Almost every eye doctor feels they are the best at delivering high quality patient care. At Leadership OD, we never get calls requesting help with delivering better care to patients. When we ask, “What do you do best?”, we already know the answer.
Today’s professional education is excellent and we all graduate with the ability to deliver patient care at a very high level and nobody degrades the care they give patients……purposely. In order to become more efficient, we tend to delegate some of the mundane components of the exam to various staff people, who train others, decreasing our direct observation of our own exams.
Realistically, Do You Even Know?
Since we began our careers with the knowledge and ability to perform at the highest level and since we believe that patient care is the area where we need help the least, we rarely stop to see how we are doing. We certainly don’t take the time to make ourselves better.
The Challenge
Periodically, at least once per year, we recommend that you audit your eye exam protocol and grade yourself on matching the current Standard of Care. There are a number of ways to do this:
Video an entire exam. You can actually ask a real patient for permission to record their experience. When you explain that it is to help improve their experience and it will only be seen by those in the office, most patients will gladly comply. Keep the camera running, for everything - including wait times - reception, pre-testing, exam room, contact lens area, everything.
Have the entire team walk through an full exam experience. This is a good exercise to do as a group during a planning retreat. It isn’t a good test of the timing of the exam, but does allow time to ensure that everyone is on the same page. Good conversations about the routine often occur here.
Grade Yourself
Compared to the “Perfect Eye Exam” - what is your score?
History - Typically, this is overdone. We ask the same questions multiple times and don’t listen to the answers. If you asked it on the form and again during the exam, take off some points.
Pre-Testing - “Put your chin here and try not to blink.” Take away points if your team isn’t describing what each instrument is testing.
Chair Skills - This usually includes testing of VA’s, Motilities, Cover Testing and Confrontation Fields and is often delegated. “Skills” indicates that it requires training and practice.
Refraction - This is our “bread and butter”. Do you routinely binocular balance, test accommodation, phorias or vergences? If you don’t, take away points.
Ocular Health Evaluation - Slit Lamp, Ophthalmoscopy, etc. Be honest.
Interactions with Patients - Take away points from EVERY occasion where someone turns away from the patient to enter information into that computer. In general, this is our biggest problem and if you ask your patients, that’s what they will tell you.
Now that you have defined “perfect” and taken an objective look at how you do - go make it better. Once you can’t improve, you are officially the very best.