What's the Best Optometry Setting for You? (With Quiz!)

Being a new graduate comes with a wave of mixed emotions. On the one hand you are proud by all you have accomplished, and on the other hand you feel as if you have no idea where your place is in this brand-new world of optometry. There is no shame in not knowing where or how you want to practice. Exploring a myriad of various practice modalities can help you become a well-rounded doctor. But in the meantime, this article will provide insight on what to expect in each optometry practice modality and if it is the right fit for you!

When a new graduate is asked to describe which type of modality they are most interested in, this type of practice most often comes to mind. Most of us have grown up seeing the family optometrist since as young as we can remember. These family optometrists know what school we attended, the sports we played and even our pets’ names. Private practice not only allows you to work with patients on a daily basis but also bond with your community. You are not only treating disease but getting to know that patient as a whole, and for some that connection with what gets them out of bed every morning.

One of the biggest challenges of working in private practice is dealing with insurance companies. However, if you hire a great billing specialist, this can help to alleviate some of the headaches. Furthermore, you are not only a doctor but a salesperson as well. Glasses account for nearly 30-40% of private practice’s income, so if you want to stay in business or keep your job you have to be able to sell glasses. Not all doctors see this as a burden, as it allows them to combine their passions of fashion and technology and clinical care. Lastly and maybe most importantly for a new graduate, although there is no loan forgiveness, the salary you could earn as a private practitioner may more than enough make up for it. And if you love private practice, you could consider becoming partners or even starting your own practice!

CovalentCareers provides great resources that can help you to negotiate your terms and help you understand what is important when negotiating a contract.

With more student loan debt than ever, corporate optometry is becoming one of the most popular modality choices for new graduates. The salaries corporate optometry offer to new graduates can reach as high as 1.5x more than one would earn in a VA hospital or private practice setting. They often provide sign-on bonuses and a relocation fee. However, with a higher salary comes an even higher patient load, where doctors are often expected to see 3-4 patients every hour. Therefore, the exams are usually fast paced and air heavily on the refractive side. So if ocular disease is your jam, this may not be the best modality for you.

For those who prefer to sleep in or work out in the morning, corporate optometry may suit your lifestyle better as doctors usually start work later in the morning and end later in the evening. Furthermore, although you are expected to guide patients as to which glasses would be right for them, you have a whole team of opticians and eyewear salespeople to seal the deal. You may even get a bonus if you see more patients or sell more glasses than expected in a given workday. Lastly, even if you do not want to work corporate full time but make extra money on the weekends, they are always looking for part-time optometrists!

If you want more information about working in a corporate setting, check out this article that delves deep into the ins and out of working in a corporate setting.

VA hospitals are one of the most sought out residencies for optometry due to its challenging ocular disease population, academic culture and having some of the best and brightest attendings to guide and teach you. From diabetic retinopathy to ocular melanoma, this type of modality will challenge your optometric knowledge every day, quickly hone your fundus exam skills and compel you to apply evidence-based research to your clinical reasoning and treatment plans. Furthermore, there is no stress about billing through insurance companies or trying to make a glasses sale. Instead you can focus on providing the best medical care for your patients.

However, with every government position comes dealing with bureaucracy, such as long and thorough exam notes that meet the requirements of the VA. Furthermore, the salary may be lower compared to other modalities, but remember you have all government holidays off and great healthcare benefits. You are expected to keep up on the latest research and attend academic conferences. Furthermore, you most likely will be overseeing and guiding fourth year interns and residents. Overall it may be one of the most clinically demanding modalities discussed in this article, but also one of the most rewarding.

Optometry schools are always looking to hire new graduates. This type of modality usually means working in an affiliated community clinic in the area. A great reason to at least start your career in this type of setting is that oftentimes the school will offer loan forgiveness can help to offset some of your daunting loans that keeps you up at night. You are most likely going to be overseeing third- and fourth-year students, which will likely keep your optometric knowledge very sharp. These clinics are oftentimes in an underserved population, so you will help your community by providing quality eye care to those in need.

Furthermore, if you would like to lecture once in a while but stay mainly in a clinical setting, this modality may be a great fit for you. The school will often invite their associated attendings to come lecture in the classroom. Eventually this could lead to a full-time associate professor position.

This practice is ideal for those looking to work alongside an ophthalmologist while seeing pre- and post-operative patients. You will be managing long-term ocular diseases such as glaucoma, macular degeneration and provide guidance on refractive and cataract surgery. You will also likely be performing all contact and glasses exams, so you will grow a strong patient base of your own. Sometimes the patient load is heavy, but the technicians are usually extremely efficient and well-trained, so you can focus on the diagnosis and treatment.

One of the great things about working in an OD-MD practice is that you often have the latest and greatest technology at your fingertips and can provide some of the best patient care. Furthermore, there is an ophthalmologist present to help manage complex cases, so you rarely have to refer and can keep most patients in-house. OD-MD practices provide not only a competitive salary, but also great benefits such as healthcare, paid-vacation, funds towards continuing education. This is often more than what a private OD practice can offer due to greater financial resources.

If you are looking to specialize, such as myopia control or vision therapy, this is probably not the modality for you. Ophthalmologists rarely focus on these specialized fields and are often not willing to invest in the equipment and resources needed to make it as successful. Therefore, it is oftentimes better to start your own practice or work in a private OD setting if this is your passion.

Lastly, if you fall in love with one aspect of optometry, such as vision therapy or scleral lenses, and that is all you see yourself doing all day every day, consider joining or opening your own specialized practice. Not only can you become very successful, since most specialized niches of optometry are very lucrative, but you will likely never be out-competed by other modalities such as corporate or OD-MD practices. It is often very fulfilling to have a specialized practice since you are providing unique services that can make a huge difference in someone’s life.

One of the challenges of working in a specialized practice is that it can take time to build a patient population and requires a lot of self-marketing. However, once you have gained a strong reputation, patients will travel across states to come see you!

One of the many reasons why optometry makes such a great career is the fact that there are almost limitless settings in which we can practice. Depending on our strengths, interests, and phases of life, we might choose to work in one setting for many years, then try something entirely new. Or, we might want to opt for a flexible role from the get-go, where every day is different. The beauty of optometry is that we can literally do anything; all we have to do is shift gears and put on our learning caps!

And remember, even after reading this article you are still not sure which type of practice setting is best for you, the years right after graduation are a great time to explore various options. It will only allow you to gain more perspective and experience so that when the time comes you’ll know which modality is right for you!