Optometric Management Tip # 292 - Wednesday, August 29, 2007
The Myth About Longer Exam Times
Eye care professionals generally equate an eye exam with more doctor time to
one of higher quality. That may be true to a point, but I think most
optometrists don't see this issue the same way patients do. There is a lot at
stake here because the length of time spent in each exam has a huge effect on
productivity and profitability.
Can we control exam length?
I want to acknowledge that to some degree, the time spent in an eye exam is
irrelevant and the focus should be on obtaining the data needed to provide good
care. We all agree that there are certain minimum tests and standards that must
be met in an eye exam and that the time needed for that is what it is. But let's
also acknowledge that beyond the time required for good care, some doctors take
longer performing some tests than they need to, some do additional tests that
are not required because they think it's impressive, and some give a longer
technical explanation of eye conditions than others.
Indeed, many eye care professionals take pride in spending more time with
patients and think of that as part of their marketing strategy or a competitive
A surprising thought
So here is the part many optometrists have not considered. Patients don't really
want an eye exam to take a long time! They really don't have that much fun in
your exam room. They have a busy life they would like to get back to.
I realize that our professional culture equates quality and thoroughness with
time spent, and to some extent we even think a higher fee is justified by more
time. But that is optometric thinking at its best and there is a fallacy there.
In fact, of patients who pay for exams out-of-pocket (and there are still many
of them), I think they would pay more if the exam could be quicker! Those that
have insurance would also like them to be quicker. Of course, patients want
their eye health needs to be met, which they really don't understand very well,
but as long as that happens and they can see great when they're done... quicker is
One more revelation
As you ponder how long an eye exam should take, consider this: The more time the
patient spends in your clinic area, the less time they will spend in the optical
Speeding things up
Smart marketing is about identifying and satisfying patients' wants and needs.
Here are a few ideas for helping your patient get in and out of your office
• Streamline the check-in process. Have everything ready in advance and don't
make the history questionnaire very complex.
• Reduce the wait in the reception area. Time spent there is truly a waste.
Doctors who are flexible about when they take patients and stay aware of their
schedule can make a huge difference.
• Reduce the inner office wait. The doctor must be aware when the next patient
is ready and adapt to the situation when possible. I wear a silent pager and my
technician uses an office phone on speed dial to call that number and then hang
up. The inner wait is a great time to play an educational video clip on eye care
for the patient.
• Delegate as many procedures as possible to a technician in pretesting.
Automated instruments are faster and save doctor time.
• Only do tests that you really need. Change your procedures based on the
history and complaint. Avoid doing tests because you always did them or because
you think it impresses patients.
• Explain tests as you do them, including stating the result when appropriate.
• Use a scribe (with either paper or electronic records). While you are
examining, she or he is recording data. When you are done with the exam, you say
goodbye and leave the room first.
• Review the exam findings and educate the patient at the end of the visit, but
don't overdo it and don't use many technical terms.
I believe in providing very thorough eye exams with lots of new technology.
Creating the wow factor is a great way to differentiate your practice, and if
that provides a clinical advantage as it works as a marketing tool, I say go for
it. Just be critical when it comes to selecting your exam procedures and work to
conserve time in every way you can.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management