Article Date: 2/1/2006

o.d. to o.d.
Looking at Optometry from The Patient's Perspective
If our patients see us performing tests and gathering data, then how do they compare us with other physicians?
BY WALTER D. WEST, O.D., F.A.A.O., Chief Optometric Editor

As practitioners I think it's important that we regularly look at ourselves through the eyes of the patient. One advantage of this perspective is that it allows us to think about how we as optometrists look relative to the other healthcare professionals that our patients see on a regular basis — perhaps more regularly than they see us.

Think about this: How do you look as a healthcare professional compared with, let's say, the dentist whom your patient visits twice a year? How do you look compared with the general physician or the family practitioner who provides them with their annual physical? How do you look compared with the physicians' assistants? How about the nurse practitioners who are now so very popular in physicians offices around the country and, in some states, even opening their own facilities and seeing patients on their own?

How your patients see doctors

Why all of the questions, you ask. What do I mean by, "how do they look?" What I mean is this: When patients see other healthcare practitioners in their offices, what do the patients — your patients — see them do or not do? Do cardiologists look like doctors at work in their offices? Sure, but do they ever perform an EKG? No, they don't! A medical technician connects the leads, administers the test, gathers the data and even makes the initial decision as to whether the data collected is good data. Then, the cardiologist evaluates the data collected, makes the diagnosis and prescribes for the patient.

Here's another one; if you've ever had an X-ray, CT or MRI; did the radiologist administer the test and gather the data? No, they didn't. A radiology tech positions the patient, determines what settings are needed, gathers the data and reviews and ensures that the images meet the standards necessary for accurate assessment. Then, the radiologist evaluates the data, makes the diagnosis and prescribes for the patient or reports his or her consultative information to the attending physician.

Here's an even more basic example: When you visit your general physician, does he or she measure your blood pressure, your temperature, height, weight, ask you to pee in the cup? No, they don't. All of that and more are done by an assistant, a nurse or a medical technician.

Are you beginning to see the similarities here? Beginning to see a pattern that is common throughout healthcare? The reason there are similarities and a pattern is because what I have just described is the medical delivery model — not only in the United States but around the world.

What about optometrists?

Now here's the really important question: Have you ever had your eyes examined by an optometrist? Do optometrists look like doctors at work in their offices? Does the optometrist measure your visual acuity, perform tonometry, refract and gather other data. Yes, for the most part they do, and in so doing they begin to look more like technicians that assist doctors in other healthcare disciplines, rather than the doctor who interprets the data, diagnoses, performs the physical examination and prescribes for the patient.

One last question and answer: Why is it that patients often don't identify optometrists as doctors? It's what we look like to our patients as we work, and all too often we look like techs.



Optometric Management, Issue: February 2006