The Optometrist's Guide to One Door vs Two Door Laws in the US

Jun 22, 2020
4 min read

As a practicing optometrist in the United States, you have many options for employment. When looking at opportunities in corporate optometry, it helps to fully understand the laws in your individual state and how these laws apply to independent ODs working in a corporate optical setting. Whether you’re just graduating optometry school and coming home to practice or planning to relocate to another state, here is everything you need to know about the difference between one-door and two-door states.

What’s in a door?

The main difference between one-door and two-door states are the laws that separate the optometry office and the optical. These rules are specifically designed for settings where an independent optical or eyewear store would employ an OD to provide eye exams or where an OD would sublease exam space from an independent optical or corporation. For ODs who are considering working for a corporation or subleasing an office, these laws regulate the separation or lack thereof between their office space and the adjacent store.

In a one-door state, an independent optical can be physically connected to the optometrist’s office, which means that you can have one entrance for both and minimal separation. In other words, the optometrist may operate inside or adjacent to the optical and the two may share amenities like internet connection and even employees.

On the other hand, two-door states require the OD and optical to be separated completely. This includes physical separation such as a wall between the OD’s office and the independent optical, which can also include two separate doors for entrance—hence the term “two-door states.” The goal of the separation, at least in theory, is to separate the clinical side from the retail side in order to benefit patients.

Two-door states in the US

Below is a list of states that are considered two-door states at this time. Remember, optometry is a legislative profession, which means that laws are changing on both the state and federal level. We always recommend that you review the laws in your state, or reach out to your state organization for specific questions.

The two-door states for optometry:

  1. California
  2. Kansas
  3. Kentucky
  4. Maine
  5. Massachusetts
  6. Mississippi
  7. New Mexico
  8. North Carolina
  9. North Dakota
  10. Oklahoma
  11. Oregon
  12. Rhode Island
  13. South Dakota
  14. Tennessee
  15. Texas
  16. Virginia
  17. West Virginia

One or Two?

Each policy has its advantages and drawbacks for you as a practicing optometrist. While you may not base practice setting on whether or not you’re in a one-door or two-door state, these are definitely worth keeping in mind as you consider various offers.

One-door state advantages:

  • Shared staffing and appointment setting services
  • Potential for marketing assistance
  • Shared costs for amenities and bills
  • Help with insurance billing

The drawback:

If you’re working with an optical in a one-door state, you’ll need to work hard to build a strong working relationship with your partner. You will also need to follow their hours of operation and any corporate requirements set by the store. Another thing to keep in mind that, if you choose to leave, you may or may not be able to take your patient data.

Two-door state advantages:

  • Independence
  • Ability to set your own hours
  • Potentially higher pay
  • Control over patient data

The drawback:

Because you’re completely independent from the optical, you’ll have to worry about marketing, appointment scheduling, and other details. In other words, you’re going to be running a separate practice with an optical that happens to be nearby. You will still want to have a good relationship with the optical staff, but you aren’t as tied to them, or the corporation that operates the optical, as you would be in a one-door state.

Important considerations

If you are considering working with an independent optical or corporation a solid agreement between yourself and the partnering optical is crucial. A few important points of consideration include:

  • Who is responsible for patient billing?
  • Who has control of patient records?
  • What happens if I need to leave?
  • Can I choose my own staff?
  • What do I love to do in terms of patient care, and can I do it in this practice setting?

While navigating the laws and regulations of each state can be tricky, it is important for ODs to be knowledgeable about the requirements in their own state in order to make the best practice decisions.

The foregoing is provided for informational purposes only, is not an advertisement, does not constitute legal advice or legal opinion, and does not create an attorney-client relationship. The content may not apply to the specific facts or a particular matter. You should not act or rely on any information contained in this article without first seeking the advice of an attorney licensed to practice in your jurisdiction.

About Irina Yakubin

I'm a fourth-year optometry student with aspirations of practicing in California and, one day, earning a fellowship with the American Academy of Optometry. Some of my optometry-related interests include contact lens, anterior segment disease (including dry eye), posterior segment disease, …

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