Medicine

GP and Allied Health relationship breakdown

I can’t find a doctor to talk to, nor do I want to. Not right now at least. Let me tell you why.

I am a graduate optometrist of three years and today I can’t believe the mindset of some older GPs.

I was working in an Aboriginal clinic and saw a twenty-six-year-old male with a history of migraines that were worsening recently.

His hyperopia (long-sightedness) had increased one diopter over four years, so I prescribed him a new prescription and since his migraines had gotten worse, told him to see the GP next door.

His GP walks him back down the hallway stating, “Go see your optometrist for a retinal photo so I can send it to an ophthalmologist.”

To explain the situation, I have already performed a dilated fundus exam on the patient to discover no ocular abnormalities and essentially ruling out any possibility of papilloedema (optic nerve swelling which is a medical emergency).

I then met the GP to tell him that there is no need to send the photos to an ophthalmologist since I have already checked the retina and it looks fine. Judging from the look on his face, I could tell he didn’t believe me.

And this is where our trust in each other smashed into pieces.

I continued to explain that there was no papilledema and no concern to seek an ophthalmologist’s help. I call ophthalmologists every day for referrals and this close contact allows me to refer patients with ease and establish good working relationships with them.

Unfortunately, the GP still didn’t believe me. So, I took a photo on my phone and sent it to an ophthalmologist. This takes me two seconds and usually I’ll get a reply back immediately – which I did. The GP even knew the ophthalmologist that I had just texted retinal photos too.

AND GUESS WHAT. The GP didn’t believe me that I had contacted the ophthalmologist and that the answer from the ophthalmologist was more reliable information.

At this point, I was holding back my frustration as the patient was still present.

So, I called the ophthalmologist and the GP spoke to him on a live face-to-face call. The ophthalmologist said hello and reassured the GP. Fortunately, there were no abnormalities in the retina.

There was no concern – apart from the fact that I was made to feel completely invisible.

Optometry is a fast evolving profession. There have been advances in technology over the last ten years that have expanded our scope of practice. I think the GP was unaware of the capabilities we have as optometrists. If a patient presents any new concerning changes in vision, it is a requirement to perform a dilated fundus exam to rule out any pathology.

Usually, my job is awesome and I have great working relationships with newer GPs. My dad is a GP and he’s definitely a lot more understanding.

The take-home message here is to make sure you understand each allied health’s role and their scope of practice. Use them to the patient’s advantage and keep them involved in the patient’s care by writing back and explaining your findings.

If you’ve got any GP parents go ahead and show them this – maybe it will change their perspective on optometry.

We know more than meets the eye.

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Veeran Morar

Veeran Morar

Veeran is a recent graduate optometrist who moved to Australia from New Zealand. He spends the majority of his time working in the outback and likes to write about his experiences and people that he has encountered so far.