A national workforce survey through Flinders University, led by Professor Nicola Anstice and the Phoropter Free Fridays administrators, with funding support from Optometry Australia, has revealed deep job dissatisfaction among Australian optometrists (Preliminary Results Part 1).
Figure 1.
Phoropter Free Fridays (PFF) is a forum formed in late-2024 by employee optometrists and independent owners, advocating for workplace reform through the Health Services Union.
A total of 505 optometrists participated in the survey, with 375 complete responses. The sample was representative of the broader profession: aged 22 to 67 years, 62% female, 65% working in full-time roles, and spanning corporate (67%), independent (24%), hospital, academic, and other settings.1 Results (Figure 1) showed that:
- Just 22% were satisfied with their career options and growth opportunities,
- Only 41% were satisfied with their clinical scope and autonomy,
- Only 37% believed their practice had sufficient staff with the appropriate skill set, and
- Just 23% were satisfied with their income.
These levels fall well below international benchmarks, where optometrists report job satisfaction rates of approximately 60−75%,2,3 and general practitioners (GPs) around 70% (or 63% post-COVID-19 pandemic).4
To identify key drivers of job dissatisfaction, over 50 variables were comprehensively analysed, including demographics, employment conditions, organisation, billing and appointment book structures. The analysis showed that Australian optometrists’ job dissatisfaction was consistent across all ages and genders, debunking claims that concerns stem from a homogeneous, vocal minority. Instead, job satisfaction is driven by the ability to deliver timely, high-quality patient care and appropriate workplace support.
We want to encourage colleagues to speak up and protect what drew many of us to the profession in the first place: meaningful, ethical, and sustainable patient care
The Systemic Issues
Generational blame has become a familiar refrain in optometry (Figure 2), but the survey reveals that today’s challenges are not about age or gender − they are deep-rooted systemic issues.
Figure 2.
Mounting clinical demands, commercial pressures, inadequate staffing, and stagnant career structures have created a growing disconnect between how optometrists are trained and how they are expected to practise.
Table 1. Factors influencing job satisfaction. Darker/larger green circle = stronger positive association, darker/larger red circle = stronger negative association.
Common themes have emerged (Table 1): working in Medicare-dependent, high-volume settings, often with underqualified support staff and limited clinical autonomy, undermines optometrists’ job satisfaction, professional growth, and the capacity to deliver quality patient care.
Limited Career Development
Just 22% of optometrists who completed the survey were satisfied with their career options and growth opportunities. Only 41% felt their workplace prioritised access to continuing professional development, 48% could reliably schedule annual leave, and 32% reported access to flexible working hours. Satisfaction was lower among those working in bulk-billing practices or who struggled to see emergency patients, both indicators of more constrained clinical environments.
While earlier entry into the profession had a modest positive link to career outlook, age itself was not a significant factor. These findings suggest that dissatisfaction with career development stems less from individual traits and more from structural limitations that have emerged over time. High-volume, Medicare-dependent models can restrict clinical scope and professional growth, particularly where short consultations and under-resourcing reduce access to urgent care. In contrast, workplaces that protect time for patient care and professional learning are more likely to support long-term career satisfaction.
Constrained Clinical Scope And Autonomy
Only 44% of optometrists were satisfied with their clinical autonomy. Satisfaction was lower among those in bulk-billing or corporate settings, and among those with limited capacity to see emergency patients. Just 45% felt safe challenging current practice conditions, and only 37% believed their voice was heard in decision-making. Despite 77% feeling confident in providing high-quality care, only 41% felt empowered to shape workplace change, highlighting a sharp divide between competence and control.
These patterns point to an emerging two-tier profession. A shrinking group of optometrists enjoy time, support, and scope to practise fully, while the majority are bound by tight schedules, strict key performance indicators (KPIs), and structural disempowerment. Additional stressors, including reduced staff support, pressure to over-service Medicare billing, and a lack of administrative time, are compounding the issue. Meanwhile, more recent graduates are leaving the profession early5 or moving into lower-scope roles like orthoptics or dispensing in search of more sustainable work.
Inadequate Staffing
Only 37% of optometrists believed their practice had sufficient staff with the appropriate skills. This was significantly lower among those working in corporate or franchise settings and where emergency care was difficult to provide, suggesting a link between support staff quality and clinical responsiveness.
While the survey did not delve into which specific skills were lacking, following the deregulation of optical dispensing, optometrists now work alongside staff who may have limited or no formal training in basic eye care, including dispensing and patient triage, leaving clinicians to bridge the gap. This misalignment between clinical needs and retail priorities can strain workflows, reduce job satisfaction, and ultimately increase the risk of burnout.
Income Dissatisfaction
Only 25% of optometrists were satisfied with their income, yet income satisfaction was not solely driven by dollar earnings. Satisfaction was higher among those with greater pay and lower in bulk-billing settings. Interestingly, longer follow-up consult times and longer patient wait times for an appointment were associated with improved income satisfaction, while difficulty seeing walk-in or emergency patients was linked to lower satisfaction.
Of course, money still matters − most people would rather cry in a Lamborghini than a Nissan (no offence). The findings suggest that income dissatisfaction often reflects a mismatch between workload and support. Encouragingly, optometrists want to deliver high-quality care in well-supported environments, not just earn more, and that’s worth protecting.
A Call To Action
If you are an employee optometrist or a non-employer independent, now is the time to unionise. We often advocate alone − one request, one grievance, one burnout at a time. But systemic issues need collective action. Unionising lets us act together with a unified voice. Optometrists are already organising through PFF in partnership with the Health Services Union. The goal is not to dissuade prospective optometrists from joining the profession. In fact, it’s quite the opposite. We want to encourage colleagues to speak up and protect what drew many of us to the profession in the first place: meaningful, ethical, and sustainable patient care.
Those already in fulfilling roles, particularly in academia where job satisfaction is higher, have an opportunity to show empathy and solidarity for clinicians. While 57−77% of optometrists reported dissatisfaction, other health professionals, like GPs with far lower rates of dissatisfaction (≈30%),4 have successfully lobbied for change through a united profession, combining union support and peak body advocacy.
We urge universities to be more transparent about the realities of contemporary optometry practice. For many graduates, the role is predominantly retail-aligned. Students need preparation for this reality, both when choosing their degree and throughout their training, to ensure expectations align with typical work environments. Curricula should also equip students with tools like graded assertiveness, empowering them to speak up when they notice a problem and escalate concerns in a structured, respectful, and increasingly assertive manner to ensure patient safety.
We also call on Optometry Australia to open itself to constructive dialogue with the union. Most health professions have both a peak body and a union working in tandem. The Health Services Union lifts the floor of optometry and supports employees by advocating for fair working conditions and legal protections. Optometry Australia, meanwhile, helps raise the professional ceiling of optometry more broadly, including expanding scope and public advocacy. These roles are complementary, not competitive.
If some optometrists are turning to the union for more affordable indemnity or better workplace support, that should prompt reflection, not resistance, on how OA’s offerings meet evolving member needs.
From Insight To Impact
In summary, these workforce challenges do not stem from generational differences or individual failings. They reflect systemic deficits in job resources and heightened demands, which can be fixed. But only if we start listening to one another, and to the data, instead of blaming our colleagues.
Tangible solutions include: mandating protected clinical (consult and administrative) times particularly for emergency patient care, ensuring access to adequately trained support staff, and fostering psychological safety and inclusion in decision-making. These are modifiable, evidence-based interventions (based on optometrists’ responses) which are likely to yield significant flow-on effects to enhance clinician wellbeing and restore sustainable engagement in practice.
Further detailed reports from this survey, alongside national focus group insights, will be released over the coming year. If you’d like to participate in or contribute to the focus group discussions which are currently underway, please get in touch:
Learn more about the movement for unionising optometry here.
Dr Matt Trinh is a clinician-researcher focused on retinal pathology. He is committed to advancing ophthalmic practice through research, with particular interests in large-scale imaging, health data analysis, and the integration of computational tools in clinical ophthalmology and vision science.
Dr Rene Cheung is a clinician-researcher who is passionate about improving access to eye care and improving the quality of retinal imaging services. She has over 10 years of clinical experience and currently supervises research students UNSW.
Rory Dowdall is an optometrist with a background in physiology and sleep science. He has a strong interest in regional and anterior eye care, and has provided mobile and volunteer optometry services across remote Australia and the Annapurna region in Nepal.
Vincent Lim is an optometrist with a special interest in myopia management. In addition to general optometry, he operates a home-based myopia clinic, reflecting his commitment to accessible, patient-centred care and early intervention in progressive eye conditions.
References
- Optometry Australia. Optometry Australia Annual Report FY2022-2023. (2023).
- Akuffo KO, Agyei-Manu E, Addo EK, et al. Job satisfaction and its associated factors among optometrists in Ghana: a cross-sectional study. Health Qual Life Outcomes. 2021 Jan 7;19(1):12. doi: 10.1186/s12955-020-01650-3.
- Alvarez-Peregrina C, Garcia de la Noceda A, Martinez-Perez C, Sánchez-Tena MÁ; Grupo de Investigação Optovisão ISEC Lisboa. Job satisfaction of Spanish and Portuguese optometrists. J Optom. 2024 Apr-Jun;17(2):100492. doi: 10.1016/j.optom.2023.100492.
- Deng Q, Liu Y, Cheng Z, Wang Q, Liu J. Global job satisfaction and fluctuation among community general practitioners: a systematic review and meta-analysis. BMC Health Serv Res. 2024 Mar 27;24(1):378. doi: 10.1186/s12913-024-10792-9.
- Duffy JF, Woods CA, Douglass AG. Optometrists who leave the profession in Australia: 2011 to 2019. Clin Exp Optom. 2025 Mar;108(2):202-209. doi: 10.1080/08164622.2024.2325633.
