New Grads Not Talking?

I have just finished reading John Murphy's recent article "What Will New Grads Do?" (July 2009). I believe that many of the conclusions that the author derived from only 19% of the 1,200 surveys distributed to fourth-year students may be misleading. Although it was apparently felt that the returned surveys constituted a statistically random sampling, I feel that if the remaining 81% of the surveys were returned, the percentage of students expecting to start their careers in a true private practice would be much lower and their level of debt higher. One has to ask why the vast majority of seniors failed to return their surveys. Perhaps there is more to be learned from the surveys that were not returned.

Dana C. Rohleder, O.D.

Port Kent, N.Y.

Reform Prompts Retrospective

Optometry is a wonderful profession, full of history, changes and diversity. From primarily refractionist in the mid-1950s, optometry as a profession has morphed to become the primary caretakers of the eye and vision system within the last 60 years. With the current scope of practice, optometrists in all states are capable of treating most non-surgical eye diseases and disorders that afflict the human eye and vision system. Every day, every hour, thousands of people trust their most precious sense to our professionals.

For the last 20 years, the primary care model of optometry has served us well. It helped us drive legislation that challenged the individuals and changed the scope of practice of our profession while establishing our role as health care providers. It focused on providing the best services that optometry had to offer to solve the eye and vision problems of the communities we serve.

With talk of health care reform, it is time for us as a profession to fully adopt a more comprehensive mode of practice that better represents our professional education and makes use of our therapeutic abilities.

Since the Medicare Parity Amendment of 1987, optometrists have been able to deliver care in a manner that reflected their new scope of practice. With more recent participation in private medical panels, some optometrists have actively moved from primary care providers to primary medical eye care providers. This more medical model of eye care delivery is based on the fact that patient encounters are health based and refraction is just a small part of what we offer as professionals.

This contemporary medical model of eye care delivery is founded on a more organ-systems approach to service delivery and utilizes our educational background to the fullest extent. This must be contrasted to the primary care model of vision care delivery, in which refractive services are delivered within an eye health screening and referral-based encounter.

The conceptualization that the eye is an organ system, and must be evaluated in its complexity and as an organ system within the human body, should be the foundation of this mode of delivery of services and must be the cornerstone of our new practice patterns in the delivery of eye care. At the same time, this better reflects the professional educational training provided by optometry programs.

The adoption by these optometric physicians of a comprehensive medical-based model of delivery for eye care truly is a better representation of our profession, and embraces the adoption of our responsibility to the communities served.

If we are to succeed in the future, optometry as a profession and optometrists as individuals have to look back to the evolution of the profession, adopt changes and embrace challenges. Adoption of new technology, changes and constant evolution are what has best exemplified the profession of optometry in the last 60 years.

With the talk of changes in health care, we have a chance to embrace our role as primary medical providers of the eye and vision system, assume the responsibility that our communities have entrusted in us, and continue moving the profession of optometry in a forward-looking path.

Agustin Gonzalez, O.D.

Dallas , Texas