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 By Neil B. Gailmard, OD, MBA, FAAO, Editor October 13, 2004 - Tip #143 
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Emergency Symptom List for Front Desk

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Additional Information

I received several emails following my last tip, which was about charging more for emergency visits. Several colleagues requested my list of emergency symptoms to assist receptionists in judging the urgency of eye problems. The list is printed below.

It's a good idea to meet with your staff periodically to discuss the emergency nature of certain ocular symptoms, and how these calls should be handled. Many factors will influence this, such as the availability of a doctor in your office every day, how tightly the practice is booked, and your desire to treat various medical eye problems.

If you want to increase the emergency care aspect of your practice, consider telling each patient that you examine that he or she should call your office if they ever have an eye emergency. Many patients routinely think they should call their primary care physician or go to a hospital emergency room, when your office may be a better alternative. You may even want to print a handout or magnet card with common eye emergencies and what to do about them as a patient give-away reference.

It's tempting to simply tell receptionists to work-in any caller who says they are having an urgent eye problem, or is concerned enough to want to come in immediately. This is a good practice, but it does not solve all the responsibility of the practice. There are two scenarios where this approach alone is not ideal:
  1. A caller does not request an emergency same-day appointment, but has an urgent problem and does not know it. Waiting for the patient to ask for an emergency appointment is not good enough if the patient does not know that sudden flashes of light is a concern.
  2. A caller who demands an emergency same-day appointment, and is squeezed into a very full day, only to find that the chief complaint is a scratch on the eyeglass lens. Some people will push for their own convenience. While this scenario is disrupting to the office - it's better to see a false emergency than to not see a true one.
Here is a guide to emergency symptoms that will help a staff member prioritize appointments. It is not all-inclusive and you may want to add or delete some symptoms.

Post at front desk

We should ask every patient who calls for an appointment: "Are you having an eye problem?" (some appointments are for routine check-ups). If yes, ask the patient to describe it and listen to the patient's level of concern and use your judgment. Ask a doctor or technician if you're not sure. This office sees all patients who are having an urgent eye problem the same day. Try to give a specific appointment time that is soon and appears to work best with the schedule. If all appointment slots are full, just tell the caller to come right over, and we will work him or her into the schedule. Advise the patient about the exam fee and the payment requirements over the phone.

Emergency Symptoms (Work patient into today's schedule or page the doctor on call. A referral to the hospital emergency room should be considered if no doctor is reached).
  • Sudden loss or blurring of vision in either eye or both eyes
  • New or sudden flashes of light or floaters
  • Pain in the eye
  • Chemical splash in the eye (advise immediate copious flushing with water for at least a half hour, even if the event seems over)
  • Injury to the eye or head
  • Foreign particle in the eye
  • Red eyes of recent onset
  • Discharge from eyes
  • Extreme swollen eyelid
  • Contact lens lost or broken in the eye
  • Steamy or cloudy vision of recent onset
  • Sudden unequal pupil size
  • Sudden double vision or sudden crossed eyes

Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week

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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.

Please Note: The views expressed in Management Tip of the Week do not necessarily reflect those of the sponsor.

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