Beginning a career in optometry and finding a job after graduation are two daunting tasks. All the schools of optometry provide an excellent education, will prepare you for a lucrative career, and help you reach graduation day. However, in that first moment after you receive your diploma and shake that hand, all those loans we tried to forget about come knocking and the next big step of your life awaits you.
Well, at least that’s how I felt when I graduated from Salus University in 2015. I was lucky enough to remain in Philadelphia for another year and complete a primary care residency at The Eye Institute of Salus University’s Pennsylvania College of Optometry. All the while, I wondered what would be my next step. I weighed the pros and cons of each job type: salary, benefits, quality of life, and so on. Whether you’ve been out of school for minutes or years, looking for your next job can be overwhelming.
Well now that I have terrified everyone into becoming lifelong students, I’m here to ease your mind and get to the good part.
This article was originally published on July 6, 2018. As of fall 2021, Dr. Africano is still happily practicing in North Carolina and is now a Clinical Preceptor!
Fresh out of residency, I began practicing with North Carolina Primary Vision Care Associates, PLLC, an independent practice with multiple offices located within America's Best Contacts & Eyeglasses stores in North Carolina.
After careful consideration of many practice modalities, I wanted my average day to allow me to practice the way I wanted to while minimizing the stresses of a career in Optometry. I concluded that a career with North Carolina Primary Vision Care Associates would be able to accomplish that.
America’s Best is operated by National Vision, which means that my practice allows me to be part of the National Vision Doctor of Optometry network.
A day in the life of an optometrist practicing within an America’s Best location
I arrive about 10 minutes before patient hours to set up for the day and review correspondences from outside doctors about my referrals. I currently have a set schedule every week in one office that doesn’t vary unless I need to request time off.
There are also opportunities to be a “float” doctor where you can travel to multiple offices, which is accompanied by an increase in salary. I participated as a float doctor for my first year so that I could better understand the Charlotte area and patient population, while determining which area I felt I would thrive in most.
When I enter my exam lane, everything is prepared for me by the optometric technicians and I can jump right into patient care. One of the nice parts of working with my practice is that I don’t have to worry if my schedule is filled for the day and I don’t have to actively fill my schedule so I can pay the rent. If I see 2 or 20 patients I will still be guaranteed a nice paycheck.
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While I’m finishing up my daily preparations and my morning green tea, the optometric technicians are working up my first patient of the day. For every patient, be it a comprehensive exam, a TPA (emergency exam), or an Rx check (I’ve heard some doctors have these 😉), the technicians perform a thorough pretest. Just like when I worked with students as a resident, the technicians perform entrance testing and acquire a patient history.
In my office, FDT perimetry and retinal photography are also options. I’m able to work with the technicians during their training if I want to tailor the order, skills, or help improve the efficiency of the pretest. The technicians are happy to make modifications to any personal preferences I have with the pretest. Technicians are essential, and my partnership with them is one of the most important keys to my success!
When patient hours begin, I get ready to see anything and everything
One of the stigmas of working in an office inside a retail location is that all you do is refract -1.00D myopes all day. That couldn’t be further from the truth in my office.
I see a wide range of refractive errors and pathology. I see a combination of spectacle and contact lens fits. And trust me, I was worried about fitting contacts out of academia. I knew ocular disease like the back of my hand, but my contact lens knowledge had grown a bit rusty. With some experience and helpful guidance from my Area OD, I became comfortable fitting in no time. I fit mono-vision and multifocal contacts quite frequently and RGPs from time to time.
I see a wide range of pathology regularly at my practice, including anterior and posterior segment, as well as the complications of systemic disease. I serve a population that sometimes desperately needs care. This provides both a much-needed service, while also exhibiting a good deal of pathology. Fitting a child with their first pair of glasses or a teenager with contact lenses so their glasses don’t go flying while performing gymnastics or playing football is a great feeling. But supplying glasses for someone whose vision hasn’t been corrected for 15 years and hasn’t been able to hold a job or drive their kids to school due to their vision is simply inspiring.
Life as an optometrist means helping patients every day
National Vision’s mission to make eye care more affordable and accessible so people can live their best lives is absolutely true and is wonderfully executed by their leadership. Their CEO is very involved with the doctors at the various Practices in the National Vision network and is willing to go above and beyond to help ODs and stores accomplish this mission.
Providing a service to so many people in need provides a rich and diverse patient population. It also can come with a larger volume of patients seen daily.
The volume at my practice has helped me hone the art of performing an exam. The amount of patients I see is not for all doctors and takes some time to acclimate to, however, the excellent support staff including the receptionist, technicians, and management really helps facilitate the process. The receptionist allows me to focus on patient care while they take care of patient scheduling, the back and forth with other offices, and eternal hold times when performing a managed care prior authorization. The general manager keeps things running efficiently and helps keep a steady flow. They make sure I get out to lunch and out for the day on time, which is always appreciated!
The support staff allows me to perform unadulterated medicine. There’s no worrying about billing and coding, staff salaries, rent, utilities, overhead, theft, and hiring (unless you want to be involved with the optometric technician interviewing process). Another thing I don’t need to worry about is selling to my patients. When they sit in my chair all I need to worry about is their optometric needs. I’m not pressured to push any products or upsell. For my patients going through economic hardship, I often encourage them to peruse single vision lenses if they can’t afford a bifocal lens. It’s more important to me that they stay within their economic means and receive some level of correction, than forego all correction. My salary does not depend on what my patients purchase unlike some other practice modalities.
When my day comes to a close I can leave with a clear mind: no charting, no coding, no billing, or worrying about restocking the frame racks. I absolutely loved completing my residency at Salus and would make the same decision again in an instant. I built a wealth of knowledge and experience that helps me every day when I practice. It undoubtedly shaped the doctor I am today. However, I remember spending hours after work and on my days off catching up on charting and billing.
It’s a really nice feeling that when I drop off my last chart and check that there’s nothing that needs my attention, I can head home truly done. My head can hit the pillow without stressing about the day and what work I need to catch up on. Of course, sometimes there will be a case that lingers on your mind. I can’t deny those “should I have gone QID over TID” moments still exist. But I can rest assured knowing that everything in the office is taken care of; I have the time to head home and crack open my Wills Eye or Kanski if I need to. I have the time to master my art and don’t have to worry about the business aspect of optometry.
It’s nice to have consistency in my day-to-day life. I know the support staff will always be there filling my schedule, working up my patients, and running the day-to-day activities. However, I also love knowing that I’m not walking into a monotonous workday.
A diverse patient population means no days are identical
The variety keeps me on my toes and keeps my skills on point. My Practice also has options to get more involved: the clinical advisory panel, ambassador program, and Area OD positions are opportunities for career growth; in my first two years, I participated in the first two and now I have achieved my goal of becoming an Area OD! These positions allow you to gain experience outside of the exam lane and make changes on a broader level that can transform the day-to-day for both yourself and many other doctors. I am happy with my “average day,” but like to step back and look at the big picture. I appreciate how my Practice allows me to care for my patients while keeping a work-life balance, by providing a great schedule, extensive paid vacation, retirement options and a generous salary. The average day is important, but everything culminates into the big picture.
“There are many opportunities in a career in Optometry. There is no one career path that is right for everyone.”
Be it one day out of school or one decade, you must evaluate your future, what’s most important to you, and what you’re looking to get out of your position. In the end, no matter what practice modality you’re in, I advise that you always strive for excellence, give your patients the best care you can, make a comfortable living, and keep flipping those dials. Because remember, like a refraction, even though it’s always between 1 or 2, life’s subjective. Only you can make the right decision for yourself and your career path.
After reviewing an average day in my life working for a practice located inside an America’s Best location, I hopefully shed some light on what it’s like being an OD in the National Vision Doctor of Optometry network. I wish you the best of luck in your future no matter what your stage of schooling or career.