Welcome to our first #WomenInFocus article!  I wanted to start things off at the very beginning -- starting salary is one of the very first numbers you have to evaluate when beginning your career, and one of the very first times that being female really comes into play in your optometric career as a disadvantage. Review of Optometry's 2015 income survey showed that the average full-time salary for male optometrists was 68% higher than the average full-time salary for women.  The average male OD made $171,603 and the average female OD made $117,020 last year.  Obviously we have an uphill climb in our industry to close this pay gap.  And Review of Optometry's numbers show the gap starts right from the beginning.  The average salary of a full-time female optometrist practicing for less than 10 years was 16% lower than that of male ODs with the same experience. 

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So what's going on in our profession? I don't think that this salary difference ("more of a gulf than a gap") is a sign of overt gender bias in our profession.  For years optometrists have blamed age differences (more established docs are male and more new docs with less income are female) or a female OD's increased likelihood for working part-time hours to balance childcare as skewing the numbers to look worse than they really are.  But when you break down the categories to just new grads and just doctors working full time, that 16% pay gap in 2015 and 29% pay gap reported in 2014 still exist.

How can we close the gap?
First, we have to admit the gap is real across our profession and talk about it -- in schools, at meetings, and in publications.  I applaud Review of Optometry for reporting their data so carefully to prevent the gap in salary figures from being blown off as skewed data like so many articles I read when I first graduated.  And then as women, we have to admit to ourselves that we're doing something wrong.  Millennial women are often of the belief that the feminist battles have been won.  The very idea that we may be treated differently than our male counterparts seems absurd.  But then why don’t the numbers support our feelings of female equality being a forgone conclusion? The easiest explanation for what we can do to close the gap is to follow the lead of our male counterparts when it comes to income - bother to ask about your pay! Studies show that one of the biggest reasons women are paid less than men is because we don’t negotiate the initial offer of pay.  

Graduation day at SCO.  I feel like this photo symbolizes optometry today.  Male leaders in our profession are passing the baton to our generation of female ODs, but are we doing our part to grab hold?

If you are a regular here, you know I was very excited to speak as a panelist for Allergan this weekend at the North Carolina Optometry Fall Congress in Asheville, NC.  It was such an honor to sit beside some of the most recognized female optometry leaders in our state:  Dr. Ann Hoscheit and Dr. Sally Miller.  Both are published, private practice owners that have held numerous leadership positions both in state and national optometric organizations, and I was a bit out of my league as the "new doc perspective" on our panel.  It was an incredible experience, and I came away with a few new concepts that I thought more female and prospective ODs might benefit from:

• Create your own personal statement:  This is a common tool used in business management, but as a person, it is so important to know what you stand for too.  Just thinking about what you want to accomplish, what you want to prioritize, and what you want as your personal identity can help guide your decision making through the entire year.  Ask yourself who you want to be as a doctor, a wife, a mother, or any other responsibility you have in your life.  If you know your own identity, and what you want to be, it really helps you stay focused on what truly matters in the stresses of daily life.
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• Don't be afraid to negotiate--and learn how to speak the language of negotiation:  For me, this is a very challenging task.  As a new grad, I felt like I was just one more face in a sea of graduating optometrists looking for an opportunity to see patients.  The first time I spoke to students in optometry school, they asked me how I negotiated my contract and employment.  My helpful response?  It didn't really work like that.  For me, I was not in the position to buy in to partnership with an established OD, and I had just two job offers to choose between.  Not much negotiation.  Looking back, maybe if I had had more of a business background I would have understood that I had more room to negotiate my situation than I thought at the time.  Since my first signed contract, however, I have done a lot more negotiating than many would think.  As an OD you are constantly negotiating your hours, your number of patient exams in a given day, your exam time slots.  The helpful advice given at this Allergan panel meeting was that as women, we need to negotiate for ourselves like we are negotiating for a business.  Dr. Rachel Wruble advised to negotiate for the business of you -- less personal desire, and more how what you are requesting is an asset to the company or situation. For example, it feels natural to say, "I want a lunch break because I will get hungry if I work for that many hours without lunch."  I know I said something similar the first time I negotiated my hours.  But if you want to have a bigger impact in the business world, negotiating is less about you, and more about how you function within the business.  You need a lunch break because without a chance to refuel, you will be working less efficiently, and risking providing a lower level of care.  That turns the exact same concept less personal; creating a greater level of importance and impact for your request. 
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• The Future Is Bright:  I capitalized this because there was an overwhelming positive message to this meeting of the female minds.  We discussed the importance of public outreach in educating Americans about the importance of the eye exam, with programs like the AOA's Think About Your Eyes campaign and even the impact on a smaller level that school screenings or career days to educate young people about what we do.  Our profession is such a legislated career, and political action campaigns are the arena where optometry gains its rights for practice and to see patients on insurance plans that may try to cut us out.   We have to fight for new healthcare changes that will provide patients access to us with equal pay as our MD counterparts.  And there are so many new fights on the horizon, like the proposal for universal licensure that would make optometrists licensed nationally instead of filing for individual state licensure.  The important take away is that we need leaders in this industry with a voice, that are willing to fight for our profession.  I hope to become more and more involved in getting the word out about optometry (the driving force between the creation of this blog back in 2011!)

In just 10 days I have the pleasure of speaking as a panelist for Allergan's VIEW (Visionary Insights for Eye Care Women) luncheon at my state's optometric society meeting.  It was such a great honor to be chosen as a speaker, representing the changing face of the new generation of optometrists--a profession dominated by females. More students than ever are graduating with their doctorate in optometry (when I first enrolled there were 16 schools in the USA, now there are 21 with more scheduled to open in the coming years).  And more students than ever are females (there is a reported 60-65% female enrollment in optometry schools across there country).

Why are so many women pursuing optometry, especially when faced with the negativity of many optometrists in today's healthcare marketplace?  There are many reasons that would appeal to stereotypic gender norms:

•  optometry is a flexible career, with part-time work available for family-minded doctors
•  shorter lenght of time in school (a 4 year program instead of 4 plus 4 or more years of residency in an MD program)
•  no surgeries, so no blood / lower stress, no life or death discussions

But we all know that for many women, these perceived "female-friendly" points may not have had any influence on their career decision at all.  My personal opinion is that optometry is appealing as a career in general, not just to women.  More than ever, women are driven to pursue higher education, and as such they are finding careers in medicine, law, and other professional degrees.  But where optometry really separates itself from other professions is the ability to focus on one topic, and become an expert at that.  Optometry is a career that appeals to the detail-oriented (maybe there are more of females with this talent/curse than males??).  You spend the entire day looking at one body part, talking about one body part, measuring and calculating minuscule changes in that body parts length and curvature.  You talk about eyes all day long.   To me, as a woman, I love having that focus, the ability to pour my entire body of knowledge and study into the smallest of details about the human eye.  Thinking of being an expert on the entire body sounds just ludicrous to me -- I don't know how primary care doctors can manage so much at once.  As an optometrist, I am the doctor you see for all eye-related questions and concerns-- the eye specialist.  You can't get much more rewarding than that for someone that loves details.

With that being said, I am not immune to the pinch of negativity in my industry. I feel my eyes are more open than ever to the uncertainties of healthcare in today's world.  I have seen the profession of optometry struggle under the weight of reduced insurance reimbursements and general perception of the value of an eye exam.  Eye exams reimburse very little through most vision insurances (between $40-50 for a comprehensive exam on average).  In the past, doctors have offset those terrible margins by relying on product sales, but glasses and contact lens marketplaces have expanded (like all products) into the realm of the internet, and doctors are feeling the heat to see more and more patients every day.  In many cases this means compromised ability to focus on the details that made our profession so unique and rewarding -- the time to discuss all of the health benefits of the exam, to investigate dry eye, ocular allergies, and UV exposure changes that affect the eye and vision.  The eye is the only part of the body to assess the blood vessels with a live view, and most of my patients are surprised to learn that I am screening them for hypertension, cholesterol issues, and diabetes during their eye exam.

So why do so few people in the general population not know that your eye exam is an important health screening?  Most people are under the misconception that if you can see, your eyes are healthy.  If you read this website routinely, you know how many times I have debunked this myth.  In most cases, if your vision is affected by an ocular disease, it is too late to improve vision, even with glasses or contact lenses.  

My charge to all optometrists, new and old, female and male, is to embrace this profession for the specialist career that it is.  We need to educate at every chance we get what we are seeing when we look at our patient's eyes.  We need to take medical responsibility for the eye -- we are the primary EYE care provider after all.  We are who you need to see for a red eye, dry eye, burning eye, blurry eye, watery eye.  You name it; we are eyes.  Embrace the medical training we have and promote it!  This is the way to bring optometry into 2014, and the new wave of female optometrists are going to be the industry leaders to usher this change in patient perception.

If you are a female optometrist or optometry student, please comment and let me know what struggles you have faced or concerns that you have about our career and our role as female doctors in shaping its future.  I want to hear from you, so that I can bring these topics to my VIEW panel discussion, and the greater audience of online readers and industry leaders!