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Notes for the new graduate


CHRISThey say, always begin with the end in mind and it therefore seems fitting to describe what could be seen as the pinnacle of a career as an optometrist. In my opinion, a high performance practice should bring in a turnover of R500 000 per month (in today’s terms), which should translate to a net profit of R1 200 000 (20%) per year. This is apart from paying yourself a market related salary. The practice must be located in the optometrist’s own free standing building. The practice must employ at least one junior optometrist. The optometrist should have completed some post graduate qualifications that are available in South Africa and the mode of practice should deliver the highest standard of care with at least one area of special interest, such as Child Vision Care or Advanced Contact Lenses. The time frame to achieve this should be about 10 years.

Learning over money

From the day you graduate, you step onto the road towards becoming a mature clinician. The only way this can happen is by seeing patients, which means, the more patient traffic you are subjected to, the sooner you will become a competent clinician, ready to deal with any visual problem. A common trap many young graduates fall into, is choosing money over learning. You may well earn more, but end up in someone’s branch office without a mentor and see one or two patients a day, which will seriously slow down the process of becoming a mature clinician. The prime objective of finding your first job, should be to get into a busy practice and work under an experienced optometrist. This will present the learning experience which will stand you in good stead for the rest of your career. Often, the best opportunity in line with this strategy presents itself in rural towns or in public hospital clinics. Be brave enough to choose learning over money, even if the location is not  your first choice.

Requirements for a high performance practice

 Clinical Skills

The real learning only starts once you have graduated. It is impossible to fake clinical skill and you only become good at it through experience. One can never establish a high performance practice without excellent clinical skills. Post graduate studies will place you at another level. For instance, becoming an optometrist with ocular therapeutics will present a great opportunity to differentiate your mode of practice. Continued Professional Development should not be seen as a box to tick in order to retain your HPCSA registration. Developing clinical skills will require much more than that. Reading still is an essential part of learning and must form part of your development phase as a clinician. To be considered an excellent optometrist requires the ability to integrate all the areas of optometry such as refraction, pathology, binocular vision, contact lenses, low vision, optics and product knowledge. The ability to draw from all these areas will ensure the best exam outcome and action plan for each patient. Product knowledge is essential to make the right choice for your patient. If you fit a contact lens, you must know all the physical properties of that lens. What is required is a broad base of knowledge to draw from.

Emotional labour

Emotional labour is the process of managing feelings and expressions to fulfil the emotional requirements of a job. It is about facial expression, body language and manner of communication, that will make your patient feel comfortable in your presence. The way you make your patient feel will determine her willingness to enter into a long term relationship with your practice. An optometrists without empathy will struggle to keep patients.


The kind of leadership you provide to your staff will reflect the overall brand of the practice. There is a big difference between finding yourself in a default position as leader and being a good leader who provides leadership. Leadership does not come naturally to everybody and it is therefore important to study the characteristics of good leadership. A poor leader is unlikely to have a strong team. The bottom line is, it is important to acknowledge that leadership is going to play a big role in the success of your business and one must guard against the attitude of “I’m the Boss and that’s it!”

Business acumen

It is important to know that there is a big difference between practice management and the deeper issues of business. Practice management has to do with the day to day running of the business, such as cutting an invoice, opening a patient file, placing a lab order and so on. If you never learn how to set up an invoice in your whole career, it won’t be a big deal. That’s why you employ staff. However, you must come to grips with the deeper issues that drive the business such as: funding, marketing, differential advantage, brand building, financial management accounts, business plan. Far too many optometrists abdicate from the responsibility of steering the financial well-being of the business. Nobody is ever going to care more about your business than you yourself. What you need is a basic understanding of these business concepts, such as the income statement and the basic principles of marketing. It’s hard to delve into these business concepts while you are employed and not affected by it personally. But, when the time comes, have the will to learn about them.

The location

There is no question that any optometrists who has been in practice for 10 years would be best off, owning his or her premises. After 10 years, you should not be reliant on the patronage in a Mall. By then, you should have a data base of returning patients who would follow you to your own stand-alone premises. It is worth taking note that once you have an established practice in a Mall, it can be very difficult to relocate, because you have to synchronise the timing of when your lease terminates and finding the new premises. One hundred and fifty square meters at an average rental in an upmarket Mall, over a thirty-year career, can amount to over R65 million in rent. Because of the rental escalations in Malls, it will eventually dilute your net profit.

Planning your exit

This may appear to be a ludicrous notion to consider as a young optometrist, but it is an important factor when you begin with the end in mind. The kind of practice you build will one day determine the options you have to exit. For instance, if you are a solo practitioner, highly specialised in an area of interest, it may not be so easy to find a successor who can do justice to your mode of practice. At some point you will have to create your buyer. On the other hand, if by the time you reach retirement and you have one or two associates, you will have more attractive options to exit. It is a naked truth that you will not be able to survive in retirement from the sale of your practice alone.

Decide what kind of optometrist you want to be

Are you prepared to give what it takes to run a high performance practice with a heavy patient load every day? Do you have your mind set on serving the less fortunate in the public service? Do you aim to be a locum optometrist? One thing in common with all the choices is the fact that you still have to be a good clinician. A poor clinician will soon run out of gigs as a locum. A career path must have a plan and a plan must incorporate goals.

Write down your dream

A goal should be specific, attainable, measurable within a period of time. The best career advice I ever received, was to write down my goals. It is a kind of commitment to yourself of what you want to aspire to achieve in your work life, your family life and your personal life. Writing it down lends a different perspective to it. It is there to always remind you of what you hankered to achieve. These can be; to own a practice within five years, to run a marathon, to lose weight, to speak another language or to watch a concert in Vienna. There must always be a documented plan. As the truism goes; those who don’t know where they are going usually get there. I leave you with my personal motto: If it’s to be, it’s up to me!