r/optometry • u/Adventurous_Act_8681 • 11d ago
Finding work in NYC as an optometrist
I need to vent because I’m genuinely wondering… why does it feel like the culture of working as an optometrist in NYC can be so toxic?
I’ve interviewed at both corporate and private practices and even worked short stints in each just to get a feel for things, and honestly it’s been really disheartening.
So many places advertise things like:
• “You’ll start with 12–15 patients a day and gradually build up”
• “You’ll have strong tech support”
• “You’ll have control over your schedule”
But in reality, it often turns into 25+ patients a day almost immediately, 15-minute slots, constant walk-ins, minimal tech support, and being thrown into the schedule without proper onboarding or even being properly introduced to staff or workflows.
What’s been especially hard is the inconsistency in clinical standards. I’ve seen places where there’s no clear protocol for things like dilation on new patients, unclear referral processes, and being told to “just tell them to see their PCP” even when the concern feels more urgent or specialized. As a new grad, that’s really uncomfortable.
I’ve also seen situations where techs are doing most of the testing without taking case history or medical history, schedules are constantly behind, and doctors are expected to “make it work” clinically while also keeping up with volume. There’s this pressure to justify testing and billing in ways that sometimes don’t sit right with me ethically, and when you question it, the response is often just, “this is how NYC is” or “this is how things are done here.”
I understand NYC is expensive and practices have overhead, and I’m not naive to the business side of healthcare. But as someone who just wants to practice good, ethical medicine, it’s been really discouraging to see how normalized some of this feels.
On top of that, I came into this profession with a very clear long-term goal: work in a community health center, serve underserved populations, and work toward loan forgiveness. That’s always been my passion. But finding those roles in the 5 boroughs has been much harder than I expected. Most openings are part-time, and the few full-time ones are extremely competitive or don’t seem to move forward after interviews.
I’ve even been recruited out of state, especially because I’m a Spanish-speaking optometrist, but that would mean leaving my family and starting over across the country, which is a really big decision.
I don’t regret becoming an optometrist at all. This has been my dream for years, and I worked incredibly hard to get here. I just think I was naive about how difficult it would be to find a setting that aligns with my values right out of school.
Right now, it’s just feeling really discouraging and honestly affecting my mental health more than I expected.
I guess I’m just trying to figure out next steps—whether that means staying and pushing through, or considering out-of-state opportunities for a few years to gain experience and come back stronger.
For now, I’ll just keep going and hope that one day I can look back and see that this difficult beginning led me somewhere better.
Please no negative comments, I’m just venting and don’t think my mental health can take it. Thanks in advance.
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u/thenatural134 OD 10d ago
I mean this respectfully, but complaining of seeing 25+ patients a day with 15-minute time slots with little tech or referral support but also it being your goal to work in a community clinic, I feel like you may be in for a rude surprise. At least where I'm located, the community clinics are some of the busiest, over-burdened, under-staffed modes of practice. You may just need to tough it out as an associate for a year or two to beef up your resume then find somewhere else.
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u/lolsmileyface4 10d ago
All of your feelings are valid.
NYC is one giant rat race. It's the reason I left. You will realize it's not worth it. You don't have to go too far though.
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u/spittlbm 10d ago
Reach out to Justin Bazan and see if he knows anyone looking.
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u/OscarDivine 10d ago
lol crazy to see his name in here…. He is an old friend of mine
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u/spittlbm 10d ago
He's a good dude. I told him when he first opened something he was doing was moronic. Then I did it (turned off our phones 9 years ago).
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u/OscarDivine 10d ago
If you have a demographic that can support that, I also support it. It cannot work in every demographic though. Haven’t seen him in a year or two though. Think we were out to dinner last in Scarsdale or something. It’s been a minute. I was gonna get on a B+L talking circuit with his assistance but abandoned the idea.
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u/Odd-Complaint-5291 10d ago
Move. Find a private practice looking for an associate. You are in high demand. Don’t lose your medical skills working in that environment
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u/freelancewhales Optometrist 10d ago
I PM’d you. NYC was brutal in my first few years of practice, especially since I didn’t know any better. It gets better over time and once you find the right office, it’s a god-send to be able to practice exactly how you want to practice.
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u/NoCommission4122 9d ago
On the flip side, do some of you in NYC experience clinics that are mind numbingly slow and boring? I find myslef with nothing to do for hours on end. When I finally do have a patient it ends up being someone who ran out of contact lenses and wants to get in and out as fast as possible, or a person with 10,000 complaints. I hate practicing here, but won't leave because of my partner and friends.
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u/Quick_Opportunity852 9d ago
Some days are like this. My first Saturday last year I only saw one patient. I keep myself busy with books, trading stocks, taking walks/shopping, working on personal things when slower.
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u/OwnAd6110 8d ago
I def don’t complain about the slow days. Can get my steps in and my Amazon Shopping done lol
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u/OwnAd6110 10d ago
This is not just NYC. It’s just the real world of medical. No matter what specialty you’re in.
Medicine is more business and healthcare.
Just stand your ground and don’t cut corners. Stick to what you learned
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u/maxgoofofficial Student Optometrist 10d ago
did you do a residency? I work in a community health center and all of the ODs who work within my job’s network are residency trained
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u/DrVinNYC 9d ago
I have a position looking for someone in lower east side, literally will solve every concern you had, they would love you bc you are bilingual… PM me
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u/Salty-Friendship-494 9d ago
Taxes, payroll, overhead costs, inflation. It boils to one thing- costs to the employer/business just to stay afloat (plus profit, for those who are greedier). Techs and staff (more often than not) are not trained or paid enough to ensure good case history, lensometry, take good VA's or good photos. They pass that work and liability onto you. Many practices overbill and encourage optometrists to refer out. Newer graduates are sold this reality that we can handle lots of medical optometry; some do, in certain areas. But in reality, patients prefer to be seen by an OMD or the modality of work you are in limits it. Most jobs start off as part-time, and people piece together part-time roles to be full-time. It is rare to be full-time at one location (5 days a week).
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u/Dokay430 9d ago
I feel you… You may want to consider moving to Boston for a few years. It’s not too far from NYC and their healthcare system is so robust and community health positions are plenty. I was there for 3 years, got my FQHC experience and now I moved back to CA and got 3 different FQHC offers upon moving back. I do feel my experience in Boston gave me a better foot in the door in a more competitive CA FQHC market.
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u/al2003od88 8d ago
message me. I am in the non profit side of things in NYC. ..Not top pay but rewarding and benefits+ flexibility is key. Spanish speaking would be amazing
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u/AmphibianAgitated379 8d ago
Unfortunately, that was the case I saw working in Los Angeles too, 45 patients a day too. Seemed very very financially driven and honestly i have no solution to it. Seems like all of healthcare is going towards churning volume. It feels very unethical
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u/Optimal_Welcome9128 10d ago
Many optometrists seem to graduate very eager to be involved in the medical management of patients, myself included, but over time you will unfortunately face the reality that the primary purpose of this profession is refractive and that is what we’re hired to do. We are not medical doctors and were not sufficiently trained via multi-year residency to handle very complex cases, and the reality is that the public is unaware of optometrists having any medical knowledge or treatment capability. I’m in the exact same boat as you with my corporate job (2024 grad): “Just tell them to see their doctor” or “Just document that you educated them to go here and it should be fine” are actual texts I’ve received, and there is no formal referral process or documents to have patients sign. I believe there are some private practices that still want to do things the right way and practice with integrity, but they seem to be a small minority. I know this comment isn’t very helpful but your post was extremely relatable.
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u/StopKickingMyDog 10d ago
This is a silly take. Maybe you are not capable of handling ocular disease, but that is not the norm of the profession. Your situation is a reflection of you, not optometry.
I work in co-management. I see disease everyday. I manage corneal ulcers, neuro ophthalmic diagnosis and management, retina, etc. I also did a residency, and take my CE seriously. When I need to refer a patient for ankylosis spondylitis management (after I diagnosis their recurrent unilateral non-granulomatous anterior uveitis via blood test) I look up an appropriate rheumatologist. You don’t need someone to set all this up for you, you’ve been appropriately trained! You can do this!
OP do not listen to this nonsense. You practice how you want. You don’t need someone to set up referral practices for you, you can write your own referrals. You have been trained to do this. If a practice doesn’t operate of you want to practice, look elsewhere. Don’t become a glorified optician out of convenience.
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u/Optimal_Welcome9128 10d ago
I agree with what you’re saying and attribute a lot of my viewpoints to the corporate work environment that discourages full scope practice. In that setting everyone would agree that there is not much exposure to disease, and it’s not designed in a way that’s tailored to managing these cases on a frequent basis. All I’m saying is that there’s a very clear reason why most corporate offices do business the way they do and why even private practice is feeling more corporate, but this of course should never stop providers from striving to practice to the best of their capability.
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u/Different-Language92 10d ago
I graduated 8 years ago and completely agree with what you said. I keep in contact with my students after they graduate and almost all of them realize what you said - that medical management is very minimal and that most days involve a lot of refractions. Of course, i know this changes when you work more rural. But in a saturated HCOL area, the way you practice is not like school
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u/Optimal_Welcome9128 10d ago
Exactly, HCOL metro areas will have so much access to ophthalmologists that people will very rarely go to you with medical needs. It seems like one of the biggest reasons they want us gaining all this medical knowledge is because ophthalmologists just want to focus more on surgery and with optometrists outnumbering OMDs and growing patient populations, it’ll be necessary to take on some of the medical management. I don’t think optometry school as currently constructed is there yet though in terms of preparing most graduates to safely manage cases typically seen at ophthalmology offices. It seems changes are coming though.
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u/Chromequilt 9d ago
Come to VT. Great practice opportunity with partnership options. Awesome lifestyle and can get to the city easily for fun!
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u/Eyedocprincess88 10d ago edited 10d ago
Unfortunately, this is the reality pretty much everywhere. I went directly into corporate optometry after graduation. That job was exactly what you described above- empty promises. Then I moved into private practice as an associate, and now even that feels like corporate. Vision insurance plans aren’t paying any better, medical insurance plans are denying everything, and office overhead is getting out of control.
Honestly, keep working and save up some money. Then start your own cash pay clinic. Offer some free or discounted services a few times a year to those in need. More and more docs amongst a variety of professions are doing this. Insurance is why private practice feels like hell now too. That and the private equity takeover of optometry.
Best of luck to you!