o.d. to o.d.
A Look at Practice
Guidelines should insure quality eye
care but do some standards tie optometry to the past?
WALTER D. WEST, O.D., F.A.A.O., Chief Optometric Editor
It's no secret that the settings in which we
provide optometric care and deliver optometric services vary greatly across the
country and even within local market areas. We see optometrists providing care
in private solo practice and private group practice, hospital settings, in
association with ophthalmologists, commercial opticals, commercial optometric
practices and also the side-by-side relationships with chain opticals.
Just as the business models of the different
forms of delivering optometric care vary, so do the individual practices'
approaches to marketing and patient management. The variations of laws that
govern the optometric profession also vary significantly from state to state.
Recognize the patient's interest
Although great differences exist in the settings
in which we provide optometric care, the demands of clinical expertise and
quality patient care are critical in each. It is important that with so many
variations in the delivery of optometric care that the eyecare provider consider
the patient's interest of prime importance. To this end, some states and
national organizations have set forth what I'll collectively refer to as
"standards" -- that is, standards of care guidelines, state board
rulings, opinion letters and even state laws.
Some states, for example, don't allow
optometrists to delegate basic data gathering, such as keratometry, refraction
and even visual acuities.
While I appreciate the standards set forth by any
organization in an effort to ensure quality care to patients, I am concerned by
standards that organizations write and then never revisit. I question what
effect they have on the ability of optometrists to provide care in what is a
continually more competitive marketplace.
Is "turf protection" an issue?
Whenever I'm made aware of a standard that seems
unusually restrictive relative to an optometrist's ability to delegate data
gathering or employ newer and more advanced technology, I have to ask, "Who
is really being served?" I often get the impression that some of these
standards are in place not for the best interest of the patients, but to protect
the "turf" of optometry.
In other cases, it seems that well-intended
entities put such standards in place so long ago that they have outlived their
relevance for the practice of optometry and its scope of care in this day and
I recognize the benefits of other standards that
are forward thinking and innovative. They're put in place to further expand the
scope of care that optometrists provide and to improve our ability to better
serve our patients.
Lead us into the future
As it seems standards are now and will ever be
part of optometry, I'd like to encourage those individuals who are responsible
for writing them to also get into the business of rewriting and updating them.
Consider how the standards will affect the optometrist's ability to provide the
finest patient care.
Let's see the "guidelines" for
optometry lead us into the future, not tie us to the past.
Editor's note: Optometric Management invites
you to share with us the standards (national or statewide) that you feel are
out-of-date or of questionable benefit.
Please mail these questionable standards to us
at: Optometric Management, Editorial Dept., 1300 Virginia Drive, Suite 400, Fort
Washington, PA 19034 or e-mail them to email@example.com.
OM will report on these in a future issue.
Optometric Management, Issue: November 2003