Dr. Gutsin outside the MD-OD practice where he currently serves as an associate. Dr. Gutsin took a strategic, well-thought-out process to find this position.
Practice options for new optometry school graduates
By Benjamin Gutsin, OD
Oct. 16, 2024
Graduating optometry students have many options for where and how they practice.
Here is how I approached my search process and where I ended up.
Search Began on LinkedIn
I was first noticed through LinkedIn. I was actively connecting with doctors and practices in my area when I received a message inquiring about my career plans.
Ultimately, this exchange led to an introductory phone call, in-person shadowing opportunity and a discussion with the human resources department of the practice I eventually joined.
Leveraging resources like LinkedIn is a job search approach that is often overlooked by healthcare professionals. LinkedIn provides a space to showcase your professional identity and personal brand.
If you don’t make an effort to display your professional brand, one will be created for you – without your input. I’d personally prefer to have some control of my image. Sites like LinkedIn are the perfect resource for that.
Focus on Ocular Disease
Ocular disease is a particular interest of mine.
Joining a practice with diverse patients and access to testing equipment meant my medical-decision making skills wouldn’t atrophy in their infancy.
Continued exposure and active management of ocular disease is the best way to learn. If you’re not in an environment that enables you to use these skills consistently it’s highly unlikely you’ll develop into your full potential as a clinician.
Collegiate Environment: Opportunity for Practice Management Input
I hoped to join a group whose management team would value my thoughts outside of the exam lane.
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While I’ll always be a doctor first, having received my undergraduate degree in business, I felt I could also provide value in non-clinical aspects of the organization. Merging these aspects of my professional identity was appealing, and something I was glad to see valued by the leadership of the practice I chose.
I also wanted to be a part of a collegiate environment where doctors in the practice expressed a willingness to mentor. One attribute that stuck out to me was the group’s interest in precepting.
Several of the doctors in the practice received their fellowships and/or completed a residency. Working alongside a knowledgeable peer group that expresses a willingness to teach is encouraging.
How Exactly Will I Be Paid?: What Does the Contract Say?
If you won’t be receiving a set salary for your compensation, it’s important to clearly understand how your compensation will be determined.
For example, if your employer states that you’ll make a percentage of revenue, you should expect a detailed example of how that is calculated.
You should understand if this figure is based on gross revenue (all billed services regardless of actual receivables) or net revenue (sales – expenses). The difference between these two calculations can be significant.
Most practices that pay their associate doctors a percentage, pay a percentage of receipts (money in the bank), which should theoretically be a higher percentage than being paid on gross billing.
Regardless of the percentage figure, what you want to see is clarity in the calculation and access to your numbers to observe for discrepancies.
Remember, if it’s not written in your contract, it doesn’t exist. Ironing out these details now can save you from possible frustration later.
It’s important to understand your contract in its entirety. Take time to understand each section before signing. If you don’t read the contract, you run the risk of agreeing to something different from what was discussed during your interview.
My Employment Status
Knowing if you’re a 1099 or a W-2 employee has significant consequences for your tax-filing status and social security.
1099 workers are independent contractors who are responsible for determining their own schedule and filing their own taxes (typically quarterly.)
They are also responsible for paying the entirety of their social security contribution and may be ineligible from certain worker protections like unemployment.
By contrast, W-2 employees have a dictated schedule and do not have to pay taxes quarterly.
Editor’s Note: Most experts believe that an associate doctor should be paid by W-2 wages unless they are a temporary worker.
What Kind of Staff Support Will I Have?
Understanding how support staff are trained, and the degree of decision-making abilities they have, will help you in your new role. Knowing this in advance can also help you decide if this is the kind of practice you want to join.
A well-trained staff can prevent a patient backlog of Rx checks by finding errors before they eat into your valuable chair time. They can provide meaningful data from their ancillary testing and even help diagnose conditions by taking a thorough history.
A helpful support staff can make or break your experience working at a practice. Two dozen patients can be a breeze or a nightmare depending on the team supporting you.
Take Time for a Wide-Ranging & Thorough Interview Process
I interviewed with approximately a dozen different practices, with settings ranging from private practice, corporate, to MD-OD.
Nearly every practice touted their compensation and company culture, but when I dove into the specifics, it was clear some weren’t the right fit.
Some offices suggested that doctors were free to treat and manage medical patients, but their organizational goals clearly didn’t align with this. For example, some didn’t take medical insurance or provide access to diagnostic imaging/testing.
Other offices seemed more interested in what I could do for them than how we could work together. Profitability is important, but when it comes down to it, I want to feel my contributions are valued day-to-day as a doctor and an employee, and I want the flexibility to have a life outside of my career.
For me, a career of vision-only exams, late nights, weekends and travel is not appealing.
Throughout the interview process I spent time getting to know the various key opinion leaders in the practice. After speaking with the optometrists, management, and staff, I felt comfortable knowing I was entering a promising career environment in the practice I chose.
Where I Ultimately Chose to Start My Career
My search for the right setting ultimately led me to start my career in a medically-focused practice that included both optometrists and ophthalmologists. One year into my role and it seems to have been the right choice so far.
I have enjoyed the challenges that come with medical optometry and have benefited professionally by working alongside many outstanding colleagues. That said, everyone’s journey through optometry will be different and it’s important to continually evaluate your situation to best align your career with your personal and professional goals.
Benjamin Gutsin, OD, is currently an associate with Ross Eye Institute in Buffalo, N.Y. To contact him: bgutsin@outlook.com
