Optometric Management Tip # 140   -   Wednesday, September 22, 2004
A Real World Indoctrination for a New Grad

Iíve had excellent success hiring associate optometrists directly out of school, and in doing so I have come up with a tip that has eased the transition from optometry school clinics to private practice. We all know that there is much to learn, but this concept accelerates the learning curve and makes the new grad a good value to hire.

The no-license syndrome

This idea was born from the inconvenient lag time that exists between optometry school graduation day and the official issue of the state license to practice. Depending on the state where you practice, that can easily be 3 months of down time for the new doctor. If you have been interviewing candidates for an associate position in their senior year, you may easily have made a selection by the middle of May. Many new grads are very anxious to begin work right way Ė at least the best ones are, in my opinion. Sure, they could take the summer off, but it says a lot about ambition and drive if they are eager to get to work. The new grad is not only at the height of professional enthusiasm, but also has a real financial need for a good paycheck.

The idea is to simply have the new doc work as a technician in the practice, on a temporary basis, until his or her license comes through. This may not seem like rocket science, yet the benefits are much greater than you might think and the situation is quite different from the part-time employment many students experience before graduation.

This concept works extremely well in my practice, because I already delegate a great number of tasks to technicians, and I use scribes in the exam room with me. Our clinical techs also perform frame selection and dispensing tasks, so the learning continues for the new grad. But even if you typically delegate fewer procedures, this new technician with an OD after his or her name will be the most skilled one youíve ever employed. This experience may even help the senior doctor move toward a higher level of delegation in general.

Work as a tech

Letís take a look at the work the new graduate would perform and how it helps assimilate him or her into the practice. An ego problem?

So how does a young doctor Ė filled with professional pride Ė react to the concept of being in the trenches with staff members who are paid by the hour? In my opinion, that reaction could actually prove to be a big indicator as to whether or not the new doc gets a job offer. If he views that kind of work as beneath him, especially in this short non-licensed period, then his ego could end up causing lots of other problems in the future.

Iíll admit that it could seem a bit awkward at first and it may take some getting used to, but it actually works very well in practice.

Salary level

This can be any amount deemed fair by all, but Iíve found that paying a salary of 50% of the agreed upon future salary when this graduate becomes licensed, works well. Even at 50%, that pay level is usually generous for technician duties. I would schedule the new doctor-tech for a full 40-hour week, with evenings and Saturdays.

After the license is issued

The new OD makes an immediate shift to become a real doctor as soon as the license arrives. The receptionists begin to schedule actual appointments, but for the first couple of months, I would space those appointments out so the new doc has about twice the time allotment as usual. This lets the doc get acclimated to the new role, and it wonít matter much anyway, since she will not be fully booked for a while.

Itís helpful during the first couple months to schedule some private one-on-one meetings with the associate, and to pull several of his patient records at random to review and discuss. This should be done diplomatically and with great respect for the associateís own professional judgment Ė even if a case was handled differently than the senior doc would have. There can be a good exchange and discussion of patient management if both parties approach this with a constructive attitude. After a short period of time, I would stop reviewing cases and let the doctor practice. At that point, both senior and junior can learn from each other.

With all there is to cover, it may seem like a three month period is not long enough, but these new optometrists are quick studies. They get it.

In addition to learning valuable skills, the new doctor will bond with the staff and will be introduced to a sample of the patient base. Itís a winning situation on many levels.


Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management