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I received several emails following my last tip, which was about charging more for emergency visits.
Several colleagues requested my list of emergency symptoms to assist receptionists in judging the
urgency of eye problems. The list is printed below.
It’s a good idea to meet with your staff periodically to discuss the emergency nature of certain
ocular symptoms, and how these calls should be handled. Many factors will influence this, such as
the availability of a doctor in your office every day, how tightly the practice is booked, and your
desire to treat various medical eye problems.
If you want to increase the emergency care aspect of your practice, consider telling each patient
that you examine that he or she should call your office if they ever have an eye emergency. Many
patients routinely think they should call their primary care physician or go to a hospital emergency
room, when your office may be a better alternative. You may even want to print a handout or magnet
card with common eye emergencies and what to do about them as a patient give-away reference.
It’s tempting to simply tell receptionists to work-in any caller who says they are having an urgent
eye problem, or is concerned enough to want to come in immediately. This is a good practice, but it
does not solve all the responsibility of the practice. There are two scenarios where this approach
alone is not ideal:
A caller does not request an emergency same-day appointment, but has an urgent problem and does
not know it. Waiting for the patient to ask for an emergency appointment is not good enough if the
patient does not know that sudden flashes of light is a concern.
A caller who demands an emergency same-day appointment, and is squeezed into a very full day,
only to find that the chief complaint is a scratch on the eyeglass lens. Some people will push for
their own convenience. While this scenario is disrupting to the office – it’s better to see a false
emergency than to not see a true one.
Here is a guide to emergency symptoms that will help a staff member prioritize appointments. It is
not all-inclusive and you may want to add or delete some symptoms.
Post at front desk
We should ask every patient who calls for an appointment: “Are you having an eye problem?” (some
appointments are for routine check-ups). If yes, ask the patient to describe it and listen to the
patient’s level of concern and use your judgment. Ask a doctor or technician if you’re not sure.
This office sees all patients who are having an urgent eye problem the same day. Try to give a
specific appointment time that is soon and appears to work best with the schedule. If all appointment
slots are full, just tell the caller to come right over, and we will work him or her into the schedule.
Advise the patient about the exam fee and the payment requirements over the phone.
Emergency Symptoms (Work patient into today’s schedule or page the doctor on call. A referral to the
hospital emergency room should be considered if no doctor is reached).
Sudden loss or blurring of vision in either eye or both eyes
New or sudden flashes of light or floaters
Pain in the eye
Chemical splash in the eye (advise immediate copious flushing with water for at least a half
hour, even if the event seems over)
Injury to the eye or head
Foreign particle in the eye
Red eyes of recent onset
Discharge from eyes
Extreme swollen eyelid
Contact lens lost or broken in the eye
Steamy or cloudy vision of recent onset
Sudden unequal pupil size
Sudden double vision or sudden crossed eyes
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
Dr. Gailmard's new book, Practice Management in Optometry: A Blueprint for Success Based on the Optometric Management Tip of the Week, is now available on Amazon.