Anonymous Confessions of an HMO Optometrist

As an optometry student, you have the freedom to practice optometry in any imaginable setting you’d like. Have you ever wondered what practicing optometry in an HMO (Health Maintenance Organization) setting would be like?

HMOs are organizations that provide full health care benefit plans and offer all medical services within their own hospitals. Is optometry in the hospital halls just like optometry anywhere else? An anonymous full-time optometrist employed at one of the largest HMOs in the United States has agreed to an interview to help readers of find out more about HMO optometry. The identity of the optometrist has been hidden because of the content of the interview. These are the anonymous confessions of an HMO optometrist!

OS: What is the first word/phrase that comes to mind when I say, “HMO optometry”? Can you explain why you chose that word?

A: Team. In a HMO practice, an optometrist is one component of the health care team that consists of many disciplines of medicine.

OS: What do you love most about your work?

A: It allows me the freedom to have fun outside of work. I work regular hours from 8:30 a.m. to 5:30 p.m. I don’t have to worry about marketing. I don’t have to worry about staffing. I don’t have to worry about maintaining the office. I don’t have to worry about billing. I can have vacations without worrying about who will see my patients while I’m away.

OS: If you could do it again, would you still practice optometry in an HMO setting?

A: Yes, for the reasons stated in the above question.

OS: Describe your typical workday.

A: I start work at 8:30 AM. I typically see nine patients in the morning. Patients are scheduled every 20 minutes. I have an hour for lunch. Then I see another ten patients in the afternoon. We are given a 15 minute break in the morning and another 15 minute break in the afternoon. We get to decide when we want our breaks and if we want to break up the 15 minutes into smaller blocks. A lot of us tend to break the 15 minutes into smaller blocks so we have a little buffer time in between patients to manage our schedules, e.g. we use that time for catching up on our dilations, for returning phone calls or emails, for our long-winded patients, for our late patients and for our more complicated cases. My facility does not have an assistant to pre-test my patients for me, so I do it myself. So if I have a slow or senior patient, ten minutes might pass before I can even get them into my exam room.

OS: What advice would you give to optometry students who are interested in working in an HMO setting?

  • A: It
  • ’s a great way to practice optometry. However, it’s not for everyone. The biggest drawback to working in an HMO setting is the volume of patients. The volume is enormous compared to private practice. In addition, there are certain things that I cannot dictate. For example, I cannot say I want my patients scheduled every 30 minutes, instead of every 20 minutes, without an agreement from the Chief and my colleagues. I cannot hire or fire unproductive support staff. I cannot say how much to charge a patient for their visit. The company that hired me compensates me for my work but the high volume of patients daily can be draining.
  • OS: What is one confession you have as an HMO optometrist?
  • A: O
  • kay… I don’t dilate all my patients like they teach you in school. It’s a very problem-focused exam. It’s not much of a confession, since it probably applies to all high volume practices.

Parting Words

What struck me most about this interview was the pace of HMO optometry at 20 minutes per eye exam. The focus of an HMO hospital is to solve problems as quickly as possible and move onto the next patient. In optometry school, the curriculum trains students to give a comprehensive eye exam that evaluates all parts of the visual system from refractive error to ocular health. Patient care is integral in both settings, but time plays a much greater factor in an HMO than what optometry school trains us for. These differences in patient care goals may be a big culture shock for those graduates fresh out of school about to enter their first job as an HMO optometrist.

As the anonymous optometrist confessed, HMO optometry is not for everyone. Practicing optometry in an HMO will appeal to those personalities that want to help the greatest number of patients and are quick to think on their feet. It is also great for those who want regular 9-5 schedules and only want to focus on optometry without worrying about the business side of things. HMO optometry will not appeal to those who strive for the most thorough eye exam ever or those who want more independence and control of their income. As reflected in the interview, HMO optometry can be the perfect optometry lifestyle for the right personality.

Thank you to this anonymous optometrist for sharing his or her opinion on practicing optometry in an HMO setting. If you have any further questions, please post them as comments for a possible follow-up interview.

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