Back in 2011 when I
started blogging, there weren’t many optometrists sharing their experiences
online. Fast forward to 2017 and it’s been so great seeing how many OD voices
are creating content and spreading their interests and expertise with the
world. Jane is one of these pioneering
optometrists, sharing witty and refreshingly candid insights into life as a
optometrist in Australia on her BrightEyedBlog. Optometry on the other side of
the globe shares many of the same challenges we face in the States, and her
experiences as a young female doctor resonate loudly. Check out Best Ways to Annoy Your Optometrist if you aren't believing me that our professional annoyances are universal.
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| BrightEyed specializes in both direct to patient communication on topics like Glaucoma or glasses wear, but also on sharing advice on navigating real world optometry issues for young new grads like gaining patient's trust in the exam room. |
Tell us about yourself and how you got started in optometry!
I'm 27 years old and I live in
Melbourne, Australia. I graduated from the University of Melbourne in 2012 with
a Bachelor of Optometry. My graduate job was out in the middle of nowhere in a
small town in rural Victoria. It paid well and I got to see lots of cool ocular
pathology but it was a 4 hour drive from Melbourne where my friends and family
are, and after 2 years I thought I had better move back before I eventually
fell asleep at the wheel one day driving up and down! I now work in metro
Melbourne just on the outskirts of the city for a private health insurance company.
It's a healthcare center which means I also work alongside other healthcare
practitioners such as dentists and remedial massage therapist (which is great
because it means I can have a sneaky massage between patients!). Aside from Dr.L: Just for the record, I’m
extremely jealous. One about massages and two about “between patients” which is
a forgotten luxury most days.
In Victoria, during our final year
of high school, year 12, we have to submit university preferences. Which offers
we receive will be determined by our final score calculated across all our
subjects for that year and the required entry score into each course changes
every year depending on the demand of that particular university course. During
my year 12, I was tossing up between dentistry and optometry. I knew I wanted
to do a health science because I like helping people but I didn't want to deal
with the hours of a medical degree; nursing and paramedic was also on the list
(as well as a really random choice of forensic science). Ultimately, I was
accepted into Melbourne University's Bachelor of Optometry course. In hindsight
it was a pretty good option - good pay, ability to have flexible working hours,
I can make a positive difference in the lives of my patients, and I don't have
to pull out any teeth!
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| Jane and her sister on graduation day! |
What inspired you to start BrightEyedBlog?
I can't even remember how I stumbled
across Eyedolatry blog but I realized it was actually kind of useful haha! Even
though optometry in Australia is slightly different, particularly with
medication prescribing and even some contact lenses, I found that that I could
learn useful bits and pieces from the articles. The vision for my blog
(good pun) is to provide information for patients, optometry students, and also
other optometrists, about various aspects of optometry and present it in such a
way that's engaging, easy to read, and possibly even entertaining. I intend for
it to be a mix of both cold hard clinical and less clinical posts, such as an
article on glaucoma but also about bedside manner and communicating with
patients. In a way the blog partly serves for me to share things I've learnt
along the way during my rather short career so far, things they don't
necessarily teach you at university.
What is optometry as a profession like in Australia?
Optometry school in Victoria has
changed in recent years. My degree was a 5 year Bachelor degree that I could
enter into immediately after high school. Since then at Melbourne University it
has changed to become a post-graduate course known as the Doctor of Optometry
(I think similar to the degree in the US), which requires the student to
undergo a 3 year Bachelor degree in something like science or biomedical
science, and then continue on for another 4 years to become an OD (so lucky I
was the second last intake of the 5 year Bachelor course!). The actual content
of the courses are the same and the scope of practice between a Bachelor degree
and OD degree is also exactly the same though an OD grad may be more inclined
to use the title of Doctor while you won't find many BOptom grads using that;
legally we are all permitted to use the title Doctor as long as we specify
optometry but the practice is not widespread. Different optometry schools
will conduct their curriculum differently. For example, Deakin University in
Geelong, Victoria, operates in trimesters, which means they cram everything
into 3 years but have almost no holidays. After graduating we can go
straight into work as fully qualified optometrists.
My class was about 50 people, and
roughly equal in ratio for guys to girls. It meant that we got to know each
other well (for better or for worse) and build a sense of camaraderie. For
Australian citizens the Commonwealth government provides fee assistance, which
meant that my school fees amounted to approximately $16,000 AUD a year ($12,305 USD a year with the current exchange rate). I know
for my international friends their fees were more in the vicinity of $100k
annually!
There are currently opportunities to
do further study in a specialist field of optometry such as pediatrics, low
vision, or contact lenses, in the form of a Masters degree or a specialist
certificate. Not possessing such a certificate has no impact on an
optometrist's scope of practice though and at the moment also doesn't even
guarantee an increase in salary. There are also laws surrounding the use of the
word "specialist", so even if an optometrist obtains a specialist
certificate in something like anterior ocular disease, we can only say we have
a "special interest in anterior ocular disease" rather than being
able to claim we are a specialist in the field.
As an optometrist in Australia we
are primary healthcare providers, and are able to diagnose and manage certain
eye diseases as well as prescribe glasses and contact lenses. All new graduates
nowadays are therapeutically endorsed to prescribe topical medications and for
those whose course didn't include therapeutics there is an additional
certification they can apply for after undergoing extra study. Unfortunately,
current training and legislation doesn't permit us to perform any surgical or
laser procedures, nor prescribe oral medications - for such situations we refer
the patient upward to an ophthalmologist. The word on the street is that one
day optometrists will be able to perform procedures such as LASIK or
iridotomies, but for the time being these treatments remain in the realm of
ophthalmology. When it comes to spectacles and contact lenses though, we're the
bees knees!
What are some of the challenges you've faced in patient care
as a young female OD?
The main challenge I've encountered
in regards to patient care is patients not believing the advice I give them or
questioning whether I know what I'm doing. I'm sure all optometrists across all
ages and in both genders have to deal with this at some point, but being short
and female and looking like I should still be in high school doesn't work in my
favor when it comes to commanding respect from certain patients (usually those
from my parents' generation). I've spent time in the room talking to patients
about their cataracts and then after the consult they'll go to the reception
desk and ask the dispenser (a big tall late-30s Caucasian male) what they
should do about their cataracts. I've learnt not to take it personally but
sometimes if I feel doubt radiating from the patient as to my competence then I
show off my knowledge a little bit more and hit them with some big words then
explain to them in full what I actually meant.
Aside from Dr. L: This is a situation that most young female
grads face in the exam room in the States too! Whether you approach it with
humor or with extra confidence like Jane, my advice to any young women reading
this post is to remember the underlying cause. The patient is anxious and
concerned; they aren’t trying to personally offend you, they are just nervous.
Have empathy with their situation and you’ll soon find that these patients that
show mistrust will be extremely loyal and thankful to you for going the extra
mile to give them an excellent eyecare experience. Check out Jane's post about dealing with critical patients aptly titled Quit Yer Whinin'.
Do you have any advice for young female ODs
entering the workplace and navigating working with colleagues or staff?
The issues I've faced with
colleagues are similar to what I imagine all human beings encounter in a
workplace. I've found majority of conflicts arise from discrepancies between
communication styles and differing personalities. For example, I've made
comments that are intended to be a matter-of-fact statement or a
straightforward question but my colleague has interpreted it differently and
tried to read between the lines something that I didn't mean to say. The longer
I am in the workforce the better I become at altering my communication style
for different people and also at understanding what my colleague means when he
or she says something peculiar.
At school and university and within
our circles of friends we get to choose who we spend time with, and of course
we would gravitate towards the people we naturally click with, but in the
workplace we're put together with a group of diverse individuals that we may
never have chosen to ever speak to of our own volition, and we're expected to
work together and be productive! (Ridiculous, I know). I think it's a great
opportunity for personal growth to learn how to work together peacefully and
get the best out of each other despite differing personalities, opinions, or
modus operandii.
A recent poll in the US found less than 50% of ODs wouldchose to enter the profession if they could travel back in time. What is the
feeling around Optometry in Australia?
At the moment things are looking a
little bleak in regards to employment options for optometrists. The industry in
all the major cities of the east coast (in the states of Victoria, New South
Wales, and Queensland) are saturated due to an over-supply of new graduate
optometrists from recently opened schools. Meanwhile, areas such as the west
coast and rural parts of the state are still under-serviced, and there is still
a call for better provision of eye care for indigenous Australians.
There is the constant war between
corporate optometry chains and small independent practices. The bigwigs such as
Specsavers and OPSM are able to provide lower cost care in the form of cheap
frames and lenses, and can more easily absorb expenses such as practice
warranties and free additional testing not covered by health insurance such as
fundus photography. It means many private practices struggle to survive the
competition with what is essentially a duopoly in the industry. Despite this, I
think many patients are beginning to realize that cheap prices often equate to
cheap quality, and on more than one occasion I've had a patient attend to me
complaining that their glasses from one of the optometry chain practices
weren't made right or they weren't given proper instruction on contact lens use
before they were sent away with lenses that they didn't even know how to
insert!
Another battle we're facing as a
profession at the moment is with Medicare. Medicare is Australia's public
health insurance system which involves the government funding certain health
care procedures such as blood tests, x-rays, doctor consultations, and
optometry exams. In 2016 the Australian government announced a Medicare rebate
freeze, which meant that there would be no further indexation of the Medicare
payments to keep up with wage levels and CPI (consumer price index) until 2021.
For health care practitioners this impacts on our ability to provide
sustainable patient care as we still need to purchase consumables, pay rent and
bills, service equipment, pay staff wages, etc, but the rebate for providing
our services doesn't match with the increasing cost of everything else. The
effect of the Medicare freeze, in some instances, has been passed on to
patients in the form of a co-payment for consultations that used to be entirely
bulk-billed and covered by Medicare. Fortunately, in 2015 the Medicare cap was
removed from the optometry profession, which meant that we were actually
permitted to set our own private billing fees rather than being limited to the
Medicare schedule of fees. The current Medicare rebate for a comprehensive
initial consultation is $56.80 AUD (only $43.68 USD with the current exchange rate). Professional bodies such as
Optometry Australia continue to lobby on the industry's behalf for the
indexation freeze to be lifted and for fairer and more realistic rebates.
Head over to Jane’s BrightEyedBlog
to learn more about optometry in Australia and her advice for young female ODs
navigating their new careers!
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