Preparing for your future

Optometric Management, Sep 2000 by Epstein, Arthur B

Although I may anger some of you by saying this: Not that long ago, many of us stood in awe of ophthalmologists. This reverence wasn't because of superior intellect or skill it was because our M.D. colleagues could do many things that we couldn't.

Looking back, in 1975 more than a few O.D.s were terrified by the thought of instilling a drop of proparacaine into a patient's eye. Some brave souls slyly hid it in wetting solution bottles, but they were the exception.

Many believed we'd never use diagnostic pharmaceutical agents (DPAs) and rationalized it by saying that we didn't want to. Some of us insisted that using DPAs wasn't what optometry was all about.

Understanding the big picture

Thankfully, some of us grasped that what we did back then would shape our future. These visionaries sacrificed a good deal to make their dreams our reality.

Although therapeutic optometry isn't a panacea, stop for a moment and imagine optometry without DPAs and TPAs. Think about where we'd be politically. Think about your patients and what it would mean to them. Think about how you'd see yourself when you looked in the mirror.

How many cases of conjunctivitis ended up in some other doctor's chair? And how many patients did we lose because we appeared less capable than our M.D. colleagues did?

Eventually, incorporating drugs and minor procedures into our practices was a no-brainer for many of us. The frustration of not being able to use a binocular indirect (once you learned how) was enough to convince even the most timid O.D. that dilating drops were an essential part of optometry. And that was just the beginning.

Now, thanks to many of us taking advantage of our expanded scope, think about how many infections we've treated, how many foreign bodies we've removed, and how many patients have benefited from punctal plugs. All of these things wouldn't have been possible had we not expanded our scope of practice.

Keeping up with high-tech advances

But what still frightens me is that many of us don't seem to realize that our fast-paced, high-tech world makes the need to prepare for newer technologies even more pressing today than it was two decades ago.

Look at laser surgery, for example. Many O.D.s are questioning why all the fuss over something they'll never use? Why support it? What's in it for me? Hey, just because you won't use it in your office today doesn't mean that your junior partner (and his patients) won't depend on it tomorrow. Just a few years from now, it'll be no different than the dilating drops or the Rx pad that you rely on today.

The greatest need

Expanding our scope of practice is especially important in states where our colleagues had the foresight to prepare for the future with broadly written laws. The expression "if you don't use it, you'll lose it" has never been more true. If we don't take advantage of the latitude these laws rightfully provide us and stake out our territory now, we'll end up right back where we started.

You can argue that you don't know how to do that "stuff" and that it's not what optometry is all about. To tell you the truth, I've heard it all before. It made no sense then, and it makes even less sense now.

If you'd like to contact Dr. Epstein via e-mail, you can send your comments or questions to him at: artepsrein@artepstein.com.