Finding the right niche might be the perfect antidote to career dissatisfaction, Alan Saks muses.
Of late, I’ve become increasingly aware of a number of disgruntled early- and mid-career practitioners, rather unhappy with their current lot in life. Employment contracts, conversion rates, key performance indicators (KPIs), and the perception of reduced remuneration (due to an apparent oversupply of practitioners) seem to be core to this dissatisfaction.
We could delve into the reasons – including qualifying increasing numbers of practitioners and the creation/support of ‘quickie’ optometry courses by multinational operators (some say the goal of which has been to ‘flood’ the market to reduce salaries) – but this has been covered elsewhere.
One Facebook group talks of forming trade unions for optometrists. A related YouTube video is fairly scathing of the current state of affairs.
Some would argue that it’s a matter of ‘you made your bed, lie in it’. Practitioners signed contracts that included things like conversion rates and KPIs, so they were aware of what they were getting into, or so the reasoning goes. Like any contract, you must be fully cognisant of what you’re getting into when you sign a workplace agreement.
Of course there are other options that don’t have such frustrating contractual issues. Most independent practices have more employee friendly conditions, like not working Sundays/weekends, flexible work schedules, no conversion rates, and so on.
Salaries are what they are and what the market dictates.
With the changes taking place in the marketplace, there are fewer opportunities to enter independent practice these days, however, we still see independents actively seeking practitioners.
You need to choose wisely.
If you’re currently in an unhappy situation, then look for other opportunities
Making the Change
If you’re currently in an unhappy situation, then look for other opportunities.
Some say they don’t want to leave the major centres and work more provincially.
That said, there are fantastic opportunities to work for/with independent practitioners outside metro areas. In some cases, you can work towards a shareholding/partnership, or outright practice purchase of an experienced, retiring practitioner who has built a great following. In more provincial settings there’s often little or no competition.
I know a regional practitioner who opens from nine to five, closes the office for an hour at lunch time, and is closed on weekends… doesn’t that sound ideal? They’re doing fine. Lower overheads for staff, rent, and travel, (with no rush hour traffic) and cheaper housing are added bonuses. You could go for a quick surf at lunch time or eat at home.
As discussed in the past, a great way to obtain job satisfaction – and to control your destiny to some or other degree – is to find a niche or mode of practice where you can follow a speciality interest. Developing skills in an area where there is an apparent shortage of skilled practitioners has many benefits.
Finding a Niche
One of the major areas in which to create a niche is speciality contact lens practice, where there’s always a shortage of practitioners. By way of example, Keratoconus Australia regularly seeks (and battles to find) practitioners who can deal with keratoconus sufferers who struggle to find competent practitioners – even in the big cities. So, there’s definitely scope for this, whether you’re working for an established independent, or startup practice of your own. And it’s not just keratoconus. Skills in general contact lens work, sclerals, corneal grafts, aphakia (including paediatric aphakes), presbyopia, astigmatism, and much else are in demand.
It’s not just contact lenses where skilled practitioners are needed. Dry eye is a tenable scope of practice. One can develop a dry eye clinic that will attract patients with such problems. You can set up the specialised equipment, structures, and modes of practice necessary to deal with these patients and provide the best care, management, and treatment possible. Many practitioners that embark on such speciality setups do well. Acquisition of expensive equipment like intense pulsed light therapy can be pricey, but there are increasingly less expensive methods and equipment that can achieve excellent results: There are many ways to treat demodex, meibomian gland dysfunction, and so on.
Behavioural optometry can provide immense satisfaction, from helping people with learning disabilities, functional visual problems, strabismus, sports vision, and other areas where you can certainly build a speciality.
Low vision is another niche. We increasingly see patients suffering from macular degeneration, and other inherited, congenital and acquired conditions, that make general function, watching TV, reading, writing, computer work, and accessing a phone difficult and challenging. Low vision care can be immensely rewarding.
Other areas of speciality include industrial and occupational optometry, ergonomics, working with people with computer vision syndrome, and more.
Optometry is not limited to twisting knobs on a phoropter and ejecting a prescription for conversion into progressives every 15 minutes, as some may have led us to believe.
If you have any questions, reach out to colleagues in independent practice and those who are already involved in these speciality fields. They are usually more than happy to offer advice and mentor you. They may even offer you a job, part-time work, or allow you to sit in during their consultations and observe how their clinics function, in order to get some experience and help with your future planning.
Having worked in different practices around the world, I can tell you that finding your niche and your speciality can be immensely rewarding. It has opened many doors for me, provided me with a sound income, and allowed me to travel the world, attend conferences, lecture, and meet with wonderful colleagues the world over.
I leave this with you as food for thought.
Alan Saks is a retired optometrist. He is the Chief Executive Officer of the Cornea and Contact Lens Society of Australia, and a regular contributor to mivision.
