contact lens economics

Delegation and Patient Education

BY WALTER D. WEST, OD, FAAO
April 2001

In an effort to streamline their practices, many eyecare practitioners delegate clinical responsibilities for gathering the data associated with contact lens fitting. In most progressive practices, appropriately-trained staff perform corneal topography, tear assays, tear break-up time and refraction along with trial lens insertion and removal. While all of these delegated tasks should be performed under the direction of a licensed eyecare practitioner, benefits include the time saved clinically and the increased convenience to the patient.

Be the Doctor

While many advantages of delegation are directly related to time savings, the greatest benefit in my practice is the additional time that delegation affords me to educate and inform patients about contact lenses as a vision correction alternative. I can focus my attention on the details of prescribing the lenses rather than the physical insertion and removal. The savings in time gained from this high level of delegation allows me to educate existing wearers about improvements in contact lens products and performance relating to patients' individual needs.

Ancillary staff can certainly talk about product innovation with patients, but I find that exploring these opportunities with patients myself is more effective. Patients are looking for the doctor to spend more time with them. Patients perceive more value in our practice services when I, the practitioner, spend time talking and educating rather than gathering clinical data.

I sit down with patients after looking at the clinical data. I help them understand which options are best, for example, a bifocal lens instead of a spherical lens. Once we decide, a staffer can go into greater details. Some practitioners want to delegate patient education and allow staff to present options. Ultimately, someone has to make a decision. If the staffer cannot prescribe, and the patient selects without practitioner suggestion, what value has the doctor added? I explain why one type of lens may be a better choice than the other. The doctor's expertise has guided the patient through the right choice. The patient who makes his own pick can do that anywhere in town. I help patients understand which is the best choice, and such assistance adds value for the patient.

Never Stop Learning

I find that patients who are better informed are more able to appreciate the value that we as eyecare practitioners add to their success. Patients who better understand their individual needs for contact lens performance and how you are meeting those needs are more likely to take advantage of additional products and services available in your practice. Take the time to educate patients. Doing so will improve the level of care patients receive and, as a result, increase your profit.

Delegation is positive because it frees you up to educate patients. Delegation can also be negative if decision-making and prescribing are performed by untrained staffers. Once the doctor suggests and prescribes, staff should give the patient more information. If a patient comes in without a clue, my time is best spent discussing what options are available.

Dr. West practices in Brentwood, TN, and lectures nationally and internationally on contact lens and practice management topics.