The results of Ophthalmic Professional’s eighth annual salary survey suggest some of the changes brought on by the COVID pandemic and shutdown aren’t going away anytime soon. OP leaders discuss the findings of the survey — which included questions on salary, benefits, the work environment, and more — and what these findings say about the state of the eye-care support field and the apparent trends developing.

This year, 399 qualified respondents replied to our survey. Of the total respondents, 44.4% are ophthalmic technicians — both certified and non-certified. The second highest category of respondents at 22.7% are practice administrators/managers (Figure 1).

An in-demand and stable career path

So, what was the ophthalmic technician’s situation in 2021? She — 87.2% of respondents are female — is likely at least in her mid 30s, works full time (93.1%) in a private-practice setting, has a COA certification, at least some college education (although not a degree), a salary of about $40,000-$60,000 (Figure 2) — and enjoys being very much in demand in the job market, if a little stressed out. The ophthalmic professional also has stability: 60.5% report working in ophthalmic-related positions for 16 or more years, and 62.4% report working in the same practice for 6 or more years.

Stress and the tech shortage

Of the survey respondents, 59.3% said they “strongly agree” with the statement, “I have experienced an increase in workplace stress as a result of the pandemic,” with another 31.3% responding that they “somewhat agree.” The cause of that stress? More than half — 57% — cited “staff shortage” as the top reason (63.3% report decreased staffing levels at their practices over the past 2 years), with “increased responsibilities” a distant second at 20.8% (Figure 3). Veteran leaders in the field, however, noted that the staff shortage has been an issue long before anyone ever heard the word “COVID.”

One issue that has exacerbated the shortage is that programs for training ophthalmic assistants are few and far between, points out Lynn Girdlestone, COA, OSA, OSC, clinical operations manager for Swedberg Eye Care, Edmonds WA. In Washington state, for example, no such program has been available since 2018. She finds that fewer trade schools offer ophthalmology externships and practices typically no longer attempt to recruit new staff from them.

Bryan D. Ross, COE, OCS, administrator at See Clearly Vision Group, with locations in Arlington and Tyson’s Corner, VA, notes another challenge: The ophthalmic technician position remains largely unknown to the public. He thinks another obstacle is that it is a “niche position.”

“Nurses, physician assistants, etc — there are so many different positions out there. And they are multipurpose — you can go into doctor’s offices of various specialties. But ophthalmic tech is specifically for ophthalmology practices,” he says.

Add in COVID …

Yet without question, the pandemic has made the labor shortage worse. Patti Barkey, COE, chief executive officer at Bowden Eye & Associates, Jacksonville, Fla., and vice president for the American Society of Ophthalmic Administrators, finds that younger job candidates learned a significant lesson from COVID: You can work from home. Jobs that don’t permit remote work are seen as much less attractive.

For a field that requires face-to-face contact, “It’s really hard to deal with this,” she says. “A lot of the patients we take care of for cataracts, glaucoma, etc., are not as tech savvy, and they want to be seen by the doctor,” rather than park themselves in front of a screen.

Extra caution about any sign of illness has also added to stress levels. Some staff may feel resentment toward the people who call out sick because they have “sniffles and feel they must leave and get a test,” explains OP co-editor Jane T. Shuman, COT, COE, OCS, OSC, and president of Eyetechs. The result for those who show up for work: increased responsibilities and increased hours.

The solution: recruit and retain

How do practices cope with the staff shortage and find appropriate candidates to reach optimal staffing levels, which may help relieve staff stress? Indeed.com is a popular tool among the practices OP spoke with. Ms. Shuman reports practices have been successful with including phrases such as “No health-care experience necessary, will train if you have the right personality and a desire to learn,” and even “No nights or weekends” in help-wanted ads.

Carrie Jacobs, COE, executive vice president of operations for Chu Vision Institute in Bloomington, MN, says her practice has reached out to local universities. “We’ve had great success through college internship programs in finding employees as well as hiring aspiring medical and optometry students post-undergrad taking a gap year,” she says. “I’d rather find great people and train them than hire experienced technicians with habits that may not align with our culture.”

Ms. Barkey also recommends finding “great people” and training them rather than holding out for an ideal resume. “The hospitality industry is a good place to look for candidates. They work for tips, ie, approval, and they work long, late hours.”

Once a new employee is found, the training component cannot be neglected, according to Ms. Shuman. Without a training plan in place, the practice often soon loses the new employee.

Ms. Jacobs concurs. “New hires that have a solid training plan are more likely to feel engaged, able to contribute, and have job satisfaction, which is critical for retention.”

It’s also essential, says Laurie K. Brown, MBA, COMT, COE, of BSM Consulting, that the new employee be made aware of the potential for a career path. Otherwise, “they may not be motivated take on the responsibility and demanding work of the position.”

Education and certification

When asked for their highest level of education, 62.2% of respondents answered, “Some college or professional school.” A Bachelor’s degree was second place at 20.2%, and high school diploma (HSD) or equivalent was cited by 10.4%. These numbers indicate a slight decline in BA holders from last year’s numbers, with an increase in the non-college-degree holders. In 2021, “Some college/professional school” got 56.7%; BA holders 25.2%; HSD or equivalent, 8.2%.

Ms. Shuman says that, in her experience, practices are not putting a premium on a BA degree. “I think they are looking for people who are driven to learn and have a good communication style, who are basically nice people.”

Ms. Girdlestone says she appreciates “Culture add” more than “Culture fit.”

“Everyone has different experiences that they can bring to the table and not all of them involve higher education,” she says.

As for certifications and continuing education, the vast majority of practices continue to provide reimbursement: 82.0% reimburse for certification, 68.5% for recertification, and 69.6% for continuing education.

COA remained the most held certification, at 52.1%, and COT was at 24.0%. Nearly 18% (17.7%) report holding OSC certification (Figure 4). All three saw an increase from last year, when COA was 43.8%; COT 21.3% and OSC 11.8%

The spike may be linked to the COVID shutdown. Among her team, Ms. Barkey has found more are seeking certifications. She feels that the people who stayed and worked through the pandemic are the more conscientious employees and are more likely to pursue certification.

Mr. Ross agrees that the pandemic and shutdown play a role in the increase. He speculates it comes from staff simply having down time. “I got my COE certification during COVID, because I had the extra time,” he says.

Ms. Brown believes that the likelihood to pursue certification depends on the culture of the practice. “In practices where additional learning is expected, rewarded, and appreciated, leading to growth in the organization with clear career pathways, certification is prevalent.”

While certification tells the practice that the employee at least has the book knowledge of the position, Mr. Ross points out that other factors are important.

“It’s really about the skillset, their experience, how they work in a team environment, how they work with patients in terms of customer service,” Mr. Ross says. When practices conduct interviews, they are more focused on the candidate’s experience and personality than anything else, he says.

A “maturing” profession?

The largest age group of survey respondents are ages 56-60 (20.7%); second largest are 46-50 and 51-55, both at 13.3% (Figure 5).

Ms. Shuman regards this picture of an apparently aging workforce as one of the most notable of the survey’s findings. Ms. Barkey reports seeing the phenomenon in her practice and region. She attributes it to the disrupting influence of the pandemic on young people’s careers and education.

Ms. Jacobs speculates that there might be a geographic component to the impression of an aging workforce. “I’m in the Twin Cities metro in Minnesota and I’m seeing much younger ophthalmic techs, mostly millennials,” she says.

Raises

A total of 63.7% report they received a raise in the past year. That’s up slightly from last year’s 58.6%. For 78.8% of respondents, the increase was in the range of 1% to 5% (Figure 6). In 2021, 85.7% received a raise of 1-5%. However, the rate of respondents who received a greater increase — of 6% to 10% — saw a significant rise: 17.9%. In 2021, only 9.7% received an increase in that range.

Given the lingering pandemic climate, Ms. Girdlestone believes raises “have been more geared toward retention than performance.”

Ms. Jacobs thinks the higher increase in salaries is appropriate to reward employees who stepped up to deal with the added stresses of the last 2 years. “Some call them retention bonuses, but I like to think of them more as recognition bonuses. These types of unexpected recognition bonuses can go a very long way when it comes to feeling appreciated and thus promote job satisfaction.”

Work-life balance

Survey respondents also indicated which non-monetary benefits their employers offer, with paid vacation/personal time being the most common at 96.7% followed by training/assistance with professional development at 55.3% (Figure 7).

When asked to rate the most important non-monetary benefits, 72.8% chose paid vacation/personal time as number one. Flexibility with work schedule ranked second, at 18.3%. The practice administrators interviewed for this article are not surprised. Ms. Barkey finds all employees now expect more time off than they did even 5 years ago.

“I think when people got to work from home during COVID, they started to value that home time more, and that’s what they are looking for,” she says. “We can’t have them all working from home, so we’re trying to give them more time at home to do the things they need to do there, so they don’t burn out.”

In her work with BSM Consulting, Ms. Brown encounters the same phenomenon and says it transcends industries. Times of crisis, such as a pandemic, make people rethink their priorities. “Time is the commodity we cannot compound, save for, or get back as a return,” she notes. “Time for family and relationships and doing good things is important to most people at the core.”

“Employees value flexibility and the ability to have work-life balance,” Ms. Jacobs agrees. “It’s no longer a badge of honor to work 50–60-hour weeks.”

Ms. Barkey finds there is another non-monetary benefit employees find very attractive. “If you are in a practice that has multiple lines, like aesthetics or optical, being able to offer those tangible products to employees at cost, or, say, two pairs of eyeglasses a year or Botox, employees love that.” She advises practices put together a menu of services and/or products available that are free to the employee. She notes this benefits the practice as well, because the employee can recommend the service to the patient firsthand.

The longevity says it all

When asked how long they had worked in an ophthalmic-related position, the largest percentage of respondents — 22.0% — answered more than 30 years. The second largest percentage, 14.6%, answered 21-25 years, and the third largest category was 26-30 years at 11.7% (Figure 8).

Ms. Shuman regards these statistics as another notable finding of the survey. Combined, the top three groups total “almost 50%,” she points out. “It’s evident to me that people who get into ophthalmology, however they do, it gets into their blood, and they stick with it despite all the challenges — and there have been many over the past two years.” OP