Would you charge a patient for this?

[alferec]

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From what I understand, a patient with a minor corneal abrasion (one that does not require an eye patch or antibiotics) will heal on its own. So if a patient came in with such a case, and all you did was check it out real quick and told them to come back in a week to check it out again, would you charge them for that visit (given that the patient came in solely for that, and not for lenses, etc.)?

 

[PBEA]

From what I understand, a patient with a minor corneal abrasion (one that does not require an eye patch or antibiotics) will heal on its own. So if a patient came in with such a case, and all you did was check it out real quick and told them to come back in a week to check it out again, would you charge them for that visit (given that the patient came in solely for that, and not for lenses, etc.)?

Do you think it is a good idea to "...check it out real quick.."?

 

[KHE]

From what I understand, a patient with a minor corneal abrasion (one that does not require an eye patch or antibiotics) will heal on its own. So if a patient came in with such a case, and all you did was check it out real quick and told them to come back in a week to check it out again, would you charge them for that visit (given that the patient came in solely for that, and not for lenses, etc.)?

I would obviously charge for the initial visit, and if the abrasion really was so minor so as not to need antibiotics or a patch (which isn't even really used for large abrasions anymore) I would likely not ask the patient to return.

 

[r_salis]

From what I understand, a patient with a minor corneal abrasion (one that does not require an eye patch or antibiotics) will heal on its own. So if a patient came in with such a case, and all you did was check it out real quick and told them to come back in a week to check it out again, would you charge them for that visit (given that the patient came in solely for that, and not for lenses, etc.)?

I have to reply to your question with another question:

If you went to your GP with a bad cough and he took a quick look at you and said it was just a virus, and to go home and get rest and drink lots of fluids, do you think you would get charged for that visit?

 

[eyestrain]

I have to reply to your question with another question:

If you went to your GP with a bad cough and he took a quick look at you and said it was just a virus, and to go home and get rest and drink lots of fluids, do you think you would get charged for that visit?

Bingo.

 

[drgregory]

are you asking this because your "district manager" frowns on non-refractive visits?
research "office visit", aka "office call".

 

[cpw]

I have to reply to your question with another question:

If you went to your GP with a bad cough and he took a quick look at you and said it was just a virus, and to go home and get rest and drink lots of fluids, do you think you would get charged for that visit?

r_salis is right on the money. 🙂 Even if you just hand them artificial tears and send them home, to call you if things get worse... they took up chair time.

Chair time = money for your services. (they're paying for your knowledge and expertise... not just because you can write them an Rx)

 

[posner]

From what I understand, a patient with a minor corneal abrasion (one that does not require an eye patch or antibiotics) will heal on its own. So if a patient came in with such a case, and all you did was check it out real quick and told them to come back in a week to check it out again, would you charge them for that visit (given that the patient came in solely for that, and not for lenses, etc.)?

I want to vomit. I will never know what makes ODs so eager to give away services. You tell me the last time you sought the services of a professional and werent charged(no matter how simple the consultation as). Let me give you an example: my father in law is an architectural engineer. He designed a new septic system for the guest home on our property. After I submitted the new plans to the city they said I needed them stamped by a civil engineer. I called up my local civil engineer and guess what? $1200 for him to sign off on the plans. All he had to do was review them and sign off...$1200.

My point is, he is a professional and that is what his services cost...period. He didnt bat an eyelash when he told me the cost and I stroked him the check; and you are worried about a $75 office visit? Shame on you and whoever made you feel that your services should be free.

Posner

 

[drgregory]

I want to vomit. I will never know what makes ODs so eager to give away services. You tell me the last time you sought the services of a professional and werent charged(no matter how simple the consultation as). Let me give you an example: my father in law is an architectural engineer. He designed a new septic system for the guest home on our property. After I submitted the new plans to the city they said I needed them stamped by a civil engineer. I called up my local civil engineer and guess what? $1200 for him to sign off on the plans. All he had to do was review them and sign off...$1200.

My point is, he is a professional and that is what his services cost...period. He didnt bat an eyelash when he told me the cost and I stroked him the check; and you are worried about a $75 office visit? Shame on you and whoever made you feel that your services should be free.

Posner

(sarcasm)...but if the whole cost of a "complete eye examination" is valued at $29 or even offered for free with purchase of two pairs of glasses, surely six minutes with the doctor should be free?.......(sarcasm)

you're better off prostituting pain meds online - at least people will pay more.

 

[prettygreeneyes]

are you asking this because your "district manager" frowns on non-refractive visits?
research "office visit", aka "office call".

Little quick on the "wally world" trigger aren't you? He is a first year optometry student, so maybe he was just... asking a question? 🙄

 

[rpames]

For some reason ODs have some kind of guilt in them for charging patients for service. I went to a dentist when I was on externs because a filling I got 1.5 months earlier back in Chicago became sensitive. I thought it may have fallen out or cracked or something and I needed it looked at. I went in and the dentist looked at it and said it was fine and to give it some more time to "calm down." He didn't do much, but as I left I wrote out a check for $69.00. I was not mad b/c I asked for his opinion and he gave it to me.

Earlier today, I had a 14 year old girl in for a new patient exam and she had an IOP of 22 ou. The nerves were healthy, but anything over 20 makes me a little suspicious. I asked the attending if I should pachy and he agreed it would be a good idea. They ended up being over 600 so there was nothing to worry about and when I went to fill out the bill I tried to circle pachy and the attending said "don't," b/c then the mother would probably get all mad that this extra procedure would be charged to her or the insurance.

The test was legitimate! Why should we feel bad for getting paid for a service the patient needed.

When you are in the hospital, they charge you for the kleenex box!

Don't over charge, but get paid for what you deserve! Our knowledge base is not something to give away. Doing the actual procedure of pachy is pretty simple and doing it is not worth much, but my having the knowledge to DO pachy is what is worth the money.

 

[alferec]

Little quick on the "wally world" trigger aren't you? He is a first year optometry student, so maybe he was just... asking a question? 🙄

Actually, yes I was just asking a hypothetical question...😳

 

[Opii]

Little quick on the "wally world" trigger aren't you? He is a first year optometry student, so maybe he was just... asking a question? 🙄

My thoughts exactly.

 

[posner]

For some reason ODs have some kind of guilt in them for charging patients for service. I went to a dentist when I was on externs because a filling I got 1.5 months earlier back in Chicago became sensitive. I thought it may have fallen out or cracked or something and I needed it looked at. I went in and the dentist looked at it and said it was fine and to give it some more time to "calm down." He didn't do much, but as I left I wrote out a check for $69.00. I was not mad b/c I asked for his opinion and he gave it to me.

Earlier today, I had a 14 year old girl in for a new patient exam and she had an IOP of 22 ou. The nerves were healthy, but anything over 20 makes me a little suspicious. I asked the attending if I should pachy and he agreed it would be a good idea. They ended up being over 600 so there was nothing to worry about and when I went to fill out the bill I tried to circle pachy and the attending said "don't," b/c then the mother would probably get all mad that this extra procedure would be charged to her or the insurance.

The test was legitimate! Why should we feel bad for getting paid for a service the patient needed.

When you are in the hospital, they charge you for the kleenex box!

Don't over charge, but get paid for what you deserve! Our knowledge base is not something to give away. Doing the actual procedure of pachy is pretty simple and doing it is not worth much, but my having the knowledge to DO pachy is what is worth the money.

This is a perfect example of why I will forever refuse to donate one penny to my school. WHen it comes down to teaching students real world applications of their knowledge, it just isnt there. THis is where much of the fear of charging patients originates; with dim-witted attendings in clinic that lack real world experience. Disgusting.

Posner

 

[KHE]

This is a perfect example of why I will forever refuse to donate one penny to my school. WHen it comes down to teaching students real world applications of their knowledge, it just isnt there. THis is where much of the fear of charging patients originates; with dim-witted attendings in clinic that lack real world experience. Disgusting.

Posner

I wouldn't take that an extreme a view.

It's not uncommon in a school setting for fees to be greatly reduced or even waived so that the students can get the experience and practice of performing those procedures. Especially if its a procedure that is of "borderline" clinical value.

However the attending should have stressed to the student that in a non teaching clinical setting, the common practice is to recommend AND bill the procedure.

 

[SydneyB]

There was an engineer who had an exceptional gift for fixing all things mechanical. After serving his company loyally for over 30 years, he happily retired. Several years later the company contacted him regarding a seemingly impossible problem they were having with one of their multimillion dollar machines. They had tried everything and everyone else to get the machine to work but to no avail. In desperation, they called on the retired engineer who had solved so many of their problems in the past. The engineer reluctantly took the challenge. He spent a day studying the huge machine. At the end of the day, he marked a small "x" in chalk on a particular component of the machine and stated, "This is where your problem is".
The part was replaced and the machine worked perfectly again.

The company received a bill for $50,000 from the engineer for his service. They demanded an itemized accounting of his charges.The engineer responded briefly:
>>>> One chalk mark $1
>> Knowing where to put it $49,999

If you are good at what you do, people will pay you for what you know.
So be good at what you do....

 

[alferec]

There was an engineer who had an exceptional gift for fixing all things mechanical. After serving his company loyally for over 30 years, he happily retired. Several years later the company contacted him regarding a seemingly impossible problem they were having with one of their multimillion dollar machines. They had tried everything and everyone else to get the machine to work but to no avail. In desperation, they called on the retired engineer who had solved so many of their problems in the past. The engineer reluctantly took the challenge. He spent a day studying the huge machine. At the end of the day, he marked a small "x" in chalk on a particular component of the machine and stated, "This is where your problem is".
The part was replaced and the machine worked perfectly again.

The company received a bill for $50,000 from the engineer for his service. They demanded an itemized accounting of his charges.The engineer responded briefly:
>>>> One chalk mark $1
>> Knowing where to put it $49,999

If you are good at what you do, people will pay you for what you know.
So be good at what you do....

Wow, what a story. Where did you get this?

 

[DFavell]

Remember, you are also charging a fee for your expertise in knowing what does NOT need to be done also

 

[SydneyB]

Alfarec:

Don't remember where I got the story, but what's important is that professionals get paid for what they know and their expertise. If you take pride in your profession and take your responsibility as a health care provider seriously, then you will never undervalue your time or the services you provide.
A student extern can go into the exam room and spend 45 min taking a history, doing exam procedures, and evaluating the patient, and still have no idea what's wrong with the patient. Maybe I can go in and know in 3 minutes---and that's what I get paid for...not the 40 pieces of data that were gathered or the amount of time spent; but for knowing what I'm doing. You should be good at what you do, and (consequently) expect to get paid for knowing what you're doing.

Okay, off my soapbox, now!

 

[drgregory]

For some reason ODs have some kind of guilt in them for charging patients for service. I went to a dentist when I was on externs because a filling I got 1.5 months earlier back in Chicago became sensitive. I thought it may have fallen out or cracked or something and I needed it looked at. I went in and the dentist looked at it and said it was fine and to give it some more time to "calm down." He didn't do much, but as I left I wrote out a check for $69.00. I was not mad b/c I asked for his opinion and he gave it to me.

Earlier today, I had a 14 year old girl in for a new patient exam and she had an IOP of 22 ou. The nerves were healthy, but anything over 20 makes me a little suspicious. I asked the attending if I should pachy and he agreed it would be a good idea. They ended up being over 600 so there was nothing to worry about and when I went to fill out the bill I tried to circle pachy and the attending said "don't," b/c then the mother would probably get all mad that this extra procedure would be charged to her or the insurance.

The test was legitimate! Why should we feel bad for getting paid for a service the patient needed.

When you are in the hospital, they charge you for the kleenex box!

Don't over charge, but get paid for what you deserve! Our knowledge base is not something to give away. Doing the actual procedure of pachy is pretty simple and doing it is not worth much, but my having the knowledge to DO pachy is what is worth the money.

bingo - but dont you think that part of the cause of the problem is "two pairs of glasses and a free eye exam for $69"? i mean, if an eye exam is free, and we have ODs lining up to do them for free, why wouldnt additional testing be free? THAT IS WHY IM QUICK TO JUMP ON THE WALLY WORLD TRIGGER. BECAUSE EVERY OD SHOULD KNOW THAT CORPORATE OPTOMETRY HAS YET TO DO ANYTHING POSITIVE FOR BOTH THE PATIENT OR THE PROFESSION.

 

[Opii]

This is a perfect example of why I will forever refuse to donate one penny to my school. WHen it comes down to teaching students real world applications of their knowledge, it just isnt there. THis is where much of the fear of charging patients originates; with dim-witted attendings in clinic that lack real world experience. Disgusting.

Posner

This I completely agree with. SUNY clinicans live in a fairytale world.

 

[posner]

This I completely agree with. SUNY clinicans live in a fairytale world.

HAve you bumped your head? You never agree with me.😕

Posner

 

[JeffChou]

This I completely agree with. SUNY clinicans live in a fairytale world.

I was wondering if you could explain, further, what your impression of SUNY's clinical influence on students. I may be missing something here, but do you mean that because SUNY's clinic largely subsidizes patient fees to attract patients, students get a devalued sense in what they do (or any other largely subsidized clinical program).
I'm curious to discover these types of differences people may see among the institutional clinics.

Thanks.

 

[orangezero]

I was wondering if you could explain, further, what your impression of SUNY's clinical influence on students. I may be missing something here, but do you mean that because SUNY's clinic largely subsidizes patient fees to attract patients, students get a devalued sense in what they do (or any other largely subsidized clinical program).
I'm curious to discover these types of differences people may see among the institutional clinics.

Thanks.

I'm not sure if thats what he's referring to.. Can't speak for him. I will say, though, that many or most schools do these types of things to get more bodies in the door. There are a lot of locals that will always go there because they like the 2hr exam (the belief that its more comprehensive, etc.) but there is a growing segment of the population that just wants it fast and be done with it.

I wouldnt' use this fact to determine your choice of schools. However, schools in bigger cities may have larger people with unmet needs, VS a smaller college town where you may see mostly healthy college age students for a good deal of the clinic poplulation. I think population demographics in the city play a bigger role than price structure.

 

[r_salis]

SUNY's clinic largely subsidizes patient fees to attract patients

Might have been true at one time, but not true today. SUNY's patient fees are competitive with others in the NY metro area. They do take just about every insurance plan, however, including Medicare, Medicaid and other state/federal-funded plans for those with lower incomes, but that makes them no different than any other provider who offers the same plans. (...no different except for the 2-hour exam. 😉 )

 

[Opii]

HAve you bumped your head? You never agree with me.😕

Posner

No bumps. I just agree or disagree regardless of the individual. Nothing personal.

 

[in_translation]

This is a perfect example of why I will forever refuse to donate one penny to my school. When it comes down to teaching students real world applications of their knowledge, it just isnt there. THis is where much of the fear of charging patients originates; with dim-witted attendings in clinic that lack real world experience. Disgusting.

Posner

Careful, careful. rpames is on externships, not at his school clinic. 😉

 

[princesspinknes]

I haven't really had much experience (seeing as how I'm just a pre-optometry student still in undergrad), but could vision insurance possibly be a huge reason for the dissatisfaction patients get when they get charged for something? I can see that the whole root of the problem may definitely stem from the fact that optometry is undermined as a profession, but if you think about it, when you go to an MD and require a service, all you essentially do is pay a copay and never see the rest; when you go to an optometrist, there hasn't been enough sufficient vision insurance that provides this ignorant luxury, therefore patients get directly charged for it. perhaps I am just an unwitting pre-optometry students, but has anyone ever considered changing the vision insurance system?

 

[cpw]

I haven't really had much experience (seeing as how I'm just a pre-optometry student still in undergrad), but could vision insurance possibly be a huge reason for the dissatisfaction patients get when they get charged for something? I can see that the whole root of the problem may definitely stem from the fact that optometry is undermined as a profession, but if you think about it, when you go to an MD and require a service, all you essentially do is pay a copay and never see the rest; when you go to an optometrist, there hasn't been enough sufficient vision insurance that provides this ignorant luxury, therefore patients get directly charged for it. perhaps I am just an unwitting pre-optometry students, but has anyone ever considered changing the vision insurance system?

You can bill MEDICAL insurance for it. They'll only pay a copay if you take their medical insurance. The problem is patients don't understand the difference between vision insurance and medical insurance for "red eye" visits. Also, many ODs aren't on very many medical plans.. so patients have to submit themselves, which might actually require some work on their part. 🙄. They might even *Gasp* have to know what their insurance is called