patient forms

**Dazedandconfused09** · 06-19-2009, 10:01 AM

I have a question that I would love to have answered or at the least a response....Why do patients give such a hard time filling his/her Update Form? At the office I work at we require our patients to fill the form out every year they come back for a n annual eye exam....is this so hard?
I go to my doctors office and just take the form fill it out and hand it back to the receptionist and sit back down and wait for the doctor to see me...Second question...What is the reason the form needs to be filled out anyway? Patients ask me and I am at a loss as to what to say anymore...

PLEASE HELP!

**k12311997** · 06-19-2009, 10:40 AM

reason forms need filled out. The information contained on the form is recognized as standard of care for a complete routine exam you either use a form or you ask the questions and note on chart.

**Dazedandconfused09** · 06-19-2009, 10:49 AM

thank you for answering my que....thats sums up what to say to the unhappy patient who complains about filling out the fprm "again"....

**Lachrymator** · 06-19-2009, 10:57 AM

Originally Posted by Dazedandconfused09

Why do patients give such a hard time filling his/her Update Form?

Because they think they are too good for it. We always have those patients who have been with us for years who neglect to update their info. Typical arrogant public. I hate it when they bring in that attitude. We have recently added a second office, and patients who come from the old office don't want to fill out info for the new location.

Second question...What is the reason the form needs to be filled out anyway? Patients ask me and I am at a loss as to what to say anymore...

The form has to be filled out so you can update their info for your office's records. You want to know if there are any changes in address/insurance information. In our office we have a short 1/3 of a page shortened update form for established patients.

**chip anderson** · 06-19-2009, 12:03 PM

Patients don't like fooling with forms and paperwork. The last time I went to the opthalmologists office, who is a friend of mine and I am a courtesy patient (translation: freebie). I had to fill out enough forms to get a job with the CIA. Then I had the usuall 45 min wait in the waiting room, then maybe 15 more before anyone joined me in the exam room.

Patient's get pi**ed about treatment like this. Hard as it is for doctors to understand patient's concider thier time to be just as valuable as the doctors. None of us gets anymore time on this earth. Doctor's seem to feel that they suffered so much in medical school, or optometry school or the fraturnity house they are more important than the rest of the general population.
Of course the general population thinks they suffered equally working thier way up on the job while the doctor got to sit in school. Probably both are right.
However when the patient comes in your office he wants to be seen in a timely manner, get an exam and leave with a prescription that will allow him to see better. I know that doctor's think the medical part of the exam is more important and some think it is the only important part. But the patient wants to leave with something that will make him see better!
Just as when he sees the doctor with illness, he wants an Rx or treatment that will make him feel better or get well.
So when you dump paper work on him, and he's the one paying you aren't paying him to do the paper work, he ain't happy.
\
Chip

**Lachrymator** · 06-19-2009, 12:19 PM

Originally Posted by chip anderson

I know that doctor's think the medical part of the exam is more important and some think it is the only important part. But the patient wants to leave with something that will make him see better!

And this is the problem in our industry with the public. They are uneducated and do not care about their ocular health. They just want aquity. :finger:

So when you dump paper work on him, and he's the one paying you aren't paying him to do the paper work, he ain't happy.

In our office, we have a 2 page form. It's not entirely lengthy either with many "check applicable" options. Not to mention my lens reps want me to add a questionare to get them in the frame/lens buying mood.

**normuck** · 06-19-2009, 02:44 PM

We have went with setting a monitor on the counter for our patients to view that has all their information displayed on it. i.e. address phone number, email, insurance info yada yada. ask the patient if the info on the screen is right, and they tell us yes or no. then we hand them the hippa form to sign and the rest is asked in the exam room. one signature and we are good ;).

**Lachrymator** · 06-19-2009, 03:34 PM

Originally Posted by normuck

We have went with setting a monitor on the counter for our patients to view that has all their information displayed on it. i.e. address phone number, email, insurance info yada yada. ask the patient if the info on the screen is right, and they tell us yes or no. then we hand them the hippa form to sign and the rest is asked in the exam room. one signature and we are good ;).

You guys are just showing off! :bbg:
Hehe j/k, that's a really good idea though, we may have to consider that one.

**rbaker** · 06-19-2009, 04:07 PM

As you get older you seem to spend more and more time times in more and more doctors office. This usually means filing out enumerable forms every time you present at a doctors office. HIPAA was supposed to have addressed the issue of portable medical records which should have eliminated a lot of these redundant records. However, it hasn't happen due to a number of issues beyond the scope of this post.

All I can contribute to the discussion is that it really is a pain in the butt to have to fill out the same form with the same doctor that you have filled out for the past twenty years. It really does get on my nerve, of which I only have one left. What is particularly irksome is the recent habit of some optometrists to request medical information well outside their realm of practice.

The Veterans Administration should be the model for portability of PMI (Patient Medical Information) as they have their ducks in a row. In the ophthalmic field there is no portability of records beyond the doors to your practice. For example, why are not doctor Smiths records available electronically on doctor Jone's computer? When will the promise of HIPAA come to fruition?

**OHPNTZ** · 06-19-2009, 09:15 PM

Originally Posted by rbaker

"What is particularly irksome is the recent habit of some optometrists to request medical information well outside their realm of practice. "

What specific medical information are you referring to? Could you provide some examples??

The Veterans Administration should be the model for portability of PMI (Patient Medical Information) as they have their ducks in a row. In the ophthalmic field there is no portability of records beyond the doors to your practice. For example, why are not doctor Smiths records available electronically on doctor Jone's computer? When will the promise of HIPAA come to fruition?

A problem with the VA PMI is it is text only. No pertinent diagrams or photos are attached.

,,

**harry888** · 06-19-2009, 10:34 PM

You should only have to fill out that long form every three years.

It why a "new" patient exam 92004 pays so much more than the established patient exam 92014.

Harry

**rbaker** · 06-19-2009, 10:38 PM

Originally Posted by rbaker

"What is particularly irksome is the recent habit of some optometrists to request medical information well outside their realm of practice. "

What specific medical information are you referring to? Could you provide some examples??

Blood pressure, lipid profiles, A1C to name a few.

The Veterans Administration should be the model for portability of PMI (Patient Medical Information) as they have their ducks in a row. In the ophthalmic field there is no portability of records beyond the doors to your practice. For example, why are not doctor Smiths records available electronically on doctor Jone's computer? When will the promise of HIPAA come to fruition?

A problem with the VA PMI is it is text only. No pertinent diagrams or photos are attached.

The patient Hx forms that are in question here are text. Imaging such as fluorescein angiography and fundus photos is being rolled out as we speak. .

**OHPNTZ** · 06-20-2009, 09:04 AM

Wow RBaker, you're really shortsighted regarding information that is "Outside the realm of practice".

A1C is not important...uhhh ok. Let's talk in optician speak. Your customer comes to your privately owned store after having his/her refraction. Said patient is diabetic, checks blood sugar infrequently. During time of exam patient had no idea of blood sugar but knew that a "some blood" test 6 weeks ago had a number around 9 or 10 (Which as you say is unimportant). You role out the red carpet, lightest thinnest lens, designer frame, all the coatings...the whole deal. Patient gets glasses, and a month and a half later, complains they can't see anymore (as their blood glucose levels become closer to "normal". Now you have to remake lenses...I don't think you would be happy about that.

Blood pressure isn't real important either...ok. Ever hear about hypertensive retinopathy? How about retinal bleeds from high blood pressure? Ok, "You know sir, I'm really not sure why you can't see in one quadrant of your vision in your one eye, there might be some blood there...I have no idea what would cause a BRVO??? Let's put prism in your glasses and call it a day."

Lipids aren't real important either. The amount of exudate in diabetic retinopathy has no apparent correlation. What's the white line inside your cornea Mr. 38 year old...ahh it doesn't matter. Sorry sir, I have no idea why you have these large yellowish lesions on your eyelids...I just refract!

I really thought you were going to list something else, but to come up with this as your argument...I have to say is just wrong.

**humbleABOCtx** · 06-20-2009, 08:55 PM

I'm just a little 'ole opthalmic tech and c.optican but I have to agree with OHPNTZ.

If we don't do our jobs in the tech room..."Updating ALL Forms" (med hx changes and all medicine changes BS/AIC count if DM....etc...) we only make our/optician's job harder with potiental remakes on the glasses.

If the DOC is informed from the beginning if Pt.X BS is 300+ , the DOC won't Refact today and do it at a follow-up appt. or even send them to their specialist or pcp....very simply......it becomes the pt. responsibilty!!! not ours!!!!

GOAL : get. medical/mecinine (rx+otc) updates!!
make the Glasses ONCE (ie. after BS under control)
...the PT. can't be upset w/ Doc or optician with 2-3+ trips for
glasses redo's (atleast for some things we can control)

RE: PT FORMS UPDATES/est. pt's getting aggitated./
I completely understand everyones frustration!!
Not only do i confirm we have Signed forms in chart (angry pt's. I politely explain "law requires" and they comply.....);
but in the Tech room I further aggitated some pt.s when I am "confirming" everything they jsut wrote.

I tell Pt. "for their best poss. care we need all updates....please".
When pt's don't want to tell all their medicines and tell me:
"doc doesn't need that info...I'm just here for an eye exam'"..
I politely explain:
"Your eye health is very important to your doctor along with your vision; alot of medicine's, rx + otc, can have many side effects directly related to your eyes. For your best care may I please list them for him." (same goes w. systemic hx...)

I get compliance everytime with no arguements and they're no longer aggitated, imagine that..(occas. you see a puff of smoke out of the nose though).....hmmmm, i hope we just made our doc's job easier too....

yea, redundant I know....just my two cents worth.

**Pogu** · 06-20-2009, 10:23 PM

People with serious medical conditions should be briefed by their medical doctors on the possible effects on their vision. That, I think, should be discussed between patient and doctor in all circumstances; not between a patient and a guy making an hourly wage (me) as its none of my business whats wrong with them other than mechanical vision correction as prescribed by a doctor.

**bob_f_aboc** · 06-20-2009, 10:24 PM

Originally Posted by humbleABOCtx

I'm just a little 'ole opthalmic tech and c.optican but I have to agree with OHPNTZ.

If we don't do our jobs in the tech room..."Updating ALL Forms" (med hx changes and all medicine changes BS/AIC count if DM....etc...) we only make our/optician's job harder with potiental remakes on the glasses.

If the DOC is informed from the beginning if Pt.X BS is 300+ , the DOC won't Refact today and do it at a follow-up appt. or even send them to their specialist or pcp....very simply......it becomes the pt. responsibilty!!! not ours!!!!

GOAL : get. medical/mecinine (rx+otc) updates!!
make the Glasses ONCE (ie. after BS under control)
...the PT. can't be upset w/ Doc or optician with 2-3+ trips for
glasses redo's (atleast for some things we can control)

RE: PT FORMS UPDATES/est. pt's getting aggitated./
I completely understand everyones frustration!!
Not only do i confirm we have Signed forms in chart (angry pt's. I politely explain "law requires" and they comply.....);
but in the Tech room I further aggitated some pt.s when I am "confirming" everything they jsut wrote.

I tell Pt. "for their best poss. care we need all updates....please".
When pt's don't want to tell all their medicines and tell me:
"doc doesn't need that info...I'm just here for an eye exam'"..
I politely explain:
"Your eye health is very important to your doctor along with your vision; alot of medicine's, rx + otc, can have many side effects directly related to your eyes. For your best care may I please list them for him." (same goes w. systemic hx...)

I get compliance everytime with no arguements and they're no longer aggitated, imagine that..(occas. you see a puff of smoke out of the nose though).....hmmmm, i hope we just made our doc's job easier too....

yea, redundant I know....just my two cents worth.

Seems like an endless battle sometimes!

:cheers::cheers::cheers::cheers::cheers:

**humbleABOCtx** · 06-20-2009, 10:55 PM

Originally Posted by Pogu

People with serious medical conditions should be briefed by their medical doctors on the possible effects on their vision. That, I think, should be discussed between patient and doctor in all circumstances; not between a patient and a guy making an hourly wage (me) as its none of my business whats wrong with them other than mechanical vision correction as prescribed by a doctor.

I absolutely agree...I never said anything about discussing the adverse affects directly with the patient, ....I just want to list all pt.meds for the doc to make his job easier. IF meds or systemic hx is not listed then HOW can the Doc Discuss this with the pt.!!!:finger:
My point is that it's like pulling eye teeth to get the patients to update forms and give correct updated info (politely and timely)----
WHICH IS OUR JOB-hourly or salary or internship---HELLO!!:hammer:

**dcdwn** · 06-21-2009, 01:13 AM

Hi I agree With Humble. The more info we have on the patient med problems the better Rx, better glasses better contact, or laisk.
So we can have the best out come for the patient. One satisfied patient and five referal from the patient. If it goes the other way on info glasses are bad contact foggy and lasik I can't see five people that,that patient told how our service was we are going to be out of a job cause of the little thing that we over looked to wright down on the patiet records. THIS VERY INPORTANT.

Don Price ABO/NCLE

**coffee joe** · 06-21-2009, 02:07 AM

pogu, i think it is exactly because you're making an hourly wage that you don't care about the medical. if you owned that business though you would. having some basic knowledge about how ongoing treatment can cause significant changes in vision several time throughout the course of the treatment can save you allot on remakes. if you're working for an indipendently owned place, you should care, because the monie that goes into remakes comes out of the bottom line. the smaller the bottom line the less monie there is to pay employies. i.e. you. i assume you do like it when there is monie in the bank to cover your paycheck.

**Pogu** · 06-21-2009, 08:58 AM

Originally Posted by humbleABOCtx

I absolutely agree...I never said anything about discussing the adverse affects directly with the patient, ....I just want to list all pt.meds for the doc to make his job easier. IF meds or systemic hx is not listed then HOW can the Doc Discuss this with the pt.!!!:finger:
My point is that it's like pulling eye teeth to get the patients to update forms and give correct updated info (politely and timely)----
WHICH IS OUR JOB-hourly or salary or internship---HELLO!!:hammer:

I have a bad tendency to post out of context without really thinking about what I'm saying properly, I apologize. I have only worked in small OD owned offices, patients discuss things with the doctor by bringing them up. Being accustomed as I am to medical issues being handled by doctors, I can see how someone would have an problem disclosing to someone other than a doctor. Those issues only become my business when it comes to an eye wear solution.

**69stingray** · 06-22-2009, 09:15 AM

Originally Posted by rbaker

What is particularly irksome is the recent habit of some optometrists to request medical information well outside their realm of practice.

WTF, lol. I'm one of those OD's that ask about A1C and BP when indicated. You have no clue what you're talking about.

**braheem24** · 06-22-2009, 09:48 AM

Originally Posted by Dazedandconfused09

Patients ask me and I am at a loss as to what to say anymore...

PLEASE HELP!

"Please update your patient info for us, so we bill the picky insurance company properly instead of getting a denial and forwarding the bill to you.

...and while you're at it please update your medical info so we dont kill you either."

Say it with a smile :)

**HarryChiling** · 06-22-2009, 10:08 AM

Originally Posted by braheem24

...and while you're at it please update your medical info so we dont kill you either."

Say it with a smile :)

I like that. :cheers:

Originally Posted by OPHTNZ

Said patient is diabetic, checks blood sugar infrequently. During time of exam patient had no idea of blood sugar but knew that a "some blood" test 6 weeks ago had a number around 9 or 10 (Which as you say is unimportant). You role out the red carpet, lightest thinnest lens, designer frame, all the coatings...the whole deal. Patient gets glasses, and a month and a half later, complains they can't see anymore (as their blood glucose levels become closer to "normal". Now you have to remake lenses...I don't think you would be happy about that.

I know I wouldn't be happy, why the heck would the doctor perform a refraction under those circumstances? And why have I never gotten any information other a simple Rx when I get scripts? I think their could be better communication on all ends. The eye's are the only portion of the body where you can actually peer inside and take a look at the gears working, so any medical information could potentialy be relevent, I still don't understand why anyone wants all that liability but it's yours so enjoy it, just do me a favor and don't give that diabetic a script until their blood sugar is normal and if their acuity is off please document it and I won't send the optical bogeyman after you.

And if their was a vein occlusion, wouldn't that require attention that is outside your scope? In a case such as that would the information requested be to keep a thorough record, or CYA?

**Tracy Lewis** · 06-22-2009, 04:26 PM

Why do they need to update every year? Ask if they've had any changes, if they answer yes, make them update. Otherwise don't waste their time. It only frustrates them which in turn frustrates you.

**OHPNTZ** · 06-22-2009, 10:22 PM

Originally Posted by HarryChiling

I like that. :cheers:

And if their was a vein occlusion, wouldn't that require attention that is outside your scope? In a case such as that would the information requested be to keep a thorough record, or CYA?

Depends on the VA, the underlying cause, etc. Often times you could contact the primary care physician for testing or order it yourself depending on the situation. If caused by elevated IOP, can be treated; monitor for ischemia and secondary neovascularization, etc. It depends what the OD is comfortable with.

There is more to these health history sheets than I think many realize here. And it's not for the OD's who think they are junior MD's either...it's about knowing what you are looking at, what can be the underlying cause, and what to do about it...

Even something as simple as blood pressure...I had a patient who was about to stroke out...we sent him immediately to the ER...his wife came in the next day thanking everyone. Also had a relative of an employee come in...history of hypertension (uncontrolled)...lead to stroke and secondary field defect...anyways caught it during exam, contacted physician and patient was evaluted and treated within hours. The list goes on...