Realistic medicine

Earlier this week the Scottish Chief Medical Officer announced a new initiative called “Realistic Medicine”. In this initiative health care professionals are encouraged to listen to our patients and discuss possible treatment outcomes before prescribing any form on intervention. By coincidence I was attending an NHS meeting discussing how optometry in NHS Highland can help improve patient care.

Over the past ten years the Scottish government has promoted optometry as the gate keeper for eye care. We are expected to listen to our patients, discuss possible treatment plans and then, where appropriate, prescribe glasses or offer relevant forms of treatment or, where necessary, refer our patients to the appropriate hospital department. Sounds familiar, doesn’t it? Because of our expertise in eye- care, and the sophisticated equipment now available in optometric practices GPs encouraged to send their patients with eye problems for an optometric evaluation before being referred to hospital.

This can only work where there is honesty and trust between the optometrist and the patient. Last week I had a patient who categorically refused to discuss his occupation, hobbies and medication. With so many drugs prescribed which can have an effect on the human eye it is essential your optometrist is informed of your general health problems. Likewise, many occupations require specific forms of optical correction; computer glasses or safety glasses being two examples.

Many people simply see optometrists only as providers of glasses. With one exception the national chains heavily promote the sale of glasses with no mention of the importance of eye- care. Your optometrist has spent at least three years in clinical training learning not only about eyes and vision but also much about general medicine and how it interacts with our eyes. Optometrists are bound by the same NHS rules and regulations on confidentiality and behaviour as GPs and dentists.