Is it just a matter of time before busy optometric practices follow the model of ophthalmology and have technicians perform refractions? How about other procedures?
Is it just a matter of time before busy optometric practices follow the model of ophthalmology and have technicians perform refractions? How about other procedures?
Don't think it's not happening already.
Some states prohibit delegation, but I don't like being defined as a refractionist.
Now, the question as to whether it's a good or bad idea is a different subject.
What's your opinion on this matter, Dick?
Maybe that's why we have so many remakes from an ophthalmologist office?
Originally Posted by KStraker
Our Opthalmic Tech's are mostley COA Certified and the three that are not, they are studying for the test and being trianed by the COA's. We have very few remakes in our office from refractions, I think it just depends on the Organization. We have alot of Tech's that have been with us many years.
It Does work that way
Dick,
sorry to tell you, that IS how it works.
Denny
Then what would the OD be doing? Our docs do everything still because we allow a half hour per patient. They prefer it that way because they like the "personal approach". If we get busier(it is a fairly new practice)we would like to add a pre-test room. This of course would be done by the "tech". The "tech" being an entry level employee. So the patient history,tonometry, VA, fields, and autorefractor will be done in pre-test. Again, what exactly will the optometrist be doing again? Tweaking the autorefraction and fitting contacts? I don't mind a "tech" to fit in more patients per hour but one of our docs barely does a 15 minute exam now.
You can teach a monkey to refract. You cannot teach a monkey to refract well.
I'm learning how to refract at the moment... the doc is kind of giving me a sink or swim instruction, however. I usually take the patient back and plug in the AR readings (we have Marco automated refraction systems), then give a tuning in monacular form if needed. He does the final adjustments and balancing. I come up with the subjective and then he generates the manifest and final Rx. It saves him maybe 45 seconds to two minutes with the system we have, but it's a step in the direction of training me how to do it. According to him I do fairly well, but I still have a long way to go.
I've worked in two Ophthalmology offices where COA's refract, and I can tell you that the attention to detail was not there. In one case, they just needed the best-corrected vision. In the other case, they sold glasses and CL's. I hated fitting CL's off their refractions though, and I double-checked a ton of Rx's on a regular basis prior to sending them out front or ordering CL's (especially torics).
I would never have it in my personal office, but that's just me.
-Steve
I am a certified ophthalmic technician (formally trained not OTJ) and I spend a fair amount of my day performing refractometry. With that being said, it is definately a science and an art. I believe that it can beneficial for an OD or MD to delegate diagnostic responsibilties to qualified technicians. In fact I guarantee that my MRs are much better than the MDs I work for.
I find that refraction can be one of the most challenging aspects of an exam. It is definately as much art as it is science, and having performed close to 25000 refractions, I can tell you I'm still learning to do it better. I certainly agree that refraction could be delegated to ancillary staff, but only with extensive training of the right individual. Otherwise, expect a lot of redos.
I once worked at an MD's office where he employed 3 other MD's and a staff of 8 OD's and 10 techs and 10 opticians. The one Doc (OD ) I worked with once told me that he could teach me how to refract in fifteen minutes, his words not mine " it's not that difficult to learn " I had just taken the COA test and passed and was on my way to taking the COT and on the COT you have to know how to refract. Never got to take the COT the MD let me go on the premise I was already making too much money and if I passed the COT he was thinking he'd have to pay me more.
Right on. You can train anyone can do just about anything . . . but to do it well . . . There is an intangible that you cant teach and that is the ingredient that separates the best from the rest.
That was my point exactly! The Doc said he could show me in fifteen minutes but like anything else the more you do the better you get. ;)
And that applies to OD, OMD, Ophth Tech, or Opticians. We can't all be the head of the class, someones gotta be at the bottom.
1st* HTML5 Tracer Software
1st Mac Compatible Tracer Software
1st Linux Compatible Tracer Software
*Dave at OptiVision has a web based tracer integration package that's awesome.
Those at the bottom, the druts, are the ones whose behavior legitimize any of the eye care professions. Unfortunately they seem to be the majority. Very few eye care businesses actually practice their art or craft with the goal of absolute excellence although they all profess this in their "mission statement."
I feel sorry for those young MD's, OD's and Opticians who want to be at the very top of their professions; and I don't mean just academically, but rather occupationally. Unfortunately clinical practice today leaves little room for meaningful continuing education or mentorship. Corporate, and soon government eye care leaves little room for professional improvement. More importantly it fosters little motivation to the practitioner.
Crank em out . . . faster . . . faster.
If your work situation is the opposite of this - kiss your boss, full on the lips.
, you know it's not nice to smack the rose colored glasses from my eyes. Your right in every sense here, and I wish you weren't. I don't even do any of the things I could do anymore, it seems patients as well as employers don't appreciate the craft anymore, it's faster faster, crack the whip.
1st* HTML5 Tracer Software
1st Mac Compatible Tracer Software
1st Linux Compatible Tracer Software
*Dave at OptiVision has a web based tracer integration package that's awesome.
I don't really agree...at least not in all cases. I still think that the cream can rise to the top. I have a rather large staff, and some are superstars and some are not. Those that are dedicated to continued learning, and going the extra mile for patients are the ones who get a raise every six months.
Agree totally! ;)
Between the Army and private practice our OD has over 40 years of experience. I doubt any certified tech will match him in terms of skill and knowledge. Personally, I would run out the door if a tech tried to do my refraction. Anyone who goes to an MD just for an glasses Rx is a fool. Your office seems to have a better success rate than the ones in my area. Now if they could just teach you to write in minus cyl that would be great. :bbg:
The reason the craft isn't there anymore is because your big boys are only concerned about the bottom line. Now don't get me wrong their is concern for the bottom line but to what end? Craft and caring has been replaced by greed and speed.
Can I come work for you??? :D
One ophthalmologist I spoke to told me that the toughest thing he had to master in all his training was refraction.
That's not hard to believe! Most md's depending what specialty ( ie: corneal,
retina or what ever ) don't have that training in refraction it's condensed into there specialty and the residency training they receive.
eww... I don't want to though! He's got bad breath! :p
Seriously, having seen it done a variety of ways, we are definitely do not have that type of situation in the office I work in. We see as many patients we can see without killing ourselves, but every one of them is guaranteed half of the visit is spent in front of the doc. Very few of his scripts have to be tweaked, too... something I really wasn't used to seeing when I first started. It was a common thing where I worked before to have at least 5 Rx redos a day.
There are currently 1 users browsing this thread. (0 members and 1 guests)
Posting Permissions
Reply With Quote
Bookmarks