New England College of Optometry Celebrates 50 years of Commitment to Community-based Training

New England College of Optometry Celebrates 50 years of Commitment to
Community-based Training

On the eve of the 1970s, progressive optometrists were pushing back against the tradition of optometry and leaning toward a broader scope of practice that included the detection, diagnosis and treatment of ocular diseases.

New England College of Optometry responded in 1972 when embarking on a transformational update to its clinical curriculum with the goal of developing optometry students to become primary eye care providers.

For NECO, this meant creating a clinical training model that would move optometry education from refraction and on-campus clinical experiences to a new multidisciplinary co-management of patients with other healthcare professionals in a community-based setting.

“NECO chose a wise path: to go to the people, where they lived, and where they sought care,” said Roger Wilson, OD ‘80, who spent 33 years at NECO expanding its affiliations with health centers and working in their communities.

Community health centers (CHCs) were created to provide health and social services to low-income and medically marginalized communities. (The nation’s first CHC was founded in Dorchester, Massachusetts in 1965.) NECO President William Baldwin and alum Charles F. Mullen, OD ‘69, recognized the multiple advantages that collaborating with CHCs could offer the students.

Dr. Mullen, the clinical architect of the health center training model went on to become National Director of the VA Optometry Services and President of Illinois College of Optometry.

“Optometry students at the time were only seeing a very narrow patient type. The clinical education program needed to be enriched with quantity and diversity of eye conditions such as glaucoma, cataracts and macular degeneration,” wrote Dr. Mullen.

In 1972, NECO established the first formal clinical training agreement with Dorchester House. A year later, it signed agreements with The Dimock Center and South End Community Health Center.

By transforming what traditionally was a micro focus on the eye into a macro view of the health of the whole patient, the NECO and health center collaborations ensured that students gained mastery in the critical thinking needed to competently diagnose, prescribe, and treat any type of optical patient or condition they encountered.

The opportunity to work alongside other healthcare professionals helped change the practice of optometry itself: it raised the level of recognition and respect the profession eventually received.

Change wasn’t easy. Some health center administrators were reluctant to work with students; some doctors and nurses declined to work directly with optometrists; an ophthalmological society opposed cooperation between optometry and ophthalmology; and private optometrists even worried that the new model would threaten their businesses.

Dr. Mullen also noted the importance of a few bold ophthalmologists who withstood the political pressure and helped establish the new optometric-ophthalmological interactional model, which has since been adopted throughout the country.

Positive word of mouth brought support from other organizations who wanted to work with NECO’s optometry students and the services they provided. Soon enough, skeptics became strong supporters.

In 1974, Kenneth Myers, OD ‘74, was appointed as Veterans Health Administration’s first director of optometry. He invited NECO to set up clinical training and residency programs in Boston-area VA medical centers.

The VA added a new dimension to the NECO clinical training model. Students gained exposure to a full range of complex ocular and systemic health conditions like diabetes, hypertension, and neurological and cardiac disease. Two decades later, in 1995, NECO also began its first residency programs based at health centers.

It was the first time optometric faculty worked collaboratively with academic ophthalmologists in community health centers in providing patient care and clinical instruction to optometry students. The principles of this model were adopted by the Department of Veterans Affairs, and later applied in affiliations between Hahnemann University Medical School and the Pennsylvania College of Optometry; and the University of Chicago Department of Ophthalmology and the Illinois College of Optometry.

Today, NECO offers residencies at 14 different community health centers and VA medical centers. NECO students also receive training and externship opportunities through a diverse list of affiliations with teaching hospitals such as Tufts Health Center and Boston Children’s Hospital and with organizations like Perkins School for the Blind, Seamark Vision Clinic at the Cotting School, Pine Street Inn, Army & Navy Health Clinics, and Boston Public Schools.

NECO students embark on their optometric careers knowing what it’s like to be part of the community and to provide vital eye care services to its members. They learn critical skills in diversity, social determinants of health, and cultural humility and competence. Many change their career aspirations toward multidisciplinary, medical-based optometry or even decide to practice at community health centers.