Contact Lenses

[odieoh]

I was just curious as to what extent other ophthalmologists are dealing with contact lenses. In residency I had plenty of experience with CL related infections/complications, but very little exposure to fitting and dispensing them. In the practice I am in I am essentially replacing an optometrist who retired. His patients are getting spread out amongst the other docs in the practice, but I end up inheriting a fair amount of them and some of them are complicated fits. I've gotten to where I feel reasonably comfortable doing basic spherical fits and some low cyl torics. I've even refilled some Rx's for RGP lenses in patients who were doing fine in their lenses and didn't have a change in rx. But I'm not particularly comfortable doing high cyl fits, new RGP fits, etc. The problem is patients kind of get upset when they call for an appointment expecting to have their contact lens needs taken care of, coming in and having a full exam with me, then being told that I would like them to see an optom for the CL, basically requiring them to have 2 exams. And I can understand why that might be upsetting.

So did other people have more extensive CL training in residency than me? Or are other people in the same boat? And how do you handle people who come for an eye exam and contacts who get upset if you want to refer them to an optom?

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[OMD]

I had little experience in residency either. I am in a practive with 2 other MD's and an older OD who does CTL's at about the level you do. Our front desk tells people when they call that I don't do CTL fitting or any RGP. I personally don't want to do any of that, ever. Keeps them from getting angry. If they have already been fitted, I'll update the Rx and may change brands but I don't like to do that. I just have no interest in CTL's and the front desk tells patients up front. They also tell them to bring their box top so I can get the fitting info. Keeps the patients from getting upset. They can go elsewhere for their CTL fittings.

 

[KHE]

They can go elsewhere for their CTL fittings.

Ok....see here's a PERFECT example of how to generate referals from ODs. odioh was asking about this in another thread.

Instead of telling patients to "go elsewhere" refer them to a SPECIFIC OD. Develop a relationship with that OD and make him/her your go-to guy/gal for contact lens patients and they will almost certainly refer surgical cases and complex med cases to YOU.

And do NOT tell patients that they can't wear contact lenses because they have 1.50 cylinder. REFER THEM!!

Don't say "you need to see an optometrist for that."

Say "You need to see Dr. Smith for that. He's on main street, and he's a great guy. Our staff will make the appointment for you." Refer to a SPECIFIC doctor.

Boom. Everyone wins.

 

[odieoh]

Thank you for the input. I can't really refer to an outside optometrist with us having 2 in our group. I think mainly we just need some way to screen patients better so that I don't inherit the complicated/RGP fits from the optom who retired, or get the patients who are calling in just asking for contacts. I don't mind referring someone who comes in for a full exam and then halfway through says "Oh and I want contacts too." But I can understand someone being upset when they call for an appointment specifically asking for contacts, and then get scheduled with me who then tells them they need an additional appointment.

 

[OMD]

You are a little stuck with the 2 OD's in your practice. We have good referral networks with OD's with some sharecare after the 1st post-op visit and referrals to certain ones for CTL's and more difficult glasses Rx's (we don't have an optical shop specifically to increase our referral network because the OD's know we won't do the surgery and then start prescribing and dispensing their glasses). We give an Rx and send them back with letters. Ultimately though you are correct in that it needs to begin at the front desk or whoever makes the appointments and screens for the needs of the patient. That can save you a lot of problems.