Born and raised in Niagara Falls, Dr. Elder graduated from the State University of New York College of Optometry after serving an internship with the Indian Health Service on the Navajo reservation in Arizona.
Upon graduating, Dr. Elder completed his residency in Primary Care at SUNY. After his residency Dr. Elder served as clinic director for TLC Laser Eye Centers in Las Vegas, Nevada before moving back east to Connecticut.
Today, he is a partner in a two-doctor private practice in central Connecticut. Dr. Elder enjoys golf, photographing historical sites, and cheering on his beloved Buffalo Sabres during the NHL hockey season. Describe a typical day at work.
I see patients 5 days a week, averaging about 20-25 per day for various eye and vision-related problems. One morning a week I see patients in area convalescent homes. I normally do administrative duties early in the morning or at the end of the day.
What mix of clinical/research/teaching work do you do? How much power do you have to change that mix?
Most of my work is clinical. I have a few small research projects on the go that center around eye movement disorders in children with reading difficulties. I occasionally lecture at local universities, usually in the education department. I also conduct a yearly cow eye dissection at a local high school. One of my patients is a science teacher and she asked me to volunteer, and it got such a positive response that I’ve been asked to do it every semester.
If you had it to do all over again, would you still become an optometrist? (Why or why not? What would you have done instead?)
In a nutshell, I would do it again but I would do it a bit differently. It took me longer to find a professional situation I was comfortable with than I anticipated it would. Also, some of the obstacles that I encountered when I graduated were things I never anticipated would be a problem. It took longer to overcome those obstacles than I expected.
Why did you choose optometry?
Ironically enough, I wanted to be an airline pilot and I found out my eyesight wasn’t good enough to join the Air Force. I was about 15 when I found this out, so I made an appointment with my local optometrist. While waiting in his chair for him to come in and perform the exam, I looked around and noticed he had a bunch of cool-looking gadgets. When he came in, I asked him what he did all day. He was young and enthusiastic and showed me around his office. I thought “Great! This is what I’m going to do with myself!”
Tell us a bit about the education of an optometrist. What specific classroom, laboratory and clinical educational experiences helped prepare you to enter the profession?
Optometrists study a wide range of anatomy, physiology, pharmacology, physics and optics both in didactic and clinical settings. The number of patient encounters was particularly strong as a student so I felt more than comfortable seeing the vast majority of patients I encountered when I graduated.
Now that you’re in your specialty, do you find that it met your expectations?
For the most part, yes. Optometry has met my expectations.
Are you satisfied with your income?
Yes, more than satisfied, but it took becoming a practice owner to achieve that. Working for someone else almost invariably left me less than satisfied with my income.
What do you like most and least about optometry?
The day to day interaction with different and unique people is a big plus. Helping people improve their most precious sense is very rewarding. Most people don’t have unusual phobias about going to the eye doctor so the patient interactions tend to be casual and low stress. The worst part is the daily battles with insurance companies, and the fact that I need a virtual armada of staff to process and chase down insurance claims.
If you took out educational loans, is/was paying them back a financial strain?
I took out more than the average loan and it was a very minor strain to repay.
On average: How many hours a week do you work? How many hours do you sleep each night? How many weeks of vacation do you take?
I work about 45 hours a week seeing patients, and about 15 administering my practice. I sleep about 6 or 7 hours a night, but we are expecting our second child very soon so I’m sure it will be much less than that soon! I take about 2-3 weeks of vacation a year. I also prefer to go away for continuing education conferences rather than do them close to home. It’s just another excuse to get out of the cold Connecticut winters.
Do you have a family and do you have enough time to spend with them?
I have a wife, who is also an optometrist, a son and another on the way. I feel that on the whole I get to spend enough time them.
In your position now, knowing what you do – what would you say to yourself 10 years ago?
I would say that the things you are worrying about are not the things that are the highest priority. Optometry students (like most doctoral students) generally tend to worry about repaying student loans, finding a “job” and finding an area to settle down in which the competition from other providers is low. I would submit that none of those things are things that need to be worried about.
What information/advice do you wish you had known when you were an undergraduate? (What mistakes or experiences have you encountered that you wished you had known about ahead of time so you could have avoided?)
I wish I had known the extent to which managed care participation would impact my ability to see and help my patients. Unfortunately, this is somewhat of a regional phenomenon so people considering optometry should have some rough idea of where they want to practice when they are finished so that they might scout those issues out ahead of time. Another mistake I made was spending far too much time dealing with and negotiating with small-time thinkers with respect to buy-ins and partnership offers. In retrospect, I spent too much time trying to work out unworkable situations. I wish I would have recognized that sooner.
From your perspective, what is the biggest problem in health care today?
Probably the amount of money that gets wasted on administrative tasks and people. I recall reading an article in a public health journal that said that from 1977 to 1997, the number of doctors and nurses went up 11%. The number of health care administrators at the same time went up 2600%. I don’t know how anyone can argue that THAT is an efficient use of resources.
From your perspective, what is the biggest problem within your own specialty?
Optometry is somewhat of a fractured field in the sense that most optometrists can’t seem to come to a consensus on what the most important issues facing the profession and the future of health care are. For whatever reason, optometrists tend to have somewhat of a “lone wolf” mentality and I think that that sometimes exacerbates that problem.
What is the best way to prepare for this specialty?
Obviously a good background in science and scientific method is important. Many people get into health disciplines because the pay is generally good, and people have a strong desire to “help people” but I would submit that that’s not enough. You need to have good critical thinking skills and a genuine sense of scientific curiosity to be a good clinician.
Where do you see your specialty in 10 years?
The advances in progressive spectacle and contact lens technologies have been astounding in the past 10 years, and I think the next 10 years will usher in a whole new generation of highly biocompatible contact lenses. I fully expect that the time will come where people will put on a pair of contact lenses and sleep in the them for months or even a year at a time. The advances in diagnostic and treatment modalities for ocular disease are also incredible. New instrumentation has allowed ocular pathologies, particularly glaucoma and macular degeneration to be diagnosed and treated at much earlier stages in the past.
What other types of providers and/or technicians do you work with in your day-to-day practice?
In my office, we only have optometrists so in that sense it gets a bit lonely. We do consult with primary care, internal medicine, neurology on a daily basis. Of course, we have a good network of ophthalmologists that we can refer to for surgical cases so we are in frequent contact with ophthalmologic counterparts as well.
What types of outreach/volunteer work do you do, if any? Any international work?
I am in the Lions club, and I sometimes volunteer to tutor high school math and science students. I have not done any international work.
What do you like to do for relaxation or stress relief? Can you share any advice on finding a balance between work and life?
I play the guitar, and I enjoy photography. As far as finding a balance between work and home life, it really varies from person to person because it’s such a personal issue. I would say though that the traditional 40 hour week is generally for people who are never going to succeed at a high level. If you want to punch the clock, you’re likely to realize only a limited amount of your potential. Yet at the same time, I have never heard of anyone who lies on his or her deathbed and declares that they wished they spent more time in the office all those years ago. So it really boils down to your own individual personality.