Is your level of professionalism based on your
location or your attitude?
Boy, did I hit a hot button! Regular
readers of my column may remember that a few months ago I asked the question, "How
do you define professionalism in optometry? Is it where you practice or how you
practice?" (February 2006)
Much of the feedback centered on the
perception that it is difficult for O.D.s in a corporate environment to practice
in a professional and ethical manner.
Kim Marshall, O.D., says, "The O.D.
who works beside an optical is there because of a prearranged agreement to refer
all the patients next door for sales. I'm sorry, but when you get into that bed
you give up your professionalism, plain and simple."
Another optometrist took issue with
the employee-employer relationship: "If you work for a chain you give up your soul
because corporate O.D.s are directly or indirectly [told] how and when ... and sometimes
what to prescribe."
The following came from an O.D. who
obviously felt that his employer had asked him to compromise his standards."Any
optometrist working for any chain is performing malpractice and has no choice. The
only way to prevent that is to outlaw this form of practice."
Of course we also heard from optometrists who
felt that they could be totally professional in a corporate environment. "I believe
that whether an O.D. advertises or works for a chain probably has little to do with
his or her professionalism. True professionalism centers around caring for the patient
and doing the best you can with what you've got," says Jeffrey Phillips, O.D., of
St. Petersburg, Fla.
Optometrist Jennifer Brady of Tampa,
Fla. says, "Can an O.D. advertise or work for a chain and still maintain professionalism
... I say, 'Absolutely, yes!' I fit the best contact lenses possible for each individual
patient (despite what the chains consider a preferred brand) and take the time to
discuss the optimum spectacle solution for each patient."
More than one responder felt that corporate
optometry's focus on eyewear sales clearly implies they are not focused on eye care.
"Many O.D.s who practice in a corporate
setting try to defend their position by arguing that their professionalism is enhanced
because they don't handle materials. Let one of those "professional" O.D.s open
a non-dispensing practice in a department store with no associated optical department
and see how successful he'll be."
And still others were more adamant:
"Optical chains are not in the health-care business. They are in the retail business
and only care about selling frames and lenses. That is how they make their money.
Why should they care about eye health? That is not the business they are in."
A bad egg in every bunch
However, Dr. Brady points out that unprofessional
behavior can occur in any setting. "I practice in a corporate setting and like to
think of myself as professional. But I've seen greedy behavior from my colleagues
in both corporate and private settings. The desire to make more money at the expense
of the well-being of the patient has no boundaries. It's in private practice, corporate
practice and medical practice," she says.
In summary, I am an advocate of private
practice optometry, loud and clear. But I want all optometrists to do the right
thing. True healthcare professionals always put the best interests of their patients
ahead of their own financial gain, regardless of where or how they practice.
THE FOUNDER OF
THE HAYES CENTER FOR PRACTICE EXCELLENCE AT
SOUTHERN COLLEGE OF OPTOMETRY IN MEMPHIS, DR. HAYES
IS A REGULAR CONTRIBUTOR TO OM. E-MAIL HIM AT
Optometric Management, Issue: October 2006