Optometry offers young ODs practice settings for every preference
Expanding scope of practice, new technologies and treatments, and various opportunities for involvement appeal to an ambitious population of young optometrists – both male and female – entering diverse sectors across the field.
Nearly three of five optometrists (59%) indicated their primary mode of practice was private, according to the 2014 Survey of Optometric Practice from the American Optometric Association (AOA). Of the survey respondents, males accounted for 76% of owner optometrists in all practice types. However, 36% of new owner optometrists – those who graduated from optometry school within the last 10 years – were female. Non-owner ODs were about equally split between males and females, while 58% of new non-owner ODs were female.
The AOA said updated survey results should be released in June.
An optometry school residency made a large impact on one of the younger optometrists who spoke to Primary Care Optometry News.
“I had that type of personality for residency, and it was very close and easily accessible. After the program, I felt well-prepared,” Alissa Coyne, OD, an assistant professor at Salus University, said in an interview.
Exposure to clinical trial work during a residency in ocular disease opened the door for a career in industry for Melissa Kleman, OD, director of clinical outcomes at ReVision Optics. Kleman told PCON that she helped conduct six clinical trials during residency.
The preventive care aspects of eye care attracted Patrick Vollmer, OD, FAAO, private practitioner, Visual Eyes Optometric, Shelby, N.C.
“Optometry is one of the few health professions where you can make an instant difference before the patient walks out the door by helping them see more clearly than when they first walked in,” Vollmer said in an interview.
Ryan Corte, OD, founder of IntroWellness, repeated the sentiment.
“In medicine, you’re often putting out fires; in eye care, you can do preventive measures to help people. That was really inspiring to me,” he told PCON.
Other optometrists, such as Gayathri Srinivasan, OD, MS, assistant professor and faculty researcher at the New England College of Optometry (NECO), like the challenge of what is unknown. She said in an interview that she is exploring the best approaches for detection of amblyopia risk factors in young children.
Finding what is right for you
In the academic world, Caroline Beesley Pate, OD, FAAO, associate professor at the University of Alabama Birmingham School of Optometry, said what drives her is the students’ energy and enthusiasm, which keeps her revived, refreshed and on her toes.
She has a diverse, ever-changing schedule each semester, she told PCON.
“Not only are we encouraged to be great teachers, but we also are encouraged to spend time providing service to the profession through committee work and educating other ODs through scholarly works or providing continuing education,” Pate said.
Coyne spends 65% of her time as the attending physician in the clinic, she said, with residents who are triaging patients, and 35% teaching in a traditional classroom or lab. Her favorite role is leading the ophthalmic lasers course.
“While it’s legal in some states, it’s where we are going to head in the next generation. It’s interesting to show students that it is possible,” Coyne said. “In Pennsylvania, it’s not on the legislative docket, but if a student is going to any states where it’s allowed, they will feel comfortable providing that service.”
Vollmer said he loves working in a private practice, as he is responsible for all decisions concerning the direction of his company.
“In many ways, you get exactly what you put into it,” he said.
“Although I gained a tremendous amount of experience in other practices, I always felt like I had a ceiling over my head. I realized that working for someone else was never going to cut it for me,” Monica Johnsonbaugh, OD, who owns her own practice, Focus 313 Eyecare in Grosse Pointe, Mich., told PCON. She has experience working in an ophthalmology group, private optometry group and within a retail lease.
Johnsonbaugh and Vollmer both possess an interest for business and agree the work can be around-the-clock.
“I can basically work all day long when I want to. Having a family, I have forced myself to shut off work mode when I’m not working,” Johnsonbaugh said.
“It’s been incredible being able to own my own practice. Now that I’m finally there, I love it,” she added.
Leslie O’Dell, OD, FAAO, wanted to move to a group OD private practice after her experience in an ophthalmology practice for 11 years.
“If you feel like you’re not in the job that’s right for you, it is OK to explore new ideas,” she said in an interview with PCON. “I would only say that I wish I did it a few years earlier.”
She was looking for more decision-making opportunities, so she transitioned to Wheatlyn Eye Care and opened the Dry Eye Center of Pa. with a two-location, five-OD practice.
Corte is currently transitioning to a non-affiliated sublease where he is partnering with another OD. In his current group practice, he has every piece of equipment on which he trained in optometry school.
“In North Carolina, we have good reciprocal relationships with primary care, neurologists, endocrinologists and more,” he said, and he is excited to practice to the full extent of his training.
Similarly, Justin Schweitzer, OD, FAAO, said the best part about working in an OD-MD setting is practicing at the top level of medical eye care. He works in collaboration with surgeons in a referral center, Vance Thompson Vision in Sioux Falls, S.D., and Fargo, N.D.
“Our surgeons prefer to be in the operating room, so the optometrists are in the clinic assisting in making the decisions on what surgery patients need,” he said. “We have a lot of pre-op and postop talks. We are really in the trenches.”
Josh Johnston, OD, FAAO, also enjoys the postsurgical and perioperative medical management. The OD-MD practice of Georgia Eye Partners allows him to apply the full scope of his training capabilities, making every day a challenge, he said.
William Smith, OD, benefits from the flexibility in his scope of practice that the Veterans Administration provides. He has licenses in South Carolina, Tennessee and Florida, and the VA Clinic in Jacksonville, Fla., allows him to practice to the full scope of any state where he holds a license.
“I can prescribe medications based on my Tennessee license that I couldn’t do in Florida,” he told PCON. “I can do certain procedures that I couldn’t in private practice.”
Kleman travels the country guiding surgeons and educating optometrists on the Raindrop Near Vision Inlay. She suggests that while optometric training did not prepare her for industry, the core content of visual science and optics has allowed her to be well-versed in this technology and educating other professionals. She enjoys the diversity of patient and practice interactions and introducing the corneal inlay to the leading doctors in both ophthalmology and optometry.
Srinivasan’s passion stems from digging deeper into what is already known in the industry and making improvements in quality of patient care for the future. She has been a part of the NECO faculty for the past 5 years.
“Research gives me the independence to pursue certain questions in pediatric optometry and challenges me to dig deeper into facts that we know and explore areas we don’t know,” she said.
Graduation debt: The cost of a career
Graduation debt is a large burden, with many optometrists managing it differently.
“No one sits you down to counsel you on what you’re getting into,” Smith said.
He makes monthly payments but will have his debt paid off in 10 years through a program under the Obama Administration, which excuses debt after 10 years of service, he said.
“Otherwise, it would be a lifelong burden,” Smith said. “It affects your life, your ability to buy a home.”
“You need to be committed to put ‘x’ amount toward it every month. I pay a large amount monthly and sacrifice other places,” Vollmer said.
O’Dell was fortunate in that she was able to lock into a low rate that allows her to pay other debts down faster, such as her home mortgage or practice payments.
“I deal with new graduates, and how they will pay off their loan is a big burden for them,” Pate added. “But it’s rare to ever hear about optometrists defaulting on their loans.”
Dealing with challenges
The main challenge of the profession is the antiquated notion that optometrists only provide glasses and contacts, Vollmer said. He visits medical offices, urgent care centers and emergency departments several times a month to let them know how he can assist.
Johnston said plenty of doctors do not practice to the full scope.
“A lot of patients have been left behind: not diagnosed, not given the proper treatment or sort of ignored,” Johnston said. “Often, these patients should have received treatment earlier. We do a lot of training and pharmacology in optometry school, and sometimes we don’t see doctors using [their full capabilities] in practice.”
For O’Dell, dealing with an older law in Pennsylvania requires waiting a minimum of 90 days to prescribe new drugs.
“It’s been a hindrance,” she said.
“There have been times when I felt people didn’t take me seriously because I’m young in my practice,” Smith added.
In the VA, he also must deal with bureaucracy.
“It could be as little as getting a pay raise or bringing a new service to our clinic,” he said. “Changes like these can take a year or two.”
Corte believes that managed care and vision care are getting tougher to navigate.
“Providing value with our services and making sure patients understand the reimbursement system and what they have to pay is the biggest challenge we have in eye care,” he said.
In addition, being in an OD-MD setting, Schweitzer initially struggled with gaining patients’ trust in tough corneal or glaucoma referrals.
In an academic setting, Coyne encounters negativity based on pushback by medical doctors, such as ophthalmologists.
“It’s always difficult to hear the negativity or their responses on our ‘lack of education.’ I’m very aware of how skilled our optometrists can be,” Coyne said.
Influence of disruptive technology
Disruptive technology cannot diagnose cataracts, corneal irregularities and accommodative issues like optometrists can, Smith said; however, he believes that online refractions will have a market, especially for web-devoted millennials.
When asked about disruptive technologies by his patients, Corte is up front.
“I tell them that they could probably get a refraction from that process, but don’t forget about the other parts of the eye exam that you’re missing out on,” he said.
The marketing messages can get confusing for patients and can send mixed messages to consumers, Corte added.
Advances in the field
As for opportunities in the industry, many experts cited technological advancements and therapeutics, such as those in dry eye and glaucoma, as some of the industry’s brightest areas.
Johnston says neurostimulation for dry eye is exciting, as are advances in multifocal and intraocular lenses.
“We’ve been fortunate to have so many people who have fought to get the scope of practice to what it is today ... there’s never been a better time to practice,” Smith said.
Johnsonbaugh enjoys fitting her patients into contact lenses, especially those who were previously told they were not a candidate for contacts.
Imaging capability for retinal disease is exciting to Schweitzer and makes it easier to take care of his patients at a high level, he said.
“Even if private practice isn’t the ultimate goal, you can see patients in hospital settings, academia, research, industry – there are a lot of different opportunities out there,” Pate said.
Optometrists might have to grow or evolve to accommodate technology, but, ultimately, ocular health and its relation to systemic disease will be significant, and ODs will be at the front line, providing the best patient care and doing the best for patients, Coyne said.
“To other optometrists that are graduating, follow your heart and don’t be overwhelmed with what seems to be scary with opening your practice,” Johnsonbaugh said. “Make it happen and find the right mentors to help you along the way.”
Young optometrists should seek a mentor, as the guidance and recommendations are immensely valuable, according to Srinivasan. – by Abigail Sutton
- American Optometric Association. 2014 AOA Survey of Optometric Practice. https://www.aoa.org/Documents/ric/2014%20Income%20From%20Optometry%20Executive%20Summary%20FINAL%20073015.pdf.
- For more information:
- Ryan Corte, OD, can be reached at: firstname.lastname@example.org.
- Alissa Coyne, OD, can be reached at: ACoyne@salus.edu.
- Monica Johnsonbaugh, OD, can be reached at: email@example.com.
- Josh Johnston, OD, FAAO, can be reached at: firstname.lastname@example.org.
- Melissa Kleman, OD, can be reached at: email@example.com.
- Leslie O’Dell, OD, FAAO, can be reached at: firstname.lastname@example.org.
- Caroline Beesley Pate, OD, FAAO, can be reached at: email@example.com.
- Justin Schweitzer, OD, FAAO, can be reached at: firstname.lastname@example.org.
- William Smith, OD, can be reached at William.Smith30@va.gov.
- Gayathri Srinivasan, OD, MS, can be reached at: email@example.com.
- Patrick Vollmer, OD, can be reached at: firstname.lastname@example.org.
Disclosures: Coyne, Pate, Smith, Srinivasan and Vollmer report no relevant financial disclosures. Corte reports he is a consultant for Allergan and Transitions Optical. Johnsonbaugh reports she is a speaker for Bausch + Lomb. Johnston reports he is a speaker for Alcon, Allergan and BioTissue and a consultant for Alcon, Allergan, BioTissue, Johnson & Johnson Vision and Shire. Kleman is director of clinical outcomes for Revision Optics. O’Dell reports she is a speaker for Allergan and Shire and a consultant for Allergan, Paragon BioTech and Shire. Schweitzer reports he is a consultant for Alcon, Allergan, Bausch + Lomb, BioTissue, Glaukos, Reichert and TearScience, and a lecturer for Allergan, Bausch + Lomb and Glaukos.