I thought this would be a fun question to ask, as diversion from the usual 3 meal staple here on SDN (100% simpleton angst, comparison to other professions, am I wasting money). My question to the docs out there, in any field (trolls welcome!) is this: What drives you crazy that OTHER doctors do that you end up having to clean up for? I do not want PATIENT peeves. (this would be very repetitive and have no readership value). So, I guess I will go first.In no particular order....
1) Getting a referral for photopsia, with no adjacent retinal imagery or follow-up of any kind. As in pt came to them, said "I see lights in places where there are no lights", doctor freaks out, sends them to the VA or to my office. And this is NOT just an OD thing....had an OMD "anterior seg specialist" send me a detachment alongside a lattice on a MONOCULAR (!!!!!) patient last month. I saw the pt 2 weeks later after this. Nuff said.
2) Optomaps....God save us from optomaps. A doc sending me a (really blurry and green from lid reflection) photo of something potentially serious.
3) No scleral depression docs; you know who you are. If the idea of putting a little Alcaine on and depressing to see if something flaps around like a ship flag into the vitreous makes you uncomfortable, please go tech somewhere. Makes me crazy.
4) Not checking in the slightest for severe BV issues...I.E. Your pt has convergence insufficiency, is a hyperope, and somehow your +5.00 with +2.00 adds make them vomit into a trash can. (OMD's, this ones a little more on you. My OD colleagues are terrible on #2 and 3) Do a little phoria testing please. Takes 3 minutes. (As an aside, do they TEACH BV in med school? I swear some of the OMD's of my age, 40's and older, are clueless about all of this.)
5) Crown glass. Please stop rx'ing this garbage. I don't care if the patient loves it. They won't love it when it shatters and Seidel signs them. Plus it is heavy and ugly.
6) Last one....and I swear my head starts to explode when I get this (happens at the VA all the time w our older pt base) ok, here goes...PLEASE PLEASE stop sending me everything that has blood somewhere as "proliferative diabetic ret". Half the time it is Eales, IJRT, or one of the million other things. (my favorite was an OD/OMD joint practice that sent me a low grade vitreous heme as proliferative DR. That is like saying "you have a brain tumor" vs "you have a headache") Anyone, from anywhere, of any training level, that sends me a DR diag without doing a glucose test should be sent away to a labor camp. Just awful...
So, I want to know these kinds of peeves that other docs have, so that I make sure I don't do them. Tell me yours. I want to make a good list and put it on my door.
1) Getting a referral for photopsia, with no adjacent retinal imagery or follow-up of any kind. As in pt came to them, said "I see lights in places where there are no lights", doctor freaks out, sends them to the VA or to my office. And this is NOT just an OD thing....had an OMD "anterior seg specialist" send me a detachment alongside a lattice on a MONOCULAR (!!!!!) patient last month. I saw the pt 2 weeks later after this. Nuff said.
2) Optomaps....God save us from optomaps. A doc sending me a (really blurry and green from lid reflection) photo of something potentially serious.
3) No scleral depression docs; you know who you are. If the idea of putting a little Alcaine on and depressing to see if something flaps around like a ship flag into the vitreous makes you uncomfortable, please go tech somewhere. Makes me crazy.
4) Not checking in the slightest for severe BV issues...I.E. Your pt has convergence insufficiency, is a hyperope, and somehow your +5.00 with +2.00 adds make them vomit into a trash can. (OMD's, this ones a little more on you. My OD colleagues are terrible on #2 and 3) Do a little phoria testing please. Takes 3 minutes. (As an aside, do they TEACH BV in med school? I swear some of the OMD's of my age, 40's and older, are clueless about all of this.)
5) Crown glass. Please stop rx'ing this garbage. I don't care if the patient loves it. They won't love it when it shatters and Seidel signs them. Plus it is heavy and ugly.
6) Last one....and I swear my head starts to explode when I get this (happens at the VA all the time w our older pt base) ok, here goes...PLEASE PLEASE stop sending me everything that has blood somewhere as "proliferative diabetic ret". Half the time it is Eales, IJRT, or one of the million other things. (my favorite was an OD/OMD joint practice that sent me a low grade vitreous heme as proliferative DR. That is like saying "you have a brain tumor" vs "you have a headache") Anyone, from anywhere, of any training level, that sends me a DR diag without doing a glucose test should be sent away to a labor camp. Just awful...
So, I want to know these kinds of peeves that other docs have, so that I make sure I don't do them. Tell me yours. I want to make a good list and put it on my door.