“I find being on the open road much more enjoyable than being on the High Street”
Chris Gould, director of Home Vision Care Ltd, on finding his vocation in domiciliary after decades in the industry
18 February 2022
I initially wanted to study medicine, but the interview at the London Hospital Medical College in Whitechapel did not go well – in fact they said I was immature, which in hindsight was probably correct.
I didn't know what optometry was at the time, but a friend of mine was studying it and he told me the pay was good, which appealed to me because in my youth I was a keen Alpine climber and needed lots of cash to spend on expeditions. I studied at City, University of London, in the old Cranwood Annexe, under professors Robert Fletcher and Gerald Dunn.
I initially started my pre-reg in Baker Street but that didn’t work out, so I changed to Timmis Opticians, an independent in Putney High Street.
I was homeless in London during my pre-reg year having been scammed for a non-existent bedsit, and slept on the floor of my testing room. I used to get up early and go for a Wimpy and then a shower at the local sports centre, then come back to tackle the day’s work. After work I used to leave with everyone else, but fortunately I had a key and so I was able to sneak back in after an evening at the pub or the climbing wall. I qualified in 1978.
My first job was at the Peterborough Co-Op, but I soon relocated to North Wales and worked at an independent.
I hated the job at the beginning. I found it boring, stressful and repetitive, and in those days the public were often rude. I would blame this on negative media coverage of opticians. However, I was soon blessed with a wife and children and cursed with a big mortgage, so I gritted my teeth and stuck it out.
Being able to examine a patient in their own home enables the practitioner to get a much better picture of their visual situation, for example their lighting, how far they sit from the TV, and posture
This was in the era of the BBC’s Watchdog consumer programme, which was virulently anti-optician. Looking back this criticism was deserved – there was little healthy competition, prices were high, and the quality of eye exams was mediocre, with rudimentary equipment. Everywhere I worked, my patients would commence the consultation by insulting me because of what they had seen on TV.
I was an early recruit to Specsavers. I started as a joint venture partner in Rhyl in 1992, and then also in Llandudno.
It worked very well: the public image of opticians was improving and the job was enjoyable, but it was a much higher volume setup and I found it extremely stressful.
This was at a time of dramatic change in the industry and looking back, they were probably the golden years, before the internet and supermarkets. Healthy competition was good for the independents too, who upped their game in many respects. To this day, a good independent who has identified a niche market is probably in a very safe position.
After 12 years I was burnt out, and in 2004 I left Specsavers.
During my time with them the quality of eye exams and equipment had improved everywhere.
I spent a year walking around the mountains in Wales and in the Alps. It was a time of reflection as I wandered in the wilderness. I was trying to decide what to do with the rest of my life. I dabbled in writing walking guidebooks and also purchased a small woodland; I love working with wood and doing conservation work there.
Then, quite by chance, I was asked to visit the housebound father of one of my friends to see if I could make him some glasses.
I immediately realised I had found my vocation in life.
I started domiciliary part-time and also did some locum work for practitioners who didn’t offer domiciliary visits; this was a good way of getting referrals. I found that advertising was not a good use of money and that networking with social services, hospital eye clinics and GP practices as well as High Street optometry practices who didn’t offer domiciliary work was a much more effective way of building a patient base. Around 2008 I gradually stopped doing locum work, and started full time domiciliary work.
I immediately realised I had found my vocation in life
As an outdoors person I find being on the open road much more enjoyable than being on the High Street. Being able to examine a patient in their own home enables the practitioner to get a much better picture of their visual situation, for example their lighting, how far they sit from the TV, and posture.
Good equipment is absolutely vital, and I have found that a Test Chart 2000 on a lightweight laptop is crucial.
I also have a Zeiss portable retinal camera and an iCare tonometer as well as the usual test room equipment. Low Vision is a very useful additional service to offer, because many of the patients I visit have dry AMD.
Domiciliary work is not for everyone. You need a strong back (there is a lot of bending and carrying heavy bags) and you obviously need a loud voice and map reading skills – the sat nav is often useless in rural areas.
It is hugely satisfying to help housebound patients, but the logistics of planning your journeys to fit in with your patients’ other commitments (GPs, district nurses, meals on wheels, podiatrists, hairdressers, carers – to name but a few) can be challenging.
Care homes, in particular, can be difficult and I try and avoid them if I can – meal times are off limits, and unfortunately, they often seem to coalesce to fill most of the day.
An ideal person to employ to handle the logistics of planning your days and taking calls would possibly be an ex-military person with logistical experience – a disabled person could very easily do this work from home.
I have been full time in domiciliary for 12 years now, and I absolutely love it. I’m 66 and I suppose I should retire, but I cannot bear to contemplate that. I have learnt a lot these last few years, and feel that I do the job well.