Luke Haynes reports
Optician readers have been reacting to last month’s article by Michael and Joshua Mandel, two pre-reg optometrists. They put forward an argument begging the important question of whether optometrists should have the title ‘doctor’. Responses have since flooded in from practitioners who agree that the use of the title would elevate the status of the profession and those who feel clinical skills still have some way to go. Below is a selection of the responses plus some comment sought by Optician from opinion formers and leading optometrists.
‘Doctor’. I have always struggled with this term. Considering the simple origin of the word and its use today, in multiple industries, it surrounds itself in ambiguity. However, within the community, I firmly agree that the term serves a purpose as an instantly recognisable title that the general public can identify with and hopefully, trust. Regrettably, the issue arises because there is a disparity between the meaning of the title ‘doctor’ and the commercially deformed landscape that the majority of optometrists find themselves in. When a patient presents to you waving a ‘free eye test’ voucher it should make you feel uncomfortable because as long as our time and expertise are being sold to the masses for free, we must concede that our training will always be undervalued and therefore the prefix is somewhat inconsequential.
However, I am in favour of anything that intends to elevate our profile as healthcare professionals and positively influence public perception, but will simply owning the title be enough?
The real question is: Are we ready for it and what else needs to be done? We need to focus on enhancing our own knowledge, adding to our repertoire of clinical skills and broadening our experience. We must seek to reform the graduate scheme for registration to empower future generations to be curious and clinically minded practitioners as opposed to commercially minded ones. Lastly, we must unite as a profession to diminish the grasp of the ‘free eye test’ ideology. If we are successful in all of these things, UK optometrists may finally find themselves in a position where they are comfortable enough with the use and responsibility of the title, ‘doctor’.
Karmelo Modina, optometrist and director of operations at Out of the Box Optics
The Mandel brothers have nicely presented a series of underlying ‘elephants in the room’, within the optometry world (Optician 18.08.17). Considering the vast amount of commercialism, pioneering technology, and the ‘free’ culture spreading like wild fire, it is of no surprise that the role of an optometrist is questioned within the public eye.
They have highlighted that optometrists are primary care providers, and are using clinical skill on a daily basis. As an optometrist myself, I find it frustrating that my patient is referred to as a customer. As a practising clinician, attending to a patient’s symptoms, this does not make me a salesman, and the person sitting in my chair, my customer.
Appointing the title of Dr is a move forward for the optometry world. Unfortunately, the question is, is it to late? It is correct that Mecs/Pears has been introduced, and it is a great step for optometrists, however, a vast majority of the general public will walk in an optometry clinic, and adapt the same mentality of going to buy milk from their grocery stores.
There is this commercialised culture of volume based sales, where the public are brainwashed into getting their sight test for free, and then get as cheap as possible glasses (or even buying them online without any further clinical consultation). This form of volume based business is suicidal to the medical profession. Not only is it detrimental to the patient, but equally to the clinician. The increased stress levels, shorter testing times, more complications when something goes wrong, possibility of getting sued (which since the Honey Rose case, is at an all time high).
If the optometry world is to seriously move forward, it needs to start representing itself for what it is, a branch of medicine. Twenty minutes testing times should be abolished (if with the college of optometrists, while pre-registration training, we get a minimum 45 minutes to perform an eye exam, then why do we only get 20 minutes to see one patient on a normal day as a qualified optometrist?
The exam should also be 20 minutes. It is ‘supposedly’ meant to be a chance for an examiner to see how the pre-registration optometrist carries out his practice ‘realistically’), the Dr title should be given to optometrists, and the university programme should include a serious in depth study of biomedicine, appropriate pharmaceutical studies and incorporated relevant residential programmes.
However, the possibility of any of this is slim. The fundamental point is, it just would not bring in enough funds (especially as how the system is set up now). As Liza Minelli once said ‘Money Makes the World Go Round’.
Niraj Sudera, optometrist
Doug Perkins, founder of Specsavers
Speaking at the launch of the Specsavers and Royal National Institute of Blind People report on eye health earlier this month, founder Doug Perkins, said there was some way to go before optometrists could be considered doctors of the eye.
‘There’s a lot of talk at the moment of whether we should be using the terms doctors,’ he said, adding that the gap to close between optometrists and doctors and education and experience are too significant. ‘We can’t make any advancement until we are further along the journey of closing the gap. We can’t say: “look we want to be the general practitioner of the eyes tomorrow,” and take a whole load off the GPs and go direct into referral, of course we would all love that. It’s about taking pressure off the medical profession rather than adding on. The government is afraid that if you open the door to direct referral you would be swamped,’ he said. In the short term ophthalmology would continue to be used as the gatekeeper for money, time and patient flow.
‘I don’t see any reason why not. We’re doing 90% of the job that a doctor is doing anyway, for example, if someone comes to us with flashes and floaters or conjunctivitis, we don’t turn them away. We put them on the right path. We do the eye part of the job a GP does. Also, by giving optometrists the title of doctor, it gives us kudos that we’re not some Joe Bloggs on the street trying to sell people glasses. We are actually providing a proper service. That way, people appreciate you a bit more.’
Kirit Patel, optometrist and owner of Radlett Opticians
Best of the rest: More readers back the Dr concept
‘As an eye care practitioner already using “doctor” when I visit the USA I fully support the use of the title “doctor of optometry”.’
John Sheinman, optometrist
‘I have read your article in the Optician magazine on Dr for optometrists. I do totally agree with you.’
Mr W Yohannes, optometrist
‘Yes I feel that optoms should be able use title doctor in optometry.’
Sheik Rahman, optometrist
Others are against the idea
‘No, because we’re not doctors. It’s quite simple, if you want to be a doctor, then you should train to be a doctor.’
Lynne Fernandes, owner and director of Lynne Fernandes Optometrists
