Specialization.. how does it work?

[RegularGuy]

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I've noticed that optometrists are able to specialize in a couple of different fields like contact lenses, vision therapy and orthoptics, pediatrics, low vision, sports vision, head trauma, learning disabilities and occupational vision. What does this require? (Do students take extra classes, apply to special programs or enroll in special residencies?)

 

[Dr Gump]

Good question.

In today's world of Optometry, specialization is somewhat of a "commercial gimmick". Every Optometrist takes the same classes from their Optometric curriculum, but some will pursue a residency. This is where the "specialization" takes place. This residency is usually one year and prepares the individual to manage patients with these "special" (low vision, contact lenses, pathology, pediatrics, etc.) needs better.

Now, back to reality. Most of the Optometrists getting out of residency join the commercial ranks, and their "specialty" (although helpful) does nothing for their bottom line. I know of many Optometrists who practice in settings that optimize their specialty, but they also need to have a general type of practice to survive.

I would venture to say that 10 to 15% of all Optometrist truly practice in a situation where they only manage patients, with a special need, in which they completed a residency. This is unfortunate, because I feel patients visual needs would be better met if they could be managed by actual Optometric specialists.

I hope this has answered your question.

Dr. Gump

 

[RegularGuy]

Thanks for the great answer. You completely answered my question.

 

[alferec]

"Specializing" in a certain type of practice in optometry is practically nonexistent in legal terms. Optometrists are legally not allowed to claim that they are a "Contact Lens Specialist," etc. after doing a CL residency because there is no board certification process, like where surgeons obtain an FACS attached to their name (e.g. Dr. Bob Brown MD, FACS). To clarify, board certification process = more board exams.

Dr. Gump, IMHO I think that "specializing" through a residency could (and not necessarily will) help your bottom line. For example, a Visual Therapy practice on the side could bring in a different pool of patients (kids, stroke survivors with ocular issues, etc.). Also a general practice residency will enhance your optometric education and thus make you a better clinician. I know I'm speaking in general terms but we can all agree that better patient care could easily make you stand out in the public beyond all the other optometrists in town.

I also wanted to add that true, legal specialties could be a detriment to our profession. If optometry introduced board certification, the docs that don't have this certification will be screwed over because all these new board certified docs can legally claim their specialty and thus make the older docs look bad. That means all the older docs are forced to do something to become board certified, and I'm sure that would anger them.

So you have to ask, attaching "Board Certified in Contact Lenses" to your business card sounds really cool, but is specialization truly better for the patient?

 

[Dr Gump]

Dr. Gump, IMHO I think that "specializing" through a residency could (and not necessarily will) help your bottom line. For example, a Visual Therapy practice on the side could bring in a different pool of patients (kids, stroke survivors with ocular issues, etc.). Also a general practice residency will enhance your optometric education and thus make you a better clinician. I know I'm speaking in general terms but we can all agree that better patient care could easily make you stand out in the public beyond all the other optometrists in town.

In order for a specialty to add to the bottom line, the practicing Optometrist must be in private practice. I am a strong advocate for private practice, so do a residency, start a private practice and advertise the bejesus out of your specialty.....I'm all for it. Find the "niche" and work it.

If older docs don't like this "specialty" world, so what. They complain too much anyway. Adapt and overcome or fade away. Progression is a good thing, as long as we don't lose what we already have.

Thanks for the input.