The Grumpy Old Optician: The Illusion of Choice
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There is a lot to be grumpy about in our industry.
If you had to distill down why we have got ourselves into some of this mess it was when someone decided that an optical prescription was a commodity. Much of what is wrong in our industry comes down to this illusion of patient choice that people still cling to.
Ask yourself for a minute why patient choice is a good idea?
If you give people the choice of where to access their medical care then they will search out the best services with the best outcomes. The people who are good at their job and provide a good standard of care get rewarded with more patients wanting to access their service. More patients generally mean that the service will benefit financially and grow. So the best stay in business, and the best services grow.
Those that don’t provide a good service and are bad at their job either go out of business or are forced to improve. Giving patient’s the choice in a service industry should mean that standards within that industry constantly improve and evolve. That ultimately benefits every patient, and is why patient choice is a good thing.
However, this does not work in the optical industry because the financial benefit of dealing with a patient comes solely on the sale of a pair of glasses. The clinical skill and equipment needed for an eye test are not valued in the same way. This means we have the situation where a very skilled, very good Optician can go out of business if they don’t sell glasses; and a bad Optician can become very successful if they attract people to buy their glasses.
Instead of the incentive to improve clinical services, the incentive is to dumb down. So we get quicker eye tests, less trained staff and poor quality equipment. There is more incentive to spend money on marketing and glossy adverts rather than clinical training and research.
We all like to see ourselves as good clinicians. We pride ourselves on the service we provide but we are part of an industry that doesn’t value clinical skill. We are not rewarded by our NHS contracts or by our clinical outcomes, instead we are graded on our conversion rates and average patient spend. That’s what makes our industry so frustrating to work in. It is not performance related in the way that we as clinicians value it.
We shouldn’t be surprised that we now have IOP referral refinement schemes that insult the clinical intelligence of good Opticians; or find that still in this day and age we have Opticians that can’t fit children with a decent pair of glasses; or that patients choose to buy contact lenses online. It all stems from this illusion of choice.
Patient choice in our industry does not benefit the group of patients we serve. It was set up to see the patient as a consumer and not a service user. Our industry as a whole is not evolving in a way that benefits the end user. Patient choice in our industry can only lead to a less clinically skilled Optometry sector that is a detriment to patient care as a whole
That is why it is an illusion of choice because patients do not understand the consequences of that choice.
See you next week,
The Grumpy Old Optician
All views expressed are views of the Grumpy Old Optician, SightCare’s sharing of the opinion piece is not an endorsement of any views stated.