There is wide variation among optometrists about what parts of an eye exam - if any - should be delegated to a technician. In my opinion, delegating some of the testing is extremely important to practice success and profitability - and it can be done without decreasing the quality of care or the perception of thoroughness by the patient.

Many optometrists have designed their clinical operations so that technicians perform certain pre-tests, usually with automated instruments like an air-puff tonometer or an autorefractor. This approach works great in our practice. No matter where you are on the scale of delegation, however, I encourage you to keep analyzing your procedures to find more ways to save doctor time - which will allow you to see more patients per day or consolidate time to spend on other important projects.

Here is a quick question to challenge yourself on how well you delegate… who takes visual acuity measurements during routine eye exams in your practice? A doctor or a tech? If the doctor is doing it - consider training some staff members to do it for you. Change is always hard - but be open-minded, it could save you 5 minutes per patient - and that can save over an hour per day! Remember there is aided, unaided, far, near, OD, OS, OU… it adds up!

Are there obstacles to implementing this? Of course! But anything good is usually some trouble, and the obstacles can be overcome.

• Do you not have an area for the tech to do this? >> There is probably a way to do it in your office if you look. If you have two exam rooms it's easy to have the tech use one room while you're with a patient in the other. Otherwise get an extra projector and screen, and nearpoint cards and do it in a pre-test room or even a wide hallway. Buy a mirror set if you have a short room.
• Do you think your staff won't do it well enough? >> Train them!
• Is your staff too busy for this? >> Hire another employee! The time you save will allow you to see two more patients per day! That will easily pay for the tech's salary and leave some extra profit.
• Do your patients expect the doctor to do all of that? >> They really probably don't. I think they are impressed with doctors who utilize assistants.