Professional Development

5 Red Flags of an Unethical Employer

Julianne Koch, OD

Jan. 8, 2020

My generation, the Millennials, are known for being job hoppers. According to the Gallup article, “Why Millenials are Job Hopping,” Millennials don’t want to be this way, but we will leave for specific reasons. One of those reasons is improper management, including unethical employers.

Per the same Gallup article: “Fifty-eight percent of Millenials say ‘quality of manager’ and ‘quality of management’ are extremely important for them applying to a new job.” While ‘quality’ is certainly a subjective term, here are some examples of what to look for and what to do before you take the job:

Unreasonable Employment Contracts
I recommended hiring an attorney to review your employment contract.Yes, I know attorneys can be expensive, but you stand to lose a lot more money if you sign a bad contract. For example, one optometrist colleague unwittingly signed an employer contract that required him to pay his employer a certain amount of money if that money was not generated by his work. The colleague did not have detailed information about the number of patients he would be seeing per day, exam costs and all the other factors that influence the money he was being required to generate.

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Do not agree to this contract clause, even if the employer assures you that you will meet that monetary goal easily. If you do, and you don’t meet the requirement, the employer can come back to you with a bill upon your leaving.

Look out for unreasonable non-compete clauses within employment contracts. It’s understandable that you can’t start your own practice within a few-mile radius of the practice. It’s also understandable that the employer would not want you soliciting patients to follow you. However, if you are presented with a non-compete clause that inhibits you from practicing within the entire city for two years after ending your employment, consider negotiating this point.

Contracts that automatically roll over should be avoided or renegotiated for term limits. A colleague had a contract that rolled over automatically if he did not submit his leave months before the contract rollover date. That stipulation can leave you vulnerable and trapped in a contract.

An Employer That Isn’t Doing What’s Best for Patients
This situation can take many forms, including pressuring patients into treatments, and/or to purchase products, which they do not need, or which will not benefit them. Educating patients about the benefits of advanced, high-tech spectacle lenses makes sense. Talking a patient who has end-stage glaucoma into purchasing glasses with high-quality digital lenses, does not.

Also beware of employers that want you to skip certain protocols that you believe are necessary to fully evaluate eye health. For instance, a colleague had an employer who didn’t want her to dilate any of her patients, saying dilation was a waste of time. Even if there is an Optos retinal camera in the office, dilation can be beneficial to patients; especially those who have unexplained vision loss. Keep in mind that it’s your license that’s at risk, not your employer’s.

Pushing You to See More Patients Than You Can Adequately Care For
When employers make you work at a pace with which you’re not comfortable, your ability to do the job right the first time can be compromised.

I believe in compensation based on the number of patients seen and work output. However, if you’re working on a day rate, or a fixed salary, and your employer is pushing you to see more patients than you can adequately care for, the quality of your work can suffer.

For example, consider this unacceptable scenario: You are asked by practice management to stay two hours after you were supposed to leave, so you can see five more walk-in patients after an already-packed schedule. In addition to the lack of ethics in asking you to work beyond what you are being paid for, you have to consider the kind of care you will be able to provide those five additional patients.

Inhibiting Your Ability to See an Adequate Number of Patients
This is the opposite of the former bullet point. One example, a colleague who was just out of optometry school, joined a private practice with hopes of one day owning the practice. He and his employer negotiated a compensation-based contract. However, the employer instructed the staff to make sure that his schedule was completely full before putting new patients on his new employees schedule. This inhibited the new doctor’s ability to see more patients and to meet his bonus. After three years of practice, the relationship was strained and the employee left the practice to open up his own.

Upon interviewing for a position, query about how the patients will be allocated to you. Ask about what marketing strategies the office does to help get patients in the door. Furthermore, make sure the office can support a new optometrist and will stand behind you in building your patient base.

Employers Who Don’t Comply with Regulations & Standards
When your employer engages in activity such as insurance fraud, tax fraud, medical malpractice and sexual harassment, it not only is illegal; it has the potential to reflect poorly on you and the entire office.
Similarly, if your employer is performing procedures that are beyond their scope of practice, or in an unsafe environment in the clinic, you have a right to question them. Everything your employer does while in the office can be perceived by patients, colleagues and regulatory bodies a direct reflection on you.

Make the Right Decision for Yourself & Your Patients
All of these things should be no-brainers, right? Why would you ever sign an unreasonable contract, or tolerate behavior that you know is wrong? The answer is because most of us need employment.
The optometric community is a small one, so ask around about the practices to which you apply. Ask people who previously worked there why they left. Ask about the office’s reputation in the area. You can also go online to or to see employee reviews of the practice.

Do your due diligence, so you can be the kind of doctor you want to be.

Julianne Koch, OD, is a freelance writer and optometrist in Antioch, Tenn. To contact her:

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