Before I became an optometrist, I worked for several years as an optician in both chain and private optical settings. I enjoyed the work, especially frame repairs and adjustments, because it often meant that I had to be creative to get the job done. It was great to be the hero when patients brought in their glasses, thinking that they were beyond repair.

“If I knew then what I know now... Hey wait, I do! Thanks for passing on your knowledge, Nate.”
Now, many years later, I obtained my O.D., completed an optometric residency in pediatrics, and have my own practice. However, I’m thankful for having been on the other side of the exam room door. Being a former optician makes me a better manager of opticians. I’m able to speak to patients more confidently when discussing frames and lens options. And while I don’t do it very often, I can get the job done if an optician isn’t available.

Here are a few things that I’ve learned from my younger self, Nathan Bonilla-Warford, A.B.O.C.

Sales is a Team Effort
I understand that selling things isn’t your strong suit. After all, that’s why you went into health care, rather than sales. However, the words you say in the exam room can make my job easier or harder. Please make it easier. Simply telling patients something that seems obvious to us helps me to better meet their needs.

For example, if the first time that patients ever hear about prescription sunglasses is from me, then they’re more likely to consider them an optional, additional expense. If they hear about prescription sunglasses from you, it sounds like an important element of preventive care.

Likewise, everyone feels better if you provide me with all the information I need upfront: First-time progressives? Computer lenses? Schedule a contact lens evaluation at a later date? It wastes time and interrupts the sales process if I have to leave the patient and track you down to clarify or confirm a recommendation. And as a reminder, if you’re going to leave immediately after the last patient hand-off, at least be available by phone so we can make that last sale.

Respect Us as Professionals
Whether I’m an experienced, licensed optician or a new employee, treat me with respect. I appreciate your acknowledgement of the skills I have that make the optical department run smoothly.

However, there are some situations that undermine this respect. For example, if there’s a communication issue with a patient, you may appropriately choose to intervene to placate the patient. But if you come to the patient’s rescue, you may inadvertently undermine me as a professional. If instead, you acknowledge to the patient that office procedure was followed and you made an exception, you won’t make me look like the bad guy for following the rules.

Let Me Do It   
Between exams, paperwork, continuing education and a variety of ongoing projects, optometrists have very busy schedules. Given that there’s a lot of overlap between our areas of expertise, why not let me take care of some of the work?

I truly enjoy some of the everyday practice tasks you’ve delegated to me, and I take pride in the results. One example is meeting with frame representatives to select and buy frames. This is a big responsibility that I take seriously, and it pays off because I’m much more in touch with the frames that we carry. However, without dedicated time and space to meet with reps, I sometimes have to work with patients and reps at the same time. This not only puts me in an awkward situation, but it can make the patients uncomfortable, too.

But Train Me to Do It
If you do delegate work to me, give me time to learn the ropes and take time to make sure I understand what I’m doing. When learning a new software program or process, give me the opportunity to read, watch training videos and work with other staff to learn the right way to do it. I know that scheduling EMR training means you might have to see fewer patients for a while, but it will make everyone more efficient in the long run.

The first time I was asked by my optometrist to order gas permeable contact lenses from the lab, I had no idea what I was doing. I didn’t know what the numbers meant or what the answers were to the questions they asked me. I got the job done and the patient was happy, but I was very uncertain about the process. Offering me a brief explanation of the whys and hows and walking me through the ordering process would have made a world of difference.

You Can Help Out
I know you don’t want to do my job all day every day. In fact, the ability to do more complex and varied things is likely one of the reasons you went to optometry school. However, I’d like to know that you understand what I do and are able to do it yourself occasionally.

I don’t expect you to check in the incoming glasses, but it’s nice to see that you still know your way around a lensometer. Restringing a semi-rimless frame and changing a screw in a flex-hinge require a bit more patience and skill. It makes me proud to work in a practice where the doctor knows how to do these things.

And it would be nice for you to answer the phone every once in a while when we’re all busy helping patients.

Go With the Flow
When the office is really busy and patients seem to be everywhere, it’s important that one of your top priorities is completing each patient’s entire exam in an efficient manner. You make decisions about patient flow based mostly on what you’ve done in the exam rooms. I know how your exams go and because I spend more time outside of the exam room, I see the “big picture” of what’s going on. I know who’s at a critical sales point, who has all the time in world to spend in the optical, and who has an important meeting coming up.

You can trust me, and other staff members, to manage patient flow with input from you. We’ll find a balance that works best, and there are some ways that you can help. While we understand the schedule runs behind at times, starting off behind because you’re running late is discouraging for both staff and patients. And while walk-ins are wonderful, working them in when we’re already behind can be counterproductive.

Incentivize Smartly
There are definitely times when the practice needs to move certain items in the optical department because we got a great deal on them or we’re overstocked. There are other times when you want to recommend a product because you feel it’s superior to others. Work with me to find a way to get the staff onboard with selling these items. Keep in mind that spiffs may not get me to sell something I genuinely distrust, no matter what incentive is offered.

However, sharing with me the reason to sell more of a certain item and coming up with a unique way in which to do so will be more effective. Perhaps a group competition or an online campaign would light my fire.

Make it Legible
Although jokes about doctors’ handwriting may be cliché, it’s not funny when a patient receives the wrong glasses or contacts due to sloppy scribbling. In fact, it actually puts me in a very awkward position if I have to question your handwriting before placing the order. Fortunately, EMRs have dramatically reduced this problem, but keystroke errors can happen as well.

Keep It Professional
To ensure that we have a sane and productive practice, it’s important that the staff gets along. I like it when you chat about your life and your kids during a staff meeting because it gives me and the other staff members a chance to connect with you. The occasional staff outing, such as going to a ball game or playing mini-golf, is great for morale.

But if you try too hard to be friends or talk about drinking and partying, it can make me uncomfortable. This is especially true with any off-color humor or making fun of patients, which is a quick way to lose the respect of the staff.

I definitely feel that my practice has benefited from my opticianry experience. The staff knows that I’m aware of what it’s like to be in their shoes, and they appreciate it. My experience makes me more responsive to their needs and better able to train them on specific tasks. And having worked with a variety of eye care professionals in different types of practices has given me a unique perspective.

If you didn’t have the experience of being an optician before becoming an optometrist, have a chat with your optician and see what the practice looks like from that point of view. You just might learn something.

Dr. Bonilla-Warford is in private practice in Tampa, Fla, specializing in vision therapy and orthokeratology. He is a frequent lecturer and writer about social media in eye care. Find ways to connect at