Staff Management

Improve Your Practice–and the Profession–with Externs

By Thuy-Lan Nguyen, OD

Oct. 7, 2015

SYNOPSIS

Employing externs helps emerging optometrists launch their careers–and provides added manpower to your practice.

ACTION POINTS

ASSESS NEEDS. Determine how many externs your practice needs, and what time of year and what schedule makes sense.

ESTABLISH EXTERN DUTIES. There are limits on what externs can do. Consult with your state optometric and medical boards.

CONTACT OPTOMETRY SCHOOL. If you don’t already have a relationship with an optometry school, contact your closest optometry school’s director of externs.

Utilizing optometry students asexterns in your practiceis a great way to give back to optometry, but it also aids your practice. Externs can provide additional manpower to your staff, and greater resources for your patients.

I am a full-time assistant professor at Nova Southeastern University College of Optometry, and I formerly owned a practice in Pembroke Pines, Fla., in which I regularly employed externs from Nova and Salus University. Integrating the talent ofthese budding ODs into my practicebenefited my practice while makingthe most of what they had to offer.

Optometry schools, through an extern coordinator or director, match externs with practices that register to be matched up with them, so you are not able to hand-pick your externs. However, once they are in your office, there are strategies you can employ to make the most of the externs’ time with you.

What Makes a Good Extern?

I noticed that the best externs had these two characteristics in common:

• Passion and a sincere interest in communicating with patients

• Strong clinical skills, and demonstration of confidence in those skills.

Thuy-Lan Nguyen, OD

Decide How Many Externs, When & What Advantages

I had two fourth-year externs from Nova Southeastern University, and occasionally one from Pennsylvania College of OptometryatSalus University. The externs worked with me for three months at a time. These externs were not paid, since serving as an extern is a school requirement.

The main advantage of having externs is having the opportunity to share my knowledge and practice philosophy with students. I want to give back and help optometry grow as a profession by inspiring students. Working with students also keeps me on my toes and challenges me. I have to be on the top of my game to be able to answer their questions.

I get great satisfaction from hearing about my former students’ successes. Many of them have gone on to complete residencies and joined successful practices or opened practices of their own. Some former externs are even teaching now, too. I am proud to share my passions for optometry and inspire students to do the same.

Establish What Externs Can & Can’t Do

Optometry students don’t become full-fledged doctors until they graduate, so I enabled my externs to do as much as was legal for them to do, which was quite a bit. They would see patients from start to finish under my guidance and approval.

I would answer any questions they had and double-check the dilated fundus exams and sign off on any prescriptions. While the externs performed the testing, legally I would have to interpret the results of any tests and sign off on the record. I would discuss the case with the extern and they would do some patient education, then I would answer any other questions that the patient had before the examination was completed. My externs worked pretty independently, but with my support and supervision. I know other practices that treat their externs differently. Other practices might be more conservative and only allow externs to learn by observing. There’s nothing wrong with that, but I wanted to allow them to learn by doing.

Related ROB Articles

Put the Right Employee in the Right Job

Create a System to Build a High-Performing Staff

Train New Hires to Succeed

Related Video

Click HERE, or the image below, to watch Bridgitte Shen Lee, OD, discuss with ROB sister publication, Women in Optometry, how she manages optometry students in her practice.

Find Externs

I did not choose my externs; they chose me!Students evaluated me much as I evaluated them. If I did a good job, and the externs enjoyed their rotation, they would give me a good evaluation for future students to see. A good extern for me may not have been in the top of their class based only on grades and book smarts. The really good externs are motivated to learn and practice clinically. The really good externs are not afraid to be busy, and they are able to communicate with patients well.

Practice owners who do not teach at, or have a relationship with, an optometry school should contact a school’s externs director to inquire about adding externs to their practice.

Carve Out Time to Manage Externs

Having externs in a practice actually requires a lot of time. Externs aren’t just free labor. They need to be oriented to get to know the proper procedures and then they need to supervised on a day-to-day, patient-by-patient basis. Fourth-year students know how to perform a basic eye examination, but it is up to me to teach them how to be efficient, and how to communicate with and educate patients. It is up to me to teach them how to run and manage a business. I did this by setting a good example. I was never too busy to answer their questions, show them a technique or help them with a challenging case.

Introduce Externs to Patients

My goal was to teach the externs to think and act like doctors, so I addressed and introduced them to patients as doctors. My staff would also address them as doctors. I also allowed them to introduce themselves to patients as doctor. It’s usually the first time they start to see themselves as a doctor, too. While everyone, including patients, know they are students under my supervision, they are considered doctors. I encouraged externs to make decisions like a doctor would. I may have disagreed with their assessment, and ultimately changed the treatment plan, but I wanted the externs to commit to what they thought first. Again, this philosophy may be very different from how other practices treat their externs, but I think students appreciate this approach, and ultimately, learn more.

Be Open to Externs Teaching You

I learned a lot from my externs. I had to be up on the latest in technology and treatments to keep up with them. For example, I saw a lot of patients that needed specialty contact lenses. I had a very challenging patient with very irregular corneas from RK surgery decades ago, and the lenses I ordered weren’t fitting well. One of my students heard about a new design that I had never used before. So, I opened an account with that company and ordered their lenses for my patient and it fit much better.

I’ve also gotten good ideas from students about marketing and social media. Social media is an effort for me, but it comes more naturally to them. Fourth-year externs can make valuable connections with younger, Millennial patients. They are typically more tech savvy, and can relate more to things like digital eye strain.

Thuy-Lan Nguyen, OD, is on the part-time clinicalfaculty of Nova Southeastern University College of Optometry, and formerly the owner of The Eye Center in Pembroke Pines, Fla. To contact her: Ttlnguyen@nova.edu

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