It was with some disquiet that I read the report in optician on December 17 that an experienced optometrist, Elizabeth Watson, was found guilty, by the disciplinary committee of the General Optical Council, of serious professional misconduct, but no penalty was made.
There are, in my opinion, a number of fundamental areas where this case calls into question the competence of the GOC in its statutory role as opticians' 'judge and jury' and one on the duty to refer.
The role of the expert witness should be publicly explained. Two eminent academics (one at least very well known to optometrists, Professor Geoffrey Woodward) appearing for the defendant, offered two expert opinions on different aspects of the case to support Ms Watson's non-referral. The professor, with his lifetime's knowledge, stated that any 'reasonable optometrist' would not have referred in the circumstances, ie the opinion of the optometrist on the Clapham omnibus or 'peer group assessment' in the modern jargon. And expert witness Alex Foss stated categorically that the tumour could not be estimated to have been of medium size at the time in question. Yet their opinions were apparently not accepted.
Dr Page, committee chairman, stated, 'we believe Miss Watson should have conducted further tests'. Just what did the good doctor expect from a normal eye examination? More than a complete history? More than thorough ophthalmoscopy? More than field examination? Perhaps he expected CAT scan or x-ray examination.
Optometrists will heed well the lesson that all cases in doubt should be referred, even with only an iota of such doubt. After this case, those optometrists who are frustrated doctors practise as such at their own peril.
Marvyn Slater
London N3