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Defining your perfect fit is harder than it sounds. It’s easy to list requirements without thinking through what each one means day to day. That’s why ETS Vision recruiters start every search with a framework called CLAMPS. The placements that last are the ones where the doctor’s goals and the practice’s goals line up, and that focus on fit is a big reason two-thirds of our business is repeat business.

What Is CLAMPS?

CLAMPS covers the six factors we’ve found have the biggest impact on whether a position works long term:

• Challenge: Scope of practice, clinical autonomy, and room to learn.
• Location: A specific city or type of area, and whether you want to live there.
• Advancement: A future title, equity, or a partnership or ownership track.
• Money: Base salary, bonus, benefits, and student loan help.
• People: The owner, doctors, and staff you’ll work with and the patients you’ll serve.
• Schedule: Patient flow, hours, call, and work-life balance.

How to use it

Before you start interviewing, decide what your ideal looks like in each area. Note which answers are non-negotiable and which have room to flex. Weighing positions by how important each factor is to you makes it easier to compare opportunities with one another.

A good understanding of all the factors that matter keeps one big number on an offer letter from outweighing everything else, and it keeps you from making a hasty decision. Accepting a position just to have a job rarely turns into a long-term fit.

Many doctors find their priorities shift once they talk them through, and they keep shifting over a career. A new grad might put Challenge and Money first, while a doctor with a young family might move Schedule and Location to the top. Revisit your priorities each time you consider a move or start a new search.

C: Challenge

Challenge covers the clinical side of the position. Get a clear picture of the work you’ll be expected to do day to day, which cases you’ll manage yourself, and how the practice approaches your clinical growth and autonomy.

Scope and autonomy

Ask how the practice handles autonomy to get a better idea of whether you’ll be allowed to practice to the full extent of your license or whether the practice controls what you can do. Some practices give doctors full ownership of their patients’ care. Others keep associates focused on routine exams. Look for the setup that matches how you want to practice.

Practice setting

Setting has a big effect on the cases you’ll see. If you want a full scope practice with a good mix of medical and primary care, retail usually isn’t the best first choice, since it tends to involve a limited range of medical procedures.

Mentorship

Mentorship is great for learning new skills, especially early in your career or if you plan to own or partner in the practice. Ask whether there will be a mentor you can work under and how the practice manages mentorship. We find most new grads prefer having another OD or MD on site to work with. That support helps them get comfortable until they’ve learned the patient flow and can work independently.

Equipment and CE

Equipment and CE show how dedicated the practice is to quality of care. Get a good idea of what that looks like when you shadow.

Look for a practice that lets you use your skill set and gives you room to grow.

L: Location

Location affects more than lifestyle. It shapes competition, earning potential, clinical scope, and work-life balance.

Metro vs. rural

Metro areas offer more practices, more practice settings, and everything that comes with big city living. They also draw more candidates, so competition for good positions is higher, and pay often doesn’t stretch as far with a higher cost of living.

Rural and smaller markets have a harder time recruiting, and they often make up for it. Our recruiters regularly see higher compensation, student loan repayment, more PTO, and a lower cost of living in these areas. With fewer providers nearby, ODs also see a wider variety of cases and get to practice medical optometry to the fullest extent of their license early on.

“Consider your compensation. Rural areas, or areas where fewer surgeons are willing to go, will have a higher compensation package.”

Chip Kidd, ETS Vision

For a closer look, read our article on the benefits of working in a rural optometry practice.

Live near the city, work outside it

You don’t have to pick between city life and a strong offer. One approach our recruiters often suggest is to live within 30 to 40 minutes of an urban area and look at practices within about 30 minutes of home. Many ODs find a great practice this way, with a larger guaranteed base, a better bonus structure, and stronger benefits than they’d see in the city itself.

Community

Look beyond the city name. Consider whether you have friends or family nearby and whether the area offers the community and hobbies you want outside of work. Do your research and visit before signing.

A: Advancement

Is ownership or partnership a priority? Make sure you’re clear about that from the beginning. Even if it isn’t a priority now, ask about it during negotiations so you understand what that path could look like.

Buying into a practice

If ownership is the goal, a private optometry-only practice is usually where you’ll find it. Many owners treat a sale as their exit strategy, either offering equity over time or the chance to buy the practice as they near retirement. Because these arrangements play out over years, the fit with the owner matters a great deal, and you should be confident you want to stay in that region long term.

Understand the terms and get them in writing

Not all partnership tracks look the same. A practice that mentions partnership in an interview may mean something very different from what you have in mind. Ask about the timeline, how the buy-in works, and when you’d become eligible. Then get those terms in writing.

M: Money

Compare total compensation, not just the guaranteed salary.

Get the real numbers behind the bonus

A bonus percentage means nothing without the numbers to calculate it from. Before you weigh an offer, ask:

• How is the bonus or production calculated, and when does it begin?
• What are current doctors realistically producing, and what is the average collection per patient?
• How often is the bonus paid, and what percentage of doctors reach it?
• Is there a cap on earnings?

Salary and patient volume have to line up. Seeing 10 to 12 patients a day won’t support a $150,000 salary, no matter what the offer letter says. With steady volume, a bonus can add $30,000 to $40,000 or more in some cases, so a lower base with an attainable bonus can pay more than a flashy guaranteed number. The same logic applies to surgical volume for ophthalmologists. A well-built plan lets both the doctor and the practice benefit as the doctor grows.

Look past salary

Most practices offer full benefits, typically health insurance or a stipend, retirement, PTO, CE, and malpractice coverage. Beyond that baseline, perks vary, and their value depends on you. Student loan repayment comes up in nearly every conversation we have with recent grads, and many larger corporate and PE-backed groups now offer substantial yearly amounts. For a doctor with heavy loans, that can mean more than a higher base.

P: People

People covers who you’ll work for, who you’ll work with, and who you’ll serve. You’ll spend a lot of time with your coworkers, so this factor often decides whether a doctor stays two years or twenty.

Know what kind of team you want

Decide whether you want a collaborative team where you can regularly bounce questions off other doctors, or whether you’re comfortable practicing on your own. Pay attention to the relationship you’d have with the owner, how the practice communicates, and how it handles busy days.

Shadow before you sign

If people rank high on your list, ask to shadow. Watching how doctors, staff, and patients interact will tell you more about the culture than any interview answer.

Expect a role in the community

Many practices expect their ODs to get involved locally to build a patient base and strengthen the practice’s reputation. In a smaller market, that involvement can grow your schedule faster than any marketing.

S: Schedule

Schedule covers patient flow, hours, call, and how work fits with the rest of your life. Many ODs, especially recent grads, put a high priority on work-life balance and a predictable schedule. Saturdays and late nights are among the most common deal breakers we hear from candidates. If either one is off the table for you, say so at the start of your search.

Get expectations upfront

Ask about patient flow, evenings, and weekends early in the process. If Saturdays are required now but flexibility comes later, find out what that path looks like and when it starts. Ophthalmologists should ask whether the practice covers hospital call and exactly what that call involves.

There’s more flexibility than you might expect

With the ongoing shortage of ODs, many practices are raising base salaries and offering flexible scheduling, including four-day or four-and-a-half-day weeks. If schedule sits near the top of your ranking, ask for what you want.

Start Your Search With ETS Vision

ETS Vision has helped optometrists and ophthalmologists find the right practice for more than 17 years. Our recruiters work with private practices, MD/OD groups, and corporate and PE-backed organizations across the country, and there is never any fee to candidates.

If you’re ready to put your CLAMPS ranking to work, send us your resume or search current openings at ETSvision.com.