Our optometry editor shares her personal observations of what makes the best optometrist.
Some years ago in Glasgow, I gave a presentation with this same title, ‘How to be a better optometrist’. I was the optometry programme director for NHS Education for Scotland (NES) at the time and my talk focused on what training our organisation could offer that would help an optometrist improve. Without the constraints of education, I thought I would reconstruct the essence of the presentation.
It is my personal observations on what can make you a better clinical practitioner, and whilst it is largely focused on community optometry, I hope that anyone working in a hospital will also find the article valuable.
It’s all about the patient
In my view, the key to being a successful optometrist is to be first and foremost patient-focused. It’s vital that you put your patient first when you are making decisions about their care. The interaction with so many different people on a daily basis is what makes the job so interesting and varied. People coming to you for an eye examination are right to expect that you will treat them as an individual, and that you will address their concerns.
Taking the patient’s history and symptoms at the beginning of any eye examination is often the most important part of the consultation. Good optometrists are good listeners and good communicators. We all think we’re good at communicating. Time and again it is a failure in communication that results in an unhappy patient, a complaint and, in the worse situation, a General Optical Council (GOC) referral. Interacting well with patients is so important to providing good care. Not only will patients continue to attend in the future, but they will recommend you to their family and friends.
And it is not just with the patient where communication skills are vital. An optometrist needs to be able to communicate effectively with other colleagues. The seamless transfer of care within a practice, especially when care is being delegated, is vital to ensuring that our patients receive the best care. Communication with colleagues outside the practice is important too. Most of us are in a practice for a considerable length of time and building up local relationships will help your practice no end.
Training and education
When we qualify as optometrists and become registered with the GOC, we are considered to have the skills and knowledge to be able to safely practise as an optometrist. Falling below this level of competence may well mean that we are not safe to practise. CET requirements are in place to maintain our skills and practise safely. We are also required to self-assess before we undertake any procedure, to ensure that we are competent. This may be particularly relevant for those returning after a career break, or for those entering a new field of practice.
I really believe that we should improve our skills and knowledge as professionals. This also supports becoming a safer practitioner. There’s a balance isn’t there? Between maintaining our skills and developing our skills. There are certainly times in any career where simply maintaining your skills is desirable. But when there are opportunities to upskill, develop and improve, these will invariably be opportunities not to be missed.
Improvement can, and often does, come from experience. Conducting a procedure many times should ensure that we get better. Also, once we’ve seen a condition and managed it, and likely followed up the patient, we should be more able to make the correct decision next time. Key to learning from our experience though is to reflect on our own performance. Our complicated, busy lives make this easier said than done. Often this reflection is undertaken when things didn’t go so well, and sometimes it is helpful to do this with your colleagues. It’s not always easy, especially when, as the optometrist, you might be the most senior member of the team. Clearly though, learning from mistakes is vital; we shouldn’t be making the same mistake twice. Others can learn from our errors too – sharing our experience can take courage but will almost certainly help others.
I’m not good at dispensing, never have been. I broke the frame in my final exams! I therefore have always worked with a dispensing optician. However, I don’t think it is always easy to identify your own weaknesses and this can make you an unsafe practitioner. It’s important to seek feedback where you can from colleagues and patients, and it is also why the feedback from our referrals is so vital. How are we supposed to improve?
I’m not a fan of the points-based CET system. It encourages a tick box process where we know we have to collect the designated number and category of points and rather than choosing the training that would be most beneficial, we tend to book what we need to ensure that all our boxes are ticked. The GOC are presently reviewing the whole scheme and this is definitely very timely.
Keeping up to date
I do not believe that just learning from your own experience is enough. You need to keep up to date as your career progresses. If you have been qualified a while and are still doing what you were taught at university then you are not likely to be providing the best care to your patients. In fact, you are almost certainly putting your patients at risk. You have an obligation as an optometrist to keep up to date. New evidence-based guidance is being introduced regularly. Decisions need to be informed by the latest guidance.
Keeping up to date is not easy. There is a huge amount of information to read and digest. We are supported in doing this by various organisations: the College of Optometrists, the Association of Optometrists (AOP), The Directorate of Optometric Continuing Education and Training (DOCET) and many local bodies and groups provide updates in accessible formats. College library alerts are a good way to keep on top of recently published relevant research, but attendance at courses, and training from experts in their field, is almost always invaluable. We also need to be connected locally and ensure that we are aware of local guidance.
I would strongly urge anyone to get involved with professional groups, either locally or nationally. The professional life of an optometrist can be quite isolating. This may be because you are working in a remote and rural location, because you have a single-handed practice or even because you are a locum and rarely meet up with colleagues. You need someone to discuss cases with and ask for advice. Nobody has all the answers and nobody is good at everything. If there is a local peer review group locally, I would urge you to attend. It’s disappointing that the peer review process is often seen as a one-off event. It works well with groups of practitioners getting together regularly, perhaps twice a year, and discussing cases and practice.
Getting involved with teaching, supervising and supporting less experienced colleagues is also important and hugely enjoyable. I’m not convinced that we do this awfully well as a profession, and it’s a resource wasted.
I’m pretty sure that you will be a better optometrist if you enjoy your job. One of the significant changes in the optometry profession in the last few decades has been the plethora of roles available and the opportunity to take on a variety of functions. Running your own practice and undertaking all the responsibilities and opportunities that this entails can appeal to many, but for those not wishing to take this step, interesting roles are available. Even if you are happy in your present practice and location, you can always take on additional activities or care; we have such a limited range of practice-based research that there are plenty of areas that would benefit from being investigated.
I am in the privileged position of being able to meet many optometrists from many different areas and with many different abilities. I’m always impressed by the desire of many to develop their skills and knowledge, enabling them to provide an improved level of care and a wider range of services to their patients. There aren’t really many short-cuts and often getting better at something is all about hard work and determination – it is not something that just happens. You may improve with experience, but experience plus some additional effort can make a huge difference from you being just another optometrist, to being someone that provides an outstanding level of care to their patients. It may lead to other roles too, but ultimately providing better care to your patients is surely something worth working towards.