It seems to me that not a day goes by without coming across an article about how difficult it is to speak to a GP or a dentist, and, as I look at today’s newspaper, I read about the loss of a further 2,000 NHS dentists because of the pressures currently upon them.
Talking to optometrists at the recent 100% Optical event, it was notable just how many had already given up their NHS contracts, with more considering the option because of the restrictions placed on them by the strictures of this outdated contract. That so many are considering this move should come as no surprise to anyone who has ever tried to provide comprehensive eye care within the bounds of the contract in an economically viable way. What makes it all the more interesting at this point in time is the ongoing General Optical Council (GOC) review into the future of the Opticians Act. This review is far reaching and, if it is to truly move eye healthcare in this country forward, the outcomes have to be radical and fit with modern methods of delivering care to patients.
Several questions immediately come to mind that I believe need to be addressed as a matter of urgency by the profession of optometry. If we do not take this opportunity to answer these questions properly, we will undoubtedly find ourselves once again in the position of having others provide cogent arguments for change and having that change imposed upon us to our eternal detriment. We have a history of this in optometry and so we should be in no doubt that if we adopt a status quo approach and attempt to merely protect what we have we will most certainly lose out.
The first question I would ask is, why are optometrists still refracting? We have so many more skills nowadays that could be much better utilised. We see an increasing number of optometrists seeking the recognition of their greater abilities by earning higher qualifications to carry out more complex work. Why then is so much of the undergraduate course taken up with out-of-date work procedures? It would not surprise me if I were to be told that the majority of people on this planet obtain their spectacles from an automated refraction process. Of course, there will be some people who have complex needs that require a more specialist approach, but the simple fact is modern day optometrists are massively overqualified to be spending their time refracting. There are many others who are suitably qualified, and indeed anyone buying over the counter reading glasses is, in effect, carrying out a refraction, and the majority of those seem to cope very well with the result.
To those who immediately jump up and say refraction is about correcting a defect of sight and reading glasses are not correcting a defect of sight but merely a defect of age, as argued successfully by Lord Rugby many years ago, I would reply that they are missing the point. As we go ahead with this review, we should be looking at the new arenas that we are now fully capable of occupying and look towards taking over those areas. Ophthalmology is crying out for assistance in many of these areas, as indeed are the patients, many of whom will suffer irreparable damage to their eyesight because of the current severe lack of clinicians to carry out the work they require.
We see the onward march of technology that further assists the modern optometrist in these new fields on a daily basis. Optos recently announced the launch of the first ever artificial intelligence powered system for analysing ultra-widefield images of diabetic retinas, which is possibly the biggest breakthrough in eye care for diabetic patients worldwide to date. Traditional methods of imaging retinas and analysing results are now being consigned to the bin as technology moves us forwards. The same has to be true for optometry as a whole. We now have a golden opportunity to leap forward and take our proper position in the medical world of eye healthcare. We need to realise that if we cling to the ‘old ways’ we will be left far behind. Some of our traditional roles are outdated and we are trained to perform far more relevant tasks.
The world is moving on and we must seize this opportunity to determine our destiny. The idea that vision has to be bold and revolutionary. Undergraduate courses need updating to reflect changing roles and our professional bodies need to understand what this new world will look like and fight for modern, highly qualified, highly capable clinical optometrists to be recognised. If we do not do this we will quickly look like the tulips in my garden: once we shone bright but we will surely wither and just become part of the background. Are you up for this exciting journey ahead? If so, make sure you take part in the GOC review. It is your future that is at stake.