The optimism of a student. I’ve had that phrase thrown at me more than once. Just last week I attended an educational dinner surrounded by dozens of practicing optometrists. I got to meet many of them and as a 4th year student just a few weeks away from graduation, we talked a lot about my ideas for the future of my career and the direction of optometry.
The optimism of a student, they said. I had doctors 20 years out, 10 ten years out, even 2 years out, label me that way, and tell me that “all students believe they’ll graduate and save the world, until they actually graduate and see the real world and interact with real patients.” A handful of them even were even taking bets with each other to see how long it would take before I became like them. FYI the consensus was it would take me about 5 years.
And I while don’t necessarily agree with them, I completely understand where they’re coming from and why they have that mentality. They themselves didn’t believe they were pessimists, if anything, they considered themselves pragmatists and realists. With the state of healthcare today, I don’t blame them. All healthcare providers are constantly being pressured to see more patients in less time for a smaller reimbursement.
Gone are the days when you can spend a whole hour with a patient listening to their stories and getting to know their families. In certain metrics, 2 patients an hour is considered the bare minimum and 3 or 4 patients an hour are the standard now-a-days. Who knows, in a few years 3-4 patients an hour may be considered the new minimum.
In my first rotation as a fourth year, I had the opportunity to work at a family health center in Florida that catered to families of low socio-economic background. When I first arrived they had me go through the orientation process of getting my name badge and learning the EHR system and then shadowing exams. After 2 hours of this, they showed me my exam room and said, “Here’s your schedule.” I had 6-8 patients each hour for the rest of the day. And that was what my schedule was like the entire time I was there. 6-8 patients an hour at 40 hours a week. You can imagine how many patients I saw. It was a grind, and I somehow got through it every day. Coffee was my best friend.
About a month into the rotation, there was a particular exam that I remember distinctly. My patient was a six year old girl whose mother brought her in because her teacher mentioned that she seemed to be having difficulty seeing the board. After a wet refraction, I found that she was a moderate hyperope with about 3 diopters of astigmatism in each eye. Luckily she was able to see 20/20 corrected. When I explained to her mother what was going on, she burst into tears and started sobbing about how she was a bad mother for not knowing or bringing her daughter in sooner. My patient climbed down from the chair to hug her mom and started crying with her. I sat there reassuring them both about how she was going to be okay and how we would be able to help her see clearly. I sat and waited with them until they had collected themselves and were ready to leave.
Outside of the exam room, my preceptor pulled me aside and asked me, “Why did it take you so long to see that patient?” I explained to him what happened, and what he told me next I’ll never forget. “Look, we’re here to be their eye doctors. If they want to sit and cry, they can either do it on their own time, or we can start charging them for being their psychiatrists. Either way, now you’re behind and have 3 patients waiting for you. Go.”
Now don’t get me wrong, overall it was a good rotation, and I would have stayed for another 3 months if I could have. I learned a lot about the art of refracting, about diagnosing, about prescribing, about optometry, and about myself. I learned what to do and the type of doctor I wanted to be, but more importantly, I learn what not to do, the type of doctor I didn’t want to be.
So maybe those doctors I had dinner with last week will be right. Maybe in 5 years, I’ll look back at this video and look at this bright eyed, younger version of myself and laugh. The optimism of a student.
But maybe, just maybe, I’ll be able to look back and see the same thing I see when I look at myself in the mirror each morning.
The optimism of a student.
Thanks for listening.
