I have been reading with interest the debate about amber phase. I am a director of a group with three practices and I also work in the hospital sector and am currently studying for an independent prescribing (IP) certification, so have seen a range of views.
It seems to me that the College is missing the point of the healthcare argument. I do not think anyone is objecting to seeing patients with genuine concerns or problems, but are objecting to seeing routine patients with ‘nothing better to do’.
I am personally happy to see 20 or more patients each day in the hospital setting as they need to be seen and I am confident about the infection control procedures.
In our own practices, the maximum I will see is 11 patients per day as I have to spend longer with each patient to do an effective full eye exam and can mitigate things less.
Not seeing routine patients is fully in line with what other professions are doing. A lot of ophthalmology departments have cancelled routine cataract surgery and are delaying glaucoma reviews, our local GPs are seeing fewer patients and suspending routine reviews.
It does seem to me a little perverse to perform opportunistic case finding of glaucoma etc, which is what the healthcare argument for routine asymptomatic patients would boil down to, when the hospital eye service has already decided to delay appointments for patients who definitely do have glaucoma.
There is a definite business case to open for routine appointments as the volume will drive sales, but I personally feel the healthcare argument is not there for patients with nothing better to do.
In my own practices we are looking to those who need us, we see lots of patients for our local GPs through a locally funded scheme and we are happy to see those with visual concerns and happy to dispense those who have broken specs or need replacing.
Am I happy to see Mrs Jones and her four kids as they have nothing better to do and want to get out of the house? No, they can wait for a few weeks. I have nothing against groups of kids as I have four myself, but I would not dream of taking them into a shop together.
It seems to me the College is afraid that, as a profession, we are shying away from our duty to safeguard the eye health of the nation, but that misses the point. I do not know a single optometrist that would not see patients with problems. However, it seems to me that we also have a responsibility to our staff and patients not to drive volume for volume’s sake and dispensing opportunities to the exclusion of all else.
The logical position to me would be to see patients with urgent or essential needs, which is what I am personally doing, and re-introduce routine when the government moves us down from the highest level, which should not be long.