To Dr. Charles Hom, History Serves Both as an Example and a Guide to Growth

By Jay Hipps, Hacienda Network Staff Writer

One of the benefits of a liberal arts education is an exposure to a wide variety of thought on any given subject. The idea is that in approaching the same subject from a variety of perspectives, something more can be gleaned about the nature of that subject than from simply looking at it from one point of view. Students of history like to add a fourth dimension to the picture and see how things change and evolve over time.

Dr. Charles Hom makes his living as an optometrist but the liberal arts he studied at UC Berkeley have played a key role in how he manages his practice and even how he views his profession.

"In college, I had a humanities professor who was always questioning his students about things like, 'Why are you here?' He was always saying that life has no meaning except for the meaning that we put into it, which is an interesting philosophy, and he emphasized learning, trying to learn as much as you can," he recalls. "He recommended that everybody learn about history because history goes in cycles or repeats itself, so you can learn a lot about humanity and people just by reading history."

Dr. Hom notes that he's not just talking about political histories but that he sees historical knowledge as a tool that can be applied to any arena.

"I look at history as more of a tool that you can apply to the future. You can take elements of the past and apply them to yourself today and your outlook for your prospects going forward. To me, the future is in research and in people today."

The subject has been on Dr. Hom's mind a lot now because of discussions among optometrists about the future of their profession. He has recently submitted papers on subjects ranging from hypertension to the early detection of cancer, putting voice to his belief that increasing the role of optometrists would strengthen the public's access to health care.

"There's a big debate among optometrists right now about whether we should increase our scope of practice," he says. "There are some elements in my profession that are working very hard to expand the scope of practice - they want to do surgery, they want to do laser surgery, they want to treat hypertension and diabetes and things of that nature. There's another group in our profession that is very conservative and don't want to upset the balance, don't want to rock the boat. Then there's another group that's pushing very hard for education among optometrists, saying, 'The other medical professions aren't going to help us so let's push very hard to learn about all the aspects of surgery and medicine and everything else that might affect our profession so that we can do it on our own.' There's a certain amount of independence that optometry is striving for and it's interesting how the situation is working itself out. Personally, I think that society's changing and as society changes, optometry will have to adapt like everything else."

Moreover, Dr. Hom points to a social benefit which will be derived if optometrists expand into other, systematic manifestations of ocular disease.

"Part of the problem with the medical profession today is that people don't have (access to care) because of the costs involved, so one of optometry's arguments is that by expanding our scope of practice we can make the health care profession more accessible to people - people who can't afford it, people who don't have insurance, that sort of thing."

To anyone who has been treated by an optometrist in the past, these might seem like radical changes. Dr. Hom explains that it's not as big a change as it may seem.

"It's all related," he says. "The eyes are highly interconnected with the body, so anything that goes on with the body affects the eye. For example, the retina is the only place in the human body where you can actually observe the cardiovascular system... when we're looking in there, we can assess the arteries and the veins and to some extent how the heart is doing. So just by doing a few more tests - listening to the heart, EKGs and things like that - I think we could do a lot more in terms of assessing the cardiovascular system. It's all related so it's a natural progression.

"More and more optometrists are actually measuring blood pressure nowadays. Some of them are even running fasting glucose tests in the office. I think it's good for the public but only if individual optometrists take the time to educate themselves, to make sure they're on top of the newest information."

In Hom's case, he relies on extensive interviews with his patients which cover their medical history and elements of their family's medical history, all in an effort to get a better picture of both that persons overall health and areas of susceptibility.

"The focus with cancer, for example, is early detection, so during the eye examination you ask them certain questions on the case history. You basically spend some time talking to the patient a little bit about their family history and personal history with cancer, their diet and exercise habits, and things of that nature. It goes beyond the traditional eye exam and into what traditionally a medical doctor may have been doing, so we are moving in that direction."

Dr. Hom thinks that optometrists could make a greater contribution to both the public's health and to the body of knowledge used by the healing professions.

"When you're diagnosing a disease, it always helps to have more than one symptom. (Expanding the role of optometrists could) make things a lot better because we're bringing in a new way of looking at things and a new profession to health care, to upgrade the new system."

While his personal interest is in helping make those changes occur, he remains circumspect about his goals.

"I think the main point is that our profession has to remain flexible, has to adapt, so if that's where the public needs us to do that, that's what we'll do," he says. "If the public doesn't need us in that arena, we won't be there."

Still, it's a change he would like to see.

"I'm always open to new technologies and new things. I don't like to be too sedentary, to just sit there and watch life pass us by. If it's out there and I think we can help the public and challenge ourselves and expand the profession, I'm all for it."

There's a simple logic behind his thought. Many people may forego annual medical checkups but some of them may visit their optometrist more regularly. Why not expand that doctor's role to something beyond a simple eye exam?

"When you have the patient in your chair and you're checking that patient, you actually go into the background of that patient and sometimes you might see something that might indicate or suggest certain things so you want to dig a little bit deeper," he says. "The way it's set up now, we have to refer someone like that to an MD. In the future, hopefully we'll be able to do that ourselves."

It won't be the first time that doctors, acting on new information about human health, expanded their areas of treatment. There's a long history of that.

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