Scott A. Edmonds, OD, FAAO, focuses his blog on the role of the optometrist in health care reform – moving from primary eye care to primary health care. He is the chief medical officer of MARCH Vision Care, the co-director of the Low Vision/Contact Lens Service at Wills Eye Institute in Philadelphia and a member of the Primary Care Optometry News Editorial Board. 

Disclosure: Edmonds is a consultant for March Vision and OcuHub.

BLOG: The role of socialization in optometry

Have you ever noticed that your practice has a group of “regulars”? These are patients that seem to be either always on your schedule or seem to be sitting in your waiting room or wandering around in your optical dispensary.

The nature of my practice has always encouraged regular office encounters. At this point in my career, I see mostly concussion patients, and our vision therapy protocol includes weekly visits.

But prior to that, with specialty contact lens, low vision and the chronic eye diseases like glaucoma, dry eye and macular degeneration, we also had a strong group of regulars. These are people that you get to know very well. You know all of their children’s names, where they vacation each year and where they work, go to school or what they did before they retired.

I am starting to realize that these people enjoy coming to my office. They know all the staff, they sometimes bring treats and they seem to enjoy learning about their eye issues and what they might be able to do to improve their vision. They want advice and reassurance and they want to validate their vision performance.

Sometimes, however, they just want to chat and spend a little time with their doctor. As you may have noted if you are a regular reader, I have a strong interest in primary medical care, and I often spend time discussing the underlying medical problems that have affected or could affect patients’ eyes, including obesity, diabetes and hypertension. We talk about increasing physical activity, improving diet and taking medications appropriately.

As I read and learn more about public health in preparation for this blog series and for my work in the public health courses at Salus University, I continue to gain new perspectives. I have started to realize that health care services in general and optometry in particular are an important part of the socialization of the American people. For my younger patients, their world is so wrapped up in the Internet and their phone that an actual face-to-face interaction is a novel event. For my older patients who are now retired, a medical office visit is a chance to turn off the TV, get up, get dressed and get out of the house.

Integrating medical care with other activities is an important factor in improving America’s health status. In looking at the social determinants of health, we are learning the importance of creating a community environment that nurtures healthy lifestyle options. In a recent Health Affair Blog by John R. Lumpkin and Brian C. Quinn, they point out the opportunity and value of integrating health care with other services. They reference an important survey by Deloitte about the new trend among hospitals to address patients’ social needs as part of their overall care.

For optometry, this is a natural extension of our practice. We see patients in a comfortable environment. They are fully dressed, and our examination is not invasive. We need to know and chat about their work and recreational habits to prescribe the best optical correction. We can photograph, scan, measure and examine their visual system, most of their neurological system and their vasculature without even touching them. We also see them yearly for the most part and can monitor changes in their health and function.

We need to think of our role as primary care providers beyond refraction and optical correction. We need to think beyond eye pressure, eye health and even systemic health. We need to consider our role in health education, fitness, nutrition and wellness. And with the new concepts of comprehensive care, we need to consider and value our role in the socialization of our patients.

Optometry is a social profession. For the most part, we like talking to people and getting to know them personally. Many of us were attached to this profession because of the social aspect of patient care.

As our society evolves, there will be those who want to get an online refraction and obtain optical goods and supplies from other sources. If, however, you focus on personalized health education and wellness and take full advantage of the social opportunity of a visit to your office, you will never be replaced.

References:

Lumpkin JR, et al. How integrating health care with other services offers significant potential benefits. https://www.healthaffairs.org/do/10.1377/hblog20180416.859212/full/. Posted April 24, 2018.

Lee J, et al. Social determinants of health: How are hospitals and health systems investing in and addressing social needs? https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-addressing-social-determinants-of-health.pdf. Accessed April 27, 2018.