Article Date: 4/1/2005

street smarts
Don't Be Singing the Big Box Blues
Your first job may not be exactly what you'd imagined, but don't let that keep you from being a full-scope O.D.
BY DAN BECK, O.D., Leland, N.C.

With graduation fast approaching, most fourth-year optometry students have their brains filled, not with material for final testing, but with wondrous practice scenarios -- images of huge, Guggenheim-like offices and waiting rooms filled with all kinds of cool ocular pathology.

For many, however, dreams of eyecare Nirvana will give way to the reality of tiny offices in corporate settings. Except for a blip of satisfaction on payday, it's all too easy to succumb to feelings of mediocrity or even inferiority. Which is exactly what happened to me.


My first job as a new O.D. was in a Wal-Mart side-by-side. The entire office was about the size of an average bedroom. I had one exam room and one "multipurpose area" filled by the front desk, the waiting area and screening instruments.

Although I was happy to get the experience, I found I was thinking less and less about the "fun stuff," the skills I'd looked forward to using, like dilating and irrigating, inserting punctal plugs and giving chalazion injections. Somehow, I'd allowed myself to believe my Wal-Mart office just wasn't the proper place for these procedures. Then I met Jack.


Jack was one of those patients I simply couldn't refer. He had very little money, no insurance and one of the worst cases of dry eye I'd ever seen. Having received little relief from lubricants, Jack was a prime candidate for punctal plugs.

After searching for the long-forgotten plugs, I finally located a pair and inserted them. A month later, Jack popped in after his weekly Wal-Mart shopping to tell me he was thrilled with how his eyes felt.

For me, this was an epiphany. From then on, I jumped in and started doing all the things I loved and was trained to do. I realized I didn't need a fancy office or a private practice to use all my skills.

Today, I work in a new building in a great group practice with state-of-the-art equipment. Even now, I'm most satisfied when I perform the procedures I was too nervous to do 12 years ago. Using these skills keeps me sane and helps me avoid "which is better, one or two" burnout.


We're fortunate to be part of a primary care discipline. Don't let your office setting or employment situation interfere with whatever area of optometry interests you. Vision therapy in a Wal-Mart location? Why not? Corneal molding with specialty GP lenses at Lenscrafters? Sure. If it's within your state's scope of practice, you can do it.

Don't ever let others -- or yourself -- convince you only certain offices have the right to practice full-scope optometry. Go out and have some fun.

A '93 graduate of PCO, Dr. Beck secretly looks forward to his next chalazion patient at his practice in Leland, N.C.



Optometric Management, Issue: April 2005