YAFOO WRITES
Price war
I had a patient mention to me the latest publicity over spectacle prices in the high street - but thankfully she mentioned it when talking about the competition. 'Did you know the prices of your "friends" have been slated in the [Daily] Mail,' she grinned. She's mentioned my 'friends' - meaning our rival multiple retailers - before. Strange way of referring to them I thought.
The fact that the national press has picked up on this 'dotcom entrepreneur' and his offers, and repeatedly printed his web address (www.glassesdirect.co.uk ...oops, now I've done it), when everyone's prices in the high street appear to be at rock bottom too, makes you wonder where it will all end.
Chasing the offers
The patient who read about saving cash by going to the cut-price web offers sums up a wider issue which frustrates me when I focus on helping people's sight. She, and many others who are shopping around for cheaper vision correction, not realising that the eye test offers much more, as does continuity of care from an optometrist. I know many people change their optician year after year and base their actions on the best prices they can get. Even though it means they save a few quid I honestly don't think they know it means they are in fact caring less about the health issue of their eyes. I know it's an old plea in these pages, but the profession really could do with a public information campaign aimed at those who plan to 'shop around', telling them loyalty means an ability for the professional to monitor disease and other matters.
What goes down
If you're reading this in a multiple, have you noticed how all our prices have been plummeting in the high street? Obviously we're all competing against each other, which is fair enough, but does anyone higher up than us professionals working in the testing rooms realise that once these prices have gone as low as they're going, there's no way the public will accept them going back up again. In reality, we're just making things harder in what is a competitive market. Do our bosses understand this?
Static salaries
Since I qualified I had quite a good pay rise, but now it's static. Unfortunately the word on the street is the only way I could get more is to work quicker - something I refuse to do. Asking around, my professional colleagues who have gone for job interviews have found that, unlike in the past when jumping ship to another company you would normally get a pay rise, they aren't willing to pay any more.
Viewing recently published figures, that old adage that we high street practitioners earn far more than hospital optometrists - and will continue to do so - looks a bit shaky at the moment, and if anything the trend might mean they will have the last laugh.
One person I know who went for an interview bemoaned the changes made in recent years to increase the number of optometrists qualifying, blaming our static salaries on the efforts made to boost the total of practitioners at a time when salaries were sky high. Some of us have never known a time when we were in demand so much it meant regular improvements to our pay packet. How the optical company bosses motivate staff today is a question for them, and not one I am motivated by my static wage to help answer.
Maybe the answer is to get involved in the wider aspects of practice in my day to day work, and doing something different rather than solely refracting patients. The eye care pathways mentioned in this week's optician are very interesting, so too our move into prescribing which could help further my career.
MONEO WRITES
New Year resolutions
At the time of writing I have not had the privilege of seeing the New Year messages from the great and good that always seem to appear in journals at this time of year. I apologise then if my ideas should happen to agree with some of those.
It became increasingly clear as last year wore on just how inadequate the GOS contract is in a modern health service. The GPs saw the introduction of their new contract, as did the pharmacists. At present, the dentists are still in dispute with the Government over their new contract. Even so, this means that our three main colleagues within primary care are all actively involved in new work methods under modern, appropriate contracts.
Anybody working within a PCT will have noticed how the focus has shifted to implementation of the various aspects of these contracts. Money that once could have been available to optometry now seems tied up with developing new services within these other contracts.
As 2005 starts, I would hope that the New Year messages that I have yet to read will hold a commitment from all professional bodies to use 2005 to announce the end of our current contract and to actively work with or without the Department of Health to develop an appropriate modern contract that can make use of the abilities of optometrists in a modern primary care environment. I say with or without as history has shown reluctance on the part of the DoH to involve optometry in anything it decides to do until the very last moment. This year should be a year when optometry shows its maturity and demonstrates its commitment to delivering medical care at the highest level.
We have spent many years demonstrating our abilities as shopkeepers but I would hope this year we can concentrate on our clinical abilities. A new contract may mean fewer optometrists working in the NHS but that should not be a reason to lag behind on negotiations.
It is clear that not all in the profession want to carry out more clinical work. There is enough evidence from the offers of free eye tests and so on that many optometric outlets regard the clinical aspect of their work as a loss leader to their retail side, despite their protestations to the contrary.
All change in 2005
I wouldn't mind if 2005 saw the development of a true primary clinical eye care service that was separate from the current shopkeeper environment. It will be interesting to see how brave our leaders are in 2005. Do they really want to negotiate a new contract or do they really just want to tinker with the current one in order to continue to protect our monopoly on sight testing? If we want the respect of our professional colleagues we should undertake a complete analysis of our primary care role and negotiate a contract to deliver high standards of eye care within primary care that is not dependent on selling products.
This may well give rise to a profession very different from the one we know now, but that shouldn't matter if it is to the good of the population and advances the roles of optometrists. I look forward to seeing just how much vision our leaders really do have.
