Article Date: 3/1/2006

reflections - THE HUMAN SIDE OF OPTOMETRY
Off the Beaten Track
A career change can open a whole new world.
RICHARD NEWTH, O.D., F.A.A.O.

More than twenty five years ago, as I was nearing graduation from optometry school, I pondered where my anticipated 40-year career might take me. I had a strong sense that I should make a major change somewhere mid-career, perhaps 15 to 20 years after graduation. I knew that solo private practice in the same city for my entire career was not for me. I am thankful that optometry allows us so many options.

I practiced for twenty years in Kansas City in a staff-model HMO and large private practice before feeling the call to move. When I did move, it was drastic ... to the Rocky Boys Indian Reservation in North Central Montana.

A step back in time?

The Rocky Boys Reservation is the smallest of seven in Montana. Unlike many reservation clinics, this one is self-managed and not directly run by the Indian Health Service.

I was part of a small staff that included three primary care physicians, a nurse practitioner and physician's assistant, several R.N.s, two dentists, and mental health, public health, and nutrition professionals, most of whom were not Native American. We had a laboratory, radiology department and pharmacy. We were relatively isolated; there was a group of three O.D.s in a town about 28 miles away and referral ophthalmologists were in Great Falls, about two hours away.

I learned to see the world through different eyes. After being accustomed to a large and talented staff, I had only one staff person to help me out — sometimes none. I re-learned how to provide eyewear services and bring broken glasses back to life. My clinical experiences were quite varied. I helped teenagers with their first contact lenses, I did exams and screenings for Head Start children, and treated a lot of diabetes, glaucoma and uveitis.

Culture shock

My wife also worked on the reservation doing developmental screenings and providing speech therapy. It was a culture shock for us when we first moved there. Like the other health care providers, we found that the reservation residents were slow to trust us. But when we eventually gained their trust, special friendships developed. We watched tribal elders work hard to preserve the language and culture (Unfortunately, many of the younger generations showed little interest). Elders of the tribe said prayers in both Cree and English, before clinic staff meetings, which underscored our role as health care providers to provide "healing" on the reservation. We despaired over the 70% to 80% unemployment rate and hopelessness that often accompanied the associated poverty. Yet many strong families were successfully dealing with these challenges.

Our traffic jams no longer consisted of cars, but of cattle drives, horses, deer and even bison on the roads. We endured the wide temperature swings of the northern plains — from –40ÞF to 109ÞF. After 20 years of wearing ties, I enjoyed the casual attire and frequent tribal holidays.

For a variety of personal reasons, we left the reservation this year, but not without a lot of fond memories. It is an experience we will always cherish.

DO YOU HAVE A MEMORABLE EXPERIENCE YOU'D LIKE TO SHARE? DISCUSS YOUR STORY WITH RENé LUTHE, SENIOR ASSOCIATE EDITOR OF OPTOMETRIC MANAGEMENT, AT (215) 643-8132 OR LUTHER@LWWVISIONCARE.COM. OM OFFERS AN HONORARIUM FOR PUBLISHED SUBMISSIONS.



Optometric Management, Issue: March 2006