Dr. Lopez outside his office in Appleton, Wis. The town had a business Halloween strawman competition, where different businesses in town created their own strawman and battled for who made the best one. This is the figure that Dr. Lopez’s practice team created. Dr. Lopez says that practicing in a rural setting is deeply rewarding, though not without its challenges.
Optometrists practicing in rural areas
Christopher Lopez, OD
Oct. 23, 2024
One of the best things about optometry is the variety of ways that ODs can practice.
Some optometrists are attracted to OD-MD ophthalmology settings while others prefer a corporate environment.
Some ODs enjoy a low-volume, high-end boutique experience whereas others thrive in a high-volume, fast-paced role.
In addition to practice settings, optometrists make career decisions due to geographical preferences.
The general consensus is that the majority of new graduates in our industry flock to larger cities.
Yet there are still some who will find what they are looking for in rural America, though they may not realize that is where they will be happiest.
Practicing in a rural area comes with its own set of advantages and disadvantages. This article will delve into the challenges and advantages that optometrists face in providing rural eyecare.
I have first-hand experience practicing in rural America. The main location of our practice, Griebenow Eyecare, is 30 minutes from the city of Appleton, Wis., which has a population of around 75,000 people, and our satellite clinic is a little over an hour from that city, in an even more rural area.
Challenge: Staffing Support Teams for a Rural Practice
Smaller towns usually draw a less-robust job applicant pool. It would be amazing to be able to hire only well-trained opticians and technicians with recognized certifications. That is not the reality for many of us, especially in areas with fewer opportunities to achieve certain credentials.
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Many rural practice owners struggle with the battle between hiring a less-than-ideal candidate because the office desperately needs help versus waiting until the “right” candidate is found.
Fortunately, our office is very lucky to have an all-star group of team members!
Challenge: It’s Also Hard to Find an Associate OD for a Rural Practice
New grads are younger in age, and younger people generally prefer to live in urban areas. Most young people want easy access to entertainment, dining and social opportunities.
For that reason, job offers from rural practices have to be more competitive than those from practices in cities. Prospective associates usually don’t accept that it’s OK to be paid less because living in a smaller town is more affordable.
It’s simple supply and demand. The lower the supply of ODs and the higher the demand for OD coverage, the more competitive the compensation and benefits package have to be.
Click HERE to read Dr. Lopez’s recent ROB article, “4 Steps to Recruiting Your Ideal Associate OD.”
Challenge: Generating Revenue in a Rural Practice: Importance of Medical Eyecare
Revenue generation can be problematic for many rural optometrists. I apologize for generalizing with a broad stroke, but usually smaller towns contain a patient demographic of lower socioeconomic status.
Additionally, many rural practice patients have coverage through state insurance. Most states across the U.S. utilize Medicaid plans that offer poor reimbursement for eye exams.
With that in mind, what’s the solution? The chances are low that Medicaid programs will generously double eye exam and frame dispensing reimbursement. Therefore, successful rural practices tend to focus on full-scope medical eyecare.
This requires investing in technology that allows ODs to provide comprehensive care to patients and manage a great variety of ocular disease conditions.
Fundus photography, anterior segment cameras, OCT devices, visual field units, and other technologies, provide us with opportunities to diagnose, treat and monitor sight-threatening eye complications while billing for these services appropriately and achieving higher insurance reimbursements.
It should go without saying that the purpose of specialty testing is not to generate revenue, but to take care of patients in the best way possible.
Advantage: Less Competition from Other Eyecare Providers
One of the most favorable aspects of rural care is the lack of competition due to low doctor saturation. Rural practices tend to be less affected by competition from other eyecare offices since there are often no others located nearby.
Additionally, because there tend to be few ophthalmologists in less populated areas, many rural ODs truly practice full-scope medical eyecare.
The mentality of many ODs working in small towns is to diagnose, treat and manage any case they are presented with, and usually refer only when a patient requires surgery.
Nasty eye infections, large central foreign bodies, painful uveitis and microorganism culturing are not outside of the treatment realm for many of our small-town optometric colleagues.
All in one recent week, I treated corneal ulcers and macular edema, removed large vegetative foreign bodies, peeled pseudomembranes and managed corneal edema, among other eye conditions.
It has certainly made my days more interesting!
Advantage: Rural ODs are THE Eyecare Referral Source
Many ODs are THE eyecare referral source for other healthcare providers in their towns. This mostly “all-in-one” location mindset can lead to more revenue for practice owners, as medical billing often provides healthier reimbursement than vision plans.
In short, rural ODs who offer high-quality and convenient medical eyecare for patients often find a rewarding professional life and loyal patients.
Years ago, I would have never imagined practicing optometry in a smaller town in the Midwest. Doing so has been one of the best decisions I made in my young career.
It is challenging, exciting, profitable and rewarding.
Christopher Lopez, OD, is a practicing optometrist and Career Director at ODs on Finance. To contact him: christopher.lopez.2013@gmail.com
