Doing the same tasks in the same way, day-in day-out, in the workplace can mask individuals to the fact there is often more variety on offer for those who seek it. Optometrists are in the fortunate position of having several settings to work within and, for those who find the four walls of a consulting room confining at times, it may be time to consider life on the road as a provider of domiciliary eye care.
To find out more about the reality of domiciliary work, I spent a day riding along with Kejal Shah, domiciliary optometry partner at Specsavers Home Visits. Shah primarily covers the county of Surrey and picks me up early from Shalford train station with nine appointments scheduled in the area over the working day ahead.
As part of the company’s efforts on sustainability, the Specsavers Home Visits car fleet includes electric and hybrid vehicles. Today, Shah is driving an electric VW ID.4 that boasts a wide array of driver assistance features that make for an easy and stress-free ride between patients.
Intrinsic benefits
Arriving at the first patient’s location, a retirement home, we don our masks and meet up with the optical assistant (OA) who is working with Shah today. The home has a resident cat and dog that are both pleased to meet us. Shah takes the lead with the patient, who has dementia, and puts them at ease.
This is the first time that Specsavers Home Visits, which is celebrating its 10th anniversary this year, has seen this patient and there are some gaps in their case history, which requires some gentle questioning and a bit of detective work. Shah sets up the sleek looking equipment, carries out the eye examination, before handing over to the OA for dispensing of frames if required.
At that point, Shah leaves to travel on and begin examining the next patient, who is roughly five miles away, with the OA meeting us there a few minutes later once the initial patient’s dispense is complete.
The next patient is in their own house and Shah, once again, assesses the environment to identify a good position to carry out the examination. Communication is very important in this line of work and Shah outlines recommendations and presents choices in simple, clear language. In this case, she recommends a photochromic pair of lenses as the patient loves spending time in their garden.
In addition to the OA, Shah is backed up over the course of the day by an office-based member of staff who she connects to via phone regularly. This proves essential as the next two patients are not at their houses and the office assistant attempts to bring existing appointments forward in the day and sees if any additional patients can be added to the day’s schedule. Any rescheduling considers location and the need to optimise Shah’s time with patients.
‘It’s not unusual to have the occasional patient cancel,’ says Shah. ‘Our patients are vulnerable and are sometimes taken into hospital, other times they simply forget.’
A new route is planned quickly and we move onto the remaining patients. A patient suffering from Parkinson’s disease in a retirement village tells me how a new pair of glasses will allow her to resume watching her favourite Alfred Hitchcock films and communicate better digitally with her family. It’s very striking throughout the day how the patients benefit massively from the domiciliary service, both in terms of the medical service and just having someone to talk to.
Varied offering
I think it is fair to say that optometrists looking to make the biggest difference to patients’ lives would do well to consider the domiciliary setting. I ask Shah what attributes domiciliary optometrists need.
‘I think the domiciliary life can suit most optometrists,’ says Shah. ‘There are no right or wrong personalities for it, but you do have to be kind and empathetic towards the patients because they are a little more vulnerable than the patients typically seen on the high street. I think the vast majority of optometrists are in optometry to be patient facing and to help people that need them, and therefore can do this job.
‘I find that it is a very rewarding career compared to working on the high street. This is because all of these patients really, really need us and you’re making a much bigger impact to their day-to-day lives,’ she adds.
Shah also notes that no two days are the same in this job: ‘One day you’ll be around a town for the day and then out in the countryside the next day. You’ll see all different types of patients so it’s not monotonous. You tend to see a lot more pathology than you would in some other settings and I think that the variety is part of the beauty of this job. You see so many different things and it’s not just a standard refraction every time.’
Optometrists interested in taking a closer look at domiciliary life can book a shadow day with Specsavers Home Visits where they would accompany an experienced optometrist out and about. For those who do want to ultimately move into the sector, Specsavers runs an extensive training and induction process.
‘Once they have been out for a shadow day, they will know exactly what the life of a domiciliary optometrist is all about and whether it’s something that they want to be part of,’ says Shah.
‘The induction process is really good, and we offer every assistance until they are comfortable to go out without a fellow optometrist. Our OAs are very good at what they do and they’ve got great clinical knowledge as well because they’re always in the testing room with you. That sense of teamwork between optometrist, OA and scheduling team makes a huge difference.’