As you begin your journey in optometry, you will study complex clinical skills and absorb a vast amount of knowledge. But none of it will matter without the foundation upon which your entire career must be built: being honest and trustworthy.

The GOC’s Standard 16 (“Be honest and trustworthy”) isn’t just a set of rules; it’s the very essence of our professional identity. It’s what separates us from being seen as “glorified salespeople” and cements our role as healthcare professionals who patients can truly rely on.

For students, pre-regs, and newly qualified optometrists, learning to navigate the pressures of the real world while upholding this standard is the most important skill you will ever develop. This post is about how to do just that.

Navigating Commercial Pressure

Let’s be direct about the biggest challenge you will likely face: commercial pressure. You might be told, “Today’s target is £3000.” I’m often unsure what I’m meant to do with that knowledge when I am seeing people for their eye health and recommending based on their presenting needs.

This is incredibly hard for all optometrists, especially those who are new to the profession. My advice is simple: your primary interest must always be your patient. Being honest and trustworthy means you do not recommend something they don’t need just to make a sale.

That said, even if a patient doesn’t require a new prescription, you can still have an honest conversation about products that they may benefit from. You can discuss a spare pair (glasses get lost and broken), the benefits of sunglasses, or replacing a damaged frame. If they’re not ready, that’s okay. I explain how long their prescription is valid for and let them know they can return later.

“…even if a patient doesn’t require a new prescription, you can still have an honest conversation about products that they may benefit from.”

Jason Searle, The Eye Care Advocate

You provide advice, not pressure. Remember what is at stake. As I often say, a company can replace you, but you cannot replace yourself. If you make a decision that benefits the business but is wrong for the patient, and a complaint is made, it is you who faces the consequences. Looking after your patient is how you look after your GOC registration.

Conflicts of Interest: An Honest and Trustworthy Approach

Throughout your career, you will encounter potential conflicts of interest. It might be an incentive from a lens company or a “referral fee” for sending patients to a specific service provider. However, when faced with these situations, your duty to be honest and trustworthy must be your guide.

A recent Financial Times article highlighted concerns about optometrists receiving fees to refer patients for cataract surgery. The claims are generally unfounded. The only fees I’m personally aware of are for pre- and post-op assessments, and in my experience, these are the same whether we refer to the NHS or an independent provider to do the same job.

I like to use a simple test: what would you advise if the patient sitting in your chair was your partner, your parent, or a close relative? Would you recommend that lens your employer is offering a bonus for if you knew it wasn’t quite right for them? Of course not. You would advise what is in their absolute best interest.

When it comes to referrals, I discuss the options with my patients, and we make a decision based on their preference, which is guided by clinical need and often waiting list times. Being honest and trustworthy means your professional judgement is never for sale.

Being Honest and Trustworthy About Your Skills

In the age of social media, it’s easy for lines to get blurred. We see an increasing number of online entities who may overstate their experience without providing verifiable names or credentials. When you post online, stick to the facts. Make it clear when something is your professional opinion versus established evidence. Being honest and trustworthy means accurately representing your knowledge and not overstepping your mark.

This applies directly within the clinic too. I have, on occasion, been booked appointments where I was expected to perform a service I am not accredited to do. The only correct and honest action is to explain this to the patient and staff immediately and reschedule them with a suitably qualified colleague or arrange an appropriate referral. We have to protect our professional image.

Being upfront about what you can and cannot do is a mark of true professionalism and is key to being seen as an honest and trustworthy clinician.

Financial Honesty: A Pillar of Trust

Discussing money can be awkward, but it is a critical part of being honest and trustworthy. You must give patients clear information about the costs of your services and products before they commit to anything. Explain what is covered by the NHS versus what is private. Let them make a fully informed decision. I always present the best options for their needs, explain the differences between them, and highlight any potential issues they might face if they go against a recommendation. But I never judge their final decision.

Patient-centred care means respecting that there are factors in their life you may not be aware of. Perhaps they are struggling financially or feel the cost isn’t justified for them right now. By explaining the good and the bad openly, you empower them. If they don’t buy glasses from you this time, they are far more likely to return when they do need them, because they see you as a professional they can trust, not someone trying to take their money.

Conclusion: Your Career is Built on Being Honest and Trustworthy

It can feel hard to be completely honest and trustworthy when you’re worrying about sales targets and KPIs. However, I have found that if you simply focus on doing the job you were trained to do, the business side of things tends to take care of itself. The clinics where I am not given a target are often the ones where my conversion rates are highest, because I’m relaxed and focused purely on my patient’s best interests. This builds rapport and trust, which naturally leads to patients wanting to follow your advice.

This doesn’t mean you shouldn’t “sell.” It means you should recommend what is right and put patients at the heart of decision making. Build relationships by treating people with dignity and respect, not as walking wallets. It’s your career and your life. The GOC takes this standard very seriously. Find a practice that values you as an honest and trustworthy professional. Look after your patient first, and in doing so, you will always be looking after yourself and your career.