By Cheryl G. Murphy, OD
Dec. 11, 2019
Working with ophthalmologists can be an incredibly rewarding experience. Optometrists seeking employment should not immediately discount this mode of practice. OD-MD practices have become increasingly popular and successful in recent years.
When I tell other optometrists that I work for an ophthalmology practice, I get mixed reactions. Some are intrigued and regard it as an exciting learning opportunity, wanting to know if I have seen any neat ocular disease cases recently.
Others scoff as if I have “sold out” by working side-by-side with an MD. However, working closely with ophthalmologists can provide many benefits to our patients by enabling high-quality comprehensive care and an extensive array of expertise from both practitioners.
Here are some of the myths I’d like to dispel about what it’s like for ODs working for, or with, ophthalmologists in the same practice.
“You must see a million patients an hour”
I have worked for two ophthalmology practices. One had only one or two ophthalmologists and me, and at the other I worked alongside five ophthalmologists. At both of these practices I was able to set my own pace of appointments. Additionally, the smaller private ophthalmology practice insisted I take half-hour exam slots for each patient, as they were not providing me with my own tech, and I had to do pre-testing myself.
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When I remarked that other practices sometimes make ODs go faster than that, the ophthalmologists were shocked, saying “How could you possibly do it (and a good job of it) in less than a half an hour?”
That practice may be a rare outlier, but it just goes to show that ophthalmology practices won’t necessarily expect you to work at warp speed. The pace of appointments is usually set as a preference of the owning doctor, or at a pace you set with their permission.
A large company or conglomerate of ophthalmology practices may have their own rules that they apply across the board to their multiple locations, and to be fair to all other ODs that work with them, they may not allow you to set your own pace, but there can always be exceptions to the rule. So, it’s worth asking, rather than making assumptions, about patient volume.
“You only do pre- and post-op stuff, right?”
I do full, comprehensive exams, and actually, I do not do any of their pre- and post-op care. The ophthalmologists also do full comprehensive exams on some of their own patients. However, I additionally perform all of the contact lens fittings and evaluations, while the ophthalmologists do not get involved with that aspect of care.
I dilate, perform OCT/HRT, manage and treat glaucoma and treat eye emergencies. I am not just a “refractionist” and contact lens expert.
Ask ahead of time, or during the interview process, what the ophthalmologists’ expectations are, and give them yours. You do not want to be expected to hand over anything and everything medical. You want to be able to deliver the level of care you have been trained to give and feel comfortable giving.
“You must have to talk everybody into a lot of surgeries and push procedures”
It is true that medical visits, procedures and testing are more important to ophthalmologists, but that doesn’t mean that they push people into getting unnecessary procedures.
On the contrary, they are careful to protect their medical licenses, and most are practicing in an ethical way. Make sure the one you interview with is practicing good ethics, and you’ll be fine. I have never felt pressure as the OD in the practice to refer patients for surgeries early or push procedures.
“I’d do that but I hear they want you to work long hours and are less flexible”
One of the ophthalmology practices, where I worked, allowed me to work “school hours only” from 10 a.m. to 2 p.m. I was able to put my kids on the bus and be there for them when they got home, and it worked well for the ophthalmologist because he had surgeries at the hospital in the mornings, and then took a lunch before coming to the practice in the early afternoon. That meant I was able to cover those hours of the day at the office when he was away.
Like OD practices, each ophthalmology practice has different needs. Be honest about your needs, and see if a compromise can be made that works out for everyone.
“I’d be too intimidated working for an MD. They might expect me to know as much as they do, and some of that stuff I haven’t seen since optometry school”
Ophthalmologists do not expect you to have all of the answers because they themselves don’t have all the answers. I think when you’re an OD starting to work with an ophthalmologist for the first time you sometimes have a case of “imposter syndrome.”
Like, “When are they going to figure out I don’t know as much as they think I do?” Relax. You know a ton! And if you don’t know something, this is your chance to better yourself and learn. Be honest about what you know, and don’t know, and then educate yourself on what you don’t know or on conditions you haven’t seen since optometry school.
Also, ophthalmologists don’t know everything either. They seek specialists when they are not sure.
In fact, you know A LOT that you can teach them!
“You work for an ophthalmologist? You must get paid a ton (or conversely, you must get paid peanuts)”
One ophthalmology practice I worked for paid me the highest wage I have ever earned as an employed optometrist. Another paid me a lower wage than the optometry practice where I was working at the same time.
Ophthalmology practices vary greatly in salary or wages paid to ODs. Hear what they are willing to pay you without “naming your wage” first because what they are willing to pay you might be more than what your wildest dreams would have ever expected.
However, depending on your individual needs and the needs of your family, you may consider sacrificing a little off your wage per hour if the practice gives you some other huge benefit (like extreme flexibility/setting your own schedule, etc.) The bottom line is: don’t get paid rock bottom, but don’t expect the moon and stars either. Come up with an arrangement that you find fair and acceptable.
Don’t let the opinions of others or your own fears dissuade you from seeking out an opportunity to work with an ophthalmologist. Go to the interview. Be proud to be an OD. Be honest about your expectations. See if an arrangement can be made that you’ll both benefit from. And if you do take a job with an ophthalmologist, I hope you take it as an opportunity to expand your horizons and ignite your passions for learning again! It did so for me.
Do you work in an OD-MD practice? What are some of the myths that you have heard about working for, or with, ophthalmologists? What are advantages or disadvantages that you have experienced working with ophthalmologists? Do you think OD-MD teams are beneficial to the future of optometry?