Optometry practice: 25 years ago vs. now

I recently achieved 25 years in private practice. This post is being written by voice dictation on my laptop-something I could not even imagine 25 years ago when I started. When I started college, I'd seen only one computer in my life, a Macintosh Plus, which was the only computer in my entire dormitory in college.

When I think back to 25 years ago, I used to book only one patient per hour, as the doctor before me had done. Eighty percent of our receipts came from optical sales, which were mostly cash sales. In fact, on my first day of practice, I had only one appointment that day at 4:30 p.m.-the latest appointment. I was not allowed to use therapeutics because we had just recently gotten diagnostics in Ohio. I remember sitting at my desk all day being overwhelmed, having no idea what I should do. I was fresh out of school and, quite frankly, I was scared to death. No clinical instructor to consult, no classmate to ask questions, totally on my own. There was no pachymeter, no OCT, no retinal tomography, no GDx; state-of-the-art was the Humphrey Visual Field Analyzer. I remember early on when I got a fax machine and was absolutely amazed I could insert a piece of paper, and it would appear somewhere else magically. Mobile phones were extremely rare, and I didn't have one for many years until I got one of the old Motorola phones that were about half the size of my iPad Mini.

Contact lenses had just started moving to disposables, and things were changing. The doctor before me did not fit contact lenses, and I remember needing to purchase a keratometer, slit lamp, as well as a soft contact lens vial crimper (remember those?).

There was no public Internet, and advertising was limited to the Yellow Pages, newspaper, and the sign in front of your office. I remember having to balance the checkbook by hand, after I received the paper statements in the mail. There were no electronic deposits, just putting checks and cash in the bank. I had a copier in the office but could not even imagine that I would have a scanner someday. Billing, what little there was, was paper claims and mail.

When I visited nursing home back then, I had a 300-pound case to carry my equipment, including portable refractor arm, that I wheeled up a handicap ramp in my van. My portable tonometer was a Makay Marg! All records were done on paper, which meant carrying all the paper files for all my patients to each nursing home. I performed 10 to 15 exams per day, which was a lot back then.

Tomorrow, when I go to the nursing home, I'll be rolling in one single small luggage bag that weighs about 20 pounds and has all the equipment I used to have-and more. My records will be electronic, and quite a bit of my work will be entered by voice/templates rather than by typing. I will be seeing about 30 patients tomorrow, which I can now do thanks to technological advances.

For all of you starting out in optometry, I can promise you this: when you reach your 25th year as I have, you will not be practicing in any way that you can imagine. I still love optometry, even more than I used to, and I can tell you that at 25 years, you can see the end as well as the beginning. You should appreciate every day you have in practice because it will all be gone in the blink of an eye. ODT

This article originally appeared as a post on ODWire.org and republished with permission from the author.