Editorial: The lure

Abstract

On many an occasion, I am asked by my colleagues about the issue of therapeutic drugs for optometrists. Generally, the question relates to circumstances in their own locale, however, they will also ask about other jurisdictions and other situations. Why? Perhaps it is to provide them with some reassurance that the question is a universal one with optometrists; perhaps i1t is to determine where the matter ranks among the priorities of Canadian Optometry.

When the question arises, I invariably remember comments from certain colleagues, some in influential positions, who are concerned about the creation of a tiered service system; i.e., one group of practitioners who would be allowed to use therapeutics and one: group that, of its own volition, avoids its use. This situation in many ways reflects the actuality of existing practice and the level of responsibility accepted by the practitioner in providing care to a patient. The practitioner can choose to treat certain conditions or choose to refer certain conditions. This is the premise of professional judgement and knowing one's level of capability. (Dr Laurence Peter has made a fortune expanding and espousing this premise as a "principle" through at least two books.)

In my mind, this concern about a tiered system does not rationally address the question. Additional comments relate to the perception that some aspects of optometric therapy will be avoided or even lost to the lure of thera­peutic prescription drugs. I reflect upon ophthalmological practice and the surgical skills they are trained to provide and wonder if, because of the lure of surge1y, they have lost their acumen in treatment for various nonsurgical problems.

It appears inevitable that some individuals will gravitate toward those areas of practice that they perceive might provide them with greater challenge or reward. Unless educational institutions forgo the training of knowledge and skills in all aspects of optometric care, it seems unlikely that these skills and abilities will be lost altogether to the profession or our patients.

The challenge we face is optimal, effective, efficient patient care. Will patients benefit from optometric thera­peutic drug use? Will the health care system benefit?