The daily practice of optometry is really quite pleasant.  Compared to many other health professions, there is not a lot that can go terribly wrong with the patients.  And many optometrists find the business of optometry to be manageable and reasonable.  But most ODs have their least favorite aspects of being in practice.  It is quite fun to talk about the favorite things about being an OD, but let’s do that next time.

Least Favorite #3:  Dealing with the impact of insurance programs.

The impact of insurance programs on the practice of optometry cannot be considered without recognizing that patients go to the eye doctor because of their insurance coverage.  But the overall challenges of managing patient insurance causes a pretty big number of ODs to skip participating in plans or even leave plans after having been participants.  I have resisted participating in some vision and medical plans and recently have found that when local employers add coverage on a plan in which I am not a participant, they still visit our clinic for care when we tell them that we simply cannot join that plan.  We do risk losing product orders to local doctors who are on the panels, but our practice is predicated on delivering top-notch eye care so that doesn’t hurt as much as it would if we were product oriented.

Least Favorite #2:  Firing employees.

If you practice in a setting where you must manage or employ staff, one of the most miserable feelings is that associated with firing an employee.  When I reflect back on the termination of an employee, two things are typically true:  I waited too long to make the decision, and the individual is often relieved.  Your employee relationship can be somewhat parental, where the doctors serve a guiding role to the staff and they define and enforce the rules.  The difference is that there are times when the OD businessperson decides that there is no possible resolution of a staffperson’s skills, attitude, or performance.  My main advice to make firing an employee easy is to make it simple and don’t try to bring up the history of issues.  Use a simple statement:  “This simply is not working, and I think we both know the issues and each of our views of how things are going; but I would like to respectfully ask that you understand that we are going to discontinue our relationship effective now.”

Least Favorite #1:  Misunderstandings of optometry.

My wife knows what I do for patients, so do my kids and my parents and many of my patients who have been paying attention.  But for the most-part, the effort of organized optometry and individual optometrists has not yet moved the pendulum of understanding to really allow for full awareness of what we do.  Insurance companies, vision plans, bad marketing programs, and indifference are all at the root of optometrists not being fully understood for what they do.  We are all proud of our history of vision correction services and products, but we are still annoyed by the question, “don’t I need to see an ophthalmologist for that?”  Thankfully, our practice is wonderfully aligned with many tremendous ophthalmologists who know that we take our referrals seriously and that we will always send patients when the case exceeds our abilities.  Many times though we can do more than the patient believes.

Do you have other least favorite aspects of optometry?  Go ahead, get it out of your system.  Next time, we will discuss the top three.