o.d. to o.d.

What's The Other Side Of The “Medical Model”?

Optometry has always been involved in the “medical” and “vision care” aspects of care. Do we need to differentiate?

BY WALTER D. WEST, O.D., F.A.A.O.
Chief Optometric Editor

Recently I've been in several conversations discussing the “medical model” in optometry. On each occasion, I realized that I didn't know the names of the other model or models in optometry. Is the “other” model the “refractive care” model? Is it the “non-medical” model? I'm really at a loss. Could it be the traditional model, or could it be that we're doing our profession and colleagues a disservice by trying to define a model of practice to be anything other than “comprehensive.”

The power of language

We know that the language we use to describe people, places and things can quickly begin to influence the way we feel about those entities. For example, for many years optometrists have referred to patients as “spectacle patients” or “contact lens patients.” The danger here is that one might loose sight of all of the vision correction options available to a patient once the patient is categorized. Do we recognize that the “contact lens patient” may also benefit from prescription glasses or sunwear?

The result is that “spectacle patients” become known as “spectacle patients” and thus always remain “spectacle patients.” It's the same with “contact lens” patients. They become known as “contact lens” patients and ultimately remain “contact lens” patients. The result: We limit the opportunities for both our patients and our practice.

So, does the “medical model” describe a method of practice that is involved in only diagnosing and treating disease, and if it is, does that mean that patients are always seen as “medical” patients and their refractive and vision correction needs are ignored? Or, on the other hand, is the “not-the-medical model” practice providing only refractions and vision correction?

You learned it in school

Personally, I don't see why we continue to attempt these differentiations when we could just practice “optometry.” In my freshman year of optometry school, I was taught the 21-point examination. Best I remember, ophthalmoscopy was part of that exam. So, as far as I can tell, optometry has always been involved in the “medical” as well as the “vision care” aspects of patient care.

Admittedly, the scope of practice now affords optometrists the privilege of doing more than diagnosing and then referring for treatment. As part of their patient care, optometrists are no longer limited to diagnosing and treating vision related issues — we now diagnose and treat medical-related issues as well. It is the completion of this care that optometrists provide patients. It's the “total care” model. It's the “comprehensive care” model. Quite simply, it's optometry!

If we need to differentiate …

I think it would be best if we refer to the medical “component” of the optometric practice rather than the medical “model,” and the “vision care” component of the optometric practice rather than the “whatever-the-not-medical model” is.

Perhaps an even bigger problem than the confusion this creates among our colleagues is the confusion it creates for the healthcare consumers. The more uniform we are in the eyes of the public, the more united we present ourselves individually and as a profession. Simplifying the “who” optometry is, and the “what” optometry does is a first step to everyone better understanding optometry. OM