Minimize burnout by adding purpose and passion

Rhue ,Brianna;

Minimize burnout by adding purpose and passion

August 8, 2024

By Brianna Rhue, OD, FAAO, FSLS

Publication

Article

Optometry Times JournalAugust digital edition 2024

Volume 16

Issue 08

How myopia management reinvigorated me and my practice.

(Image credit: Adobe Stock / ©Rido)

A recent survey of American Academy of Optometry fellows found 1 in 3 respondents said they were burned out, and 44% said they have a poor quality of life.¹ The term burnout was coined by Herbert Freudenberger in the 1970s to describe the effects of stress on people who were in what he called “helping professions.”²

I believe burnout comes from being overworked, having poor work-life balance, and, most importantly, not feeling valued. Feeling valued—having purpose and contributing to others’ lives—creates an energy that can counteract factors that contribute to burnout. As a clinician, you have to empower yourself to be valued and feel valued. In 2015, I realized that refraction was just a part of what providing great eye care is about. It’s what drives people to the practice, but we have the choice to do more, to look at people more holistically. That same year, I got pregnant with my first son. I’m highly myopic and so is my husband. So my interest in myopia management became very personal. When I added myopia management to my practice, I got my pep back. It gave me passion and purpose and the vision of how I wanted to take care of people’s vision. I wanted my clinic to be our community’s holistic vision experts.

Road to myopia management

After attending a conference on myopia management and learning about clinical advancements internationally and domestically, I became excited about expanding our clinic services to include myopia management. Because it’s clinical in nature and not just a report on refraction, I realized that myopia management would prompt a much different conversation with families. There was a lack of awareness of myopia and minimal information available. If the parents are myopic, they are somewhat familiar with it and the conversation is easier because they've gone through it and know that their vision got worse when they were a kid. They have experienced the thick lenses. Maybe some had a LASIK procedure. But if the parents don't wear glasses and this is the first time they have been told that their child has a vision problem, one that can get worse over time and needs to be treated in addition to being corrected, it requires more information and understanding. We’re not just handing them a prescription; we are discussing how to slow the progression of myopia to prevent complications for this child later in their life.

Because of this, we need a mindset of problem-solving and providing solutions rather than selling. For example, I had a new patient appointment with an 11-year-old girl and her parents. Her glasses were a –4.00 diopter (D) and were 2 years old. She was already scoping a –6.50 D, so I knew it was going to be a myopia conversation and was prepared before I entered the room. As a busy mother, I know it’s a conversation we needed to have in that moment because it’s hard to bring them back in for a consultation visit. As I do the thorough exam, I provide the parent with information about myopia so they can read it while I’m taking keratometry readings, axial length measurements, and a refraction so I can put the entire equation together.

Once the exam is done, it’s time for the conversation, which must include both the child and parents because the solution needs to be one all of them are comfortable and engaged with. If only one parent is at the exam, I often recommend that the present parent have the other one on the phone because I’m going to be talking about treatment that is going to take time to explain and has a monetary investment that they were probably not expecting. I’ve found there are 4 things the conversation must include: what the treatment is, what it does, why they should care (the value), and what the investment is (I forgo the word cost). Remember, every word matters so make the explanation yours.

If there is silence at the end of this portion of the conversation, be comfortable with it. The parents are processing quite a bit of information, and we’re talking about a medical condition and treatment that affect their child now and into the future.

Make it easy to move forward with care

Typically, the first question asked is, “does my insurance cover it?” Although some plans are starting to offer a benefit for myopia management, most don't and it's hard to get the benefit. Myopia is a preventative treatment, which is typically not covered. Our job is to inform the parents, make sure they understand what myopia is and the short- and long-term value of clinical care, and encourage action. We also have to make it as easy as possible for them to move forward with care. That’s why we accept the CareCredit credit card and offer it up front as a financing solution. (Many patients already have it for their dental care or their pets’ veterinary care.) The goal is to slow down the progression of myopia, which means starting treatment immediately. With CareCredit, patients can move forward with care and pay for it over time.

Another way we make it as easy as possible for parents is to do all the work for them. That’s why we created a comprehensive program—Myopia Patrol—to give parents all the needed documentation so implementing care is simple. The Myopia Patrol program includes the contracts, pediatrician letter, school nurse letter, teacher letter, the research around myopia management, and the plan of treatment with all follow-up visits scheduled.

I wanted myopia management to be a big part of our clinic, which it is, along with other areas of focus such as dry eye and scleral contact lenses. But it’s not about specialization; it’s about being the community’s comprehensive eye care experts. It’s exciting for me to treat 6-month-old infants and the 107-year-old patient we’ve been seeing for years. Because another part of mitigating burnout is developing relationships with your patients and team and creating a community around you that sees your value and honors that by paying appropriately for the wonderful care you give. When you get the opportunity to see an 11-year-old girl, –6.50 D, put contacts on for the first time, it is amazing. You look at the parent and they starts crying, and the child is smiling from ear to ear, because you just boosted the girl’s confidence like no one else could with the type of care you give. That's the gift of what we get to do every day.