With the new cycle of CET underway, we have been looking at optometrist and colleague development in our practice. Over the years I have come across optometry colleagues who felt that once awarded their degree, there was no need for further learning and they were relieved to not have to sit any further exams.
I would always argue that learning and professional development – although nerve-racking when you are examined again for the first time in years – is essential to provide the best experience for our patients. I have never stopped learning and wouldn’t feel confident if I remained at the same level.
Thankfully nowadays, most optometry colleagues are hungry for further learning and more responsibility in primary eye care. It makes for a much more enlightening conversation with patients if you can refer to recent learning that you have undertaken, particularly if directly relevant to their condition. Their confidence in your ability and professionalism grows considerably; we have all heard patients singing the praises of our pre-registration optometrist for their thoroughness and up-to-date knowledge.
In practice we look at development for all colleagues. It means that patients benefit from more knowledgeable frontline colleagues and it helps them to be more independent in their decisions rather than seeking help, as each time they do, they lose the patient’s confidence. It also supports us in our role as optometrists to know that our colleagues are adequately trained to perform delegated functions.
Some businesses cite a fear that training their colleagues means they will leave and move on to better things, but my view is that we want colleagues who are prepared to develop themselves if we want the best care for our patients. Nowadays very few jobs stay the same and there is always something new to learn, and optometry is very fast-paced with the changes we see both in the development of more advanced equipment for examining the eyes and in our remit. The advancement of community eye care schemes has certainly seen our role evolve and become more extensive. There is, thankfully, plenty of opportunity for further learning from LOC meetings and courses, CET in optometry journals, conferences and post graduate qualifications.
In our practice we are preparing for the arrival of our OCT with excitement and a fair amount of nervousness. It reminds me of when we first took delivery of our fundus camera and the concern over what we might find that had not been picked up previously by the usual direct ophthalmoscope. The worry with more advanced equipment is that we may end up referring unnecessarily for conditions that it picks up, which are just variations of normal and of which we would have been otherwise unaware. The mindset must be that it is just a further tool to aid our diagnosis and I certainly won’t be encouraging referrals on OCT findings alone. The decision should be based on a full history and symptoms along with other findings throughout the examination. There is no need to swamp the hospital eye clinic with unwarranted referrals. However, I can think of many cases over the years where an OCT would have led to a more accurate diagnosis for the patient and hence a more relevant and timelier referral.
Ophthalmology will regularly highlight that the quality of optometrists’ referrals into the hospital eye service can be poor and optometrists will as regularly report that they get minimal feedback as to what happens with their referrals when they reach the hospital eye service. This isn’t good for either our optometry professional development and learning or, more importantly for the patient’s care and experience of optometry and the hospital. I need too many hands to count how many patients have told me of multiple hospital appointments as the correct ophthalmologist wasn’t on clinic at their first visit, or they needed to return for a specific clinic.
I was therefore recently tasked with organising a big referral refinement evening on behalf of our LOC. With the help of a very able subgroup we were able to look at referrals to the ophthalmology specialties and take feedback from the ophthalmologists of both good and bad referral examples. We anonymised these and organised an evening of small discussion table groups where a facilitator and ophthalmology colleague moved around the tables with various packs covering each specialty. The packs included at least two good and two bad referral examples. The discussions that resulted between the ophthalmologists and the optometrists on the table were extensive and it was well received on both sides. The consensus from both parties was that this was long overdue, and we needed to do it more often. Hopefully both the hospital and our patients will benefit from our learnings on that January evening.
Judy Lea is optometrist director of Specsavers, Longton, Staffordshire.