Buckeye Optometrists Around the World Nicole Abrashoff (OD ’06)
In this issue, we feature Nicole Abrashoff (OD ’06), who is working at a Native Alaskan/IHS hospital serving 16 village communities in rural western Alaska. The setup sounded so different from mainstream optometry that we had to include her in the series.
I asked Dr. Abrashoff to describe the work she does. She took on this position two years ago and is signing on for another two years. This particular position is four weeks on and four weeks off.
- Question Tell me about your work.
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Answer
We serve a large community comprising multiple villages in our region, so we see patients at the main hospital and in the smaller village clinics. These small clinics have more limited services but do an excellent job of providing care to the local people. When optometry travels, we go to the local small village clinics and set up a temporary eye clinic (think: SVOSH) to serve the people of that village who cannot travel to the main hospital, as many of our villages are only accessible by plane! Usually I am traveling to a village one-to-two weeks out of the four that I am there. When I travel to the villages, it is just me! We pack up multiple cases of portable/hand held equipment and eyeglass frames and fly out to the local small village clinic. I run a temporary clinic on my own there. Therefore, the ODs have to act as receptionist, scheduler, technician and optician as well as being a doctor on these trips. It’s a lot of work but is also very rewarding, and the patients are extremely grateful.
- Question What are some of the best aspects of this job?
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Answer
I love that I am working to help a rural, underserved community. We are certainly busy, but the clinic is not so busy that I have to rush through patients. It’s a nice balance, and I’m able to spend time with my patients. It’s very satisfying to have that luxury and not have to rush to keep up all the time. I also love the local travel that is involved. Going out to the smaller villages has been very rewarding and is a bit of an adventure in itself! I’ve gotten to travel to some remote, untouched places I never even dreamed of going. And I really appreciate the larger blocks of time off. It has helped prevent burnout and been great for my mental health.
- Question What makes it challenging?
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Answer
The remoteness and lack of resources can definitely be challenging. Supplies, medicines, etc., can take much longer to get to the region (if at all) and there is not a specialist down the street to consult with or refer to, so we don’t always have access to our first choice of treatment or management. Also the need for travel to get certain services, whether it’s getting a patient to the main hospital or to Anchorage for ophthalmology care, can be affected easily by weather or other outside factors. So you often need to be adaptive and get creative on deciding how to handle urgent cases out in the villages or figuring out what we DO have access to best treat someone. For example, I recently had a patient in one of the villages with a significant corneal ulcer. First, we had to get him to travel to the main hospital to see us, and then we were not able to compound fortified antibiotics in our pharmacy. I had to decide on and coordinate treatment based on what we had available in the clinic and how quickly we could get the patient to Anchorage for ophthalmology consultation. It took a lot of coordination, but I’m happy to report the patient did well! There is a great team down there and we have a good relationship with them to best care for our patients. The back and forth travel and large blocks of time away from friends and family can be difficult at times and may not work for everyone.
- Question How did you find out about this opportunity?
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Answer
I lucked out and found the job posting online! The timing was just right, so I think it was meant to be. It’s been a very good fit for me.
