For a woman whose diverse career includes college professor, clinical researcher, chief of an HMOs 

contact lens clinic and now private practice, optometrist Patricia Keechs biggest professional challenge has always been figuring out what to do next. Once she had a goal, she says, it was simply a matter of working toward it each day.

Dr. Keech loved her job as an assistant professor at Indiana University School of Optometry. However, she felt as though she lacked enough professional experience to carry out significant clinical research. So, she went to work for a Seattle HMO, but after 20 years realized she no longer cared for the chain of bureaucracy there. Now,  Dr. Keech feels that she at last has found her fit in private practice.

The problems are soluble, she says. One is rewarded for persistence and problem solving. Whereas in a bureaucracy, the same problems crop up time after time, and no one owns the problem in many cases.

This third installment in our Profiles in Excellence series looks at Dr. Keechs distinct career path and how her varied experience has helped her find the right niche.

Starting on Her Path
Dr. Keech decided to become an O.D. mainly through convenience and serendipity. She was an undergraduate chemistry major at Indiana University, when a high school friend mentioned that he was going to optometry school.
I was interested in health sciences, but didnt much like blood and guts, Dr. Keech says. So, I wandered over to the school, and liked the fact that I could get in after only two years of undergrad.

Dr. Keech had taken all the prerequisite courses, so she applied late and was accepted.

She graduated at age 23. It took me another decade to realize that it was a very good fit, combining patient interactions with science and math, she says.

After graduation, Dr. Keech became an assistant professor at the school, teaching diagnostic procedures and refraction, while her husband, Barry Keech, finished law school. Along with her teaching career, Dr. Keech became involved in early contact lens research, including clinical studies with soft toric lenses and the Polycon gas permeable lenses.

Before Dr. Keech and her husband moved to Seattle in 1979, she passed the IU teacher acid test: The student optometric association named her professor of the year.

IU professor Sarita Soni describes her friend and former colleague as a natural teacher who gained a reputation as a tough but excellent educator. Dr. Keech is an excellent clinician because of her ability to define a problem and then figure out how to solve the problem, Dr. Soni says. She is extremely bright and has a fantastic memory. One of her best traits is that she is always trying to learn more.

Working for an HMO
After leaving the world of academia, Dr. Keech accepted a position with Group Health Cooperative of Puget Sound. Group Health had a good reputation.
Most of its O.D.s were fellows in the American Academy of Optometry. (Dr. Keech became a fellow in 1979 and a contact lens diplomate in 1980).

I always went to bat for my patients and my clinic. I was willing to fight the battles and work with management, which allowed our clinic to function at the highest level possible.

Unlike some doctors who preferred a passive approach and let the HMO run the practice, Dr. Keechs personal philosophy was This is MY practice or business.
This philosophy kept her active and involved in her work as part of the larger group.

I always went to bat for my patients and my clinic, Dr. Keech says. I was willing to fight the battles and work with management, which allowed our clinic to function at the highest level possible. I went beyond the expected limitations to train staff and develop processes that worked. Being a participant in the multidisciplinary setting, willing to do the committee work and the administrative work, trained me for functioning in any setting.

Dr. Keech stresses that even though she worked for 20 years at an HMO and finally came to the conclusion that she didnt want to work there for another 20 years, it wasnt all bad.

She took a year-long sabbatical. During that time, she worked with the Center for Health Studies at Group Health, providing research and information for states that needed appropriate data during the contact lens prescription legislative battles.
Getting to Private Practice

Dr. Keech went out on her own four years ago. Her contact lens specialty practice at the HMO was strong enough that when she left to join Highland Vision Clinic in Shoreline, Wash., her patients followed her.

She joined an existing practitioner, John Otto, O.D., and they turned a one-doctor practice into a two-doctor practice by expanding hours and using part-time support staff. Today, Dr. Keechs practice encompasses all aspects of primary care, with an emphasis on contact lenses. The office is open 60 hours a week, six days a week. Dr. Keech sees patients 30 hours a week.

By being willing to work flexible hours and picking a great partner in a wonderful location, the transition to private practice has been very fulfilling and rewarding, she says.

Besides the work in her practice, Dr. Keech remains busy with the AAO. She has served on committees for more than 15 years, including four years on the executive council (now the board). She is just finishing up four years on the western region admittance committee where she was chair for two years. She is currently the education co-chair for the Washington State Optometric Association.
Dr. Keechs spare time is mostly family time. She has one son, Evan, 20, and Dr. Keech is currently helping her daughter Erika, 17, with her college search.
She participated in the San Diego Marathon last June, and meets monthly with a neighborhood book club she started nine years ago.

After a few forks in the road, Dr. Keech says shes now on the right route. In the last few years, I realized this was a good place to be.