you said "And it tires me that I have to fix people who have received
inadequate
eye health and vision care because they were shopping for the lowest
cost or the fastest get-it-done."

and it tires me to have to fix patient who came from a private doctor
with an Rx that wasn't right and the patient was told "you'll get used
to it" and "no, we won't refund your money for those lenses that you
can't wear-- we are a 'doctors' office".  it really bothers me that
they were charged outrageous sums of money to get this kind of arrogant
treatment too.

sorry you don't like commercialized healthcare.  it has settled in well
in the field of optometry because customer needs were not being met by
the private docs.  customers were tired of paying too high of prices
and getting treated by a bunch of doctors who have inflated
self-opinions.  this country needs major healthcare reform, and i'm not
claiming that it needs to go the direction of "eyeglass world, inc."
but it does need to go away from the direction self-important
overpriced private doctors who try to maintain mystique around what
they are really doing.

some of your concerns are valid but others aren't.

yes, you might find turnover at a commercial outfit.  where i work the
doctor has been there for 10 years however so thats not true.

no, the private doc is not necessarily going to have more experience
fitting contact lenses than the commercial doc.  the commercial doc
sees more patients, recommends more lenses, and probably have more
communication with the contact companies than the private docs in my
part of the country!  we get the trial sets for the latest lenses, as
well as courtesy fitting samples well before any of the private doctors
do.

in my experience i have seen private docs preferentially fit
private-label contacts on patients.  these contacts are very similar to
the more widely distributed versions but they have slight parameter
differences that inhibit patients from taking their prescriptions and
going somewhere else to get them filled.  they only place they can get
them filled is at the same doc who fit them.  obviously they care more
about protecting their income than getting the best fit for the patient
(whose real need may include having a good fitting contact lens that is
also inexpensive and can be purchased readily anywhere-- perhaps the
patient travels)

sometimes private docs resist giving out a final CL Rx claiming that
they need to recheck the patient again in 3-6 months after their box of
private label (expensive) contacts is empty to revalidate the Rx.
recent changes in federal law makes this more difficult that it was
before but i know that it still happens.

look.  my point is simple.  don't have bias against any one group.
there are good and bad eye docs practicing at any location.  find one
with a good reputation and stay there.  i happen to KNOW for a fact
that the better eye docs in my area practice at commercial locations.
better in the since that they have equivalent training, at least
equivalent experience, aren't out the rip off their patient for
expensive materials, etc.  some private docs could be like that too but
some aren't.