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Saturday / April 20.
HomemicontactThe Practise of Optometry Pearls to Make it Great

The Practise of Optometry Pearls to Make it Great

Feeling despondent about your chosen profession? There’s no need to be. The following comments from colleagues, compiled by Alan Saks, provide useful advice on how to keep things fresh in practice.

A recent social media post by an optometrist raised some interesting questions. The responses provided valuable insights.

The Kiwi practitioner posed the question, “It scares me to think that after university, what we do on the first day of the job will be the same as on our last day before retirement. Does that mean we learn nothing along the way?”

We can’t possibly imagine how everyone feels or thinks until we’ve experienced more of life and even then, people’s experiences and reactions to situations differ enormously

He also asked:

  • What skills make an optometrist truly great?, and
  • What did university not teach you?

The post went on to say that something he really struggled with (and was actively addressing) was communication:

  • How do we ‘read’ another person; interpret their body language and reaction?, and
  • When a patient says ‘I understand’, does it really mean they do?

Optometrists are, by nature, generous people and in this instance they didn’t disappoint. The advice they provided for this practitioner’s consideration was both bountiful and thought-provoking, as you’ll see in the text that follows.

As one wise respondent said, university cannot teach us everything; it merely provides us with a scaffold, and takes us to a point where we are safe to be ‘let loose’ on the public. It’s up to each practitioner to enhance that knowledge, fine-tune skills through self-motivated learning and to make optometry into what we would like it to be. This changes over time.

Or, in the words of the American writer and professor of biochemistry, Isaac Asimov, “Education isn’t something you can finish”.

On Communication 

We need to hone our skills in the essential cornerstones of care: communication and empathy. Some suggested doing this by making small talk, with people of all ages, on buses and in supermarkets. In the consult room, build rapport by getting to know about a patient’s family, hobbies, sport, travel etc. Ask about their job and find some way to relate to it.

We need to address cultural differences and language barriers to ensure patients feel comfortable and safe in the consult room and in the practice.

We can’t possibly imagine how everyone feels or thinks until we’ve experienced more of life and even then, people’s experiences and reactions to situations differ enormously.

Listening is a critical skill: sometimes we are more counsellor than optometrist.

However, many people don’t tell us everything, so being a good detective and asking probing questions is important.

On Clinical Understanding 

Some people are terrified of eye exams, so it’s important to take cues from their body language and to take the time to reassure them.

Remember that although we may have described cataracts/glaucoma/myopia/ astigmatism thousands of times, the person we are addressing is often hearing it for the first time. This means that they may only absorb 20% of the information and understand less than that. Take time to explain the condition thoroughly and address any concerns or questions.

My father taught me to use a flip folder of diagrams he hand drew, to easily explain such things. I used them over my four decades in practice. Today of course we might use an iPad and follow through with handouts, pamphlets, brochures and/or an emailed PDF or YouTube video.

On Career Development 

Most commentators said their routine today was definitely not the same as the day they started. They recommended ‘evolving’ to avoid getting bored; don’t just work in the practice, serve on boards and committees, work at an ophthalmology practice or teach and examine optometry students.

A recurring theme was to make each patient interaction fun, interesting and as enjoyable as possible for all concerned. The same applies to continuing education: have some fun while learning.

On Technology 

To keep life interesting and provide the best eye care, invest in, adopt and understand state-of-the-art technology.

Although some optometrists use assistants for pre-testing to save time, it can be immensely valuable to do some of these tests yourself. This provides a golden opportunity to showcase your technology and explain the key features of an individual’s topography, optical coherence tomography findings or widefield retinal imaging. It also provides an opportunity to observe tear film stability during a topographic capture, observe abnormal blinking, read the body language of nervous patients, and so on.

Use your iPhone to shoot a 30-second video through the eyepiece of the slit-lamp, of your patient’s cataract, tear film, meibomian gland dysfunction, rigid gas permeable lenses, fluorescein staining etc. Screenshot the best image for show and tell. Your patients will be impressed, plus they’ll be able to see that the cataract you’ve told them they have is not a pterygium or cancer…

If your skills and superior technology help you discover things that less thorough practitioners have missed, your patients will not want to go anywhere else. Those patients will age with you, they’ll tend to follow you around, and they may also refer their friends and family. But accept that some people, including friends or family, may not want to see you. Don’t take it too personally.

Other Tips for Long-lasting Practise 

  • Surround yourself with great people – a toxic work environment is just that,
  • Be yourself. Be friendly, approachable and centred on patient needs,
  • Learn not to be anxious when making recommendations or sharing bad news,
  • Display an air of confidence – but avoid being arrogant,
  • Take your time and use the time available,
  • Explain what you’re doing and why,
  • Keep detailed, accurate records,
  • Send thorough, concise reports and referrals,
  • Stay up-to-date and learn something every day,
  • Sit in with colleagues to observe their special skills, perhaps watch your friendly ophthalmologist perform surgery,
  • Join societies like the Cornea & Contact Lens Society (of Australia or New Zealand) and/or the Australasian College of Behavioural Optometrists etc.,
  • Create or join a study group,
  • Don’t be afraid to tweak your techniques, and
  • Enjoy a work life balance to keep things fresh.

There’s much more to making your career in optometry enjoyable, rewarding and stimulating, but hopefully these pearls will set you on the way. If or when it is no longer so, it may be time to retire or find another profession/job.

Thanks to all those who contributed their experiences, ideas and advice.