Article Date: 6/1/2009

Wisdom for Making the Best Career Choice

Wisdom for Making the Best Career Choice

By Janice M. Jurkus, OD, MBA

QUESTION: Which subspecialty in optometry is one of the most lucrative?

Answer: Many new ODs ask this question. But the answer isn't clear-cut. Optometry has many specialty areas, such as contact lenses, pediatrics, boutique eyewear and several others. So it's almost impossible to single out any sub-specialty as one of the most lucrative.

What makes a subspecialty lucrative depends on which one you're passionate about, the need for that type of eye care in your community and your ability to provide quality patient care to a specific population base. Here's what you can do to ensure your career will be profitable — no matter which subspecialty you choose:

Chase your passion. Your passion and enthusiasm for your subspecialty will enable you to offer high-quality services to patients and produce outcomes that exceed their expectations.

Know your patient base. Do some research on the demographics in your area. If the median age of residents is greater than 55, you might want to steer clear of a pediatric practice. Likewise, if the area has a large number of young families, the odds of building a profitable glaucoma or cataract practice probably aren't good.

Consider the competition. Determine how many ODs are in your community and what their specialties are. If there are practices that specialize in contact lenses, there may not be room for another. But if there's a need for an additional contact lens specialist, you have an opportunity to build a lucrative practice.

Pay attention to chair cost. Chair cost is the amount it costs you to practice every hour. Currently, the average breakeven point for an OD in the United States is $92 an hour.1 To turn a profit, you have to earn more than $92 an hour for your services. So you'll need to look beyond how much you charge for services, and focus on how much you'll receive in reimbursements from insurance carriers. Subspecialties, such as disease management, generally are a medical insurance expense for patients, although vision care insurance may offer benefits you can use for contact lenses or eyeglasses. Because of this, you should know beforehand how much of a discount you'll be agreeing to when deciding which insurance to accept. Selecting a specialty that pays less than what you need to turn a profit in chair cost doesn't make sense financially.

Follow Your Heart

When choosing a subspecialty, always pursue the one you'll most enjoy. Once you do your research and choose a community in which to practice that needs your services, the odds will be in your favor to build and grow a lucrative practice in the years to come. nOD


  1. The American Optometric Association, “Caring for the Eyes of America: A Profile of the Optometric Profession,” 2006.
Dr. Jurkus is passionate about teaching and seeing patients in her specialty — contact lenses. She's a professor at the Illinois College of Optometry, where she teaches practice management. You can reach her at

Optometric Management, Issue: June 2009