overtested to death

[yushin]

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Thank you. This is exactly what I was saying.


I know some clowns try to charge extra for a photo. I have never done that. It's part of the routine exam. In additon to the 'wow' factor, it increases efficiency greatly for me (automatically zoomed into their electronic medical record)--- Another thing that is very important in today's health care enviroment (which is code for: Crappy insurance reimbursement).

QUOTE]

I disagree with the statement that it is part of the routine exam..It isn't. When you do it "routinely" you set the tone for insurance companies to not reimburse a retina doc, optometrist or ophthalmologist when a patient truly does need a retinal photo. More so it isn't indicated. Getting a hand massage is not related to the teeth. It is non medical. If you want to provide free medical services for your patients that is your call of course but I think it does you and your profession a disservice. I don't irrigate every patient's nasolacrimal system that I see as routine or photo their face unless it is needed. If I am doing a blepharoplasty, a patient needs to pay for it. I don't haggle the price or make "discounts". As doctors we should do what is necessary, no more and no less. I understand that things may be different in optometry as I have read the oversupply threads but then you wonder why VSP and those other providers can get away with what they do. It is because people undervalue their own services. Soon insurance companies will say you need retinal photos on each exam and if you don't do it, we wont pay you.

That is an excellent point. But I wonder who's doing a more disservice to the profession: an OD advertising $99 for two pairs or OMD advertising a LASIK for $299 or Tippytoe giving away free service. Or a urologist who has a huge highway billboard sign that says call 1-800-xx-urine (I'm not making this up. I saw it.)

 

[Tippytoe]

Deleted

 

[thiaeyemd]

Its a good point...they probably all are...The ads are one thing but giving away or discounting stuff is not good. I think the Lasik for 299 is usually a scam/trick to get people in the door then tell them "Oh you want followup?" 500 bucks more? Oh you want sterile technique? $300 more. The 299 is if you want me to do it with a kitchen knife in the parking lot" It is sleazy as heck.

 

[PBEA]

Thank you. This is exactly what I was saying.


I know some clowns try to charge extra for a photo. I have never done that. It's part of the routine exam. In additon to the 'wow' factor, it increases efficiency greatly for me (automatically zoomed into their electronic medical record)--- Another thing that is very important in today's health care enviroment (which is code for: Crappy insurance reimbursement).

QUOTE]

I disagree with the statement that it is part of the routine exam..It isn't. When you do it "routinely" you set the tone for insurance companies to not reimburse a retina doc, optometrist or ophthalmologist when a patient truly does need a retinal photo. More so it isn't indicated. Getting a hand massage is not related to the teeth. It is non medical. If you want to provide free medical services for your patients that is your call of course but I think it does you and your profession a disservice. I don't irrigate every patient's nasolacrimal system that I see as routine or photo their face unless it is needed. If I am doing a blepharoplasty, a patient needs to pay for it. I don't haggle the price or make "discounts". As doctors we should do what is necessary, no more and no less. I understand that things may be different in optometry as I have read the oversupply threads but then you wonder why VSP and those other providers can get away with what they do. It is because people undervalue their own services. Soon insurance companies will say you need retinal photos on each exam and if you don't do it, we wont pay you.

without exception, I completely agree. EVERY service is valuable when provided based on clinical presentation. It totally loses its value when provided for no other reason then to "make it look good". Its a dog and pony show at that point.

 

[Tippytoe]

Deleted.
I've got nothing new to add.

 

[Odie2011]

I do not agree with the wording of the waiver the OP was asked to sign. However, I wanted to put my two cents in regarding this OD vs OMD nonsense. One of my rotations during my fourth year of optometry school was at an ophthalmologist's clinic. My first day there, rather than seeing patients, I was instructed to shadow the OMD while he saw his schedule of patients. A patient came in with an "emergency red eye" (subconj hemorrhage). The eye had a little blood-filled cyst within the hemorrhage area, which the OMD lanced with a needle. After the patient had left, I asked the OMD why he had lanced the cyst. Having worked and rotated only through optometry practices, I had never seen anyone treat that way, and I wondered if maybe I had missed something. The OMD shrugged his shoulders and said, "Just something to do," like he was so bored with his routine of seeing patients that he would add a little "surgery" to the patient's bill to spice up his day. Also, the additional tests this doc ordered (VF, OCT, photos) were ordered in certain intervals (basically, whenever the insurance company would pay for another office visit and more testing), regardless of progression of disease, such that it was not clinically necessary and was not providing the doctor with new information. This made his partner nervous, and the partner made it a point to let me know that I should probably not order testing in that way, unless I thought I would look good in stripes. So, do OMD's provide services that aren't necessary? At least in that case, yes. This OMD is a very well-respected glaucoma specialist in a large city, so he is not some quack MD that is hocking LASIK from the back of a van. There are going to be the greedy ones in every bunch. Just because someone had a bad experience with one professional does not make it okay to bash the entire profession. I don't assume that all OMD's are crooks from my one experience. Rather, I am thankful for OMD's- it is nice to have someone more knowledgeable than I am in certain diseases/pathology so that I can send my patients on to have the best care possible. That is the ultimate goal, right?

 

[KHE]

Well, I'm going to close this one as well.

The OP is long gone and this thread is just going to turn into a whole lot of needless tit for tat anecdotes.

I think we can all agree that there's a small handful of unethical or marginally ethical providers in both optometry and ophthalmology.