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Thread: Contemporary clinical situations unique to the modern eye care practitioner

  1. #1
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    Contemporary clinical situations unique to the modern eye care practitioner

    I'll describe two situations here. They are deliberately not being written in PC-language, in an effort to paint as unambiguous picture as possible my feelings and what is going on. I'm pretty sure these are situations that we are more likely to encounter today than say, 20 years ago. Hence the use of "contemporary" in the title. I can't be the only ones with these types of experiences.

    1. The appalachian kid with the nervous dad
    White 10-year old kid with his dad. Neither seem particularly sharp. Kid is introverted, kinda scared to bump into anything. He looks weak, certainly not athletic in any way, which surprises me given his age. In a sense, he looks sickly without actually being sick. Father is hovering, looking over everything I'm doing and everything coming into contact with his son (that includes me). He says with pride (and to my surprise) that his entire family is really healthy, and does everything naturally, and we talk at length at some of the healthy decisions that he makes for his family. Shows really big concern and doubt when I bring up the idea of dilating drops. Eventually they convince me not to give the kid drops. Patient leaves. I conclude I just saw an anti-vaxxer, and the kid has no immunity to anything.

    2. The jihadi husband and wife couple (x3)
    Young married couple. Husband is ~20 studying engineering at the local university, wife is ~18 studying English at the same university. Both are on a full ride from the Saudi Arabian government for their North American education. Wife is the patient in the chair. She's in full jihadi mockup - matching black/white headscarf and gown (although her face is entirely exposed). I know from experience that "other" men aren't supposed to touch Muslim wives, so I'm careful. But I still get barked at, when I (1) pull her eyelids open to put drops in (2) accidentally bump my knee into her knee when I'm in my rolling chair in front of her (3) hold her upper eyelid open with my finger when she downgazes during fundus examination at the slit lamp. "Please don't touch her," the husband sternly warns me. These 3 descriptions of contact are from 3 completely different husband/wife pairs that I have met. I do the rest of the exam as friendly as possible, and try to let the husband know using my body language, that I'm just trying to do my job.

  2. #2
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    Not as clinical.

    3. Be careful of what you wish for
    I'm talking to my optical chain's "area" manager regarding my conversion ratio. Manager says it's no good. "Dr. Opposite across the street sends more patients to us than you do. He builds our practice better than you do. We should use him here instead of you." I reply, "Dr. Opposite loses all his patients to the optical across the street. He has an even worse conversion ratio than I do. Are you sure that's what you want?" Manager stops. No reply.

  3. #3
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    #1: Unfortunately, but thankfully, we're only here to fix vision. Morality, general bodily health, and vaccines really are not our expertise and are only pertinent as it has to deal with eye health (hypertension et al). Sure, we can have opinions about things, but it's important to keep in mind that we can't fix everything all the time.

    #2: It hasn't come up enough at this practice, but I would consider adding something to the intake paperwork that specifies patient-doctor contact. There are other reasons why a patient may not want to be touched by their doctor, religion notwithstanding. "Certain procedures require physical contact from the doctor or technician staff. If you have a concern that makes this a problem..." Some kind of wording like that. If your patient base offers enough of a reason, go for it, but it's absolutely not something that I would discuss per-patient. Even something as simple as, "okay, I need to hold your eye open to insert drops, is that okay?" can go very far, even with patients who do not have these issues.

    #3: Be aware that area managers are often transitional positions based on driving metrics. If you're being beat up for metrics, either there's a good reason for it, or you're being used to drive the area's overall conversion because you show higher growth potential. I would take their feedback to heart, but only if it's feedback -- simple "these numbers are bad" gives you nothing to work with, and it sounds like that's what happened.

    Hoping you feel better from getting some steam off, and that the above helps in any way! Surprising to see a dedicated griping thread in the Canada subforum!

  4. #4
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    LOL. Oh I'm not really trying to gripe. They were meant to be shared to try to create a really contemporary thread on contemporary topics, for amusement, for interest, and for "relating-to". But thanks for your feedback.

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    Blue Jumper "Please don't touch her," the husband sternly warns me..............................

    Quote Originally Posted by optio View Post
    I'll describe two situations here.


    2. The jihadi husband and wife couple (x3)

    She's in full jihadi mockup - matching black/white headscarf and gown (although her face is entirely exposed). I know from experience that "other" men aren't supposed to touch Muslim wives, so I'm careful. But I still get barked at, when I (1) pull her eyelids open to put drops in (2) accidentally bump my knee into her knee when I'm in my rolling chair in front of her (3) hold her upper eyelid open with my finger when she downgazes during fundus examination at the slit lamp.

    "Please don't touch her," the husband sternly warns me.

    I never thought that this could happen when doing an eye test.

    However if you want to find out how to proceed with such cases I would consult the nearest "Gynaecologist" how to proceed with a jihadi couple.

    However checking on Google I found the following article. Maybe you can not win.

    Gynaecologist jailed after inappropriately touching his patients during exams

    A DISGRACED gynaecologist has been jailed after touching his patients during intimate exams.

    By JOHN TWOMEY
    PUBLISHED: 17:03, Wed, Jul 27, 2016 | UPDATED: 17:25, Wed, Jul 27, 2016


    Mahesh Vidyadhar Patwardhan, 53, made one patient bend over while he squeezed her breasts in front of her husband.

    Another of his victims attempted suicide following his assaults, which she said had ruined her life.

    Patwardhan, from Essex, assaulted his victims between 2008 and 2012 at the Queen Elizabeth Hospital in Woolwich and Blackheath Hospital in Lewisham.


    See all of it: ===========>
    http://www.express.co.uk/news/uk/693...s-during-exams






  6. #6
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    Quote Originally Posted by optio View Post
    I'll describe two situations here. They are deliberately not being written in PC-language, in an effort to paint as unambiguous picture as possible my feelings and what is going on. I'm pretty sure these are situations that we are more likely to encounter today than say, 20 years ago. Hence the use of "contemporary" in the title. I can't be the only ones with these types of experiences.

    1. The appalachian kid with the nervous dad
    White 10-year old kid with his dad. Neither seem particularly sharp. Kid is introverted, kinda scared to bump into anything. He looks weak, certainly not athletic in any way, which surprises me given his age. In a sense, he looks sickly without actually being sick. Father is hovering, looking over everything I'm doing and everything coming into contact with his son (that includes me). He says with pride (and to my surprise) that his entire family is really healthy, and does everything naturally, and we talk at length at some of the healthy decisions that he makes for his family. Shows really big concern and doubt when I bring up the idea of dilating drops. Eventually they convince me not to give the kid drops. Patient leaves. I conclude I just saw an anti-vaxxer, and the kid has no immunity to anything.

    2. The jihadi husband and wife couple (x3)
    Young married couple. Husband is ~20 studying engineering at the local university, wife is ~18 studying English at the same university. Both are on a full ride from the Saudi Arabian government for their North American education. Wife is the patient in the chair. She's in full jihadi mockup - matching black/white headscarf and gown (although her face is entirely exposed). I know from experience that "other" men aren't supposed to touch Muslim wives, so I'm careful. But I still get barked at, when I (1) pull her eyelids open to put drops in (2) accidentally bump my knee into her knee when I'm in my rolling chair in front of her (3) hold her upper eyelid open with my finger when she downgazes during fundus examination at the slit lamp. "Please don't touch her," the husband sternly warns me. These 3 descriptions of contact are from 3 completely different husband/wife pairs that I have met. I do the rest of the exam as friendly as possible, and try to let the husband know using my body language, that I'm just trying to do my job.
    1. They reside in the Appalachian mountains and their family tree looks like a telephone pole on ancestry.com

    2. When in Rome...(no backpack jokes)

    Welcome to 2017. Google 'melting pot'.

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