Ophthalmic technicians are an integral part of any practice’s team. They take on myriad tasks that remove bottlenecks in patient care and allow physicians to focus their energy on creating personalized treatment plans and performing surgery. Technicians conduct preoperative workups, fulfill the role of tester, and act as scribes. They operate equipment, gather and enter patient data into an electronic health record system, and optimize the clinical experience for both their colleagues and patients. Technicians also influence the bottom line by providing the support surgeons need to make faster, more accurate diagnoses.

A team of good technicians can help increase practice efficiency and meet the growing demands on eye care clinics. Many practices, however, are experiencing staff shortages that include the role of technician. In 2020, there was an average of three ophthalmic technicians for every ophthalmologist in active practice.^1,2 Given the increased health care demands due to the COVID-19 pandemic, this number is too low.

TWO FACTORS

Turnover rate. This is the first of two factors influencing the technician shortage. Many ophthalmic practices have experienced high technician turnover rates. Reasons for increased turnover include poor management, low salaries, minimal advancement opportunities, relocation, the offer of better benefits elsewhere, lack of professional challenges, change in profession, the pursuit of continuing education, and responsibility for raising children or caring for a family member.³

One way to combat a high turnover rate in your practice is to consider offering a more competitive salary and incentivizing technician performance with raises and promotions. In my experience, most managers are shocked to learn that what they are offering potential technicians is no longer competitive (see By the Numbers). According to 2021 statistics from Indeed.com, less than half (40%) of technicians believed that their salaries matched the cost of living in their area and their work responsibilities.⁴ Additionally, offering a sign-on bonus could mean the difference between someone’s taking a position with your practice and losing them to a competitor.

Providing technicians with incentives to remain with the practice can help prevent them from being poached by other practices that offer better pay and nicer perks and thus reduce the need to hire and onboard new technicians. This lengthy process affects the entire practice. It can also increase tension in the workplace as supporting staff are asked to take on additional tasks while a newcomer is brought up to speed.

Lastly, it is important to recognize that the issue of burnout is real—especially in the third year of the COVID-19 pandemic. Stressful workloads, a lack of support and adequate staffing, and increased patient numbers can all drive technicians to leave a practice. (For more on burnout, see “Physician Burnout in Ophthalmology.")

Certification. The second largest factor in the technician shortage is a lack of available ophthalmic technician training programs. Currently, there are no formal requirements to become an ophthalmic technician. As a result, some job postings for ophthalmic technicians include requirements for certification, whereas others do not.

In an ideal world, all ophthalmic technicians would receive formal training and certification. Not only are fewer resources required to onboard certified technicians, but it is typically easier to retain them compared to uncertified technicians who receive on-site training in the practice.

On-site training has long-term repercussions. First, it typically includes education modules that cover only the bare minimum of skills required to perform technician duties. Such training cannot compete with a specialized curriculum designed to teach technicians the fundamentals of ophthalmology and advanced concepts such as the use of Goldmann applanation tonometry for IOP readings. Second, uncertified technicians with no prior ophthalmic experience may be less confident in their work, uninterested in their work, and more likely to quit when the load becomes too great. On the other hand, individuals who invest in their own education are generally more committed to staying in their field and advancing in the practice (see By the Numbers). Like the strategies mentioned previously for combatting high turnover, offering pay increases and promotional bonuses to technicians who complete formal training can incentivize them to remain with your practice.

If your practice is in the position to only offer on-site training, the key is to use the proper resources. Books and other training materials are insufficient on their own. A classroom-like setting for didactic learning is a better approach. Additionally, a certified technician and/or one of the practice’s doctors should be appointed to mentor and train the new technician, and both a training schedule and reasonable competencies checklist should be instituted. Outside consulting firms can also be hired to provide on-the-job training.

INVEST IN YOUR TECHS

Retaining good ophthalmic technicians requires promoting their success. Encourage any tech who has not completed formal training to do so and offer to cover the costs of continuing education and skills courses.

Investing in your technicians can increase employee satisfaction and retention, build employee skill sets, build employee loyalty, enhance the practice’s reputation, increase engagement and morale in the workplace, ensure future growth and long-term success, attract top recruits, create a sustainable workforce, and boost the practice’s bottom line. If you are worried that technicians may leave your practice after they have become certified, consider asking them to sign a contract stating that they will stay with the practice for a determined length of time after they have completed their coursework. If they break the contract, they will be responsible for repaying the practice for their coursework.

CONCLUSION

Job security and financial stability are key drivers of job satisfaction. Additional factors include the opportunity to use one’s skills and abilities and the pursuit of professional growth and development. Incorporating incentives such as a more competitive salary, performance raises and promotions, and pay increases for completing formal training can motivate good technicians and encourage them to be loyal, long-term employees.

1. Parke DW II. The ophthalmology workforce. AAO. Accessed July 22, 2022. https://www.aao.org/eyenet/article/the-ophthalmology-workforce

2. US Bureau of Labor Statistics, May 2020.

3. Astle W, El-Defrawy S, La Roche GR, et al. Survey on allied health personnel in Canadian ophthalmology: the scalpel for change. Can J Ophthalmol. 2011;46:28-34.

4. Ophthalmic technician salary in United States. Indeed. Accessed September 6, 2022. https://www.indeed.com/career/ophthalmic-technician/salaries