You Know What To Do, Now Do It Faster!
to speed up your exams without missing a step? Follow these timesaving tips.
BY DAN BECK, O.D., Leland, N.C.
two kinds of businesses, the saying goes, the quick and the dead. Fiscally speaking,
your optometry practice is no different from any other business. You must be profitable
to stay open. As managed care continues to expand, we're all forced to see twice
as many patients to collect the same revenue dollars we did 10 years ago. The
simple fact is we must now work faster than we used to.
New O.D.s often find it difficult to perform exams
quickly. This is understandable, as speed comes from experience and confidence.
That doesn't mean you can't quicken the pace while learning on the job. Even saving
a minute or two on each exam can add up over the course of a busy day. Here
are four simple ways to optimize your chair time.
1. Don't Read Along
It amazes me how we all tend to watch the acuity
chart when patients read it. We watch it when they read it while wearing their eyeglasses
or contact lenses, and we watch it after we're done refracting. Instead of reading
along, use that time to update the chart or write prescriptions.
2. Don't Instill and Then Chill
For those who use a Goldmann tonometer
which I hope is most of you there's a window of about two minutes after the
drops are instilled where the test can still be performed.
I can fill out almost the entire chart
in that time frame, and you should too. Don't just sit there and chat. Use that
time to chat and document something.
3. Don't Examine the Same Structure Twice
If you're using a retinal camera, and you're confident
you have the clearest photograph possible, there's no need to view the same structures
with a slit lamp condensing lens. You can move right to indirect binocular ophthalmoscopy.
Skipping the slit lamp can shave several minutes off your examination time.
4. Dilate Patients Before You Enter the Exam Room
I've heard arguments on both sides of this controversial
topic, and I still find little reason not to dilate ahead of time. Some practitioners
say you don't get an accurate refraction, but I disagree.
Accommodative spasm is a daily occurrence
with so many people working on computers. I find the wet refraction much more accurate
and a must when examining children.
All controversies aside, pre-dilation
not only saves a fair amount of chair time, it almost always shortens the patient's
time in the office. Most people appreciate getting in and out of appointments as
quickly as possible.
Be Thorough, Friendly and Fast
No patient wants a doctor who's in and out of
the examination room in 3 minutes flat. People know when they're being short-changed
in terms of time, especially if they had to wait a while to see the doctor.
However, that doesn't justify spending
more time than necessary in the exam room with that patient to make up for the wait.
Be thorough and friendly, but remember the clock is always ticking.
A '93 graduate of PCO, Dr. Beck operates his
practice like clockwork in Leland, N.C.
Optometric Management, Issue: September 2005