A Sit Down – with Dr. Dan Bowersox
This post appears as part of a series called Sit Down – candid conversations with real people detailing their journeys and experiences with Vision Therapy.
A Sit Down – with Dr. Dan Bowersox
For the benefit of our readers, can you explain how you are involved in Developmental Optometry?
I have been in private practice since 1995 in Shelbyville, KY where I am in a modified solo practice. Modified in that I am a Residency Supervisor for Southern College of Optometry and thus I share my practice with a Resident Doctor while they are here. My office is also an external rotation site for Indiana University, so we have 4 externs for 3 months each at our site. I am a fellow of COVD, a member of OEP and NORA. I have been fortunate enough to go on 2 SVOSH mission trips and plan on more in the future.
What led you to Developmental Optometry?
As a strabismic myself, I have always had more than a passing interest in how our eyes work, or don’t work, together. I knew when I was in my training at UM St. Louis, that I would someday find a way to incorporate Developmental Optometry into my practice.
My old office was very small and I didn’t have the space to do any type of specialized treatment. I was in that office for 10 years and referred my binocular vision cases to my friend, Dr. Dan Weinberg. In 2005 I purchased my current office and went from 725 sq ft. to 3760 sq ft. on 2 levels. So I effectively increased my square footage over tenfold! I finally had enough space to begin bringing Developmental Optometry into my practice.
Your office is unique in many ways, one of which is that you employ a mascot. Can you explain?
My esteemed furry colleague, Skeffington, is a one year old English Goldendoodle. He is the therapy dog in training at my office and will be taking his final exams to get what we call his Dogtorate as a therapy dog. He is a wonderful, non-shedding / low allergy, addition to the office! His job is to stay in my personal office and greet the people that want to pet a big, white fluffy dog. He is a wonderful dog with kids and is amazingly gentle. The big surprise for me is that it is our senior patients are the ones that will drop little treats off for him so they can sneak in for a quick scratch behind the ears with Skeff. He is also in much of our advertising; he attends all our small town community functions, often in costume, and even has his own Facebook page. He is also the great for the staff when its been a rough day. He is becoming a huge part of the practice in many ways.
Another way we are unique is the 1000 sq ft extern apartment. It is a fully furnished one bedroom apartment in the lower level of my office. It is a rent free place to live while the externs are at our office. It is definitely “win-win”.
A little known fact about my practice is that I actually have 2 practices, but one is fairly exclusive “members only” type practice. That’s right, I also have a full time practice in a prison. I have doctors that work with me there and I go to jail when needed. I have worked with the Dept of Corrections to serve 7000 inmates of 4 facilities since 1996. Our “home” prison is the Kentucky State Reformatory and it is the medical and psychiatric prison for the state. The pathology is high and often advanced. We have good equipment and our own OCT. (This cuts down on the number of patients that have to be transported out for medical care which is a huge expense.) I have more than a few good prison stories, just ask!
You also have a special offer that is made to members of our Armed Forces, correct?
Correct! Any vet that has post 9/11 service related TBI can come to my office and receive free neurovisual rehab. We originally set the limit to 4 people in the program at any one time, but have actually never had more than one in the program at any given time. Many of the people who need us don’t understand the link between the visual system and some of the problems they are going through. It’s my personal opinion that many of the problems with PTSD are dramatically exacerbated by the symptoms of the TBI for those who have also suffered TBI. If we could find a way to treat those with TBI and improve the way they handle their visual world, they would, in my opinion, find they have less problems with PTSD.
As a side note, you have never seen someone work in a therapy session until you have watched a vet! Those guys work! I have seen patients use so much mental muscle to do a task they have literally soaked the shirt they were wearing!
Among other areas, you seem to be very dedicated to helping those who have suffered a Traumatic Brain Injury. Can you tell us what draws you to this population?
My interest in TBI started with my desire to help veterans. I wanted to learn more about how to assist them, how neurovisual rehab is different from developmental optometry, and the most effective methods of treatment. Then, almost by accident, I have started to attract other patients with TBI history. We are helping them and the word is just spreading.
What draws me to this population is they know what they want and they desperately want to get back as close as possible to what was “normal” for them. As a group, I think TBI patients are more motivated because they have lost something and want it back. When we are dealing with a child in normal vision therapy, it is often a process of discovery and wonder, which is also very exciting. However, they have not experienced the goal you are describing and have a harder time seeing the need for diligence in the therapy room.
Strabismus surgery continues to be a polarized topic within vision care, and the tactic of “fixing poor surgical outcomes with more surgery” remains at the forefront. You have an interesting perspective on this idea, which is both personal and professional. Would you mind sharing your story?
As a child I was esotropic. I had my only surgery at 9 years old and was aligned for about 2 years. Then the extropia took over. When I fuse, I have a great deal of cyclorotation and thus I feel my case is beyond what current VT can offer. I have always been frustrated by my lack of stereo and so the Developmental aspect of optometry was appealing.
In most, but not all cases, I feel strabismus surgery is purely for the comfort of the parents and cosmesis. It should be classified as a cosmetic surgery and have the same level of insurance coverage. Functional binocular vision is seldom achieved and most studies of “successful” strabismus surgeries count cosmetic alignment as a success! That is an incredibly low hurdle. There are times, whether due to a lack of understanding, or for outright profit motives, multiple surgeries are foisted upon a patient. This is when I feel strabismus surgery borders on malpractice.
Do you think Vision Therapy could have helped had it been done prior to your surgeries?
I was an intermittent alternating esotrope. I have no doubt in my mind that if vision therapy had been available when and where I needed it, I would not have the problem I have today. This fuels my desire to teach the next generation of Developmental OD’s. The other side of that coin is that I would likely have not become an OD also. So in an odd way, I am glad for the bit of misfortune I had.
Nowadays, as an eye doctor living with a “poor surgical outcome”, are there still times when you feel strabismus surgery is warranted?
Certainly! There are some excellent strabismus surgeons out there. I have referred several patients to an OMD colleague of mine over the last several years. These were cases of strabismus at birth (not at 4 months), a case of muscle entrapment after trauma and a nerve palsy case that come to mind.
You recently made a trip to Mexico on for “Optometric Business”. Can you tell us about it?
My recent trip to Mexico was with the SVOSH group from SCO. It was work, to be sure, but so very satisfying! There a multiple reasons that I have gone on these trips. The obvious ones include my enjoyment of helping others in a purely humanitarian way, the opportunity to teach a few “old eye doc” tricks to students, a bit of travel and a change from the normal office life. Not so obvious reasons would include trying to show students how binocular vision and prisms can be used to dramatically change a life, trying to nudge a few of the students to find the love of binocular vision, to meet potential future residents, to have fun pictures to show my patients at my office. The unintended consequences would include making some friends that I will see at meetings for years to come and with luck, that meeting will be COVD or NORA!
What is your “Wall of Fame”?
When a patient graduates from VT, we give them a choice of paint colors and ask them to put their hand print on the wall and then sign their name below it in the stairwell going to the VT area of the office. We want them to leave their mark on us as much as we hope we have left a mark on their life. Our kids love to do something that is so “wrong” and it is a huge motivator for those coming to VT who want to put their handprint and name up on the Wall of Fame. It is also good for staff to look at a name and say to themselves, “Timmy is a really hard patient that I am about to see, but he is no harder than Jason and look how great Jason is doing now.”
You recently started blogging, correct?
One blog entry is a thought. Two are a quirk. Three or more are a real blog! I did start one, The Divergent View. As you could guess from Skeff’s name, I like names that have a double entendre. To date, my single blog post is about how the kids born in summer are better served to wait a year before starting school. I have plenty of things to talk about if I could just find the time! If you would like to see that thought, it can be found here.
Lastly, you seem to have found a good balance between the serious work we do and the playful side of life. How important is this balance to your work both in the exam room and in the VT room?
People who are always serious and proper creep me out. I always think they are hiding something or trying to make up for some flaw. Anyone who knows me will tell you I am not a formal type person. I have few filters and am seldom the first pick on the etiquette team. My interactions with students and resident allow me to remain extremely humble as I have to explain why I do this or that and sometimes don’t have an excellent reason. But I believe that if you do what your heart tells you is right, every time, you will have very few regrets. I actively try to be empathetic and to figure out how to help the other person the best way I can whether that is a patient, resident doctor, student doctor, staff, family or a friend. Zig Ziglar said “You can have everything in life you want, if you will just help other people get what they want.” I guess I have because I love what I do and every day of doing it.
Some Closing Thoughts – A great thanks to Dr. Dan Bowersox for taking the time out for this interview. Although I knew of him, it was not until last year in Orlando at COVD’s Annual Meeting that we actually met, and then we were able to spend some time talking this year at the NORA conference in April. What a fantastic doctor, humanitarian, and human being he is! As you can tell in this interview, he truly is a class act. He also shares my love of playful sarcasm which makes him aces in my book! Please join me in wishing Dr. Bowersox, and of course Skeff, the absolute best! 🙂