It is 2020 and I declare it the year of the optometrist. We should be grasping each day with pride and energy. We should be fulfilling the great future of our profession.
This is not an easy task. We live in a world that shakes our sense of safety. We are witnessing a major revolution in the delivery of health care, we worry about the stability of governments, we watch as countries burn. What are we, as individual professionals, to do under these harrowing conditions? My answer is to concentrate on what we do best. I believe that we should read and learn and practice the excellence that this Academy stands for.
To this end, the Academy's Strategic Plan delivers a perfect map. You may already have embraced the activities that the Education Pillar offers. This month it is Research that captures my imagination. As Zora Neale Hurston stated, “Research is formalized curiosity. It is probing and prying with a purpose.”
Research is an interesting word that suggests returning to the search. In my experience with my colleagues, it triggers 2 opposite reactions: the eye-rolling what-has-this-got-to-do-with-me reaction and the wondrous GIMME MORE. As a profession we have a tendency to divide ourselves into scientists and clinicians and believe only scientists can do the research. At some institutions, research scientists are considered the "real" faculty, while clinical teachers take second place. None of these divisions are real, of course. The physicians I work with are immersed in clinical research within their practices. The truth is, that without clinicians delivering the science to our patients, we have no profession. Without science leading our profession, we fall to technicians.
Basic science, translational science and clinical science are all essential aspects of our profession. All of us can contribute to the broad, bold initiatives of the Research Pillar of the Academy’s Strategic Plan:
a. Increased scientific engagement within the Academy
b. Working with the Foundation to financially support ODs pursuing PhDs
c. Continuing to host our Research Academy every other year
d. Creating Think Tanks to discuss important research questions
e. Creating a Cochrane Center of Excellence within the Academy
f. Creating an Academy Clinical Research Training Certificate Program so that more clinicians can incorporate research into their practices
I am going to concentrate on the last two items. As a clinician, I have been inspired, renewed and humbled by the clinical research performed in my office. I know that clinical Academy Fellows can find a way to enhance their professional lives through participation in research.
Let's take the Cochrane Review idea. Like you, I try to keep up with the literature and thereby maintain my evidence-based diagnostic and treatment skills. But this isn't very easy. For one, I do not have access to a library to receive full transcripts of most papers. Also, there is so much to read that I am not sure that I am weighting the information correctly. By definition, the Cochrane approach takes a topic and defines which results are more important based on scientific rigor. Important factors like the number of subjects, and the use of control groups influence the final outcomes. A Cochrane review can give you all of the information you need to maintain your practice. I, for one, would love to participate in a Cochrane review of the visual, refractive, and patient satisfaction results of cataract surgery. I have scoured the literature and found most papers are authored by the surgeons who did the work, and that they report on 3-6 month findings. My post operative clinical care of these people does not match up with the published results.
And what about a research training certificate? Right now, the Fellows Doing Research SIG gathers groups of clinicians who have clinical questions and helps them formulate their studies, including the traditional Academy Booth at our annual meeting. As a part of that process, FDR leadership trains these Fellows in best clinical practices and the rules of research. Our Strategic Plan Research Subcommittee believes that workshops and online teaching of these rules can lead to an Academy certificate. With this accomplishment, Fellows can create their own studies or work with our industry partners to help them investigate medications, contact lenses, and dry eye products.
So as we grapple with climate change, who should lead us, and how to raise a family, we can concentrate on our professional lives and use this oasis known as the American Academy of Optometry, to improve our days. Why not take a chance and participate in the initiatives of this Research Pillar. Great discoveries await us.