Do something spectacular!

April 28, 2012

I’m sometimes asked, “Why on earth do you live where you live?” I thought of this the other night as I was driving and my entire view to the north was filled with the Northern Lights. They are spectacular. My best memories of growing up revolve around lying in the grass late at night watching nature perform for me.

The lights dance across the northern sky and sometimes even into the Southern Hemisphere like flames of a fire. Usually they are shades of green but once I saw them dancing in shades of red – those were truly incredible. I grew up assuming I could always look forward to watching those Northern Lights… and then I moved away from northern Minnesota.

Some of you know Mark and I were recruited to North Dakota by a little town looking for an optometrist. In the end they got two! Yet, when we were starting to be serious about moving from the Pacific Northwest to North Dakota we looked at Sherry Cooper’s maps. We didn’t know who Sherry was at the time, but she works for the AOA and is the keeper of the maps of privileges for optometry.

Those maps are a geographical representation of the scope of privileges for optometry in each of the states. At that time, the maps showed North Dakota would allow us to write prescriptions for medications that many states did not – including my home state of Minnesota. We decided that if we could use the knowledge we had learned in our residencies – we would move there. That SINGLE factor was a key decision-maker for us.

After we made the move it was a great experience to help the state association add the treatment of glaucoma to our prescribing privileges – something we had been able to do while working in the VA. And wasn’t that, after all, what all optometrists aspired to do – take care of the needs of our patients and use ALL aspects of our education?

Fast forward 22 years and I’m visiting with a couple of pharmaceutical-based industry partners. Some startling facts came up in the conversation:

  • There are a little over 38,000 licensed ODs in the United States
  • 12,000 of those ODs write 80 percent of the prescriptions for medications.
  • The next 5,500 write 10 percent of the scripts.
  • SO, 17,500 optometrists write 90 percent of all prescription medications.
  • Optometrists in rural areas write five times more prescriptions for glaucoma than doctors in urban settings.
  • Dry eye and allergy are two of the most prevalent conditions seen by ODs that have safe and effective prescription treatments, yet in the past 3 months: 13,000 ODs did not write a single prescription for an allergy medication, and 19,000 ODs did not write a prescription for the only Food and Drug Administration-approved product for dry eye.
  • In 2011, primary care MDs prescribed more ocular allergy medications than either optometry or ophthalmology. That would be the same doctors who prescribe medications like sulfacetamide for those green mattery conjunctivitis cases.

I go to a lot of meetings and hear about the refractive model or the medical model of optometry. I think we owe it to our patients, and our practices, to have a more “comprehensive model.”

There are plenty of patients who walk into our offices on a daily basis and have multiple concerns (refractive AND medical) – we just need to know those concerns. Taking a comprehensive case history about their general health, past ocular health and allergies allows us (optometrists) to position ourselves as a more knowledgeable profession about ALL aspects of a patients’ care.

Unless you ask the questions, you won’t find out what the problems are and how you, the optometrist, might be able to help your patient. Take charge of ALL aspects of your patients needs and don’t be afraid to write that prescription when necessary. You know far more about comprehensive eye care than general physicians who did a two-week rotation in the eye clinic during their residency.

In the land of little traffic I have time to think when I drive and especially on the nights when I’m watching nature. On those nights I think two things:

1. I’m thankful to live and work in a place that allows me to use ALL of my education – including the education I’ve attained as a seasoned clinician.

2. Seeing the Northern Lights is a spectacular reminder that I’m HOME!

This year do something spectacular! More importantly, do something spectacular for your patients!

Dori Carlson, O.D.
AOA president

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