Professional Development

Focus Group: How Well Do Optometry Schools Teach Practice Management?

By Diane Palombi, OD

Nov. 28, 2018

Do you remember what you learned about practice management in optometry school? If it wasn’t much, you’re not alone. Many ODs are unimpressed with the practice management education they received. I recently queried the Facebook group Optometry Divas to see what the group’s participants, women ODs ranging from new graduates to Baby Boomer ODs, like myself, thought about the state of practice management education. I got over 100 responses. Many agreed it was necessary, but that schools were falling short.

I graduated from the University of Missouri – St Louis School of Optometry in 1985. It has been renamed College of Optometry since that time. We had one semester of practice management. I remember listening to a lawyer and an accountant. We might have had other guest speakers, but I don’t recall. So, when I opened a solo private practice cold in 2000, after 15 years in practice, I had to start from scratch researching the business management side of owning a practice. I was lucky since my husband by that time had a successful manufacturing company. He also had a business degree, so I had the opportunity to be mentored by him.

As an undergraduate I had worked in the banking industry, which gave me some accounting skills. In addition, I helped run the reception area at my optometry college while waiting to pass state boards and obtain my state license. While I was still a student, I also worked for a private practice doctor where I learned some of the ropes of practice ownership. However, when I decided to start my own practice, I could find little helpful information. I learned from the school of trial and error. It sounds like all these years later, many are still learning business management on the job.

How Important Is It to Learn Practice Management?
I had some respondents on Optometry Divas who were not practice owners. Since they did not want a practice, they did not care about practice management education at all. They did not think it was relevant, and that it took time away from other important information that they needed to learn. One doctor said that it is not the job of the optometry college to teach practice management, but how to be a good doctor. A doctor should educate themselves on their own time or find good help.

Others did not take the class seriously because they were studying for the optometry national boards at the time. Some said that most graduating doctors have too much debt to own a practice immediately, so why bother with the class?

How Good are Current Practice Management Courses?
From the doctors who wanted to learn about practice management, it sounds like the curriculum hasn’t changed much over the decades. One doctor said that she was infuriated by the class. All of the guest speakers had “lucked into” their amazing positions, by their own admission. It’s hard to learn much from that. Another doctor called the class a total joke. A third doctor said the course is usually taught by professors with no experience running a practice themselves. Many said they learned more from private practice clinical preceptors and private practice externships than they did in the classroom.

In some cases, it sounded like the practice management education new ODs received wasn’t setting realistic expectations. One doctor said that she and her group got a 95 percent on their final project of designing their own office. It was 6,000 square feet, opened cold with four full-time doctors. They projected it to be profitable within six months with all the doctors making six-figure incomes. In addition, they owned the building, equipment and “everything else that they may need.”

Editor's Note

ROB welcomes opinions on all aspects of optometric practice—and the subject of how well practice management is taught in optometry school is one of central importance. In the coming year, ROB will examine this issue in depth in a series of interviews with presidents of optometry schools.

ROB Editors Note:
On Practice Management Curriculum in Optometry Schools…

Practice management is taught in OD schools. The Association of Practice Management Educators provides an educational exchange among members, representing PM educators at more than 20 OD schools. ROB editors recently met with the APME for an open dialogue on practice management education needs.

Clinical education prevails. “That which gets tested gets taught” is an axiom of education. The OD school’s first responsibility is to prepare students to pass their boards, which is a test of clinical learning, not management competency. And with widening scope of practice, more clinical information must be imparted than in years past.

Students listen when it matters. Practice management issues are pertinent mostly to fourth-year students and graduates entering practice. In addition to offering PM courses, OD schools address this with career symposia for third-and fourth-year students, private practice club events, hiring skills workshops with students and alums, as well as ongoing PM education for local ODs in practices, be they alums or not, to promote networking and OD/OD student interaction.

Some recent ROB content on this:
Highlights of the SUNY Career Symposium

“Use Optometric Alumni Networks as a Practice-Building Resource”
By Thomas A. Wong, OD

“Buying and Selling a Practice: How Both Sides Can Profit”
Lecture by Bob Schultz, CEO of Vision One Credit Union; and Mark Wright, OD, FCOVD, at NOVA Southeastern College of Optometry


Another respondent said that she got a copy of “Business Aspects of Optometry” as her only help in practice management. She said it was like her college telling her to go figure it out herself, and she is still learning. Another doctor said that her textbook was at least 20 years old, so the information did not seem relevant.

How Can Practice Management Education Be Better?
Many said additional coursework in coding and billing would be extremely beneficial. One said she would have liked it if someone had better explained the importance of getting onto medical insurance panels. Doctors also wanted to learn more about financial management. It was suggested that integrating practice management into other classes would be a good idea, so that students could see how business management is interwoven into their day-to-day work.

To improve staff management, some suggested role-playing exercises in which common doctor-staff scenarios were practiced, so that a doctor would know how to respond when a similar situation arose in their own practice.

Other suggestions were either a practice management “boot camp,” or short externship after graduation, for those doctors who were interested in practice ownership. Post-graduate online practice management courses were recommended, and a mentoring program was also a popular idea.

Some optometry schools are on the right track in helping new optometrists network. One of the doctors mentioned that her college of optometry has a private practice club. There is also the Student Optometric Leadership Network, SOLN. This is a national organization that promotes private practice with mentoring from seasoned doctors and industry leaders.

Bottom Line: More & Better Practice Management Education, Please
The consensus is that optometry colleges are not educating students properly on how to run a practice. There are still some who say they don’t want to take a practice management course anyway. However, there are enough optometry students who do want more instruction in business management that more of an effort by optometry schools should be made.

Perhaps the availability of a private practice rotation for interested students would be a solution. An optional post-graduate class sounds good in theory, but may not receive high participation levels because new graduates are busy during that time studying to pass state board examinations.

It’s important for the profession of optometry that the challenge of providing business management education is met. The future of independent practice may depend on it.

What do you think about the current state of practice management education in optometry school? What was the business management education you received in optometry school like? What could have been done to make it better?




Diane Palombi, OD
, retired now, is the former owner of Palombi Vision Center in Wentzville, Mo. To contact her:

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