reflections
THE HUMAN SIDE OF OPTOMETRY

A Practice Misconception

Despite what you may have heard, practice real estate doesn't always determine professionalism.

MARGARET PLACENTRA JOHNSTON, O.D.,
SPRINGFIELD, VA.

It's high time our profession did away with the false and obsolete belief that mode of practice — meaning the type of real estate in which one sees patients — always determines professionalism. My story of my own career path as an O.D. illustrates why.

Self-fulfilling prophecy

When I completed optometry school almost 30 years ago, my first job was in a commercial setting. Specifically, it was in a side-by-side operation in a mall. Because I'd heard from other optometrists that working at a commercial practice requires rushing through exams and, thus, providing subpar care to patients who desire nothing more than fast spectacle prescriptions, I found myself automatically following suit. "Only the private practice setting is 'professional,'" rang in my ears.

Before long, however, it became clear that practicing this way wasn't necessary and that the patients who presented to the commercial practice weren't just eyeballs needing glasses. Some needed hand-holding, while others had intriguing questions about their ocular health. So, I gave my best to each patient. After all, nothing prevented me from doing so but myself.

Although I loved my commercial job and was fiercely proud that nothing lacked in the care I provided, I was concerned about the stigma of "commercial practice" hanging over my career. As a result, I eventually bought an established private practice.

Private practice

At last, I could feel like a "real" professional, I thought. Each day, I moved from patient to patient sharing friendly smiles, a caring ear — anything within my power that could help each patient.

After 20 years, I received an offer to sell my practice to a privately held company that owns and coowns several private practices and attempts to maintain the "professional" private practice look. For pressing family reasons, I decided to accept their offer, though I would continue seeing my patients there on a contract basis.

Working for this company afforded me outsourced medical billing, a slew of high-tech equipment and a wonderful assistant who took pre-testing way beyond what I expected. Together, we saw more patients per day than I ever thought possible. Soon, however, the company demanded I schedule more patients — forcing me to listen less and rush through exams. In other words, despite the guise of a "professional" setting, my mode of practice no longer felt professional to me. As a result, I eventually left.

O.D. employee

These days, I see patients in a tiny office at the back of an optical shop, which is owned by a small optical chain, and in an old fashioned optical owned by an optician. Despite these humble surroundings, I'm once again free to serve the patient as I see best — just like my first job out of optometry school.

So, my message is it's time optometry do away with the notion that practice real estate always determines professionalism. Having this preconceived idea may not only have a negative impact on patient care, as described above, but also prevent many optometrists from accepting perfectly fine, and perhaps, enjoyable positions at commercial practices. OM