In her career, optometrist Glenda Secor, a 1978 graduate of Indiana University School of Optometry (IUSO), has seen many changes affecting women, from the number of women in her classes to the length of lines to the ladies room at CE meetings.

Of the 79 students in Dr. Secors graduation class, only 13 were women. Thats up from only three women in the class of 1975. The faculty then was all male.

After Dr. Secor graduated, she encountered questions in job interviews that employers cannot legally ask today. An example: Do you plan to have children and quit? As a young female optometrist in the late 1970s, she felt she had to validate her commitment to her career. So, she chose to be active in local associations, which led to state and then national appointments. Today, she is chair of the Cornea and Contact Lens Section of the American Academy of Optometry. Becoming active in organized optometry validated my commitment to the profession to others, she says.

Today, women outnumber men in optometry classes. In 2005, nearly 24% more women graduated from optometry school than men, according to data from the Association of Schools and Colleges of Optometry (ASCO). And, in the 2005-2006 school year, women made up 42% of didactic and clinical faculty, according to ASCO.

Women are also catching up to men in the increasing numbers of practicing optometrists. In 2000, the American Optometric Association (AOA) Workforce Study estimated that there would be 24,953 male optometrists and 10,901 female optometrists in 2005. However, by 2007, the number of female O.D.s was expected to increase by 1,002 to a total of 11,973, compared with an increase of 156 male O.D.s to 25,109. The study also estimated that in 2000, 43% of O.D.s under age 40 were female.

Why Optometry?

The profession of optometry has been gaining popularity. This year, U.S. News and World Report and Money rated optometry as a top career choice.^1,2 Many optometrists say they chose their career due to a personal eye-related experience and a desire to care for people one-on-one.

But, some women who wish to enter a health-care profession say they chose optometry for another reason: It can offer them a work-life balance so they can have a career and care for a family. Optometry offers several career options, such as academia, private practice and commercial settings, and these options can help women balance work and family life, says optometrist Rhonda Robinson, who works in a private group practice in Indianapolis. This balance is a big issue for women because many want to have a career and be able to do other things with their life.

Although optometry can offer women a work-life balance, the profession poses several career obstacles to women.

Societys Perceptions

One such obstacle: Patients who question whether female optometrists can do what has been traditionally a mans job. When I began my practice, patients questioned my competency and seriousness, says optometrist Kelly Kerksick, who owns a private practice in Columbia, Ill. When patients came into my practice, they would ask my receptionist, Is he running on time today? she says.

Optometrist Diana Shechtman, assistant professor at Nova Southeastern University College of Optometry, says she occasionally encounters a male patient who seems disrespectful because she is a young female doctor. For example, after Dr. Shechtman discussed the potential ocular and health risks of smoking with a male patient, he responded, Honey, I have been smoking longer than you have been alive.

But I always enjoy a challenging case, she adds.

Dr. Shechtmans advice for handling such patients: accurately meet their needs. I try to determine what these patients need from me, such as sympathy or firmness, and I provide that to be an effective doctor and to get the patient to actively participate in his management plan.

Dr. Kerksick reports having difficulties with business transactions because she is a woman. I am buying a new office, and the bank wanted a spouse to co-sign the loan for me, she says. However, I dont think that many banks ask men for their wives to co-sign a loan.

To overcome this kind of challenge, Dr. Kerksick is always more prepared than she needs to be. I brought everything except a PowerPoint presentation to the bank with me.

Although some patients may question the competence of female optometrists, others prefer them to male optometrists. Studies examining patient preferences for physicians based on gender show that patients typically are more satisfied with female physicians than male physicians.^3-5

One study showed that patients of female physicians were more satisfied than patients of male physicians, even after adjusting for patient characteristics, visit length and physician practice style behaviors. In this study, female physicians spent significantly more time counseling patients than male physicians.³ In another study, patient visits with female physicians were about 10% longer than visits with male physicians.⁴ Female physicians also tended to engage in significantly more positive talk, psychosocial question-asking and emotionally focused talk than male physicians.⁴

In another study, women patients reported that seeing a female doctor is important to their relationship with their physician.⁵

Women often carry the traditional traits that they provide for their family, such as empathy, into the workplace, and patients tend to be happy with this, Dr. Secor says. Because women tend to be nurturing and open communicators, more women in optometry is a great thing for patients, says Dr. Robinson.

Patients typically are more comfortable with a specific gender depending on their personality, says optometrist Sarah Marossy, who owns a private practice in Coeur dAlene, Idaho. Men also have good qualities to offer patients, such as getting to the point quicker and spending less time chatting, and some patients of both sexes prefer that kind of doctor, she says.

Work Hours

Flexibility, one of the factors that drives women to optometry, means that women typically can work fewer hours. For example, women optometrists who graduated from the Pennsylvania College of Optometry (PCO) worked an average of 36 hours per week in the first five years after graduation, whereas male graduates worked 41 hours, according to data collected in 2005 by Larry McClure, Ph.D., assistant professor at PCO.

Also, men worked an average of 40 hours per week throughout their careers, whereas women began working fewer hours six years after they graduated, Dr. McClures data show. Women worked an average of 33 hours a week at six to 10 years after graduation, and 26 hours a week at 11 to 15 years after graduation.

Many women work fewer hours to raise their children, and they increase their hours when their children are grown, Dr. McClure says.

This raises an important question, however: Could more women working fewer hours affect patient care? I dont see this issue as a threat to patient care as long as other optometrists are available to see patients for emergencies 24 hours a day, says Dr. Marossy.

Currently, many optometrists seem to be more concerned with a potential overabundance of O.D.s, rather than a shortage of O.D.s. However, as women outnumber men in the profession, we could see reduced optometrist availability because more women will be working fewer hours.

To rectify this, Dr. Marossy thinks optometry will see more group partnerships and partnerships among female practitioners in the future. Such partnerships will offer women more opportunity to balance their work hours, Dr. Kerksick says.

Minority Faces Changing Slowly

Although the majority of the future faces of optometry will be female, many of these faces will still be white. Of all students enrolled full-time at optometry schools and colleges for the 2005-2006 school year, about 63% are white, 23% are Asian, 5% are Hispanic or Latino, and 4% are African-American. American Indians, Alaska Natives, Pacific Islanders and other ethnicities make up the remaining 5%. In addition, the number of minority optometry students has been stagnant for several years, except for a slight increase in the number of African-Americans students. Access to minority physicians can be important to patients. One study found that African-American and Spanish-speaking Latino men preferred seeing physicians of the same race or ethnicity because it contributed to a practitioners empathy.5 These patients also expressed concern about the lack of African-American and Latino physicians. Another study found that about 20% of African-Americans prefer a physician of the same race.6 Last year, a conference titled Minority Faculty Development Leadership Summit: A National Call to Action was held by the Department of Health and Human Services, Health Resources and Services Administration (HRSA)/Bureau of Health Professions so attendees could discuss the Minority Faculty Development Model. This model, which was proposed by the HRSA, will be used by health professional schools to train, recruit and retain underrepresented minority faculty.7 Optometry Students by Ethnic Identification School Year White Asian Hispanic or Latino African-American Other 2005-2006 63% 23% 5% 4% 5% 2002-2003 60% 23% 5% 3% 9% 1998-1999 63% 24% 5% 2% 6% Optometrist Melvin Shipp, dean of the Ohio State University College of Optometry, stated that many aspiring health professionals, particularly in the minority community, are not familiar with optometry as a career option. There is a need for a more diverse applicant pool for optometry schools and colleges, a need to recruit and retain individuals from underrepresented population groups and a need for a more diverse optometric workforce to satisfy the health-care needs of diverse communities, Dr. Shipp says. More minority optometry graduates could encourage more minorities to pursue careers in academic optometry, he adds. The Association of Schools and Colleges of Optometry (ASCO) Optometry Diversity Task Force recommends emphasizing the medical side of the profession to underrepresented minority groups that are not aware of optometry as a health-care career option.8 Last year, as part of ASCOs efforts to diversify optometric education and the profession, the organization awarded grants to four schools to conduct diversity/multicultural symposiums. These schools include Pennsylvania College of Optometry, Ohio State University College of Optometry, University of Houston College of Optometry and New England College of Optometry.

Two factors can account for this imbalance, according to the AOA. First, the median number of years in practice for male respondents was 25 compared to 20.5 years for female respondents. Second, female optometrists are more likely to be employed by others than male optometrists, and employed O.D.s earned an average of nearly $94,000 compared to nearly $149,000 for self-employed optometrists.

Another reason for the imbalance: Women work fewer hours than men, says Dr. McClure. Even so, this does not explain why women graduates from PCO earned a lower income than men their first year after graduation, when both men and women worked an average of 40 hours per week. In 2001, women surveyed by Dr. McClure reported average earnings of $74,175 a year, whereas men earned $81,538.

Dr. Shechtman believes that one reason an imbalance exists is because many men are more aggressive with salary negotiation than women. However, some women accept a job for less pay because of other rewards, such as flexibility. 

Dr. Marossy agrees. Vacation time, sick leave, insurance coverage and pregnancy leave weigh heavily on what a job is worth, she says. If a position doesnt offer premium pay but instead offers paid maternity leave, this could be a lucrative job offer for a female optometrist planning on having children in the near future.

Dr. Kerksick feels that the income imbalance could also be related to the lack of women currently in leadership roles, which is tied to higher pay. However, in the next 10 to 15 years, women will likely bridge this gap and take on leadership roles, so they will earn higher salaries, she says.

Owning a Private Practice

As of 2005, nearly 50% of male PCO graduates were self-employed one to five years after graduation compared with less than 30% of female graduates, according to Dr. McClures data. The number of self-employed women increased the longer women were in practice, but more men were consistently self-employed than women. For example, at 16 to 20 years after graduation, nearly 80% of PCO male graduates were self-employed, compared to nearly 60% of women.

Some women may feel uncertain about how they would manage a private practice, Dr. Kerksick says. Instead of admitting this uncertainty, they assume that owning a private practice is not flexible, and they do what theyre comfortable with, such as seeing patients in a commercial setting.

Ironically, commercials settings may offer less flexibility than a private practice, she adds, because the hours are more extensive and the stores limit what the optometrist can do.

Helping Minorities Show Their Faces

The National Optometric Association (NOA) is an organization dedicated to increasing the number of minority eye care practitioners through student recruitment and career placement. In addition, several schools and colleges of optometry have also recognized the demand for minority optometrists and have implemented programs to recruit and retain minority students. Some of these schools include: Pennsylvania College of Optometry. PCOs Office of Minority Affairs coordinates recruitment of minority and disadvantaged students and provides enrichment and counseling programs. For example, PCOs six-week, tuition-free summer enrichment program helps minority and disadvantaged students who have been accepted for admission and have completed PCOs prerequisite courses to adjust to professional school. The program includes mini courses, clinical observation and study skills. Also, the National Optometric Student Association (NOSA) at the Pennsylvania College of Optometry is dedicated to increasing minority representation in optometry. Some of NOSAs efforts include reaching out to the minority community by talking to students about the importance of optometry in the minority community, holding vision screenings to teach the community about the importance of vision care and tutoring NOSA members. University of Houston College of Optometry. UHCO offers the Texas Optometry Career Opportunities Program (TEXOCOP). The main goal of TEXOCOP is to add diversity to optometry. The program attempts to recruit students with disadvantaged backgrounds, enrich academic skills and knowledge, retain UHCO students, enhance entry qualifications for UHCO and provide information about financial assistance. Since TEXOCOP was founded in 1987, UHCO graduation rates for minorities have increased. For example, between 1955 to 1979, 0.6% of the students who graduated from UHCO were African-American, 2.6% were Hispanic and 1% were Asian.8 However, between 1988 to 2001, 3% of the students who graduated from UHCO were African-American, 11% were Hispanic and 23% were Asian. Ohio State University. OSU offers several resources for minority students. Specifically, the Diversity Enrichment Committee is composed of faculty, staff and students who are seeking ways to increase diversity in the college and its clinics. Also, OSU offers scholarships specifically for minority students. The Office of Minority Affairs provides services in academic advancement, specialized programs and lectures, mentoring and orientation programs for minority students.

Dr. Marossy cites three reasons for the current lack of female leadership in optometry:

         Women do not recognize the available opportunities.
         Women feel intimidated by the current lack of female involvement at
                 the leadership level.
         Women do not want to be involved in leadership positions because of current
                family and job responsibilities.

I think the lack of female leadership also reflects that optometry previously was a male-dominated profession, and many men continue to hold the leadership roles theyve held for years, Dr. Shechtman says. At Nova Southeastern University, we dont see this problem because the school is younger than other optometry schools in the U.S., so about 50% of our faculty is female, and many of these women hold high-ranking positions, she says. And, as more women graduate, entering faculty are more likely to be women.

Currently, women are beginning to catch up to men in the number of faculty positions they fill. For example, in the current 2005-2006 school year, men hold 53% of all clinical faculty positions at U.S. colleges of optometry, while women hold 47%, according to ASCO.

Still, men hold more high-level faculty positions (i.e., professor and associate professor) than women (i.e., assistant professor and instructor). For the 2005-2006 school year, 73% of the professors and associate professors were men, compared with 27% of women, according to ASCO. However, of the assistant professors and instructors, 57% are women and 43% are men.

Men also outnumber women in higher-ranking clinical faculty positions. Of the clinical professors and associate professors, 74% are men compared with only 26% women. However, of the clinical assistant professors and instructors, 56% are women compared with 44% men.

As Dr. Shechtman stated, men may hold more high-ranking faculty positions because they have been in these positions since optometry was a very male-dominated profession. However, as the face of optometry continues to change, more women will likely be promoted into these higher-ranking positions.

Some organizations are helping women move into leadership roles. These include:

Women of Vision. This organization was created in 2003 to provide education, mentoring, and networking opportunities for women optometrists. An organization for women was needed for several reasons, says Dr. Robinson, president of Women of Vision. First, there are now more women in optometry schools than men, so more women will be entering the profession. Second, women tend to have more work-life balance issues than men because they tend to work and take care of their homes.

Women of Vision provides a forum in which women can discuss these issues and how they manage them. It also is looking at ways to improve the work-life balance for women. For example, the national optometry meetings do not offer babysitting services, so many women optometrists do not attend because they need to care for their children, Dr. Robinson says. Women of Vision is looking into sponsoring babysitting services at next years OptoWest meeting to allow more women to attend.

The charter members of Women of Vision also felt that an organization for women was needed to offer women better access to mentoring. There are a variety of jobs that women can do in optometry, and many young graduates arent aware of all their choices, Dr. Robinson says. Some of these include academia, owning a private practice, working for a group practice, or working in a commercial setting.

Finally, this organization was needed because women with a support system are more likely to take on leadership roles, and expanding the leadership roles of women is a goal of our organization, Dr. Robinson says. (For more information on Women of Vision, go to http://www.wovonline.org .)

Optometry school programs. Some optometry colleges have programs to help women find and develop their ability to be leaders. For example, Ferris State University sponsors a group called Select Sixty, in which female faculty and administrators mentor undergraduate female honors students. The group holds monthly meetings at which speakers discuss leadership, networking and work environments.

Optometrist Nancy Peterson-Klein, associate dean of the Michigan College of Optometry at Ferris State University, has mentored a pre-optometry female student for the past two years. The mentoring experience has helped her better understand the importance of demonstrating strong leadership skills and serving as a role model to future women optometrists, she says.

American Optometric Association. Because the AOA is a federation of state affiliates, leadership development begins at the state and local level, says optometrist Kevin Alexander, Ph.D., vice president of the AOA. Currently, 13 women serve as state presidents and 11 as president-elect. Also, eight key AOA committees are chaired by women and one woman serves on the Board of Trustees, he says.

Nationally, more women are serving in the AOA volunteer structure than ever before, Dr. Alexander says. And I anticipate that even more women will step up to AOA leadership roles after having acquired excellent leadership training at the state level.

The AOA and its affiliates encourage women to take an active leadership role in optometry, as they are the key to the professions future, says optometrist Richard Wallingford, president of the AOA.

Since women have recognized that optometry is a career option for them too, they are taking their place in the profession. Their expansion into academia and some leadership roles demonstrates that many women will work to overcome professional obstacles and make their mark on the profession. Other female optometrists will divide their time between giving their best to their patients and their families.

Whatever route they decide to pursue, the future of optometry will likely be in womens hands. Says Dr. Marossy: It is our responsibility to step up to the plate and take charge in the coming years.

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