COMMENTARY

Good Eye Care Can Be Given Anywhere

Christina M. Sorenson, OD

Disclosures

July 01, 2014

The locum tenens position was advertised as a 2-month appointment to allow the current optometrist some family time. It was located in a small, isolated community that had a very large draw for eye care. There were 2 examination suites: One was described as the "grand suite," with 5 examination lanes, and the second was the "private suite," with 3 examination lanes. Full staffing and equipment were promised.

Travel to the site was difficult, taking about 5 hours over a rutted, muddy track of a road after a 4-hour drive to the turn-off. I arrived early on my start date to familiarize myself with the patient order, the lane equipment, and the medical records -- paper or electronic?

My first day was on a Tuesday. The schedule was packed with everything from cosmetic contact lens fitting to ocular trauma. As at many isolated community centers, appointments were made in cattle-call fashion. Patients show up either at 9:00 AM or at 1:00 PM. The doctors crank through as many patients as they can in the morning, stop at 12:55 PM to swallow a few bites of a mid-day meal and to guzzle some water, and then start all over again at 1:00 PM.

As I entered the grand suite, I was overwhelmed by the blinding green AstroTurf that covered almost every surface -- the floors, the half-walls separating the exam lanes, and the cabinet fronts. It turned out that a local resident was somehow involved in the development of the artificial turf, and this was his donation to the center.

The stands were all of the tripod variety, with plus cylinder phoropters of the 1950s era, entirely of metal and weighing about half a ton. A good upper arm workout, I reasoned. A single Project-O-Chart cleverly served all 5 lanes. The chairs were the metallic putty-gray fold-up type. The slit lamp was on a rolling table tethered to a central extension cord that afforded enough length to travel from lane to lane without having to plug and unplug. The supply cabinet had the requisite eye drops, and a good supply of ophthalmic samples to start therapy when needed.

The private suite differed from the grand suite in size and lighting. There were only 3 examination lanes, and the lighting was muted; it reminded me of those windowless steak houses with the tall wooden booths and the red glass candle in the center of the table. You got up to go to the buffet line and then return to your own private man-cave of a table to gobble your plate of food. I think the darkness was intended to achieve the privacy designation.

As I waded through the flashes and floaters presentations, the myriad of red eyes, the contact lenses, and the refractive cases, it occurred to me that despite the AstroTurf and the drive-in movie atmosphere, the care delivered was no different from that at any typical upscale office. This thought brought a smile to my face until I touched the Project-O-Chart and the entirely metal phoropter, which completed a circuit and blew me across the room, killing all of the lights in a full-block radius -- and so ended my first day as a locum tenens optometrist.

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