• Opinion

    If You Build It, They Might Come

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    Ruth D. Williams, MD

    By Ruth D. Williams, MD, Chief Medical Editor, EyeNet


    One of the persistent challenges for ophthalmology practices is finding, training, and retaining compe­tent ophthalmic technicians. The medical depart­ment manager at our practice, Kati Read, oversees nearly 70 ophthalmic technicians, and she is chronically a few employees short.

    The natural turnover among hourly wage employees, especially during the lowest unemployment rate in decades, contributes to the problem. In a survey of 1,200 young peo­ple in entry-level jobs, the Harvard Business Review found that half intend to leave within one year.1 Kati reports that employees leave our practice to care for elderly parents, move to another state, return to school, or try out another career. They will also leave for a modest wage increase, even if the benefits aren’t as robust. “It’s most frustrating,” she said, “when a well-trained technician leaves for another ophthal­mology practice that offers $1 an hour more than we pay.” It’s also expensive to replace an employee.2

    The reality is that there is a nationwide shortage of oph­thalmic technicians. According to the Bureau of Labor Sta­tistics, there are about 48,000 ophthalmic technicians in the United States.3 That amounts to fewer than three technicians per practicing ophthalmologist.

    Why is there a shortage? First, people who are interested in technical medical jobs might not think of ophthalmology. Indeed, career counselors at high schools and community colleges might promote medical technician training but not be aware of the opportunities within ophthalmology. Second, ophthalmology requires specific skills, and we typically don’t draw employees from the much larger pool of medical tech­nicians. Third, there aren’t enough ophthalmic technician training programs. (In our case, the closest training program to our office used to be 45 minutes away. We occasionally had a trainee do a brief internship, but the students were not consistently exposed to our practice. Furthermore, they were mostly from towns closer to the training program and tended to take permanent jobs in that area.)

    Dave Dopp, our ever-creative practice administrator, sug­gested we try to increase the numbers of qualified technicians in our region by collaborating with the local community col­lege to establish an ophthalmic technician training program.

    “It wasn’t easy,” Kati acknowledged. Illinois requires its state colleges to document that new programs are affordable and provide reasonable job opportunities. After approval by the College of DuPage’s Health Sciences department, the training program was reviewed by the college board, a regional state college board, and, finally, the Illinois Commu­nity College Board. The process took nearly two years.

    Kati and comprehensive ophthalmol­ogist Michelle Andreoli developed the curriculum for an 18-month program of three courses, inele­gantly titled Eye 1101, Eye 1102, and Eye 1103. Combined, the courses include 40 hours of classroom work and clinical training onsite in ophthal­mology practices, after which the students are expected to be prepared to take the Certified Ophthalmic Assistant test. Tuition is $3,400. The program recently graduated its first class of seven ophthalmic technicians, and eight are enrolled in the second class.

    Today, a beautiful brochure pro­moting the College of DuPage’s health care–related training programs includes a description of the ophthalmic tech­nician track. The brochure is made available to high school counselors and students interested in careers in health. We are hopeful that awareness of this career option will increase. As Michelle said, “Eye care is such a wonderful career. Our students acquire knowledge that ushers them into a profes­sion that is meaningful, sustainable, and fun.”

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    1 https://hbr.org/2017/12/how-to-improve-the-engagement-and-retention-of-young-hourly-workers. Accessed Nov. 13, 2018.

    2 www.americanprogress.org/issues/economy/reports/2012/11/16/44464/there-are-significant-business-costs-to-replacing-employees/. Accessed Nov. 13, 2018.

    3 www.bls.gov/oes/current/oes292057.htm. Accessed Nov. 13, 2018.