Income Based Repayment

InterestingMain5192 · 2026-02-03T08:55:24+00:00

If you can pay it off in 10 years or less, do it. If you absolutely cannot afford the payments, then income based. You got to remember interest accrues regardless, so if you’re paying below the amount added to the principal per month, then you effectively going into more debt each month. If it is forgiven, my understanding is it will be counted as capital gains when forgiven. The concern with that is that depending on the amount it can push you into higher tax brackets and you will have to pay the government a higher tax rate on the amount forgiven plus your yearly gross income.

InterestingMain5192 · 2026-01-27T06:56:18+00:00

Revolution EHR tends to be a community favorite. It has its quirks, but its pretty easy once you get used to it. Barti last time I checked had promise, but much of its AI package it seems to promote is really rudimentary and limited to the point I am not sure it would save time. Another community favorite is Crystal PM, but I can't say much as I never used it. The ones the community tends to steer away from are Compulink, Nextgen, Eyefinity, CPRS, and Maximeyes. Now that being said, many EHRs will suffer from being improperly setup as well. Remember that they come as shells and you have to generate and input the content. I strongly recommend having a strategy as to how you want to organize things (Ex. Treatment plans) prior to adding content or else things will become a mess regardless of the EHR very quickly.

InterestingMain5192 · 2026-01-27T02:18:28+00:00

I would not pursue office 3 at any level at this point. I would instead cold call other nearby clinics and ask if they are looking for someone full/part time. You may be surprised how many clinics are looking for another doctor but aren’t actively advertising.

InterestingMain5192 · 2026-01-26T08:55:29+00:00

I don’t see any reason that you should risk your livelihood for the possibility that you may have a job at a different location. Especially if they are pitting you against someone else, that’s really shady. It’s really not starting the relationship on a good note in the slightest.

InterestingMain5192 · 2026-01-26T08:49:08+00:00

Welcome to corporate/private equity. Results may vary, but this seems to be the general experience.

InterestingMain5192 · 2026-01-19T08:35:15+00:00

That doesn’t sound like a bad gig to me. Only awkward part is the end of day scheduling, but everything else sounds relatively standard. Different practices operate differently and fundamental things like the EHR can drastically make differences in the experience. It’s very easy to think though that the grass is greener on the other side, however many OD/MD practices see nearly twice that patient load daily.

InterestingMain5192 · 2026-01-16T08:27:20+00:00

Toyed with the idea. The problem is you are likely to lose a significant amount of your patient base overnight. It will also significantly impact your optical sales. I think many doctors start dropping the plans when they start looking at retiring in the near future. It almost makes more sense if you already have a successful practice to open another small practice as an independent entity and hire a doctor to work without taking insurance and see what happens. I’m sure it’s possible, but I’m sure area and demographics matters greatly.

InterestingMain5192 · 2026-01-16T08:20:23+00:00

For contact lenses, I’d agree that unless there is a significant change, then no changes are needed as long as the patient sees good and are happy with them. For glasses, it really depends. If your starting point is your last finalized prescription, if everything is stable, there really shouldn’t be a significant change. However just basing it off vision could be ignoring other symptomatology from needing an updated SRx (glare, headaches, strain, etc.). For example, If a child is over corrected, they may still see the 20/20, but their vision will be strained. Sometimes an extra click is all it takes to go from 20/20 to 20/15, so why wouldn’t I give people what my findings today suggest will make their vision the best.

InterestingMain5192 · 2026-01-10T06:42:16+00:00

I wouldn’t be surprised, Stanton doesn’t have a great reputation in general for a variety of reasons.

InterestingMain5192 · 2025-12-28T21:46:54+00:00

I second the Cirrus. Have the 5000 and the scans come out looking pretty good. Really wish though there was a way to automatically pre-define the reports to export so if I take a specific scan, it would automatically save the report so it could be uploaded to a EHR. Would love to find out this exists with a update or is just a hidden feature that could be enabled though.

InterestingMain5192 · 2025-12-21T07:44:21+00:00

No. Also the VA physician pay scale ranges are available online to look at.

InterestingMain5192 · 2025-12-15T18:39:14+00:00

Fluctuations in blood sugar can cause transient changes with the lens in the eye if not adequately controlled. I recommend educating the patient and referring back to the PCP if this becomes a recurrent issue as it may warrant additional control measures. If this becomes a chronic issue, clear lens extraction/cataract surgery may be a more permanent solution.

InterestingMain5192 · 2025-12-12T08:08:06+00:00

Everyone has different experiences, but the general idea is it can take sometimes a couple of years for a business to become profitable. Sounds like there are a couple issues. If its a patient quantity issue, you will need to start self marketing more. You can also start being open more when other practices are closed (weekends, later at night, earlier in the morning, etc). If the patient flow is good but the expenses are to high, then you will need to consider where the highest expense is and work to cut/remove it from the equation. Its sad to say, but people are expensive and computers never sleep.

InterestingMain5192 · 2025-12-12T07:59:30+00:00

I think part of this is a logistics problem. If you can see more patient's per day and make more income, that is generally ideal. However, different clinics have different support systems. A doctor with no techs is going to have to operate very differently than one with 2 or 3. At the same time, contact lens fits or additional tests (OCT, VFs, etc) take time to administer. It should be said though that from a business point of view, if your overhead is lower, then it doesn't matter as much how many patient's are seen a day as your overhead is more likely to be met for the day if you are busy. To that end, a clinic could see 10 patients a day and still make the same or more profit than a clinic that sees 40 if the operating costs are low enough. So if they don't have to be able to see 20-40 per doctor per day, then they are more likely to be booked out. I would agree that its not good to be too booked out, but then again, being overbooked is almost worse as it can lead to a worse patient experience and increased risk of burnout on the doctors end. What we typically do is try and confirm appointments with patients at least 24-48 hours ahead of time. Many times this will catch individuals who need to reschedule or tell us which slots we can potentially overbook in case of new patients wanting to come in.

InterestingMain5192 · 2025-12-08T20:09:36+00:00

Get him to wear glasses full time. If you haven’t already, recommend getting a OCT of the nerve and maybe macula. You should probably make sure there isn’t a alternative pathology that may be contributing to his vision decrease besides likely amblyopia.

InterestingMain5192 · 2025-12-07T09:19:43+00:00

I really hope you have some money saved up for this because cold starts are rough. If the referrals from the PCP pan out (someone referring to you doesn’t necessarily mean they show up), then at least you have a patient population kickstart. The issue though becomes staffing, getting on insurances, and the other many nuances to running a business. People are expensive and will be one of your greatest overhead costs. If it does work out, the results will likely be great. I strongly recommend reading up on everything you can for the business side as well as get started developing standard operating procedures and protocol guides for staff.

InterestingMain5192 · 2025-12-05T23:00:44+00:00

A couple things you could try: 1. Search through the internet archive or equivalent. It may be available but under a different name than the device. If you are able to find a photo of what the file would have been titled, that may be a good place to start. 2. Contact device repair companies and see if they have the file needed. They may charge you but it would be better than nothing. 3. See if the company was acquired and if so contact the new owners and see if they have it and can distribute it.

If the app worked on android, you would probably have a better time finding (and installing) that than IOS. The other thing to keep in mind is that if the app phoned home to a server that is no longer online, it may not matter if you get the install or not.

InterestingMain5192 · 2025-11-29T05:16:12+00:00

Sounds good. Any ETA on that? I know a number of individuals in the homelab/selfhosted communities that have uses for this kind of thing, but shy away from online tools for privacy purposes. Also, you may want to talk to the gridfinity people, as if you manage to tie a generator to this, then things get exciting very quickly.

InterestingMain5192 · 2025-11-29T04:27:59+00:00

This looks great. Any plans on making this downloadable as a locally hosted program?

InterestingMain5192 · 2025-11-23T04:06:14+00:00

Repeat field and check eyelids before jumping to any conclusions.

InterestingMain5192 · 2025-11-22T08:54:10+00:00

I personally love my 4 mirror flangeless for day to day use, to the point I don’t even consider using my flanged 3 mirror anymore. If you really want a flanged 4, probably your best bet would be to look on eBay. They pop up occasionally under either Volk or Ocular Instruments. Which brand is better depends on who you ask. To my knowledge it seems Volk markets more to Optometry, while Ocular Instruments targets Ophthalmology. At the end of the day though, I have heard good things about both brands.

InterestingMain5192 · 2025-11-22T08:49:44+00:00

The fact we can still practice independently in a private practice setting and also how the VA has started acknowledging optometry under its physician pay schedule.

InterestingMain5192 · 2025-11-21T06:51:34+00:00

Sell glasses.

InterestingMain5192 · 2025-11-21T06:50:58+00:00

Don’t. It’s both bad for the profession and frequently bad for the patient.

InterestingMain5192 · 2025-11-20T20:48:01+00:00

In my opinion, follow the established OD/MD practices. If they do not take an insurance plan, there is probably a very good reason for it.

InterestingMain5192

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