In a time of great change, Optometry Australia is working to improve patient outcomes.
It’s funny how things tend to come in runs – nothing on a topic for months and then all of a sudden, everyone is calling to discuss the same thing.
My run this month has been queries about how far you can go in trying to get a reluctant patient to seek further care – or even to adhere to your own advice.
The retail market is challenging the income historically gained from ‘vision’.
A typical scenario: you diagnose a patient with glaucoma, mac degeneration or even a retinal detachment. They don’t want to know – don’t want a referral to an ophthalmologist, aren’t interested in the potential impact on their sight, certainly don’t want you discussing it with a family member or even their GP.
As a concerned health professional, you’re really worried; have you failed to do enough to convince them of the seriousness of the matter? No amount of talking or explaining will shift them – they are in denial.
So what do you do?
Firstly, everything you do will be recorded in the patient’s clinical record – copies of letters and emails, notes about discussions and recommendations. Copious notes.
Of course you do need to make sure that you really have made clear the essence of the problem and what the likely outcomes are if the condition is left untreated. If possible, do engage a family member in the discussion – but that won’t always be possible. If language is a barrier, get someone to interpret for you – if need be, use the telephone interpreter service. At the very least, take whatever extra time you need to explain matters to the patient.
Offer (as firmly as you can) to make an appointment for the patient with an ophthalmologist. Don’t just give the patient a referral and ask them to make the call – if they are this reluctant, they probably won’t.
If you feel that the patient either hasn’t or doesn’t want to understand (or is just avoiding the issue) write to them briefly, outlining the issue and re-stating your recommendations. Send the letter by registered post or email it if you have those details.
You could, if you are really concerned, phone the patient a day or two later to ask if they have had a chance to think about your advice and to see if they are now willing to seek further care.
However if, after all this, the patient does not respond, doesn’t keep their ophthalmologist’s appointment or simply tells you to leave them alone, then STOP! There is a line between care and harassment and you should not cross it.
As brutal as this sounds, everyone has the right to go blind or to die if they so choose. You can but advise – it is up to the patient to decide if they wish to accept your advice.
This is my last report for mivision. After an enjoyable, interesting and occasionally frustrating seven years in my role, it is time to move on. I have really appreciated and enjoyed the opportunity to work with, and for, the members of Optometry Victoria over these past seven years.
As we gear up for a state election in Victoria we have been in touch with the three largest parties to seek their ongoing support for the crucial role optometry plays in the delivery of primary eye care services. We have taken the opportunity to discuss important issues with the three parties and seek their written commitments to our election submission. The submission is available on our website and we will keep you informed about the responses from the the individual parties.
Our advocacy doesn’t stop with politicians. We still need to convince many GPs about the central role of optometry in primary eye care. We take every opportunity to promote optometry to GPs – including medical students.
The introduction of new Royal Victorian Eye and Ear Hospital referral guidelines last year saw an important step forward after many years of representation from Optometry Victoria. The guidelines highlight the crucial role of optometrists in primary eye care and will make a significant difference to referral pathways over coming years.
RANZCO ASO Challenge
The current challenge from RANZCO and ASO to a small increase in autonomy for endorsed optometrists is a frustrating hurdle in the natural progress of optometry. After 16 years of safe prescribing in Victoria their challenge has me shaking my head. In a recent meeting with the Victorian Health Minister we were pleased with the Minister’s understanding of the safe history of optometry prescribing in Victoria and his willingness to support optometry prescribing.
Optometry Australia and the six State Divisions are working together more than we ever have but sooner or later (and I hope it is sooner) we will need to take the step to become one legal entity instead of seven separate bodies. The Board of Optometry Victoria is committed to this goal as the sensible way forward. These are difficult times for optometry but I believe Optometry Australia is well placed to advocate for the important work you do every day.
I will finish up on 8 August and will be taking some time out before thinking about what comes next. Thank you to the many members who have sent me lovely thoughts and good wishes. I will continue to be an active advocate for optometry.
North Queensland Vision 2014 (NQV) is ramping up to be quite an event. Come and join us in tropical North Queensland and enjoy its famous reefs, spectacular scenery, fantastic weather and delectable local cuisine, all while gaining your annual CPD.
The 2014 clinical program incorporates an excellent array of lecture topics to suit all practice types, while still delivering over 40 CPD points. As in previous years NQV is offering complimentary optional online assessment, the gala dinner for full delegates and two sponsored breakfast lectures. Delegates will also be treated to a night of fantastic live entertainment, delicious food and excellent company all within an iconic Cairns location. This is a night not to miss.
NQV will be held over the Labour Day long weekend (Qld/NSW/ACT/SA) on Saturday 4 and Sunday 5 October in the comfort of the Hilton Cairns Hotel.
Visit the official NQV 2014 website at www.etouches.com/nqv2014 for information on the program, the gala dinner, all other convention details and to register. Or phone phone (AUS) 07 3839 4411.
Celebrating the Profession
Members from Optometry Queensland and Northern Territory are invited to join together for ‘VISIONaries: Past, Present & Future’ on Saturday 8 November at Rush CBD, Brisbane. This event will celebrate the optometry profession and its achievements over the past year. During a night of delicious food and impressive entertainment, we will welcome our QUT graduates and present a number of prestigious Qld/NT awards. Additionally, reunions will take place for five, 10 and 20-year classes.
Do you know a fellow colleague who has worked tirelessly for the profession? Don’t forget to nominate them… Nominations close on 15 September.
For further event information or to request an award nomination form, please email firstname.lastname@example.org or phone (AUS) 07 3839 4411.
In mid-June members of Optometry Western Australia volunteered their services at the Riverview Church Homeless Connect in Victoria Park.
Thanks to two optometrists, Antoinette Abouhamed and Bruce Willis, ably assisted by Jeff Gorton from Perth Scientific and his wife Sharon, we examined the eyes of more than 50 people who are homeless or in need of extra assistance. The people we saw were from diverse cultural backgrounds and from primary school age right through to the elderly.
On the day we gave out over a dozen readymade spectacles and during the following week we dispensed another 44 spectacles that were made up to meet the needs of those people. Once again the team at CR Surfacing kindly supported the event with the supply of all the lenses for the spectacles provided.
It was great to be involved in the Riverview Church program once again. Prior to this we were unable to be there due to a clash of dates with our annual WAVE conference scheduled for the same day, but with the event moved to June it helped considerably.
WAVE August 15–17
WAVE 2014 is looking fantastic with registrations almost to capacity and about to be closed off. Of course we will never turn anyone away and there’s always enough room on the ‘WAVE bandwagon’ for any interested in attending so if you would like to come along, please contact our office on (AUS) 08 9321 2300. The educational program we have planned for WAVE has been extremely well received and delegates have registered from as far as New Zealand and Singapore. Sunday, in particular, is jam packed with fantastic speakers including Mark Roth, who will speak on ‘Fabry Disease – Save Life with a Slit Lamp’ and local ophthalmologists including Assoc. Prof Dimitri Yellachich, Dr. Ian Chan and Dr. Mike Wertheim. Assoc. Prof Yellachich will speak on ‘Plaquenial Protocol Guidelines’ as well as the AREDS 2 study while Dr. Chan will provide a keratoconus update covering off collagen crosslinking and other treatments. We also have optometrist Adrian Bell presenting ‘Top Tips to Make Kids Examinations Easy’ as well as ‘Retinoscopy – the Forgotten Art’. Of course, there’s plenty more planned for the weekend – visit www.optometrists.asn.au/WA/ for details.
Rebranding Well Received
The recent re-branding of Optometry Australia and with it the State Divisions has been very successful. I’m pleased to say members have commented positively about the increased presence
the Association has already achieved in the media.
Thank you to all the local members that took part in the review and workgroups that helped get the rebranding achieved for all members.
Perhaps as a result in part of this new direction, the financial year has started on a high with a 3 per cent increase in membership numbers for Optometry Western Australia alone on last year.
I’d like to welcome back all those new and former members who’ve re-joined Optometry Western Australia – it’s great to have you with us or back and we are looking forward to your participation in the Division and to catering to your future needs.
Finally, I would like to take the opportunity to farewell two outstanding individuals who sadly will be leaving us. Optometry Australia professional services manager, Jared Slater heads off to commence a new career in academia and Optometry Victoria CEO Terri Smith. On a personal note, I would especially like that these two outstanding individuals who not only provided a fantastic and professional level of commitment to the profession but to the WA Division as well. Best of Luck to Jared on his future endeavours and I wish him and Lauren all the best for their future together also. To Terri, it’s been a pleasure working with you not just as a colleague but as a strong and motivated advocate for optometry and our members. Hope you enjoy your time away and I look forward to catching up again in the near future.
How’s your week been? Personally, I’ve had a fantastic week and am sitting at my PC fired up and suitably enthused to fly the flag of optometry, and to actively promote all that optometry practices have to offer the community and our medical colleagues.
I have facilitated three Professional Hubs for members recently: for independent practice owners, locums and ‘mums and bubs’ (my ears are still ringing from the sound from the crèche down the hall). I was both delighted and agreeably surprised by the optimism and passion in the room for what we do: optometry – vision and eye health.
One concept we explored was the fact that visually, optometry practices in general do not shout ‘eye health’; they shout ‘spectacles’ as convincingly as Dame Edna herself. Furthermore, the volume at which they shout ‘fashion eye wear’ and ‘retail’ effectively drowns our vitally important primary eye health message. If you think about it, it’s akin to expecting your patients to sit in a shoe shop and yet gain the necessary information to fully understand the health benefits of visiting a podiatrist.
My experience tells me that it’s not only the general public who are misinformed about the capabilities of contemporary optometry. Recent discussions with a range of health service decision-makers in government and Medicare Locals (as well as GPs and their clinic staff) have demonstrated that they, too, are largely unaware of the specialised education and equipment optometrists capitalise on to provide relevant, timely and cost-effective eye-health care to the whole family, at every stage of their life. I am totally energised by the plethora of light bulb moments I have witnessed across the table in recent weeks.
Even the recent budget announcements and ensuing media debate have led me to think about how much optometry has changed even since a ‘comprehensive eye examination’ was defined and costed in the Medicare Schedule. There is now so much more that optometry can do in that comprehensive eye health check that enhances patient care both in the moment and also in the information optometry can provide to ophthalmology for tertiary care, or back to the GPs for holistic health care management. I’m seriously hoping that the removal of the Medicare ‘cap’ can effectively provide an exciting opportunity for optometry to redefine what we do, outside the constraints of a Medicare schedule. In so doing, we should aim to charge appropriately for our significant professional expertise and modern diagnostic technology.
The public is used to paying for health care: at the chiropractor, the physiotherapist, the GP – the list is endless. It is also appropriate to expect them to pay fairly (by way of a gap payment) for optometry expertise.
I’ll end my column this month by throwing down this gauntlet to our optical dispenser colleagues. The retail market is challenging the income historically gained from ‘vision’. There needs to be a conversation between optometrists and dispensers about how to work together to realise the income on offer from the proactive promotion and delivery of eye health. Start by coming along to SA Blue Sky Congress from 6–8 November – we will be dedicating
a session to exactly this.
The Tasmanian Division like the other State Divisions and the National Association has participated in comprehensive consultation and implementation of Optometry Australia’s new brand and focus. As the influential voice for optometry we will be focusing on the professional needs and aspirations of our members as well as continuing to promote public awareness of eye health and the need for regular eye examinations to help prevent vision loss
and avoidable blindness.
Tasmania’s Lifestyle Congress
The 10th annual TLC will be held in Hobart from 22–24 August. The year’s theme continues on from last year’s celebration of the centenary of regulated optometry. Registrations are still open.
Keynote speaker this year will be Prof. Nathan Efron who will make his first appearance at TLC. Prof. Efron will deliver two presentations on contact lenses including the Sunday morning Contact Lens Breakfast. He will also present ‘Expanding the Role of Optometry in Diabetes Management’.
Dr. Laura Downie will present this year’s Keith MacKriell lecture, which also focuses on contact lenses. Adrian Bell, Paula Katalinic, Dr. Xavier Fagan and Dr. Andrew Traill will also appear on the TLC program for the first time.
The Australian Low Vision Seminar will again be held as part of TLC on the Saturday morning. Speakers this year will be Dr. Sharon Bentley, Dr. Alan Johnston and Graham Sheil. A CPR course is being offered on the Friday afternoon as well as two financial planning presentations. The Coopervision Congress dinner will be held at the Henry Jones Art Hotel on Hobart’s historic waterfront, just a short walking distance from the congress venue, which is The Old Woolstore Apartment Hotel.
Full details of the Congress program, including details of the speakers and the registration form, are in the TLC brochure which is available on the Associations website: www.optometrists.asn.au/tasmania. Further information is available: phone (AUS) 03 6224 3360 or email email@example.com