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Ethics & Professionalism: Road to the Future of Eye Care

Posted on February 18, 2021

 

Hello. And welcome today. We are going to speak about the importance of ethics and professionalism, not just during this very difficult COVID 19 pandemic, but for the entire future of eyecare in this country, I am Dr. Thomas Wong an associate clinical professor at the SUNY College of Optometry. I am a proud graduate of both Georgetown University and the State University of New York College of Optometry. I am very privileged to serve as the director of clinical externships and new technologies at the SUNY College of Optometry. Previously, I served as the chief of both adult and pediatric primary eye care at SUNY Optometry and optometry chief at Kaiser Permanente, mid-Atlantic States. Our SUNY College of Optometry is very privileged to be right across the street from Bryant Park and the New York Public Library, right in the center of all the university clubs in Midtown Manhattan. Let's start with the three fundamental principles of professionalism.

 

The first tenant of the optometric oath and the Hippocratic oath has always been that the patient comes first. We affirm the primacy of patient welfare. Next. We have patient autonomy, respect for the self-governance and decision-making ability of our patients. And next, we have social justice where we are able to provide important services to all communities and those less fortunate optometry as well as all of medicine is a team sport. We work in healthcare teams to take care of our communities, patients, and their families. We often hear this term patient-centric, which is often misused. Really what patient-centric means is that we want to improve outcomes for our patients. Now, especially during this COVID-19 global pandemic innovation and new technologies transforming the way we take care of patients is really critical and even more. So we need to emphasize that value-based care is important, providing affordable care to everyone so that it is available to everyone.

 

What makes one, a professional. This is first characterized by special knowledge and application of that knowledge to patients and their communities. Next let's look at empathy, which is an important part of providing compassionate, empathetic care to patients. Next, we have formation which refers to the lifelong professional journey that each optometrist and clinician starts within the beginning of their education throughout their entire life. There is the philosophical question is professionalism, a stable trait. And in my opinion, it is not that it is something we all have to work for study, and strive for and improve in our entire life. Next, we begin with an inquiry, although many optometrists and other clinicians are not university educators or consistent writers and professional journals as I am, but each optometrist and a clinician is obligated to study the science and evidence-based studies to improve care for patients so that we are current and provide state-of-the-art care for patients.

And next, and most importantly, each optometrist, clinician, and healthcare provider is obligated to contribute to the common, good to the discourse and the discussion of what is best for society, our patients, and our communities. How do we approach clinical ethics? It starts with an awareness of the moral content of our actions we need to evaluate. And self-assess our choices of action and intent. We must use reasonable judgment to select choices and make important decisions we need to share and consult with other experts and use other communities and our patient discussion to provide good care that we collaborate with our healthcare teams and our patients. It is normative. We need to answer questions though, about what is good and bad for society and for our patients. Let's talk about principles of bioethics, autonomy, respect for a person's freedom of will or action, non-maleficence primum non nocere when ought not to inflict evil or harm to patients, we cannot provide good care or provide quality care to our patients.

 

And they cannot be our first priority. If we are causing harm next beneficence, the duty to help others prevent evil or harm, remove evil and do or promote good justice giving to each his right or do treating similar cases. Similarly, now let's look at my model of the future eye exam, which I will argue during this COVID-19 pandemic and in the future is going to be much more interactive. It's going to involve discussion of patients, healthcare teams, and other experts. It involves advanced clinical outcome support with new technologies, telehealth, waveform optometry imaging, and all kinds of fancy new technologies. Let's look at my model of the future eye exam, which I would argue during this COVID 19 pandemic and in the future involves new technologies such as telehealth providing advanced clinical outcomes support to patients in their communities. Let's start in the beginning with Cura Personalis, optometry Cura Personalis is a medical concept that refers to the care of the entire person.

 

Each person is not just a number, but a human being with a family, with feelings that we need to treat appropriately with empathy and compassion. Let's look at the base of each eye exam. It starts with the doctor, patient relationship, establishing that trust with each patient and their family and their communities. Let's move to the left and talk about biomedical informatics. We often think of patient surveys and case histories, but in today's high technology world health information exchange, other medical data is in each patient's file. And it allows us to collaborate and provide better care for each patient. More personalized care. Next week, we move to image, which refers to a lot of high-tech imaging, MRIs OTTs and also some older technologies such as ultra-scale, such as ultrasound. We next move to communication with each patient and their families, including healthcare teams and other secondary providers and experts is very vital and key to the care of each patient.

 

Let's move to the right. Unlike past years, we don't just do test one, test two, and test three. It's important that we do the proper testing and it may go out of order and may often be digital and may look following a different sequence to take better care of our patients. It all relates to patient outcomes and education. We can each provide as an optometrist or clinician the best possible medical care to our patients, but if we're not educating them properly and patients don't know how to use their glasses, take their glaucoma meds or their dry eye medications, then we're really not doing anything to improve the health and outcomes for our patients and communities. It all relates to clinical outcomes support, whether it's high technology or older technologies moving forward. The important thing is it's going to be more interactive and more collaborative allowing patients to have really a say in how they are cared for.

 

I have been fortunate throughout my life to participate in Georgetown University's Kennedy Institute of Bioethics and the Pellegrino Medical Ethics Intensive Bioethics course in June, where experts from medical schools and countries all over the world, come to collaborate and discuss the proper ethical behavior and care for patients. It's not just about the proper clinical and scientific care, although that is vital to each patient's care, but certainly ethical, compassionate care is important to improving outcomes and doing what's best for the common good. And for society. I am Dr. Thomas Wong. It's been a pleasure to speak to you today, and I want to thank you.

 

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