O.D. To O.D.: Do Today's Students Want Practice Ownership?

With high student debt, managed care hassles and a desire to raise families, it seems like employment is the only option.

o.d. to o.d.
Do Today's Students Want Practice Ownership?
With high student debt, managed care hassles and a desire to raise families, it seems like employment is the only option.
BY NEIL B. GAILMARD, O.D., M.B.A., F.A.A.O., Chief Optometric Editor

I recently presented a lecture on practice management to the students at Illinois College of Optometry. I served on the faculty there for 20 years, so optometric education is in my blood, and I'm honored to continue to serve as a guest lecturer. As I got to know the 130-plus third-year students in my lecture room (a good turnout), I learned that some things have changed since I was in their place back in 1976 -- and some haven't.

Bright students

Today's optometry students are extremely bright. They asked many excellent questions, and they weren't timid about responding to questions I asked. They were eager to learn about practice management -- they asked for my PowerPoint notes, asked to visit my practice and many e-mailed me a thank you message.

Early in the lecture I asked the class if they were interested in some form of practice ownership some day. Nearly every hand went up. But as we discussed the real-world aspects of buying into a practice or starting up cold, I got the distinct impression that they felt it wasn't feasible for them. It was what they had dreamed about when they chose a career in optometry -- but it seemed elusive now.

I firmly believe that owning a practice is just as feasible today as it ever was, and I think I helped the class see that. Sure, obstacles exist, but when haven't they? Somehow my class of 1976 knew that ownership was a real option, and I felt like these students didn't think that way.

Myths of practice ownership

Of course, a successful practice won't simply be handed to these new O.D.s -- it takes self-discipline and hard work, but it always has. Here are some of today's myths about practice ownership:

Myth: Graduates can't take on more debt to finance a practice. They need immediate high income to service the debt and live. Yes, the typical student loan debt is in excess of $100,000. Yet there are plenty of ways to finance a practice -- opening cold isn't that expensive, and you can lease equipment; all that's needed is another source of income while the fledgling practice grows. Sellers of practices are often willing to finance.

Myth: Optometry classes are well over 50% female. If these doctors want to raise a family, they can't be burdened with running a practice. There are many unfair and untrue generalizations about female O.D.s. But even if these were true, why can't three females form a partnership and each work 20 hours per week?

Myth: Generation X wants immediate rewards without the work. The students didn't seem averse to hard work, and they seemed to have plenty of drive and ambition. They do, however, need a hand in understanding the business of health care.

Myth: Managed care has destroyed the profitability of private practice. Managed care can help bring patients to a new practice that has insufficient volume, and smart management can build the practice to become less dependent on it.

Myth: Many jobs are available working for chains or for ophthalmologists, and the salary is often better than what you can net in private practice. There is nothing wrong with these modes of practice, but studies show that the most financially rewarding mode involves ownership. It only takes a few years to pass the higher initial salary.

Conquering obstacles

Today's students still apply to optometry school wanting to be their own boss, and they graduate with the same goal. Having experienced their enthusiasm and drive, I'm sure they will find a way to conquer the obstacles. It is in our best interest to help them do it.

You may contact Dr. Gailmard at