Article Date: 1/1/2006

o.d to o.d.
What You Do Speaks So Loudly
Why the public, patients, insurance companies and even some optometrists are confused about what it is that we do.
BY WALTER D. WEST, O.D., F.A.A.O., Chief Optometric Editor

As the profession of optometry has evolved over the years and expanded in many directions, some confusion has developed � among the general public, patients, insurance companies and in fact, some of our fellow optometrists � regarding what we really do. Are we doctors? We definitely are, but what do we do that looks "doctorish" to all of those who seem to be confused?

Now, I'm not talking about differences like the cars that we drive or the way we dress. I'm not even talking about the way our offices look compared with those of ophthalmologists. Many optometrists attempt to make it easy for anyone they come in contact with to recognize them as a doctor by putting "Dr." in front of their name along with the "O.D." afterwards on their office signage, letterhead and business cards (thereby providing the ill- or uninformed with two opportunities to recognize the individual's status). Still, it seems that even this double-barreled approach is lost on many, if not the majority.

A look at other doctors

Being puzzled by this great misunderstanding, my thoughts turned to encounters I have had with other healthcare specialists.

I recently visited a cardiologist for an EKG consult requested by my general physician. The visit went as usual. I was taken to an examination room by the nurse, who reviewed my history. Then a technician connected all of the leads, gathered the data in the form of an EKG and did the initial evaluation as to whether the data were accurate. The cardiologist then entered the room, reviewed the findings and, once I understood my situation, made his recommendations for my future care.

As the result of trying to find a light switch in a dark room and breaking a toe in the process, I also paid a recent visit to my friendly orthopedic. Same scenario: the nurse took me to the examination room, an x-ray technician gathered the data necessary and reviewed the x-rays to ensure that the information was available to the orthopedic. Then the orthopedic came into the room, reviewed the x-rays, showed me the location of the break and explained what needed to be done and what he recommended.

A look at many O.D.s

Now I turn to what I know about most optometrists and how patients are examined. The patient is taken to the examination room sometimes by a nurse or tech, but often by the optometrist. The pre-testing is done sometimes by a tech, but often by the optometrist. The data gathering, such as visual acuities, tonometry, refraction, are most typically done by the optometrist and then hopefully, the optometrist makes the recommendations for treatment or care.

An inescapable conclusion?

So I wonder if perhaps the reason that patients, the public in general, insurance carriers and in many cases, other healthcare professionals are confused about whether optometrists are doctors is a function of what they observe in our offices. Even though an eye examination includes many "doctor-ish" responsibilities, decisions and recommendations, the bulk of what they see us do isn't "doctor-ish," but rather "tech-ish" and that, unfortunately, is more of what patients remember.

"What you do speaks so loudly that I cannot hear what you say."� Ralph Waldo Emerson.

Optometric Management, Issue: January 2006