has moved far beyond your old phoroptor and your patients know it.
GERBER, O.D., Hawthorne, N.J.
order to concentrate on my consulting business, I recently retired from private
practice. So, after 22 years in the field, I thought I deserved the answer to
optometry's longest unsolved mystery which is better, one or two? Well, I can tell you:
Even when you leave practice, you still won't know. But I did learn that the ways
we ask that question are changing.
A new standard
What was once thought of as little more than a toy for the wealthiest
opto-techno-geeks, electronic refraction systems are becoming mainstream and with
good reason. I admit, while practicing I, too, was hesitant to take the plunge into
this new technology. But the recent precipitous drop in pricing for these systems
made the plunge a much smaller step. Many of the "fully-loaded" systems are now
available for less than $30,000, putting them in reach for almost any practice.
The complete systems I'm referring to typically include an auto-refractor/keratometer,
auto-lensometer, electronic phoroptor and electronic chart. The data from the auto-refractor/keratometer
and auto lensometer is "dumped" into the phoroptor. The final refraction data can
then be further dumped into your practice management software. Beyond the instant
elimination of transcription errors, let's look at the other benefits to these systems
and how they can help your patients and practice.
For your patients
We have many clients who call us on the verge of burnout. Indeed
after years of spinning the dials on their phoroptors and never finding out which
really is better, one or two, can you blame them? Even with optometry's expansion
into medical eye care, a thorough refraction with a phoroptor remains
the symbol of optometric care. But even in the most high-tech practices that have
yet to use these systems, it's common to hear patients say, "Doc, I don't get it.
With all of these gadgets and computers, my eyeglass prescription still comes down
to me guessing at letters with the one or two machine. Why is that the one
thing you haven't updated?"
Yes, one reason to consider a refraction system is that patients
do notice that you are still using the same phoroptor you've had since the day you
opened your practice. While waiting for you to enter the examination room, they
are checking e-mail from handheld PDAs and talking on cell phones and staring
at your phoroptor. See a technology disconnect here? Patients think refraction systems
are cutting-edge, and that's a compelling reason to add them to your practice!
Make life easier
This article is about refraction systems and isn't intended to
once again open a debate about delegating refraction. Suffice it to say that with
these systems, if you choose to delegate, it's easier than delegating refraction
without them. For example, your sequence of refracting can be pre-programmed for
different patient populations. Want to use a 0.25D cross cylinder most of the time,
but a 0.50D for seniors? On most systems you can easily set-up these two different
Should you choose not to delegate your refraction, you can still
gain some speed in the exam room because you won't have to load in the data from
your pre-test room. Also, showing patients the difference between their habitual
Rx and their new Rx is a fast, one-button process instead of utilizing multiple,
slower lens changes. The targets on your chart can be programmed to change simultaneously
with each phase of your refraction sequence. This enables you to avoid this embarrassing
phenomenon that has happened to all veteran OD.s . . .
Doctor: "Is that line of letters blurry?"
Patient: "Uh, Doc there isn't a line of letters up there.
There's only one letter."
. . . And for yourself
Many clients have told us that a major benefit of these refraction
systems is that the doctor is now practicing "pain-free." While optometry isn't
historically thought of as a physically taxing profession, reaching for that phoroptor
patient after patient, year after year, has caused many a sore shoulder and back.
Now, you can sit down, face your patient and spin the dials from the comfort of
your desk. No more leaning, no more reaching, no more pain.
With some of the newest refraction systems, it's now possible
to eliminate a conventional refraction entirely. They talk to the patient and self-direct
them to complete the refraction. Newer wavefront refraction systems allow data to
go directly from the instrument to the eyeglass lab with the push of a button. The
prescription, as well as the correction of higher- order aberrations, is recorded
with a bar code that is transmitted to the lab via the Internet. There are no transcription
errors and should you choose to do so, it's easy to delegate.
This one's a no-brainer
Which is better, one or two? I still don't know. But I do know
that these new refraction systems are better than the manual ones.
|| EPIC, TRS, Evolution
VELO Refraction System,
System w/ slit lamp
Automated Subjective Refraction
Digital Refraction System,
DRS-3100 Lite Digital Refraction System,
Futura Digital Refraction
Dr. Gerber is president of The Power Practice,
a company specializing in making doctors more profitable. You can reach him at (800)
867-9303 or at www.powerpractice.com.
Optometric Management, Issue: September 2005