difference you are making every day in the lives of our patients. With that in mind, we will be hosting the Health & Wellness Conference May 3-5th, 2010 in Bentonville Arkansas.

You have been chosen through a nomination process to take part in this exclusive gathering of professionals; you’ll hear from the executive leadership of Walmart on our company’s ongoing growth strategy; discussion from governmental and NGO’s on health care reform in America as well as inspirational messages from medical visionaries on the impact they are making within their communities.

We have made several changes of this conference design from years past. For example a smaller more intimate gathering will facilitate the opportunity for you to interact with and learn from key leaders as well as your peers. Representatives from all of the Walmart Health & Wellness business units will take part including professionals from the practices of Optometry and Pharmacy as well as our Clinic Operator partners in addition to select representatives of our internal support teams.

In addition we elected to conserve time and resources in an effort to present a holistic message around health care and the challenges that our customer, health care professionals and company is facing today, therefore CE credits will not be offered at this meeting. And as this meeting has been limited to a select group of attendees, we are asking that spouses not attend.

We look forward to having you take part in the Health & Wellness Conference 2010. Please click the View Event Summary link below, view the event details, and respond by clicking either the Yes or No button at the bottom of the invitation. Or you can simply select the register button on the Event Summary website. Registration will close on March 13th, 2010

Thank you,
Health & Wellness Professional Affairs

To nominate me, find the e-mail that was sent to you from Walmartod.com on 1-8-2010 and click on the link. Here is the information you will need:

David Langford
Store # 1888
North Logan, UT

Why should you nominate me?

• Because I guess you can’t nominate yourself.
• I’m a cub scout Wolf den leader. I go to church every Sunday
• The associates in my vision center like me- we’re even friends on Facebook.
• I’m all techie. I even have a Humphrey Matrix VF and HRT2 in my office.
• I recently raised my fees and no longer charge extra for dilation.
• I was featured in the Review of Optometry with an article highlighting Walmart optometry.
• I’m like one of the original optometry bloggers. ‘Nuff said. I’ll blog the whole thing so it’s just like you being there (except without having to lose money while not doing exams at your office.)

There you have it. All the reasons you need.

Walmart practices grew 10% during 2008, on average, as Sam’s Club practices grew 6%.

Growth also varied depending on years at location.

I’ll be interested to see what 2009 stats will say. Anecdotally, my business was up 8% in 2008 while so far for 2009 I currently forecast it to be down over 8% (so back to 2007 levels). So when you think about it, 2009 could see me be down 16-18% from where I wanted to be.

Thanks Obama. That was such a great idea to spend our way out of a recession and have the government take over several private sector industries. Idiot.

Yup, I’ve said it before and I’ll say it again. Ophthalmic vendors think we optometrists are so stupid. Just because we picked this profession, they think we are prone to making poor financial choices just like some people are accident prone.

Any of you vendors seeking to do insurance billing for me are wasting your time. All I need is my practice management software and Apex EDI. It’s as automated as can be. Most of the vision insurances have their own website for authorization and billing, and then I use Apex EDI for my BlueCross, Medicaid, DMBA, and other miscellaneous insurance companies. (You can do Medicare also, but I am disinclined to participate with them.)

Apex EDI works great. It’s fast and easy. And I don’t need no stinking slick Rick to be some unnecessary middle man. It’s cheap too. I pay 43 cents per claim, less than a postage stamp these days. I also pay the extra $20 a month for the ERAs and Electronic Tools which make my life a lot easier, so it’s worth it.

Call up Apex EDI and tell them I sent you. Use my Champions Code (sales code) to get a better deal: Champ148. I use it in my practice (VisionHealth EyeCare PLLC), and you can use it in yours without the growing cottage cheese industry of Walmart insurance billing middle men.

[Note to Slick Ricks: Any more "comments" made by you to advertise your middle man services will be marked as Spam and deleted. Do us all a favor and go con some other profession.]

Also I see that Walmartod.com‘s interactivity has been transformed from a bulletin board to a Facebook-like community. Looks pretty neat. I still can’t get logged in, but I hope to join in…someday. UPDATE: I got logged in just fine after an e-mail to support. Any rumor that I’ve been blacklisted is completely unfounded.