Ethical Issues in Optometry?

[Stirling]

Hello! I'm prepping for more interview questions and wanted to know of some common ethical issues optometrists face. One that I can think of deals with billing insurance/patients for photos when the photos didn't diagnose anything. For example, a fundus photo appears normal, but the optometrist tells the patient that the photo shows X disease/problems and further testing is required. In the chart, however, the doctor notes that the photo appears normal. Ethically, this is definitely not acceptable, especially when the doctor is stealing money from the insurance/patient.

What other examples can you think of?

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[generallyspeaking]

I don't think that is a good example as there isn't really much ethical debate - it's just pure and simple fraud.

I hear all the time patients saying their previous eyedoc said they couldn't wear contacts or get LASIK because they had "astigmatism". I'm not sure how much of that is the doctor really misrepresenting something vs the patient just lying, but I hear it fairly frequently. There is a contact lens for everyone, even the most extreme prescriptions that even glasses can't help can be corrected with sclerals or RGPs but since most practitioners fit soft lenses, they'll refuse to refer to another office for fear of losing a patient so they'll just deny that there are other options available. Or in the case of LASIK, they are told they are not a candidate without even getting a proper evaluation (topography/pachymetry), nor even understanding that LASIK is just one form of refractive surgery while there are other options out there like ortho-K, PCIOL, ACIOL, PRK. It just reeks laziness from the practitioner and misinformation to the patient about their options for their eye care.

Lastly I'll add I wouldn't worry about these kinds of questions for a simple interview.

 

[Purkinja]

I agree with the above post.Your example is not an ethics query but one of criminality.A better one would be replacing a scratch lens under warranty for a patient who doesn't realize the lens has one.

That said,I would not expect any such questions regarding ethics as well.

 

[Optoman24]

Contact lens companies offering bonuses for doctors to push their products/contacts, over other brands/materials that would be more beneficial to the patient.

 

[Stirling]

I don't think that is a good example as there isn't really much ethical debate - it's just pure and simple fraud.

I hear all the time patients saying their previous eyedoc said they couldn't wear contacts or get LASIK because they had "astigmatism". I'm not sure how much of that is the doctor really misrepresenting something vs the patient just lying, but I hear it fairly frequently. There is a contact lens for everyone, even the most extreme prescriptions that even glasses can't help can be corrected with sclerals or RGPs but since most practitioners fit soft lenses, they'll refuse to refer to another office for fear of losing a patient so they'll just deny that there are other options available. Or in the case of LASIK, they are told they are not a candidate without even getting a proper evaluation (topography/pachymetry), nor even understanding that LASIK is just one form of refractive surgery while there are other options out there like ortho-K, PCIOL, ACIOL, PRK. It just reeks laziness from the practitioner and misinformation to the patient about their options for their eye care.

Lastly I'll add I wouldn't worry about these kinds of questions for a simple interview.

Thanks for the help! I was actually asked this last weekend in my interview and hadn't prepared at all, so I came up with what I posted. I asked because I wasn't sure how well my response fit the question, and now I think I understand what an ethical dilemma really means.

 

[Stirling]

I agree with the above post.Your example is not an ethics query but one of criminality.A better one would be replacing a scratch lens under warranty for a patient who doesn't realize the lens has one.

That said,I would not expect any such questions regarding ethics as well.

Thanks for the help! I was asked this exact question in my interview over the weekend, so I wanted some feedback on the answer I gave. I only thought of my example because my optometrist is auditing another practice over this issue.

 

[Purkinja]

Your question seemed (maybe unintentionally)to frame fraud as a "common ethical issue". My response was firstly to put fraud in it's proper context and secondly think of the probability that an interviewer would ask someone not even one day deep in dealing with insurance companies such an outlandish question.I can only think it was a under handed pitch to make sure you weren't a pathological criminal.

Having two children as well as myself go through multiple interviews each for OD school we never were asked anything whatsoever in that vein.Tired interviewer?

 

[Stirling]

Your question seemed (maybe unintentionally)to frame fraud as a "common ethical issue". My response was firstly to put fraud in it's proper context and secondly think of the probability that an interviewer would ask someone not even one day deep in dealing with insurance companies such an outlandish question.I can only think it was a under handed pitch to make sure you weren't a pathological criminal.

I understand where you're coming from. I didn't mean to make it sound like fraud was something every optometrist faces; I was just unprepared for the question and didn't want to just say, "I don't know." Either way, I got highly recommended from the interviewer, so I'm just happy my answer was satisfactory haha.

Having two children as well as myself go through multiple interviews each for OD school we never were asked anything whatsoever in that vein.Tired interviewer?

Haha possibly. I think I was in the third or fourth group of interviews that day.

 

[deleted853480]

Finding affordable options for low ses patients. Being able to accommodate individuals with disabilities such as autism. For example what if a person can't sit that long with out moving? What if the patient is in a wheel chair?

 

[generallyspeaking]

Finding affordable options for low ses patients. Being able to accommodate individuals with disabilities such as autism. For example what if a person can't sit that long with out moving? What if the patient is in a wheel chair?

I don't think any of these are ethical issues. Your latter two examples conflict with the ADA in America - you have to have accessibility for all patients, even if they are immobile or speak a different language. If a provider doesn't feel he is doing what's in the autist's best interest (ie they aren't confident in their objective testing for whatever reason), they can do their due diligence by referring to another clinic more suitable for their care, but you can't refuse patients and you have to be prepared to see them if they insist.