Access to eye care is out of reach for many Community Health Center patients around the country. The New England College of Optometry (NECO), which is celebrating 50 years of training students and serving patients in health centers throughout Massachusetts, is trying to change that statistic. As the first optometry school to conceive and create such a clinical training model, NECO has influenced thousands of optometrists and optometry itself. NECO has provided over 1 million eye exams in community health centers since 1972.
In our 2022 Chartbook, NACHC reports that, while dental services are offered in 82% of all health centers, only 25% of health centers offer eye care services. This highlights the problem of limited national eye care access for marginalized populations.
“I am so proud of NECO’s legacy in developing new optometrists to provide equitable eye care to the underserved in our communities,” saysDr. Amy Moy, the current Director of NECO’s Health Center Network and Chief Compliance Officer.
Dr. Amy Moy leads the NECO Clinical Network, nurturing and managing partnerships with community health centers and many other community care locations. NECO believes community-based clinical training is essential to developing culturally competent eye care providers and it also fulfills NECO’s commitment to expanding access to eye care.
Optometry at health centers has many benefits beyond just vision care
“It’s the student who has had perpetual headaches and has not found the right doctor to realize that they have eye focusing issues preventing them from performing well in school.
It’s the middle-aged woman who has had headaches for months for which ibuprofen does nothing, and her optometrist listens to her, and does more testing to find a brain tumor.
It’s the elderly man who comes in without money for his next meal, not to mention his glasses, and we are able to provide him with both food and glasses with good old-fashioned health center teamwork.
And it’s the little 4-year-old girl who just arrived from another country, who turns out to have high myopia, and when we put on her glasses, her little face breaks into a giant smile, and your heart just melts.”
Providing eye care while developing the next generation of providers
In 1972, NECO developed a model of training the next generation of optometrists in the health center setting. The idea was to generate more eye care access and raise future optometrists interested in public health and viewing optometry as a vital part of the interdisciplinary healthcare team.
This new clinical training model moved optometry education beyond refraction and on-campus clinical experiences into a new educational realm: multidisciplinary co-management of patients with other healthcare professionals in a community-based setting.
No other optometry school or college offered anything like it
“NECO chose a wise path: to go to the people, where they lived, and where they sought care and other services,” said Roger Wilson, OD, who spent 33 years at NECO expanding its affiliations with the health centers and working in their communities.
Dr. Moy often says: “NECO goes to the people, instead of the people coming to us. This allows us to serve the community while training our students in diverse populations and with diverse ocular conditions.”
Coincident with NECO’s educational mission was a commitment to provide eye care services to underserved communities. 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.
A catalyst for change in optometry
From vision screenings to patient care in community health centers, NECO students start their clinical training within the first few weeks. Relationships with community organizations and health centers make it possible to expand access to care while providing top notch clinical training.
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 not just in fundamental skills, but also in the critical thinking needed to competently diagnose, prescribe, and treat any type of optical patient or condition they encountered, in any type of clinical setting they choose, anywhere in the world.
The opportunity to work alongside other healthcare professionals as peers did more than help change the practice of optometry itself: it raised the level of recognition and respect the profession received.
Impact that continues beyond training
Today, NECO offers residencies at 14 different community health centers and Veterans Administration (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 now requires students to complete at least one rotation at a community health center and one VA center to graduate. 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.
The impact on neighborhood residents has been just as positive. NECO clinics in CHCs enhance access to vital eye care services for thousands of patients every year – at lower cost and closer to where they live and work.
The NECO Legacy
What NECO started 50 years ago has changed optometry education today:
- The community-based clinical training model is the gold standard, with many optometry schools and colleges affiliating with Community Health Centers and VAs for clinical training.
- NECO’s model for optometric-ophthalmological collaboration is widely used, so much so that it’s hard to recall a time without it.
- NECO added momentum to the efforts to broaden the scope of practice in optometry. This included training the first optometrist in the use of pharmaceutical agents.
- Eye care is now integral to overall health care delivery.
- Future optometrists see a wider and more fulfilling array of paths
“We have the ideal stage in our health centers to teach NECO’s students about culturally competent eye care and social determinants of health, as well as how to advocate for equitable healthcare for all,” says Dr. Moy. “I look forward to working with NACHC and other organizations to further develop eye care access across the country, and to train more optometrists to seek community health careers in the future.”