“There are too many optometry schools!”
“The job market is saturated!”
“It’s going to be hard to find a job in optometry!”
We can debate whether the marketplace is oversaturated with options for consumer access to eye care. Some believe this is accelerating the increase of new optometry schools, or vice-versa. In my consulting work, though, I am consistently hearing from practice owners that it is difficult to find associates- not just good associates, but any associate! When you consider the multitude of employment options- private practice, ophthalmology, commercial entities, big box, Internet vendors opening brick and mortar locations, even drug stores– the pool of available ODs is shrinking.
According to Brad McCorkle, founder of the online job site Local Eye Site, 75% of his company’s ad volume comes from organizations looking for ODs. “In our thousands of conversations with administrators, recruiters, HR managers, and doctors,” he says, “the overwhelming feedback is that it’s difficult to recruit ODs, especially in rural markets.” Lauren Simon, founder of the ophthalmic recruiting firm The Eye Group, states that in 30 years of recruiting optometrists, they currently have the most job openings and least amount of candidates they have ever had.
My personal experience as a practice management consultant is consistent with these examples. Having done hundreds of consultations on HR issues alone, one of the most common challenges I hear from our members is how difficult it is to find an associate OD. Here are a few things to consider when hiring an associate OD:
Am I ready for an associate?
The decision to bring on an associate OD is usually driven by patient demand. Do you have a large enough backload of patients to keep the associate busy? Hiring an associate before patient demand exists usually results in the associate seeing patients that the owner could have seen. This will not translate into higher revenues for the practice- just a higher payroll.
A secondary consideration is whether you desire to work less and transfer more patients to the associate. Trading income for more personal time is a common strategy for many practice owners.
Where do I find associates?
There are several places you can advertise positions for associate ODs. Some examples are optometric job boards (Local Eye Site, Covalent Careers, etc.,) social media forums like the ODs on Facebook group, schools of optometry (ICO,) and even recruiting firms such as The Eye Group. Spread the word among colleagues and sales reps that you are looking to hire. Considering the limited supply of candidates, it benefits you to cast a wide net.
What kind of candidate fits my brand and culture?
Even in a tight job market, you should use discretion in your hiring decision. If you have built a successful practice, odds are you have strived to create a certain culture and brand. As an employer, I think it’s a fair expectation that an associate would adapt to the office culture that you have worked hard to build. Hiring the wrong “culture fit” can lead to tension in the workplace and patient dissatisfaction. Successfully transferring established patients to the associate (if that is a goal) will go more smoothly if the patients receive the consistent level of care and service they have come to expect.
What compensation can I offer?
There remains a fairly wide range of salaries for employed optometrists. Salary does not always reflect the clinical abilities or years of experience an OD brings to a practice. As many parts of the country, especially rural, are experiencing a shortage of available associates, supply and demand is often the biggest factor driving compensation. For this reason, the average pay for an associate OD has risen in many areas.
Keep in mind that an associate OD has the potential to generate hundreds of thousands of dollars for the practice. I’ve seen practice owners balk at hiring an OD who wanted moderately (or even slightly) more money than the employer was willing to offer. Before declining negotiation, consider the full return-on-investment of the associate. Aside from salary, the only significant costs to the practice are increased cost-of-goods and staffing (if necessary.) If patient demand supports the hire, it’s usually not difficult for the associate to produce enough revenue to cover their costs and generate a profit.
How can I “sell” the job offer?
As you negotiate pay and benefits, you may hear from the potential associate that they are making (or could make) X dollars at another practice or location. This may be more than you are willing or able to offer. Consider if there are other, non-monetary factors that could make your offer superior. Some examples are flexible hours, the ability to practice a wide scope of care, professional development opportunities, ownership potential, and even quality of life considerations.
In a tight job market, you can’t just offer a job- you have to sell it! Make a list of all the great reasons to work at your practice. Most of the job ads I see focus on everything an employer requires of someone working for them, but very little about why the opportunity is good. Ask the candidate what they like and dislike about their current or previous position. The OD may be willing to accept less pay if the entire package is more attractive than alternative offers or the their current employment situation.
Do you have a large enough backload of patients to keep the associate busy? Hiring an associate before patient demand exists usually results in the associate seeing patients that the owner could have seen.
Should I employ an associate or a full partner?
Carefully consider the decision to sell equity in your practice. While a partnership can be financially beneficial for some situations, it does require you to relinquish some ownership and control. In some cases, you’ll end up spending more money than if you’d just employed an OD and paid them a fair market rate.
If you choose the partnership route, analyze the numbers closely. Make sure the OD you are considering partnering with shares a similar business philosophy and vision for the practice. I’ve worked closely with practices that failed to consider this, and it led to a great deal of tension and turmoil between the partners.
What expectations should I set up-front?
There are certainly strategies to increase motivation in the workplace. That said, we need to consider that the mindset of an owner/entrepreneur is often different than that of an employee. Instead of expecting your associate to be “motivated,” you’ll have better success setting clear expectations. Then, meet with your associate on a regular basis- monthly or quarterly- to review these metrics.
These can be sensitive conversations. Steer the dialogue away from “selling,” and focus on the value of educating and informing patients on the best eye care options for their specific needs. It just so happens that people frequently spend more money when they realize the full value of the products and services they are considering.
How can I be the CEO of my practice?
Hiring an associate OD is a true turning point for many practices. Often, the greatest obstacle to success is time. As a practice grows, the doctor becomes increasingly occupied with patient care and managing the day-to-day operations of the practice. This leaves little time to work “on” the business. As a result, many private practices plateau at an early stage.
Hiring an associate OD allows you to spend more time managing and growing the practice– not just maintaining it. It also allows you to spend more time away from your practice. It’s easy for busy practice owners to get caught up in the daily grind and lose sight of one of the main reasons they chose the ownership route – a better quality of life!
Steve Vargo, OD ’98, serves as IDOC’s Optometric Practice Management Consultant. A published author and speaker with more than 15 years of clinical experience, he is now a full-time consultant in practice management and office operations.