When I was applying to optometry school, I met with an advisor at Michigan College of Optometry and my cousin, who is also an optometrist, to discuss the different directions one can take as an optometrist.
During our visit, it was said, “There are about 13 different career paths you can take when you become an optometrist, and there are more that just haven’t been created yet.” As optometry continues to grow, the opportunities are endless when it comes to making new career paths. Today, there are more options for optometrists than ever before.
In my optometry career, I have been able to explore several of these paths, from starting in private practice to working with sublease and corporate-employed optometrists as an industry professional. Each avenue was equally rewarding and showed me how I could continue to help patients in different ways.
Here is a walk-through of clinical and non-clinical career paths that you can take as an optometrist.
The main modes of optometry practice
Optometry can be broken down into two primary modes of practice: clinical and non-clinical. When people think about optometry, typically people envision the clinical aspect in which your day is focused mostly on caring for patients in the exam lane. While this seems like a pretty straightforward route, there are myriad potential routes within clinical practice.
Private practice
Private practice is the most traditional form of clinical practice and is mostly thought of when people think of optometry. My first experience in practicing optometry was in private practice. I spent my days caring for patients between 6 months to over 100 years old. My days spanned from refraction to medical examinations to contact lens fittings.
Approximately 50% of people who responded to the Eyes On EyeCare 2022 Optometrist Report identified themselves as being a part of a private practice; 20.8% of respondents were practice owners, meaning that a vast majority of optometrists are employed. While there may be optometric specialties within the practice, a majority of private practices are focused on primary care optometry. In private practice, the medical clinic and optical are owned by an optometrist or group of optometrists, without having a larger corporation’s name attached.
Positives and negatives of private practice
Private practice is a great way to practice with a small group of individuals with the ability to have autonomy over all parts of the practice. Within the practice, the owner is able to dictate their own hours, location, specialty, equipment, and optical inventory. This flexibility allows for private practice to cater to the practitioners and patients in ways that feel most comfortable to them.
The downside is there is less opportunity for employment benefits in the workplace. Some benefits that are not as common in private practice include medical benefits, 401K benefits, or maternity leave benefits. Employed optometrists may also have a higher cost for the benefits they do receive. These changes in benefits can impact your salary based on more money from your salary going to benefits provided outside of your workplace.
Lately, the lines have begun to blur a bit when it comes to private practice. There are large buying groups (such as Vision Source) or private equity groups (such as EyeCare Partners or AEG) who own private practices. These groups still maintain the integrity of the private practice by maintaining the office name, specialties within the practice, and other key pieces that make up the constitution of the office.
While technically, this would no longer classify the practice as a true private practice, the optometric community continues to view these locations as private practices rather than corporate locations. Take a look at corporate optometry to learn more about this path in clinical optometry differs and is similar to private practices.
Corporate practice
Corporate-affiliated practice is the second most common form of clinical optometry, with 16% of respondents from the aforementioned report employed by a corporate optometry entity and 8% of respondents who are sublease owners.1 There are two different ways for optometrists to affiliate with corporate entities; optometrists can sublease their space from the corporate entity or be employed by the corporate entity or the sublease owner.
Optometrists who sublease their clinic space from a larger corporation create their own business entity and clinical practice to see patients. There is not an optical within the practice, patients are able to go to the optical they are affiliated with for their eyewear needs. This is a great way to enter into practice with a low start-up cost and gain a patient base quickly by being associated with a corporate optical. There is also the opportunity for rapid expansion with a low cost to add additional clinics.
There are employment opportunities within corporate practices. This could be as an employee of the sublease owner or, in certain states, by the corporation. I have been fortunate to know many optometrists that practice in a corporate setting. They see patients of all ages and spend their days practicing full-scope optometry. Clinics are focused on primary care optometry, but several will have specialities as well.
Benefits and downsides of corporate practice
Optometrists with sublease practices have the ability to create specialties within their practice. Since they are the business owner, they are able to create the clinic’s specialties and scope as they desire. For optometrists practicing in corporate settings, there is a wide range of benefits that can be received.
From a sublease owner's perspective, the low cost to create and expand a practice. Practices also have built-in advertising and notoriety since they are associated with corporate opticals. Optometrists do have to work with their corporate entities to agree to operating hours, location, equipment within the location, and other possible contractual stipulations.
As I mentioned before, there are two forms of corporate practice, including the traditional sublease model (such as EssilorLuxottica or National Vision) and private equity corporate practices (such as MyEyeDr). Optometrists in both corporate and private settings are dedicated to serving patients with incredible opportunities to create wide-reaching impacts in optometry.
Hospital or MD/OD practice
When I think of a hospital, many times I think about surgical centers, babies being born, or emergency departments full of patients. While these examples are what is seen most on TV, they do not give an accurate picture. There are tons of departments with doctors who are managing patients in clinics within the hospital. Optometrists can be hired by ophthalmologists who are members of these clinics within hospitals or directly by the hospital itself; approximately 11% of optometrists practice in this setting.1
Ophthalmologists may not practice within the hospital but instead have their own clinic offsite and manage their surgical cases through a surgical center. Optometrists are hired in these clinics to focus on the medical side of optometry, with an emphasis on pre-operative and post-operative care.
This is the third most common practice type, following private practice and employed corporate practice. Sometimes an optical will be a part of these clinics, but that is not always the case. For an optometrist to be a great candidate for these roles, a residency or further education are highly encouraged.
Pros and cons of a hospital or MD/OD practice
Being affiliated with an ophthalmologist or a highly medical setting can provide benefits in unique ways. Optometrists have employment benefits that come from being involved in a larger business entity while still functioning similarly to a private practice. However, ophthalmology-based practices often have a high volume of patients, which requires optometrists to see a large number of patients each day.
VA, IHS, or community health centers
Though you may wonder why I chose to combine Veterans Affairs clinics (VA), Indian Health Services (IHS), and community health centers (CHCs) under one category, these multidisciplinary settings are much more alike than they seem on the surface. All are federally funded to help a group of people who must meet specific qualifications to be seen by a provider. Additional tests are covered (or greatly reduced) for patients and are interconnected with all other medical clinics in the same building.
At the VA, patients are military veterans who are typically older adults but can be any age of a person who has left the military. In IHS clinics, patients need to be affiliated with a Native American Tribe to receive their medical care. Patients can range from infants to geriatric populations in the clinic. Community health centers are affordable clinics for underserved patients of all ages. These clinics are usually found in urban settings or low-income areas and serve patients for free or at greatly reduced rates. The optometrists in these clinics play an important role in the patients' holistic medical care.
Each of the mentioned clinics is medically focused but does have free or discounted associated optical dispensaries. Patients’ ocular and systemic medical conditions are managed throughout the entire medical center, with doctors working across specialties to regulate patients’ medical conditions. This means optometrists are often able to have access to full diagnostic testing and, many times, privileges to order tests outside of the optometry clinic.
According to the Eyes On Eyecare Optometry Report, IHS optometrists were the least represented, with a mere <1% of respondents working at an IHS clinic. Optometrists at CHC clinics made up only 1% of the respondents. A much higher number—17%—work in a VA or military-based practice. However, federally funded clinics, collectively, were the third most popular practice choice for optometrists.1
Benefits of working in a federally funded clinic
One unique aspect of working at one of these federally funded medical facilities is that you can qualify for student loan forgiveness after 10 years of working within the clinic. Other benefits include federal or state government benefits and having guaranteed national and state holidays off.
The Indian Health Service Loan Repayment program can also help optometrists tackle their student loan burden. While the paid time off (PTO) benefits are exciting for these clinics, they usually can have a pay scale that is set by the government with a slower growth potential.
With a growing number of CHCs interested in offering eyecare services, their salaries and benefits packages are becoming more competitive. A residency is required to work at a VA, and though not always required, is highly recommended for IHS and Community Health Centers.
Military optometry
Another aspect of medically focused optometry is practicing as an optometrist in the military. The patient base in these clinics is active duty soldiers. A majority of patients are young and healthy, but there is still a large portion of the optometrists’ day filled with medical optometry.
Hospitals and ophthalmologists are located on more prominent bases, and often optometrists and ophthalmologists practice hand-in-hand as they manage many patients in the clinic. However, in smaller areas, optometrists are the primary eyecare providers for all ocular medical cases, meaning, in more remote military bases, there is even more opportunity to manage complex medical cases.
Most optometrists decide to become a military optometrist while they are still in optometry school. The Army and Navy both provide scholarships to cover 2 to 3 years of your optometrist education, along with funds for books, and living expenses. These scholarships do come with a commitment to the military for 3 to 4 years after graduation. Optometrists go through military training exercises that optometrists go through after graduation, such as boot camp but then go through officer training as well.
What does working as a military optometrist look like?
Optometrists are able to rank the locations they would like to be stationed at, but their assignment is decided by the military. This assignment could be national at a base here in the US or involve international placement. Just like other active-duty military personnel, optometrists can be deployed to a clinic for a period of time. These clinics are typically more remote and don’t offer the opportunity for families to transfer to that base as well.
While many military optometrists will choose to do active duty optometry, there are also options to be a part of the military reserve as an optometrist. These time commitments for the scholarship are longer than the active duty commitment to the military. Simultaneously, there is more flexibility to choose your location to practice and practice in any modality type in addition to being a part of the military reserve.
There is a commitment of 1 weekend a month and 1 week a year to be on a military base for training. In the military reserve, there is still an opportunity for deployment for optometrists. A residency is not required for these roles but does allow you to be qualified to work in federally funded optometry clinics.
Specialty clinics
The last clinical practice type is a specialty clinic. Specialty clinics are usually found in a private practice clinic, but can be found in any clinical practice setting. What makes this different from any previously mentioned clinic is that the clinic specializes in one area of optometry. Over time, some private practices have evolved into specialty clinics as they have proven their expertise in a certain area; 35.2% of optometrists stated that they have a specialty.
Some examples are specialty contact lens clinics, vision therapy practices, or aesthetic practices. The most common specialty type is ocular disease, with cornea and contact lens next and followed by dry eye. These clinics act as referral centers, where other primary care optometry clinics are able to send patients who need specialty care.
Many times, these clinics are small, with only one or two optometrists working within the clinic. These practices are typically owned by optometrists who are residency-trained in their specialty. Optometrists in these specialties have more flexible hours and typically see more cash-pay patients, which increases revenue for the practice.
Non-clinical practice options
Though it is fulfilling to serve patients every day and create lifelong relationships with them, optometrists can also impact optometry through non-clinical settings. The impact of optometry can be seen in influencing policies and procedures in corporations and businesses across the globe. I like to think of it as impacting thousands of patients a day, which is on a scale that is larger than what I could do in a clinical practice.
A major benefit for non-clinical roles in optometry is the benefits provided by a large corporation, such as health care benefits, paid maternity leave, and 401k matching. Non-clinical roles are not as common as clinical roles, and many times require you to move to be in the same city as the corporate headquarters. While there are many considerations when taking a non-clinical role, 58% of optometrists reported they would consider the shift in career.1
Practice leadership
In corporate or private equity practices, there are local or regional optometrists to make sure optometrists and clinics are able to be successful. Optometrists are perfect for these roles because they can understand the clinical setting and be able to relate to optometrists within the business setting. Becoming a regional leader usually occurs from being promoted out of a clinic within the region.
Optometrists that enter into these roles have shown their leadership capabilities within their office. They are able to perform at high levels in the clinic setting and have an understanding of the business portions of the clinic. Regional leaders have days filled with travel to clinics and meetings with business executives advocating for their optometrists and clinics. These roles do require significant travel but allow for a significant impact close to the clinical setting.
Industry
A step further removed from clinical practice to work within a corporate or business setting as an optometrist. These roles are in an office setting, working with eyecare corporations to bring the voice of the optometrist to the larger eyecare industry. I have been fortunate to have this as a piece of my optometric journey. I have worked in a marketing team in optometry and opticianry engagement.
Other opportunities in industry include:
- Operations
- Professional relations
- Recruitment and training
These roles require varying amounts of travel and public speaking. Another aspect of industry can be working as a medical science liaison. These individuals are tasked with educating other eyecare professionals on the understanding behind advancements in optometry. These roles are held by people with a great understanding of ocular disease and the ability to teach others about ocular disease. Medical science liaisons usually travel a majority of the time in their role but do have opportunities for quick growth within the company.
The impact on eyecare can be more extensive within these roles because there is more opportunity to influence corporate policy and direction. Talent recruiters are looking for an optometrist who has keen business knowledge, the ability to project manage, proven leadership capabilities, and an ability to affect the larger industry.
Academia
There are optometrists who will say that the academic portion of optometry should be considered a clinical career path. However, I believe academia is a great way to be a part of the clinical setting while also investing in non-clinical portions of optometry. Only 2% of optometrists reported that they are in an academic or research setting.1
Professors at optometry schools do a lot of work outside of the clinic setting by educating students, preparing course lectures and coursework, conducting research, and examinations. Though there is some travel involved for professors, while attending conferences and/or guest lecturing, they spend the majority of their time at their home campus mentoring and empowering future optometrists in the clinic. Residency or further education is required to enter into the academic career path.
One additional benefit of being affiliated with a public institution is the ability to be a part of the Federal Student Loan Forgiveness program. Optometrists are paid based on tenure and their status within the academic structure. Growth is not as quick as it is in the private practice setting.
Research
Research is all about creating the future of optometry. Optometrists have a deep knowledge of the entire visual pathway and the ability to conduct the testing needed to understand the visual system. There are research optometrists in academic settings and in corporate settings, typically with other responsibilities in addition to their research duties. There is some travel involved, but usually, the time is focused on creating new innovations.
You can find these optometrists writing articles, creating protocols, and running studies. While they may see patients, it is in a non-traditional way to satisfy study protocol. Optometrists in this setting typically need further education to qualify for these roles.
These roles have a wide range of pay and growth potential depending if they are affiliated with public or private opportunities. Private research for pharmaceutical, spectacle, or contact lens companies usually has a higher pay scale and quicker growth potential compared to their public counterparts.
Consulting
Optometric consulting is a new area of optometry that is all about an individual optometrists using their skills to improve other optometry clinics. Optometrists who have had a lot of experience in a specific area, such as medical billing, will travel to improve practices and build their profits.
This is a new area of optometry and is small but growing. Often consultants speak at meetings to share their knowledge. As this area grows in optometry, there will be great perspectives on how to build your own brand to consult with other optometrists.
Final thoughts
There are so many ways you can be an optometrist. Each direction of optometry allows for top-notch care for patients and optometrists to utilize their best skills. And the best part is, you can shift to a different part of optometry. With the background and knowledge of the visual system, ocular disease, business management, and higher education, optometrists are the perfect candidates to fill these roles.
The ever-changing nature of optometry will also create new career paths within optometry. Since we are the deciders of how optometry grows, we get to build new aspects of optometry every day. Optometry is a profession that is invested in creating a better world by creating diverse experiences for all optometrists and, whatever way you practice optometry, it inevitably creates a better world for patients everywhere.
