Student to New Optometrist – Crossing the Void

Ever wondered what real-world optometry is like, or questioned how you’d make the transition from optometry student to new optometrist? At VisionExpo West 2017, a group of young ODs sat down to discuss exactly that!

Topic One: How does a new optometrist become eligible to practice?

Good News!!! Going from student to new optometrist can be EASY! You simply have to know what steps to follow. Below are the step-by-step instructions recommended by our panelists:

Step One: Start looking for positions, preferably before you graduate. You will need to know what job you will be assuming in order to know which state(s) to become licensed in and what insurance panels to join.

Step Two: Get Licensed. If you think you may practice in more than one state, go ahead and get licensed in multiple states. offers a great guide on each state’s rules for licensure, so make sure to familiarize yourself with your individual state’s requirements. Keep in mind you will likely have to provide board scores and potentially proof of graduation from optometry school.

Some states only offer their licensure tests once per year, so make sure you don’t miss your deadline in your graduation year!

Step Three: Obtain your NPI number, or National Provider Identifier. This number is issued by the Centers for Medicare and Medicaid Services (CMS) and will follow you throughout your career. You can apply for this number online.

Step Four: Register with CAQH, which is a database of information that insurance panels can pull from when credentialing you. You will fill out your information through CAQH one time, and then any insurance company that utilizes this service will be able to process your application without you having to enter the information on each individual site. Unfortunately, some plans do still require you to apply through their specific websites.

Step Five: Select which insurances panels you need to join. Remember, many will use CAQH. This will depend heavily on where you are going to be practicing. If you are opening cold, consider casting a wide net. You can always narrow down plans later.

Step Six: Get malpractice insurance. Typically inexpensive, this is a must-have. It is a liability insurance policy, and your new practice will often cover this expense.

Step Seven: Maintain your license. Most states renew every year or two and have CE requirements that differ per state.

Step Eight: Join state associations, AOA, AAO, and/or any other optometry organization you are interested in and start networking!.

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Remember: Don’t wait — some of these steps take weeks or months, so get a jumpstart while in school if possible.

Topic Two: How does a new optometrist decide where to practice?

We hear it often . . . location, location, location. Whether deciding where to live or where to work, location is important and can be a daunting challenge if a student does not know where he or she would like to practice after graduation. Thankfully, there are resources available to help you.

First, look at census data. You will be able to see where growing areas are in your region of interest. Secondly, you can call your state associations to get an idea of how many ODs are currently in that state. Thirdly, do your research. Find out where up-and-coming areas are within the state and look at lifestyle qualities in areas you’re interested in (what’s fun to do there, what the weather is like, community groups that may interest you, etc.). Remember, you will be living there, not just working, so make sure you’ll be happy in the location you choose.

The US Bureau of Labor and both are great resources for researching potential locations you may be considering.

Topic Three: What is the most challenging thing our panelists encountered when they first started practice?

Challenge 1: How to prove your value without stepping on established doctors’ toes.

Whether you bring a new clinical skill to the table or are talented at something beyond patient care (social media, marketing ideas, etc), don’t be shy in letting the practice know how you can help. Just make sure you do so with a servant mentality so that others know you are trying to help build the office, not simply glorify yourself.

Challenge 2: How to navigate not knowing exactly what a patient’s diagnosis is.

You don’t have a preceptor anymore, so all of your clinical decisions are yours. That responsibility can be scary at first. Remember, you are well-trained, but no one knows everything. It is perfectly okay to excuse yourself from the room and research the condition or even phone a friend. Some doctors choose to be upfront with the patient and let them know that they don’t know the exact answer but will step out to figure it out. Others offer up a small excuse (i.e., “I’m going to go get some eye drops for you”) and do the investigating while they’re out of the room. Either way, it is important to utilize your resources, both print and peer, to find the answers.

Other recommendations our panelists offered that can help both you and your patients gain confidence include:

  • Giving your patients your cell number if you’re comfortable doing so. This allows them to contact you if they worsen and builds both rapport and your patient base.
  • Seeing patients back for follow-up sooner rather than later so that you can confirm their progress and gain confidence in your treatment choices. In other words, you may choose to bring a patient back for a one day follow-up during your first year of practice, but after seeing for yourself that your treatment is effective, you may be comfortable pushing that return visit out to multiple days the next time you encounter that condition.
Remember to establish yourself as approachable with your patients — don’t use big words or try to over-explain, make eye contact, be human.

Topic Four: How should a new optometrist interact with the staff??

It’s common to hear that staff can make or break a practice. There is nothing that is more true when it comes to optometry offices. Remember, while you are a doctor and you have worked hard to get where you are, you are not above the staff. You’re part of the team, and the practice does not succeed if the team is not cohesive. Keep in mind that they were there before you. Respect their knowledge of the practice.

If you approach your interactions with the staff as if you are there to serve them and your patients, they will almost always return that sentiment many times over. Also, it never hurts to bring treats on your first day. Who doesn’t love bagels?

Topic Five: How can a new optometrist bring value to the practice?

First of all, know the practice you’re entering in to. This will give you a good idea of what the company could benefit from that you might bring to the table. Even if you don’t already know how to do the skill the office needs, express your willingness to learn. If you do have a skill that the practice doesn’t have (you speak another language or you are proficient in a clinical specialty that is not currently offered, for instance), make sure to mention this in your interview and when you join the practice. It is important to remember that these skills do not have to be clinical. They could involve social media, website design, or marketing expertise, for example. Utilize your time in school to become competent in an area that you don’t see your peers focusing on, clinical or otherwise.

Secondly, show up with an outstanding work ethic. Be willing to pound the pavement to visit businesses in your area to generate patients for the practice or develop other ways to introduce yourself to the community and bring positive press to your new office. There is no underestimating the power of hard work.

Topic Six: How can a new optometrist navigate becoming a partner in a practice/buying a practice without getting stuck in a complacent contract?

Having ownership in a practice means owning shares or membership interests in that practice, and therefore, receiving a portion of net profits and revenue from the sale of the practice should you ever decide to sell. Equity stake is important. As the practice grows, the value of your equity grows as well. You are not tied to a simple bi-weekly paycheck or small bonus incentives. For these reasons, many new graduates would like to eventually buy their office or join into a partnership. They just don’t know how to go about doing so.

The most important thing to remember is to establish your intentions from the beginning. If you know you want to buy-in, tell the hiring doctor that you’d like to do that during the interview. Ask them how they feel about you becoming a partner and how to start the process with them. If the owning doctor says “yes but at a later date”, make sure you’re having scheduled meetings (quarterly, etc) with him or her to evaluate how you’re doing and address where you’re at regarding your pending partnership.

Red flags to keep in mind:

  • if the owning doctor will not share the practice numbers with you, he or she likely has something to hide or isn’t serious about the transition
  • if the owning doctor keeps pushing out your partnership transition timeline, there is a good chance he or she is not fully committed to the deal

If you move forward with becoming an owner of a practice, you will need to consult with an accountant and a lawyer to make sure everything is in place properly in a legal document for you to become an equity stakeholder.

Topic Seven: How can a new optometrist respond when someone says: You’re my doctor?? How old are you??

While there are different approaches to responding to these types of questions — humor, vague answers, or straight honesty — the key is to not act offended or like the question bothered you in any way. Show confidence and your patient will gain confidence in you. Wearing your white coat can help garner more respect and set you apart from the staff members, so consider doing this if you find this situation uncomfortable or more frequent than you’d like.

Additionally, explaining your patient’s diagnosis/treatment thoroughly will gain their respect and show them you know what you’re talking about despite your young age. Don’t be afraid to utilize technology both for diagnosis and education as many older patients will find this impressive. Finally, reinforce the idea that your office is a team and that you are not independently caring for the patient alone.

Topic Eight: How do you differentiate yourself while in school to land a job?

There are many things you can do while you’re in school to set yourself apart. Some of the panelists top recommendations were:

  • Stay connected — utilize resources like CovalentCareers, NGO, FB, and other platforms to connect with peers and future employers.
  • Go to meetings such as VisionExpo — while you’re there, network and meet everyone you can. You never know who will open a door for you.
  • Go to state meetings if you know where you’d like to practice — again, networking is key. Don’t be afraid to tell people you meet what you’re looking for.
  • Form a good relationship with your peers and upper/lower classmates to build your network. These relationships can help you throughout your career.
  • Grow a skill set that you don’t see your peers or the market doing (online publications, building a blog, social media for businesses, marketing, etc).
  • Don’t close the door to any possibilities — do workshops, shadow, and diversify your externships (what you think you like or hate in school may not be how you feel when you actually try it in real-life clinic).
  • And one tip for setting yourself apart once you join the practice: be willing to work during your downtime at the practice. Don’t go on Facebook or read if you’re between patients; instead, work on things the practice needs such as the website, staff training, etc.

Closing tips from our young ODs:

  • Understand what your late career/retirement goals are, and where you want to end up (wealth, where you’re living, what your life looks like). Doing this will help you answer interview questions, make career decisions, and know where you’re truly going; you will be able to know better what kind of practice you want to be in, where you want to practice, and what you need to do to get there. WRITE THESE GOALS DOWN and reevaluate each year. You will find this practice makes decisions much easier along the way.
  • Maintain your fire and the optimism that you have when you are getting out of school; don’t get complacent.
  • Get a mentor — there are a lot of established ODs that are more than happy to mentor students and new grads. All you have to do is ask!
  • Use your core group of friends from school to keep you grounded, give you a sounding board, remind each other of things happening in optometry, and build your career.
  • Start with location when trying to decide where to settle down — once you know where you will be practicing, it will be much easier to put the remaining pieces in place.

To see this information delivered straight from our panelists, be sure to check out the full video of this fantastic panel filmed at VEW 2017.
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About Patricia Fulmer O.D.

Patricia Fulmer O.D.
Patricia is a 2012 graduate of The University of Alabama at Birmingham School of Optometry and former AOSA National Liaison to the AAO. After graduation, she moved to Amarillo, TX, to complete her residency in Ocular Disease and Primary Care at the Thomas E. Creek VA Hospital. Patricia is the current Center Director for VisionAmerica of Huntsville, a co-management practice specializing in secondary and tertiary care, cataract surgery, strabismus, and oculoplastics in Huntsville, AL. She recently earned her Fellowship in the American Academy of Optometry at the 2015 meeting in New Orleans. In her free time, she enjoys traveling, attending concerts, art, and Alabama football.

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