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BLOG: Primary care optometry moves mainstream
It is the time of year to think about resolutions. As this will be my last blog of 2018, written in the waning days of December, it’s a good time to not only to plan for next year but to reflect on the past.
I wrote my first commentary for Primary Care Optometry News on the role of optometry in primary care in 2013. This piece, “Today’s optometric physician provides primary health care,” started me on a new path in my thinking about optometry that has changed my practice, my health care consulting work and my teaching and has spawned this blog series.
In considering optometry’s role in primary health care, one of the first systemic diseases that come to mind is diabetes. In my old optometry paradigm, our role was to detect diabetic retinopathy and refer to a retinal specialist for panretinal photocoagulation. Our secondary role was to provide low vision care for partially blind and disabled members of the diabetes community who suffered the inevitable vision loss of diabetes complications. Times have changed.
We now know that diabetes is often preventable, can be aggressively managed and that the management can prevent or minimalize that end organ damage. We now know that, with diabetes, loss of vision is not inevitable. And for those of us who have carefully studied this disease, we know that the role of optometry can be the difference.
I penned another blog in my early work for this series, “Manage patients with diabetes as your first step on the road to primary care.” This piece, however, drew criticism from colleagues who felt that I was trying to change our profession into primary care physicians. I was told by some that we need to “stay in our own lane.” There was even an online petition started to keep me from advocating for optometrists to collect vital signs on our patients.
In another blog I wrote about state legislation that would assure we would be ready for primary care. After the publication of “Determining optometry’s role in health care reform,” I was asked by a state leader to please notify her if anyone other than me felt that optometry should move in into a primary care role. Well, today marks a turning point in my seemed “lone wolf” quest to this end.
In the November/December 2018 edition of AOA Focus magazine titled, “The great diabetes pandemic – Optometry’s role in solving a 21st century problem,” the rest of the choir has joined the song. This is an excellent and detailed edition with multiple articles on this timely topic. Written by Will Pinkston, senior content producer for the American Optometric Association, it features the work and comments by the experts in this field, including Michael Duenas, OD, chief public health officer at AOA; Tina MacDonald, OD, CDE; and A. Paul Chous, OD, CDE. There is also a piece on diabetes in young patients written by Lorraine Kee and featuring the work of David Masihdas, OD, the chair of the AOA’s Evidence-Based Optometry Committee, and Linda Chous, OD, chief eye care officer at UnitedHealthcare.
This edition of AOA Focus is a must-read for any optometrist who wants to continue to expand and grow our profession into the 21st century and beyond. It is a stark rebuttal to the old school leaders of our profession who continue to moan that there are too many new optometrists and that online retailers and vertically integrated optical companies are going to kill our profession. It is a shining example of how optometry must change and grow by sharpening our medical education, leveraging technology, collaborating with fellow health care providers and moving beyond the phoropter into a strong and meaningful profession.
And, so, back to my New Year’s resolution: I resolve to continue to learn more about diabetes, to add more diabetes prevention and management to my patient care, to collaborate with other health care providers and, of course, to pay my AOA dues!
Reference:
Pinkston W. The great diabetic pandemic – Optometry’s role in solving a 21st-century problem. AOA Focus, November/December 2018.