Real-World Lessons From a Rural Practice

Someone once asked me why I practice rural optometry. That request made me reflect on my path and realize just how important and satisfying practicing in a small town has been for me. It’s not just about geography. It’s about the opportunity for growth, the relationships formed and the difference you can make when resources and options are limited.

PRACTICING AT THE TOP OF YOUR LICENSE

Being in a rural area means you rarely have a specialist right down the street. For us, there’s no immediate retina or cornea expert nearby. That is both a challenge and a privilege. It forces you, as a practice owner and optometrist, to stay on your toes and expand your knowledge so you can handle as much as possible in-house—because when a patient needs to drive several hours for a consultation, it isn’t just an inconvenience for them. A family member will likely need to take a day off from work to drive them to the appointment. This makes every bit of care you can provide locally all the more meaningful.

A rural practice pushes you to learn and resource up, not just for your own growth but to serve your community. The way I see it, we get to see a little bit of everything, and our skills must stretch accordingly.

I currently lead a single-location practice in Martin, Tennessee. My daughter-in-law recently joined as an associate, turning us into a two-doctor team. We have eight support staff members and see between 100 and 120 patients per week.

Breaking it down, about 40% is traditional eye care, glasses and contacts. The remaining 60% is medical: monitoring or treating glaucoma, macular degeneration, diabetes and other eye diseases. That split keeps each week interesting and full of variety.

ADVANTAGES AND REALITIES OF A RURAL PRACTICE

One of the clear advantages to rural practice is the chance to do more at the top of your license. The market isn’t oversaturated. In our county, only three optometrists serve the entire population. The next nearest eye doctor might be more than a few towns away, and just across the border into Kentucky, many counties don’t have an optometrist at all.

This means we see lots of different cases—and sometimes unusual ones. It’s rewarding to solve complicated problems when there isn’t a specialist nearby. But you also need to recognize the realities:

• It can be tougher to attract or keep employees who crave the city lifestyle. Entertainment, restaurants and shopping options just aren’t the same here.
• Even simple conveniences, like having multiple grocery stores or a nearby airport, aren’t guaranteed. My closest major airport is a three-hour drive away.
• For outsiders, the quiet and the tight-knit community can be an adjustment, especially for family members who may have fallen in love with big city perks.

I grew up in rural Florida, so moving to Martin felt like a natural transition. But if rural life is a big change for you, you should be upfront with yourself and your family about what rural life will be like.

INVEST IN YOUR EQUIPMENT AND YOUR TEAM

Serving a rural community means you need the tools to handle whatever comes through the door. In my office, that means having wide-field photography, optical coherence tomography (OCT) for retina and nerve, OCT angiography, topography, electroretinograms (ERGs), meibography, intense pulsed light (IPL) and low-light therapy (LLT). Patients invest in us, so we must invest in technology that will enable us to practice at a high level.

Buying this equipment is a big investment, but it’s necessary when you don’t want to send your patients on long trips for care. We added IPL and LLT during 2020, which was, in retrospect, quite a challenging time to make such an investment. Still, patients have been receptive, and yes, it is profitable if managed wisely.

When it comes to recruiting in a small town, it’s not about posting ads and sifting through resumes. I regularly ask my team for recommendations when we’re planning a new hire. I also pay attention to customer service experts I meet in daily life—at the bank, for example, or at the local hospital. When someone stands out, I approach them and ask if they’re interested in trying something new. That personal connection goes a long way.

IS SPENDING POWER REALLY LOWER IN RURAL AREAS?

There is a real misconception that rural patients can’t or won’t spend on out-of-pocket procedures. I’ve found that’s not true. People here have iPhones. Many are part of the farming community where equipment like combines and tractors often costs more than the average home. People will invest in their health if you educate them about the value. Insurance coverage or not, patients want the best care—and many are willing to pay for specialty services.

Marketing in a rural setting is less about billboards or big ad buys and more about word of mouth and community involvement. Good care sparks conversation, and happy patients bring in their friends and family. I make it a point to thank those who refer others, sometimes with a handwritten note. I’m also active in local organizations, serving both area hospitals and participating in the local university’s annual health fair.

THE CHALLENGE AND JOY OF WEARING MANY HATS

Most rural practices are still independently owned, which means doctors aren’t just doctors—we’re business owners, managers and sometimes even bookkeepers. That can be daunting, since not many of us went to school for business. It’s both a challenge and a pleasure because I’m shaping not only my practice but also my role in the community.

I’m grateful for strong professional networks and mentors—fellow rural doctors, my Vision Source group, and others have helped me learn the business side and reminded me to be the best provider I can be. Over time, I get to pay that forward by mentoring and encouraging the next generation.

Thriving in a rural practice isn’t just about serving a need or avoiding competition. It’s about connection. You need to be as comfortable running a business as you are running an exam, and you need a team who shares those values. For me, all the little moments of connection and teamwork add up to a fulfilling career. Rural optometry isn’t for everyone, but if it calls to you, it can be one of the most rewarding paths you’ll ever walk.

For more on rural optometry, read “The ROI of Practicing Optometry in Rural America” here.

Read more Professional Development stories on Independent Strong here.