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Overcoming Post-Grad Fears

MICHAEL BACIGALUPI, O.D., M.S., F.A.A.O.

I asked several current optometry school students, “What worries do you have for after graduation?” Their answers fell into one of three categories: (1) student loans, (2) practice opportunities or (3) changing healthcare regulations. No one mentioned patient care or educational gaps. The students truly focused on the business aspects of optometric practice. So, either students feel well prepared for clinical practice, or they are a bit naïve about the challenges that patients may present. In any event, let’s look at their concerns and see how we can help.

1. Student loans: This number one concern creates fear and apprehension: Most will graduate with debt loads in the $150,000 to $200,000 range. I have argued that it also drives young graduates into “safe harbors” with guaranteed income and away from “unique opportunities” that may offer better long-term gains. The simplest solution, a decrease in tuition, isn’t likely. Thankfully, another answer, Income-Based Repayment (IBR), allows students to pay back loans based on what they earn. Monthly payments are 15% of discretionary income — definitely lower than monthly payments under the 10-year Standard Repayment Plan, and maybe less than extended repayment plans. If students meet certain requirements, any remaining IBR balance will be forgiven after 25 years of qualifying repayment or in 10 years if public service was their career modality. This new program will continue to assist students in meeting their financial responsibilities, while not preventing them from looking for the unique practice opportunities.

Debt drives graduates away from “unique opportunities”

2. Practice opportunities: Millennials often look for that “classic” situation in which an older O.D. takes them “under their wing” and transitions the practice to the young O.D. This model has appeal, because the new O.D. works toward being in private practice. Former AOA President Dr. Ron Hopping once said that it is “a tragedy every time a private optometric practice is closed.” I wholeheartedly agree. Why would a retiring O.D. not want their practice to continue beyond their work life?

But, a gap exists between what practicing O.D.s believe their practices are worth and what young O.D.s can afford. Isn’t this something we can overcome? I applaud the AOA’s attempts to bring sellers and buyers of practices together. Let’s increase these efforts. If you are considering retirement within the next five years, begin planning now for a practice transition. The conventional model can work for all with some compromise and education.

3. Healthcare regulations: Consider the dramatic change in the healthcare climate: We have gone from PQRI bonuses to PQRS penalties, from a private insurance system to one of government oversight. Paper patient records have become EHRs. The list goes on and on. I don’t know if we can calm our young colleagues’ fear of healthcare changes. However, when you are young, you have the energy to embrace change. So, if an older O.D. fears the new demands placed on their method of patient care delivery, why not find a young O.D. to help? They have the energy, computer skills, creativity and drive to succeed in this ever-changing landscape.

When I began this column, I thought these three student worries were tough to overcome. I haven’t changed my mind. The future for our young colleagues will be challenging, but with some hard work, good networking, timely information and motivation… they will be just fine. OM

DR. BACIGALUPI, A FREQUENT AUTHOR AND LECTURER IN THE AREAS OF PRACTICE MANAGEMENT AND STUDENT AFFAIRS, IS THE ASSISTANT DEAN FOR STUDENT AFFAIRS AT NOVA SOUTHEASTERN UNIVERSITY COLLEGE OF OPTOMETRY. FROM 1995 TO 2005, HE FOUNDED AND GREW A PRIVATE OPTOMETRIC PRACTICE IN RURAL TEXAS. SEND COMMENTS TO OPTOMETRICMANAGEMENT@GMAIL.COM.