Article Date: 9/1/2005

Street Smarts
You Know What To Do, Now Do It Faster!
Want to speed up your exams without missing a step? Follow these timesaving tips.
BY DAN BECK, O.D., Leland, N.C.

THERE ARE 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