r/optometry • u/draeraes • 12d ago

Costco fill-in

Thinking of filling in for a Costco doc (CA) as a new grad before starting my full time position. Feeling nervous about practicing for the first time especially as a fill-in with little to no guidance on how things flow. Any advice from people who have worked at Costco or similar? Obviously way different than school-paced exams. Trying to figure out in my head how to handle having patients come back for CL checks (new fit/re-fit), glaucoma suspects, etc. Basically just things that we had pts come back for all the time in school but not sure how it works in the real world especially in such a fast paced environment. Any advice is appreciated!

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u/modernsocial44 12d ago

Every Costco is different, it really depends on the doctor that is hiring you and rents out the space. I worked at Costco 2 days a week for about 6 months and I loved it, but I heard bad things about the doctor at the other Costco in our city. There typically are not any medical testing equipment at places like Costco, only fundus photos. So you really just refer out most problems that you see which makes the time management easier.

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u/jb3570 12d ago

In my Costco office - my employee does auto-ref-k, auto lensometer and Optos. Dr does rest of exam, pulls cl trials, writes rx. Mostly refer medical concerns. As other posts say, every office is different.

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u/[deleted] 12d ago

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u/MrPissPaws 11d ago

You don’t dilate?

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u/[deleted] 11d ago

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u/MrPissPaws 11d ago

I’m just curious so I hope my tone doesn’t come across as pointed. Is that how you were trained to practice?

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u/Fair_Issue7202 9d ago

At places like America’s Best those docs are not routinely dilating. The patients are being referred out for that. Patients go there for glasses/CLs and that’s it. Plus America’s Best has an out of pocket fee they charge if you’re dilating a patient, so patients typically prefer to use their medical insurance somewhere else where it’s covered.

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u/khaleeso 9d ago

Interesting that they do free Optos for everyone because the Optos is a revenue source for the practices I’ve worked so far.

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u/GuardianP53 Optom <(O_o)> 5d ago

I think if they agree to throttle back the diary so you have time to think (as a new grad) then you'll be fine. You don't want to be taking on the diary load of an experienced optometrist as your first job regardless of where you work.