Where did you attend optometry school? Do you have any school advice/study tips?

• Inter American University of Puerto Rico
  

Which one thing that you learned in optometry school do you use the most in your daily practice?

• I am not sure I can name one thing I use daily, but I do know one thing I learned that I absolutely do NOT practice by: steroid's are your friend, not to be feared.  I was terrified of steroids coming out of school but have learned through clinical practice that they are your friend and should be utilized way more than any boards prep course or pharmacology class led on.  For reference, look up the article in 2019 Clinical Guide to Ophthalmic Drugs.  If you do not know what guide I am talking about, look it up!
  

Did you do a residency? If yes, what area and would you recommend it to others?

• No residency.  Residency should be decided on a case-by-case basis.  Everyone is different. 
  

Where do you practice now? Pros & cons? How did you end up there/make the choice to be there?

• Clarity Vision of Apex in North Carolina.   I started my optometric career by practicing in NYC, but quickly decided down south is where I ultimately wanted to be.  I did some research and NC seemed like the best state for me.  Raleigh had all the characteristics of where I wanted to lived (a weekend trip from family, the beach, an international airport allowing easy travel, a large young professionals population) but also a great scope for Optometry-- a much better scope than NY.  After sitting for the state board and negotiating through 3 contracts at different private practices in the area I ultimately ended up in the suburbs at my current private practice. I turned down two contracts before settling on my current Private Practice. Don't be scared to negotiate whatever you feel essential and important to you and always have the courage to walk away if you have even the slightest negative gut feeling.
  
• Pro's:  I am twenty minutes from the office-- far enough to way to not run into my patients at the local grocery store, something I prefer not to happen.  I am not small town enough in that way.  I am confident in my practice choice because I was selective and spoke up about my wants and desires.
  
• Con's:  Twenty minutes easily turns into thirty minutes when I hit traffic. 

What state do you practice in? What are the benefits and drawbacks of practicing there? 

• North Carolina.
  
• Drawbacks: the state board oral examination.  Do your research before deciding to sit for the exam!  Never hesitate to reach out to others currently practicing in NC for any insight, advice, tips, etc. It is 100% doable with the appropriate preparation.
  
• Benefits: great scope allowing little-to-no restrictions.  There is a great rapport among practitioners in our state, which I think exists because of the oral examination.

Do you have a specific patient demographic that dominates your area and if so, how have you adapted your practice to serve them better?

• While I am in a suburb, I do serve a large Indian and Asian demographic.  Cultural competence can carry you far if you take the time to do research to better understand.  It will allow you to 1.) better understand you patients needs, why they carry the concerns they do thus allowing better patient communication and 2.) better treat and manage diseases that are more prevalent in that specific race-- this goes for systemic diseases as well!
  

Do you own your own practice? How did you join/open it? How long have you been there?

• I am an associate within a group private practice.  We have 6 locations, but all offices are recognized and operate independently.  This allows the freedom for each location to act and operate in their own best interest but gives us the privilege to be recognized as a large group among industry (great from a business standpoint).
  
• I joined the practice officially in March.  We are a three doctor location, including myself.

What was your most valuable resource when getting involved in your initial private practice setting?

• Mentors and industry representatives!  Optometry is a small profession where everyone knows everyone.  I found it to be wise to do homework on the practice and its OD's.  Getting acquainted with the local drug and industry reps could also be very beneficial as they are eyes and ears of practices and can give you unbiased insight.
  

What outside services do you use to help manage/elevate your practice (patient recall services, social media, buy-in groups, CPA, financial advisor, lawyer, etc.)?

• We are a VSP Premiere Practice, which does a lot of our patient scheduling for us.  Being a Premiere Practice elevates us towards the top of the list when a patient is selecting a doctor through their vision insurance network.  Additionally, the exclusive rebates and offers accessible to the patient is showcased to them when selecting their Optometrist.
  
• Within two weeks of starting and accepting new patients I was coming into work every day with a completely booked schedule. This was in part of being a VSP Premiere Practice and because we are a high volume practice and I am the only full-time doctor.
  
• As for personal finances, I found it to be helpful to have a financial adviser that was specialized in healthcare providers.  This established trust and confidence to take financial advise from someone who was familiar with massive amounts of student loans.
  
• As for buy-in groups: they can be very beneficial and helpful in elevating and growing your business.  But I challenge you to do your research and decide how much of that you would be able to do on your own.  Put yourself in a position where you possess the knowledge to do the things on your own, too. This allows less dependence on industry and vision insurances and more control from the practitioner.

What is one thing you wish you knew before you started practicing?

• Being a doctor is easy.  Learning the language of insurance, billing and coding is hard. Also, building patient rapport is done with time and not a guarantee because of your degree on the wall.

What tips do you have for hiring/training staff and how do you motivate them?

• This is a great question! I am not involving in the hiring process as we have two office managers for that task, however, I will jump in with training technicians on things I find crucial to my patients work-up. Motivating my staff comes with developing a relationship with them. Get to know your staff and small personal details about their life: do they have any pets or children and if yes, what are their names? Is their family local or did they grow up somewhere else? Those small details can allow you to carry a short conversation a long way and demonstrate you care about them by remembering things about them. I have a post-it note under my laptop at my desk that has small details in case I forget. When they feel you care about them it is easy to correct errors they may consistently be making or talk to them about any issues that might arise. I am huge on positive feedback, as well. Patients can be tough sometimes and will say things to the technicians and staff they would never say to the doctor. A small compliment can help erase the small battles the staff faces that we do not.
  

What have you done to set yourself apart from other eye care professionals near you?

• I call certain patients and give them my email address to reach me if needed.  Taking that one extra step (a phone call) a few days after their exam to show them that you're still thinking of them will take you FAR! Additionally, giving them my email opens the door for any doubt they might have concerning treatment they're undergoing from you. I've only given my number out a handful of times for serious conditions I've detected that require further testing such as an MRI. It opens the door for them to pick your brain in times of worry, something few providers do for patients. Both times I did this for stroke patients they did in fact call me while awaiting their MRI results from the ER, so chose wisely!
  

Please add any additional thoughts or advice for our members.​

• Some days you will be the best provider you can be and some days patients will pick you apart. Everyone goes through this-- push forward and keep putting your best foot forward!
  

If you have any further questions for Dr. Bianca Augustino, her email is: [email protected]