It was never a conscious decision to live half a mile from my office. I moved to Highland Park, NJ six months before graduating optometry school and knocked on the door of the local OD to ask for a job. It took two years but we became a team. I had no ties in the community, so all the patients were strangers, and it was easy to keep my private and professional lives separate. As time went on that changed, and my exam room became filled with my UPS guy, my pharmacist, and, trickiest of all, my friends and neighbors.

Short of hibernating in a cave, how do you balance professionalism with being an active member of the community? There are a multitude of tricky scenarios which if not dealt with correctly, could set a precedent for future unpalatable behavior and make practicing difficult.

Acknowledge that patients will have access to your home number and address. Be prepared for the occasional desperate call, or patients showing up at your house. A couple came over in a blizzard with their baby, who scratched his eye. In pajamas, I evaluated the situation and made a call to the pharmacy. If necessary, I would have opened the office. Emergencies happen, and patients rarely abuse our friendship. Patients who you help in these situations are forever loyal. It also gives you that tingly “this is why I became an OD” feeling.

Also common is the inelegant chance encounter. The other day I was dripping wet at the gym, wrangling myself out of my bathing suit. A patient moseyed up and says, “Hey doc, my eye is red, can you take a look?” Unruffled, I informed her I couldn’t evaluate it without equipment. I told her to call the office and tell them she met me at the gym and needs to be seen that day. The patient felt like a VIP and the doctor/patient boundary was (mostly) unbreached.

The absolute worst, I’m-moving-to-Guam-this-second, situation is when the locals have outstanding bills. How do I send my neighbor to collections? If I know someone’s lost a job, I’ll have my biller write a personal letter asking them to call. Sometimes things don’t resolve well, and it’s uncomfortable but unavoidable to meet these people socially.

Other things come up, like forgetting names when you see patients out, or deciding which charities to donate to. Each situation has to be dealt with on a case by case basis; I rely on my instincts. The key to managing this is to embrace the awkward.

Patients will see you without makeup, taking a trashy novel out of the library. This is good. It makes you a person. Working where you live has its challenges, but the rewards of caring for people you know are immeasurable.

CHANI MILLER graduated from SUNY in 1993. In 2015, she bought her practice and has been living the joys and horrors of being a practice owner. She has raised two daughters with her husband of 29 years. You can find her on Instagram @ccspecs or This email address is being protected from spambots. You need JavaScript enabled to view it..

This article originally appeared in the May 2018 edition of INVISION.    

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Optometric Practice in a Small Town

Practicing in a small town gives you the diversity and opportunities to practice full-scope optometry. See how one OD found professional and personal fulfillment in a small town.


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