An optometric calling

Why did you embark on a career in optometry?

It was partly for educational reasons – I am of a generation where we had an exam called the 11-plus, which separated the ‘bright’ from their counterparts. I managed to fail the exam and, as a result, attended a secondary modern where my choices in terms of O Levels were somewhat limited. However, I attended a grammar school during sixth form and got a couple of A Levels. 

Throughout my school years, I had a vague idea that I might like to do something healthcare-related. We used to have career advisers in those days, and I remember sitting in their waiting room and there was a brochure on ophthalmic optics sitting on the rack. I picked it up, had a look through it, and thought that it seemed like an interesting career. From there, I went to the open day at City University and got bitten by the optics bug.

Has your career been what you would have expected?

It has been much, much more. Entering optics, I assumed that I would be a ‘normal’ community practitioner for my entire career, but it turned out to be much more varied and interesting than I ever thought that it would be.

Who are the people that you feel have impacted on your career?

This is a really difficult question – there have been a few people that I have worked with along the way, particularly when I was younger and less experienced, who really impacted on me. 

Optometrists John Francis, Ron Mallett, Janet Stone and Ron Rabbetts, who I worked with at the London Refraction Hospital (now the Institute of Optometry) are some of them. They were great clinicians, good with patients and excellent teachers. They taught me a lot, most of which has stayed with me throughout my career.

How has the sector changed during your time in the profession?  

There have been a lot of changes, but one of the most significant has to be technology-related.

The instruments that we have these days, particularly imaging, I don’t think anybody would have previously conceived. When I was starting out, practitioners generally had a direct ophthalmoscope and possibly a slit lamp in their armoury. One or two of the big institutions had fundus cameras, but these were huge bits of kit with massive flash attachments. Now we have things like optical coherence tomography (OCT), which gives practitioners almost undreamed of levels of imaging – what we can see and do with an OCT is amazing. The technological changes I’ve observed have just been phenomenal. 

"Entering optics, I assumed that I would be a 'normal' community practitioner for my entire career, but it turned out to be much more varied and interesting than I ever thought that it would be"

What has been the most significant change that you have seen the profession go through?

I think that one of the big changes that has been occurring in optics in recent years, and one that I am most concerned about, is the decline in independent practices. The landscape has changed quite a lot, and I’m saddened by it.

I started life in independent practice and I think it’s a shame that the majority of young optometrists today aren’t able to see the possibilities and a future linked to setting up their own independent practice. Sadly I do worry that the days of independent practices are numbered. 

With an education review underway by the General Optical Council, what’s your view on the future of education for optometrists?

For some time now, I have felt that the profession has gotten to the point where a three-year undergraduate course is not long enough. From an educational point of view, when I was a student, the curriculum was smaller and we saw many more real patients than has been the case for a very long time now. We probably saw 50–60 patients in the final year in those days, compared to an undergraduate now who is lucky to see 10–20.

What I hope the GOC will recognise and recommend as part of its review is that too many things are being squeezed into the undergraduate course and too many other things sacrificed, and will recommend lengthening the degree. I believe that a four-year undergraduate degree, followed by a traditional pre-reg period is what is needed.

You joined the AOP in 2006, what have been your standout achievements during this time?

I don’t think I can claim to have any standout achievements – I’ve just done my job as effectively as I can. However, there are two things that I am particularly proud of. The first is the development of Quality in Optometry (QiO). I was involved quite significantly in the early development of the tool and wrote much of the original version. QiO has proven to be a really useful resource for AOP members. 

The second relates to the consultation on independent prescribing. I drafted a response, which the AOP Board to agreed to, that took a much more aggressive position than what was adopted by other professional bodies. In our response, we asked lobbied for optometrists to be able to prescribe any licensed medicine for any condition within their skill and competence. And that’s what ended up being agreed.

What has been the overall highlight of your career?

I’ve always liked working in teams, and I have to say that, despite the long hours and very hard work, my time at the Institute of Optometry was really fun. I worked with lots of young, very talented people – there was a buzz about it, which made it a really good place to be at that time. Plus I met my future wife when I was working there.

"Mixture is the one thing that I have been really blessed with in the way that my career has evolved. I've had a really nice mixture of things to do"

Any career regrets or disappointments?

I don’t think so – I’ve been very lucky. I picked a career that suited me, and I’ve met a lot of wonderful people and learnt a lot along the way, while hopefully making a minor contribution.

Variety is the one thing that I have been really blessed with in the way that my career has evolved. I’ve had a really nice mixture of things to do.

If you could change one thing about the profession, what would it be and why?

Based on my experience of working at the AOP, and the situations that we deal with, if I could change one thing, I would remove the commercial pressures that are put on our members – pressures to see more patients in a shorter period of time, conversion rates and having to generate sales, to name a few. That is a significant challenge for the profession in itself, and I’m not sure I have the answer for how to deal with it.

What pearl of wisdom would you share with undergraduates who are preparing to enter the profession today?

Don’t lose sight of the fact that the patient must come first. I recognise that there are lots of pressures on optometrists these days, but, ultimately, we are there to help the public, to make a difference and to help them use the sight to their fullest.

Where do you think the profession will be in 2030 and what key changes will have taken place?

I think that the most significant changes ahead will be brought about by technology and new ways of doing things. However, there are big technological threats that need to be recognised and addressed also, such as online sight tests, apps and Doctor Google. And while I think that they will drive key changes over the next decade, I’m not sure I would like to predict what those changes will be. It is up to the profession to meet those challenges and to find a way of adapting and dealing with them effectively.

What will you miss about the profession once you retire?

I’m not going to retire completely just yet – I will keep my hand in optics with some consultancy work – it’s going to be a soft retirement.