Inferiority complexity?

A new case study by the AOA Ethics & Values Committee tackles the potentially ticklish issue of the relationship between new doctors of optometry and medical doctors in a multidisciplinary practice.

Authored by committee member Inrava Khasnabish, O.D., the case explores the topic of new optometry school graduates working with ophthalmologists. Some new graduates may encounter feelings of an inferiority complex to the medical doctors (OMDs) in the practice. But that can be overcome, Dr. Khasnabish said.

“This case will explore the relationship fostered by an OD within an OMD practice and how newer graduates may experience an inferiority complex with OMDs, where in reality the OD-OMD relationship is a beautiful springboard when in the right setting, all parties flourish,” she writes in the case study, “Outgrowing the ‘Inferiority Complex’ as a New Clinician” available in AOA’s EyeLearn Professional Development Hub.

The ethical dilemma

In the case, Dr. Khasnabish describes the workings of a “high-volume MD/OD medical practice in an urban setting” that a recent graduate has joined. The graduate works with an ophthalmologist who regularly performs cornea crosslinking in patients with keratoconus. refers basic refractions to new graduates—leaving them both dissatisfied with the arrangement, the case’s author says

“What can and should this (young) clinician do?” Dr. Khasnabish wrote. “She possesses a skillset that would prove valuable and useful to the cornea specialist, and she is confident in her clinical abilities, but how does she articulate this to her ophthalmology counterparts? Is there a way for her to develop stronger relationships with referral partners both within her practice and in her neighborhood?”

In the subsequent discussion, Dr. Khasnabish suggests that handling these complex relationships takes a multifaceted and collaborative approach to managing care. An evolving health care landscape—co-managing cases—demands it, she adds. But, you have to work at it.

“This discussion considers techniques I have observed along the way that have helped me outgrow the looming inferiority complex that comes along with being a new graduate,” Dr. Khasnabish writes.

Among her helpful recommendations to new grads:

• Advocate for your own skills.
• Find mentors and seek their guidance.
• Maintain an active dialogue with other members of the health care team.
• Be willing to ask questions.
• Be open to learning and growing after graduation.
• Recognize the limits of one’s own expertise.

Passing on her personal wisdom

Since graduation, she has worked in a variety of setting. She currently practices in Ozone Park, New York, but previously worked in high-volume ophthalmology practices and in the ophthalmology department at a level one trauma center.

“I have a lot in common with the provider in the case,” she says. “I was working with a cornea specialist right out of residency and let him know about my additional expertise. Working in his office, I learned a lot about the importance of advocating for oneself and the importance of direct communication in order to fulfill the goals of his practice in addition to my goals in clinical growth.

“I think being a new grad is really daunting, and having some set of guidance would have been so helpful for me, which is why this case is so personal and I hope it helps all newer (and seasoned) grads.”

Have an ethical dilemma?

The AOA Ethics and Values Committee routinely produces hypothetical case studies concerning ethical challenges and how best to approach such situations based on the AOA Standards of Professional Conduct, AOA Code of Ethics and the Optometric Oath. Access these case studies through AOA’s member-exclusive, centralized education portal, the AOA’s EyeLearn Professional Development Hub.

Have an ethical challenge or question you wish to share? Submit your idea or a case description to legal@aoa.org. The case description may be reviewed by the AOA Ethics & Values Committee.