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Are you into P?
I’ve had quite a bit of feedback and discussion recently about the state of eye care in NZ (and the rest of the planet). I stated many years ago that NZ was fortunate to have maintained a high standard of optometric practice compared to many other countries. There were high standards of professionalism, ethics and education. Much has changed, due largely to the misguided deregulation foisted on us by all manner of politicians and those with vested interests. It’s now a free for all.
After my previous column one reader commented comically that it ‘dealt with way too much science’ while the profession was reeling from the free eye test fiasco and many other things’ which I won’t bore you with or waste space by rehashing. Previous columns have discussed how to counter this retrograde slide.
Adding value is one such key.
Two additional and essential qualities required to make a successful optometrist are: Passion and professionalism.
Education is of course a given as you wouldn’t be in practice if you hadn’t satisfied the criteria of academic achievement. Academic achievement doesn’t however guarantee success or competence. An example is that too many optometrists graduate with little or no experience in contact lenses and other sub-specialty areas. The reasons? Therapeutics have become the seeming be all, end all focus of an increasing number of academic institutions. Although I have been pleased to encounter a few (too few) recent graduates that show passion for optometry and contact lenses, I regularly encounter the outcomes of a lack of such things. On an almost daily basis my colleagues and I see patients complaining of a lack of professionalism, or specifically a lack of basic and essential communication skills.
Bedside manner is another key to success.
Part of the problem is the purely academic selection of students. Brainy boffins with 90% academic averages do not necessarily have these essential communication skills. In the old days such academically inclined types were often the back-room boys and researchers. Today they are thrust on patients who do not understand the scientific jargon. Astigmatism sounds like religious stigmata to many and similarly unexplained terms like neuro-retinal rim thinning or casually bandied terms like macula degeneration and cataracts freak patients out. They ask, ‘Do I have cancer?’ or ‘Am I going blind?’ Others feel like criminals when they are labelled ‘glaucoma suspects’.
Many times the poorly communicating optometrists have actually done a good job as far as the exam and Rx are concerned but it’s all wasted when the patient lacks confidence in the practitioner or outcome and see us for a second opinion and reassurance. This totally negates any initially perceived cost saving.
Confidence is an additional element.
All that was really missing was the use of simple diagrams, images and layman terminology to briefly explain what these things mean and the implications thereof. Although ‘customers’ of recent grads working in chain stores are often the greatest source of increasing numbers of new patient eye examinations in our practice, they are not solely to blame for this. Too often I also see patients of ophthalmologists who come and see me for a re-exam, simply so they can ask me what all the high tech mumbo jumbo meant and what the implications are, as it was never properly explained.
We are grateful to all of them for their blanket advertising and modus operandi that help keep our books full.
Quick Fix?
I’ve mentioned some simple things that can help improve the patient-practitioner relationship and patient retention process and in previous columns some strategies and techniques that also enhance this process. There are however some even simpler things that go a long way to making one seem a whole lot more professional. That’s the crux in fact.
The P word.
Professionalism.
I was recently asked to deliver a few lectures on professionalism during a lecture trip in Asia. The lectures covered many of the things already mentioned.
Some additional but really simple things relate to semantics: Even experienced practitioners are being sucked into the commercial-speak that is partly responsible for eroding the stature and professionalism of optometrists. Reading some comments from recent grads in the June NZ Optics regarding ‘free eye tests’, it seems that many agree that they didn’t obtain a professional qualification to simply be human auto-refractors: Hidden away in a dark back-room to churn out twenty minute prescriptions is not what they studied for. They didn’t sweat blood for four or more years to simply be the source of an Rx to be up-sold from the promised cheap spex into high-index, multicoated, photochromic progressives in titanium or designer frames that typically end up costing $700 or a grand; way more than the expected two pairs for $299 or $79 ‘specials’, or whatever the flavour of the month may ‘promise’. Some patients take exception and see through the smoke and mirrors. One recent patient email requesting an appointment read as follows;
“In the past I’ve come to you for eye tests and glasses. I did make the recent mistake of going to xxxxxxxxxx and realising that what you pay for - is what you get.”
Cheap Sex and Prostitution
Is there a difference between cheap spex and cheap sex? Some liken the act of performing free eye tests to prostitution but that’s an insult to the world’s oldest and now legal-in-NZ profession. Show me a prostitute who offers free sex!
It may seem trivial and that we are quibbling about semantics but optometrists who use terminology like shop or store, free, and customer are selling themselves short. They are playing into the hands of the commercialisation of their profession. Such shopkeeper terminology, if used by the so called professional, simply cements the idea among store managers and patients that this is what it’s all about; the retail sale of glasses and lenses. Some go so far as to say that we should use terms like spectacles rather than glasses, or contact lenses rather than contacts. The D-word or ‘discount’ is another word that some professionals ban from their offices. They prefer words like ‘allowance’.
That’s really the essence and a key difference between shoptometry and doctometry.
Recent grads especially and a growing number of older practitioners are licensed medical professionals. They are able to diagnose and treat a myriad of serious medical eye conditions with potent drugs such as steroids and antibiotics: All the more reason to use proper medical terminology like patient and practice rather than shop and customer.
I am surprised on an almost daily basis at how many practitioners use shopkeeper words. As I say to those who care to listen; why bother to study for four years and drum up a thirty grand student debt while losing a potential income of hundreds of grand when a school leaver can these days sell glasses with few regulations or restrictions?
Like never before the words caveat emptor have a literal meaning.
As they say these days; ‘get with the programme dudes’!
Normal service will be resumed next month when I will be able to tell you about some new contact lens enhancements for this year with some potential significant developments due in 2011 and a few abstracts thrown in for good measure.