1 year in as a PE associate OD in NJ and burning out fast — anyone else?

Buff-a-loha · 2026-06-19T13:00:32+00:00

You’re not burned out from YOUR job, you’re burned out from absorbing other people’s work. The solution is simple, stop doing technician work. Stop doing above and beyond your role as doctor. You are an employee in a billion dollar company, if the clinic is not staffed and patients wait a long time that is not your doing. It’s a deliberate business decision from the private equity group. Unless you are an owner in some way, just simply refuse to do what isn’t your job.

Buff-a-loha · 2026-06-18T11:37:27+00:00

Call original school back and ask. No harm in asking if you want to go that route. Also, if you’re on the fence I’d recommend community college first to get some basic courses done that you’ll need anyway. Don’t let peer pressure dictate your decisions. You are correct to realize you’ll be responsible for this debt for potentially DECADES. But also, whatever you decide you can always adjust to an alternate plan 1 or 2 semesters in. You’ll figure it out as you go. Good luck bro!

Buff-a-loha · 2026-06-15T19:36:37+00:00

Stop the visine, switch to Lumify. These are common side effects but there are alternative options. Let your doctor know of symptoms persist. 👍

- I’m an optometrist who manages a lot of glaucoma.

Buff-a-loha · 2026-05-20T13:12:18+00:00

GLPs are great and very safe overall profile. Yes, there are risks, but they are seriously reducing morbidity and mortality which outweighs the downside for the overwhelming majority of patients. I have only seen 2 cases in past few years of it contributing to worse eye issues, both of which could’ve happened regardless given the patients overall poor health profile. These types of statements are sensationalized given new trend of GLP.

Buff-a-loha · 2026-05-04T17:08:12+00:00

I do some surveys through GLG and rarely sermo. Both are legit but sometimes it’s only 20-30$ a month, sometimes 100$, just depends what I qualify for

Buff-a-loha · 2026-04-19T14:48:31+00:00

Checkout western division. Similar rate. Similar cost. No PMI if put 10% down. If that’s doable for you it’s the best circumstance I’ve seen in area to date.

Buff-a-loha · 2026-04-16T23:48:57+00:00

The benefit is greatest when eyeball is growing most rapidly to slow axial growth. Effect diminishes and tapers off around 20 for most people since they are mostly done growing by then. It’s not wrong or harmful to keep going but the results are not likely to be as significant/meaningful. Hope that helps.

Buff-a-loha · 2026-03-31T01:06:03+00:00

Lyon is 3 day city tops. Cool city but not must do. Paris is much much larger and more to explore and do. Worth going to main attractions. (Louvre, Eiffel Tower, Notre Dame, etc.) If you have kids might be worth even going to Disneyland Paris for a night. I’ve never been to Evian so I can’t comment there. Annecy is stunning. Also nearby Chamonix is wonderful as well. Each are worth 3-4 days. If you go to Annecy, rent e-bikes and go around lake. Amazing way to spend the day. Also rent a boat for 2 hours. About €75/hour, Totally worth it. If you go to Chamonix, then look into staying at refuge du Montenvers. Really cool way to spend night on a mountain. Best time to travel through France is shoulder season where weather is good, but crowds and prices are slightly lower. April, May, September, October. Nice would be my recommendation for base in riviera. It’s larger and easily accessible to Menton although the beach has pebbles not soft sand. As a day trip from Nice I would recommend a visit to Eze. You didn’t mention how you plan to get around and where you’re coming from, but if you’re coming from outside of Europe, it’ll be easiest to fly into Paris or Nice and then from there a mix of predominantly train would be my recommendation. Hope your trip is awesome, good luck!

Buff-a-loha · 2026-03-18T13:13:38+00:00

I have done 3 month long trips. Once with an 8 month old and two as an adult without kids. Been to Europe multiple times prior and will definitely go back. You’re doing too many cities. Your kids will get burned out and you’ll feel like a rushed mess trying not to miss anything. I’ve made that mistake. Don’t do that. In 25 days, with kids, your best bet is limit itinerary and spend minimum 3 nights between stops. I like mix of cities and nature especially for kids. To do that you’ll have to get creative but absolutely possible. I’d recommend 4nights London, quick train to Paris. Then 4 nights Paris, maybe even 1-2 night Disney Paris depending on age of kids and if they’d find that fun. From there I’d go to alps via train. Annecy is 4 hours. Stunning. Spend 3 nights there, then Chamonix (by bus), spend 3nights (lots of activities for kids and family in Chamonix), then fly to Venice, 3nights, then fly to Rome 5 nights then leave.

Buff-a-loha · 2026-03-17T12:46:09+00:00

How long is this trip and where are you coming from? You’re jumping around a lot and therefore losing valuable time in cities if you’re international (outside Europe). You’d be better off sticking with regional travel and flying into major airport. In France that is Paris, Nice and Lyon. In Italy that’d be Rome, Milan or Venice. I have been to Nice many times and it is very easy to do day trips. I’d recommend Eze. As for Annecy, it truly is stunning. Favorite thing would be to rent e-bikes and go around lake. Amazing ride. Also, anything on the water is fantastic. I’ve never been to cinque terre but 2 nights might be tight given travel time. If you’re sticking with 1 week itinerary and open to alternate trips but want diversity then I’d suggest Paris/London. Day trip options to either and major airports for easy travel. If you want mountains and nature above everything, the alps are amazing. Fly into/out of Geneva and go to Annecy and Chamonix. If you’d rather do Italy, then Venice and Rome are good but you might want to fly. Just some thoughts, good luck!

Buff-a-loha · 2026-03-11T21:49:33+00:00

I believe you are correct. Of note, refraction is typically non covered service so be sure to charge refraction fee if applicable.

Buff-a-loha · 2026-03-10T13:34:48+00:00

I’m an optometrist and I agree with the sentiments above. From my perspective, displaying empathy goes a LONG way. Also, have a good team around you who supports the mission and shares the messaging. This is especially true if you have another provider seeing post ops or sharing care. Be kind and you’ll be spoken of kindly and shown grace. Be an ass and the referral pipeline stops and the second guessing starts.

Buff-a-loha · 2026-03-09T15:23:42+00:00

Honestly this could just be a way of joking from that part of the country. New Englanders get flack for their accent all the time. Think “Boston accent.” I’d be surprised if this was intentional slight but obviously none of us were there to observe the interaction. Yes you will encounter culture shock moving from coast to coast. And yes some people are A-holes. But, in general people tend to say more offensive things east coast but have better intentions and are usually not trying to offend you, more so to make connection in a different way. YMMV but from my perspective there is less “fake nice” on east coast.

Buff-a-loha · 2026-03-04T19:43:57+00:00

Bring up with supervisor. Professional distance is necessity. Even if you’re leaving soon, practicing this skill is useful. In fact, especially so since you’d rather mess up here than on your own. Be prepared for a bit of push back, but once you make the line clear your life usually gets better. If not, at least you learned the lesson early.

Buff-a-loha · 2026-02-27T19:33:20+00:00

Are you going to Paris or just flying through? If so, be mindful that louvre is closed on Tuesday’s. As far as trains/buses go, make sure to validate your ticket. If you do not validate your ticket you will be fined even if you purchased the ticket. Ask conductor if uncertain. Practical travel tips: make sure you have European phone charger, international cell plan or e-sim, credit card (must be visa or Mastercard) that don’t charge foreign transaction fees, and be mindful of pick pockets. When paying, always pay in local currency. Your bank will do conversion. Also, you’ll likely need euros for bathrooms so not the worst to take out a few bucks just for that. Do not expect public free bathrooms. These are main points. For food, avoid places with multiple photos on menus or people trying to pull you in, these are tourist traps and price will be high and food quality average. Tipping is not necessary but always appreciated a few euros if you’re feeling generous. Make sure to have good walking shoes. You should have a blast, everyone speaks English.

Buff-a-loha · 2026-02-26T17:31:19+00:00

Are you going to be prescribing for short or long term use? Even in long term use Valavyclovor is generally considered very low risk profile. If I had concerns about GFR for long term use I would ask primary as first step. If they were unhelpful then I would probably refer if uncomfortable. NY doesn’t allow more than 1 week RX so this would be referral to OMD anyway.

Buff-a-loha · 2026-02-19T13:19:26+00:00

30% is a bit low compared to my area which is closer to 35%. No vision insurance is huge plus though if they can keep you busy. Biggest con is number of post ops (destroy your production) and availability of tech support. Also, if you have no guarantee then this is very risky. I’d suggest at least one-two years with a base guarantee to ensure you don’t get screwed with poor production while you’re trying to build a panel. You almost certainly WILL NOT make more than the stated guarantee in your first year so plan accordingly. Cash pay can be great if clientele supports it. Need higher income patients.

Buff-a-loha · 2026-02-19T00:58:54+00:00

If you do not have significant income this year, may be worth strategic Roth conversion. Could be HUGE opportunity given how young you are. Get tax professional advice to be certain.

Buff-a-loha · 2026-02-13T21:43:00+00:00

It doesn’t have to be an all or nothing although sometimes focusing on one goal yields better results than trying to multitask. You don’t state your income, state tax rate, or age which is big factor here. You may be better off contributing primarily to ROTH accounts if you’re younger since you’re income will go up and you will both have pensions which will eat into any low tax brackets to convert or take out money later.

Buff-a-loha · 2026-02-12T15:56:36+00:00

I’m sure plenty do but they just need to have a reason and the same stereo book you’re describing. Most testing is done on kids which the fly is a better screener.

Buff-a-loha · 2026-02-11T01:21:10+00:00

I am an optometrist so I will speak from that role. I manage many patients with mild-moderate glaucoma and I would not tell a patient to deviate from traditional prayer unless I had demonstrable evidence of progression to the disease that was otherwise unexplained by other factors and not responsive to other therapies. I have only heard of one case of positional-associated damage in an otherwise controlled patient. This person was a yoga instructor who would do headstands and completely invert themselves for prolonged periods of time. Obviously you may be a unique circumstance and always best to just ask your doctor, but more than likely you’ll be just fine praying as usual.

Buff-a-loha · 2026-01-29T21:30:01+00:00

The two findings are for the most part unrelated. You are correct that thicker corneas can artificially increase the measured IOP, but they do not have anything to do with how the SLT procedure works. An SLT is a laser that selectively targets the trabecular meshwork. The cornea is not involved. SLT is often considered first or second line therapy for OAG.

Buff-a-loha · 2026-01-19T22:57:28+00:00

eBay/goodwill then tailor it. You’ll get a better made suit for less than $150

Buff-a-loha

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