What Eye Dr's DON'T do..

**Eye glass lady** · 06-12-2012, 01:56 AM

I know this is a touchie subject in some offices, but I'm really curious. How is it in your office or clinic, what exactly does the eye doctor do 'besides' of course what he/she does best , perform the pts exam. Does the dr. also take the pupil distance measurement, choose the pts frame, tell the optician what and how to measure, how to repair ? I'm asking because I work with a new dr. who is doing these types of things. I understand if the dr. is concerned at times per certain pts with health issues, something that would cause issues later if the optician is not doing his/her job correctly. I've been an optician now for more then a few years and am abo, and I've been in this same job now for 6 years without this kind of issue with a dr. Oh, I know some dr's get paticular sometimes but I really feel like this new dr is stepping on my toes abit by interrupting my fitting process. He will send a pt to me with comments like: " The dr. told me to tell you that I need a deeper frame, a wider frame and it needs to fit such and such a way...and when we choose which frame, he wants to see it...and to put the seg height at such and such...or I need a screw put in here and to do it this way' , I need an adjustment and the dr. said to bend it this way... and or he'll put on the order the pd measurement ... Am I out of line, am I being too sensitive? I know I'll get straight forward answers on here...lol ...But I sure need some advice on how to deal with this dr. because I do not want offences down the road..

**chip anderson** · 06-12-2012, 08:50 AM

Some doctors and others are control freaks and want to be in charge of everything. I do speciallty contact lens fitting and irritates me to death when the doctor specifies lens specs, may or may not take his own measurements. Since he does no follow-up one feels ones hands are tied if things don't work out over time. Almost as irritating as doctors that feel refraction is not part of a "complete eye exam."

If you work for him you might ask just what are you supposed to do beside function as a frame stylist? Of course I do sometimes feel the doctor is giveing the patient an Rx that can be filled at the Big Box where the contact lens fitting consists of reading the label on the box.

Chip

**NavyChief** · 06-12-2012, 09:19 AM

Must have too much time on his hands! My Doc doesn't dilate. So he has lots of time on his hands. But he still never does any of that.
Maybe you should take him aside & let him know you don't question or tell him how to do his job and you'd appreciate he not tell you how do yours. Especially in front or to patients. It's unprofessional!

**Java99** · 06-12-2012, 10:58 AM

Originally Posted by NavyChief

Must have too much time on his hands! My Doc doesn't dilate. So he has lots of time on his hands. But he still never does any of that.
Maybe you should take him aside & let him know you don't question or tell him how to do his job and you'd appreciate he not tell you how do yours. Especially in front or to patients. It's unprofessional!

In the offices where I've worked, doing this would be a great way to get fired. I honestly don't think there's much recourse for the optician, unless the optician can speak to another doc or manager who can speak to the doc in question.

**Happylady** · 06-12-2012, 11:38 AM

That would drive me crazy! I had a friend that worked for a doctor that was some what that way and it got really old.

**normuck** · 06-12-2012, 11:39 AM

When I have worked for a very "hands on doc", Ive had to put my pride on the back burner and do what the doctor asked, to the best of my ability. You have to realize that this is typically the Doc's buisness/passion/baby, so the doc wants what is best for his/her practice. Just do what the doc desires and as long as your doing it well, you will eventually be given more trust and freedom. Just my experiences. Hang in there! It will get better ;)

**sharpstick777** · 06-12-2012, 11:48 AM

Yikes. I have seen that before. Is your practice slow? The busier he is the less junk he can throw your way. Try booking the patients tighter together, maybe every 15 minutes. That way he is a frantic mess and will understand the word "delegate"

**mdeimler** · 06-12-2012, 11:54 AM

Find out how long he's going to last. Get his peers opinions. If everyone else likes him and it looks like he'll be there a while, get your resume in order.
If you are skilled, maybe there is somewhere else for you.

**OHPNTZ** · 06-12-2012, 12:12 PM

Originally Posted by NavyChief

Must have too much time on his hands! My Doc doesn't dilate. So he has lots of time on his hands. But he still never does any of that.
Maybe you should take him aside & let him know you don't question or tell him how to do his job and you'd appreciate he not tell you how do yours. Especially in front or to patients. It's unprofessional!

What's unprofessional is your doctor not dilating patients!

**OHPNTZ** · 06-12-2012, 12:18 PM

To the original poster...i would assume this od is from the old school.

From my standpoint, and from many of my friends, the less involved I am in other aspects of the whole experience, the less headaches I have.

**optilady1** · 06-12-2012, 12:36 PM

Of course, the other side of the coin is the doctor telling patients they can get a glass executive in a silhouette frame. Trust me, it's not the end of the world for a doctor to be involved in the eyeglass side of things. It's certainly annoying, but I would try to find the good in having a doctor who is willing to make suggestions to the benefit of the patients. I agree that you may have to find another place to work if it's too difficult to mesh with that personality. If you are comfortable having a sit down with the doc, you may want to ask what role the doctor is looking for you to have in the office. Good luck, I hope for your sake that he takes a step back and allows you to do what you are trained to do. If not, you could always suggest he start selling the glasses, and you could do the exams (I kid!!!!)

**Java99** · 06-12-2012, 12:41 PM

Possible the doc worked with very unskilled opticians in the past as well, and will ease up once he/she realizes you know what you're doing. If not, get the doc to also sell polarized, arc, etc from the chair. If he's going to do your job and be in the way, have it benefit the practice more.

**Chris Ryser** · 06-12-2012, 01:49 PM

Originally Posted by NavyChief

Maybe you should take him aside & let him know you don't question or tell him how to do his job and you'd appreciate he not tell you how do yours. Especially in front or to patients. It's unprofessional!

There is only one difference in above statement................do you work for the doctor............or does the doctor work for you ????????????? Who is the boss ????

**AustinEyewear** · 06-12-2012, 02:14 PM

Originally Posted by Eye glass lady

I know this is a touchie subject in some offices, but I'm really curious. How is it in your office or clinic, what exactly does the eye doctor do 'besides' of course what he/she does best , perform the pts exam. Does the dr. also take the pupil distance measurement, choose the pts frame, tell the optician what and how to measure, how to repair ?

It really depends on the doctor, the patient and the optician. Any strategy is acceptable as long as the patient is comfortable with it, and the owner is comfortable. Discuss it with each doc/owner you work with, and come up with a game plan. Once you have done this (and it may not be easy at first) I think you'll find that you are happy you did. Opticians often see a very centric view of themselves, I wish they didn't do this so much. They so often forget about the techs. Heck, even our techs discuss glasses with patient, but optician is always kept in the loop, and handles the brunt of the work unless patient makes a particular request. A lot of it will depend on your real skill level. You never mentioned whether the doc was previously an optician - that also makes a diff.

**fjpod** · 06-12-2012, 02:27 PM

sheesh...ODs can't win around here. Either we do too much or too little.

**Optician1960** · 06-12-2012, 02:48 PM

I go back to a statement about how the Dr sends the patient to you and has them say, "The Dr says I need a bigger frame...". The first patient care rule should be a proper transition from the Dr to the optician with the patient at the center of the conversation. The Dr should share the Rx, some info they found out about the patients visual needs and any recco's or considerations they believe the patient should learn more about from the optician. If the Dr thinks a larger frame should be considered, then they can mention it to the optician with the patient there. Ego's asside, patient care 1st... When the Dr spends a bit more time with the handoff's, you may also find that they have less time to talk about how to fix or adjust a frame...

**Barry Santini** · 06-12-2012, 02:58 PM

People rarely need "larger" frames. What tey need instead is more room/distance below their pupil for comfortable reading.

Semantics? I don't think so.

B

**pseudonym** · 06-12-2012, 03:07 PM

I worked for a micro-managing doc for two months. She was a nice lady but didn't even realize how much she was undermining morale in her own office with her meddling. I think she's on her 5th optician since I left about a year ago.

**EyeCare Rich** · 06-12-2012, 05:35 PM

Depending on who owns the office, this OD or someone else, it sounds like your job description needs to be defined and discussed. I hope you get to be a part of the definition. I would suggest an office meeting where this info is discussed for the sake of everyone involved. If this cannot be accomplished, I think you need to polish your resume and keep your eyes and ears open for something else. Good Luck!

**Robert_S** · 06-12-2012, 06:00 PM

In my opinion, the person conducting the test (you guys call it 'doctor', we call it 'optician') absolutely should be discussing the patients needs and what kinds of products they should be considering, whether that be digital single vision or a better progressive design, or even talking about abbe value.

But they should also have the modesty not to think that unless they tell everyone exactly what they need to be dispensing, the right decisions won't get made. Because, frankly, we are usually in the best position to choose design/ material/ coating etc.

The best way to look professional and to instill confidence in your patients is for all the staff to work effectively and efficiently as a team. People often think of one person as a salesperson, but usually think of a team as an authority.

**shannon** · 06-12-2012, 06:35 PM

May I make a suggestion? Have a few of your vendors donate some free lenses coupons (Zeiss is usually pretty good about it) and try making a couple of pairs of glasses for this doc in the ways that you know are correct and provide the hightest level of quality for the functions they are being used for. Put the doc in a smaller frame with a PAL that will only work within it (a nice free form might be the way to go) and for another pair, go against the grain of another "suggestion" that leaves their lips. This will not mean that they love them endlessly, but it will introduced them to what else is out there and maybe they will allow you to decide what is appropriate for the patient. I always love my doc suggetions, but her and I are on the same page. And finally, please remember that just b/c someone has the habit of going about things the "old way"...remember one thing, the basics never change, only the technology does. You may be able to learn alot from this doctor who may be feeling lost in a world where tecnology just swept right past him/her. You all, please forgive me, I've been running on straight caffiene alllllll day, so if my messages are not making any sense, feel free to PM me and tell me to cool it! :)

**sharpstick777** · 06-12-2012, 06:41 PM

fjpod, don't feel bad, no one really wins around here. Except Fezz, after every storm he seems to land upright with a drink in his hand.

Originally Posted by fjpod

sheesh...ODs can't win around here. Either we do too much or too little.

**Wes** · 06-12-2012, 06:47 PM

Originally Posted by fjpod

sheesh...ODs can't win around here. Either we do too much or too little.

If ODs knew what they were getting when they hired an "optician", this wouldn't be as much of an issue. Sadly, however, even "opticians" often do not know what we bring to the table. Hence, the need to define and standardize the profession, and the education that supports it.

**Java99** · 06-13-2012, 09:03 AM

Originally Posted by Barry Santini

People rarely need "larger" frames. What tey need instead is more room/distance below their pupil for comfortable reading.

Semantics? I don't think so.

B

I see a lot of rxes from a doc that does this. Makes me crazy because people rarely believe me if I try to educate beyond what doc said. Most of the time I just shut up and give these people what they think they want because they refuse to believe there is an option doc didn't tell them about.

**pseudonym** · 06-13-2012, 08:23 PM

Originally Posted by Java99

I see a lot of rxes from a doc that does this. Makes me crazy because people rarely believe me if I try to educate beyond what doc said. Most of the time I just shut up and give these people what they think they want because they refuse to believe there is an option doc didn't tell them about.

One drew a line straight across the alignment circles in a PAL and told the patient it was cut way too low because her pupil should be at the center of that line. I pulled out the marking chart and showed her the dot at her pupil was actually 4mm above that line. She didn't believe me. Period.

This doc also likes to check the AR box on his scripts, even for kids. Question: Does checking the AR box make AR a part of the prescription? Because I've been ignoring it for kids, construction workers, and farmers.