Taking the High Road


Toward the end of Robert Frost’s poem, he says that he kept the first road for another day, doubting that he should ever come back. That is perhaps why he tells of his choice to take the road less traveled by … with a sigh.

With regard to our practices, the road less travelled is usually the one on which we swallow our tongues when someone says something that misrepresents what we do. Most often in the VT world that is a pediatrician or ophthalmologist, and I have blogged and written about that ad nauseam. It is what we have referred to as “The Cats Must Also Fail Syndrome”, patterned after the comic drawn by Leo Cullum,  for The New Yorker magazine, and adapted from a line by Gore Vidal. Freud would have had a field day with such insecurities.

What has made all the difference is when we take the high road, ignore the misrepresentation, and carry on doing what we do – which is to keep the best interests of the patient paramount at all times. Thankfully there are sufficient numbers of professionals and parents who substantiate our outcomes, and word of mouth referrals continue to keep our practices going strong.

It is therefore a bit mystifying, and to some extent disappointing to encounter an optometrist who misrepresents what another optometrist does. In order to share information about what I am doing with prism in my consulting practice, I sent a letter to all of the optometrists in our area with a hard copy of an article on the subject, as well as a link to the article online. I did this not to toot my own horn (I have a significant waiting list for appointments and don’t seek optometric referrals), but to help fellow ODs follow a template should they be interested in prescribing therapeutically for the population that we see. Indeed, due to the volume of referrals from OTs, PTs, SLPs, teachers, reading specialists, and pediatricians which is almost more than I can handle, I would love nothing more than to have others duplicate our success.

The response of ODs in our area has been underwhelming. One started to Rx prism in a cookie-cutter fashion simply because patients were coming to him expecting to have prism prescribed. Another OD, who I’ll call Dr. Y, refers to a colleague outside of our area, Dr. X who uses an electrodiagnostic technique. Despite receiving my article, Dr. Y tells his patients: “You need to see Dr. X because prism can’t be prescribed accurately without the machine that he uses. To do it the way Dr. Press does is more of a guessing game.”

That is sad because as many patients as I see, there are considerably more who could benefit from a well-founded and well-grounded prism approach. Each of us has patients who are challenging despite our best efforts. They seem to weigh more heavily on our consciousness than “feel good” patients until we remind ourselves that the latter far outnumber the former. The same holds true of colleagues, some of whom are apparently insecure to the point of needing to elevate themselves or their opinions rather than having an honest and open dialogue.

With somewhat of a sigh I feel sorry in a way for Dr. Y, though it won’t change my contentment or security in remaining on the road less travelled. I share these thoughts primarily to bolster colleagues who face similar challenges. Other colleagues have in fact bolstered me. A couple of years ago, at the peak of COVID-19, I gave a Zoom lecture on my neuro-therapeutic approach to microprism, which resulted in an invitation to give a similar lecture to the COVD chapter in Israel. A few weeks ago, I received this lovely e-mail from a VT-OD colleague there:

It has been about a year and half since you lectured about rxing prisms and since then my husband and I have been rxing a ton more than we used to and with far more confidence.  Embarrassingly, we used to hardly check vertical prisms at all and I believe that was a missing component that left us scratching our heads with a good handful of patients.  My husband, does not enjoy VT at all but regular ol’ optometry was really boring him until he saw your lectures.  Since then, he is literally changing lives daily and his name is really getting around.  Clients are traveling from all over the north and even from other parts of Israel to see him because of the amazing effects that others have felt and are talking about.  And he is feeling so much satisfaction from his job!

Signposts like these illuminate the road less travelled.

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