- Perhaps no other field of medicine is expanding as quickly in its knowledge of the disease process and its use of technology to detect and correct problems.
- The world's population is expanding and living longer; therefore people who expect to be well and active into their senior years are demanding more and better eye care services.
- Pressure from the government and insurers to reduce the cost of eye care is encouraging providers to find creative ways of safely supplying services through alternative means like same-day surgery centers by employing a beam of care providers who can boost the productivity of an office or department. This trend is making eye care more affordable and more accessible.
Recently, the eye care industry has been successful in attracting a diversified pool of aspiring professionals. There are many programs for people of any age, sex, or cultural background who seek a career in eye care including financial aid for training. One of the most comprehensive programs is administered by the Association of American Medical Colleges. The goal of the AAMC's "Project 3000 by 2000" is to dramatically increase the number of under-represented minority students enrolling in U.S. medical schools. Since the problem of minority underrepresentation is common to all of the health professions and health science research specialties, the AAMC now cooperates with other health professions schools and graduate health science programs. AAMC projects also include summer educational experiences to encourage promising minority students to pursue a career in medicine and seminars to help minority junior faculty with promotion to leadership and mentoring roles in academic medicine.
The health care field always has been in the forefront of training, hiring, and promoting disabled workers. As you read about the various career opportunities, imagine what it would take to accommodate a disabled worker: a closer parking space, barrier-free buildings, equipment that could be lowered, communication devices such as TTD or Braille directional signs.
Many are the places where eye care workers have already made these changes for patients. There is little data on the number of disabled workers in the eye care field because disability doesn't matter as much as giving good patient care.
The Ethical Dilemmas of Modern Eye Care
In health care, progress is a double-edged sword. With each advance, there is both the potential to do good and the potential to do harm. In a society where the expectation for a high level of technology clashes with the limited availability of resources, the boundaries between good and harm are often blurred. In a care-giving profession, the care givers must have a strong sense of what is right and what is fair. This is what constitutes ethical behavior in the world of treatment and research. It is also the greatest intangible reward for choosing a career in health care… the knowledge that you leave the world a better place than you found it. But who gets to decide what is "better?"
A double-edged sword facing ophthalmologists these days is the increasing use of practice guidelines that are algorithms or formulas for providing efficient care, Man-aged-care insurers are particularly interested in these formulas because they can result in a lower cost of care. Fortunately, many physicians who resent being told to use the cookbook recipe for patient care have applied their good medical research skills to not only looking for the cure of disease, but also the safest process of treatment. In Canada, where national health care has been available to citizens for a long time, the Canadian Medical Association has taken an active role in compiling a database of physician-developed practice guidelines. The Medical Association has redefined practice guidelines as "systematically developed statements to help physicians and patients make decisions about appropriate health care in specific clinical circumstances."
Ophthalmic research is another area of ethical controversy. You know the future of ophthalmology and know that the science of genetics figures prominently in the elimination of vision-threatening diseases. But who decides that blindness is a human "defect" that should be eliminated? Think of the contributions of blind musicians, scientists, and humanitarians.
Using animals in biomedical research is also an ethical dilemma facing all scientists. Fortunately, there are guidelines for the humane treatment of research animals that are strictly enforced. But if you are opposed to animal research, you may want to avoid pursuing an eye care career that will require experimentation on the job or as part of your training.
