SOCIAL

  the way i see it

Conscious Coupling

Let’s end optometry’s disconnect between medical and refraction.

MARC R. BLOOMENSTEIN, O. D., F. A. A. O.

Peeps, I think it is time that we, as a profession, have a hard look at the state of affairs of our relationship. I know how this sounds: scary, worrisome, even a little creepy. However, this is the perfect time for us to take a cue from Chris Martin and Gwyneth Paltrow’s recent “conscious uncoupling.” Rather, we need to have a “conscious coupling” of the refractive and medical aspects of our optometric profession.

Come together

Some of us have allowed the refractive and medical sides of optometry to grow into separate entities that do not even recognize each other at times. Unlike Martin, who is planning his man cave for his mates across the pond, we need to keep both natures of our profession in close proximity.

I am not implying that we should abandon our sense of who we are and the soil where our professional roots have been planted. That would be like trying to get Johnny Weir to give up his furs and Birkins. However, I am implying that there is no need to keep these entities separate. In fact, they are and have always been “coupled.”

Think about it: We cannot get a good refraction unless the patient’s eyes are healthy, yet the “unconscious uncoupling” of medical and refraction has played out in every exam lane for as long as patients have chosen between one and two.

Changing our mindset

The crippling effects of this segregation only serve to undermine the heart of our profession. This disunion has very powerful influences that have created a monetary rift to dissuade those who want to bring these two together. Ironically, the potential value that providing a patient with a medically minded exam (that includes the refraction) can be exponential.

A clinician who walks into an exam room should not be directed by which insurance the patient handed to your front desk. Rather the orientation should be evaluating the ocular health that is limiting the refractive abilities of our patient.

I walk into an exam lane, and my first and only thought is “why is this patient really here?” That may take on a whole slew of thoughts: Did they come here to get away from the kids, think we had free coffee or even want to smell my minty breath (#coffee breathsorry)? My conscious tells me that patients want to see well and maintain good vision, which is not accomplished unless we are allowed and willing to medically manage the ocular surface and all aspects of the ocular system.

A refraction is a means to an end, yet this is what patients will gauge their visit on, and rightfully so. Can you really get a great refraction with inspissated meibomian glands, inferior staining of the cornea or incipient cataracts? Looking for disease state at all visits, using new diagnostic tools and not waiting for the patient to be symptomatic only serves to solidify the refraction-medical partnership.

A perfect couple

Today is the day O.D.s establish a coupling of medical and refractive care. All of us are needed to help make this coupling fruitful and lasting. We must make this union strong so that it will be an unconscious coupling — unlike my conscious uncoupling from my fat pants, but that would mean stopping my conscious coupling with pizza and Mexican food. OM

DR. BLOOMENSTEIN CURRENTLY PRACTICES AT SCHWARTZ LASER EYE CENTER IN SCOTTSDALE, ARIZ. HE IS A FOUNDING MEMBER OF THE OPTOMETRIC COUNCIL ON REFRACTIVE TECHNOLOGY. E-MAIL HIM AT MBLOOMESTEIN@GMAIL.COM, OR SEND COMMENTS TO OPTOMETRICMANAGEMENT@GMAIL.COM.