business advisor
Reviewing Professionalism
Is your level of professionalism based on your location or your attitude?

Boy, did I hit a hot button! Regular readers of my column may remember that a few months ago I asked the question, "How do you define professionalism in optometry? Is it where you practice or how you practice?" (February 2006)

Location, location, location

Much of the feedback centered on the perception that it is difficult for O.D.s in a corporate environment to practice in a professional and ethical manner.

Kim Marshall, O.D., says, "The O.D. who works beside an optical is there because of a prearranged agreement to refer all the patients next door for sales. I'm sorry, but when you get into that bed you give up your professionalism, plain and simple."

Another optometrist took issue with the employee-employer relationship: "If you work for a chain you give up your soul because corporate O.D.s are directly or indirectly [told] how and when ... and sometimes what to prescribe."

The following came from an O.D. who obviously felt that his employer had asked him to compromise his standards."Any optometrist working for any chain is performing malpractice and has no choice. The only way to prevent that is to outlaw this form of practice."

Practice focus

Of course we also heard from optometrists who felt that they could be totally professional in a corporate environment. "I believe that whether an O.D. advertises or works for a chain probably has little to do with his or her professionalism. True professionalism centers around caring for the patient and doing the best you can with what you've got," says Jeffrey Phillips, O.D., of St. Petersburg, Fla.

Optometrist Jennifer Brady of Tampa, Fla. says, "Can an O.D. advertise or work for a chain and still maintain professionalism ... I say, 'Absolutely, yes!' I fit the best contact lenses possible for each individual patient (despite what the chains consider a preferred brand) and take the time to discuss the optimum spectacle solution for each patient."

More than one responder felt that corporate optometry's focus on eyewear sales clearly implies they are not focused on eye care.

"Many O.D.s who practice in a corporate setting try to defend their position by arguing that their professionalism is enhanced because they don't handle materials. Let one of those "professional" O.D.s open a non-dispensing practice in a department store with no associated optical department and see how successful he'll be."

And still others were more adamant: "Optical chains are not in the health-care business. They are in the retail business and only care about selling frames and lenses. That is how they make their money. Why should they care about eye health? That is not the business they are in."

A bad egg in every bunch

However, Dr. Brady points out that unprofessional behavior can occur in any setting. "I practice in a corporate setting and like to think of myself as professional. But I've seen greedy behavior from my colleagues in both corporate and private settings. The desire to make more money at the expense of the well-being of the patient has no boundaries. It's in private practice, corporate practice and medical practice," she says.

In summary, I am an advocate of private practice optometry, loud and clear. But I want all optometrists to do the right thing. True healthcare professionals always put the best interests of their patients ahead of their own financial gain, regardless of where or how they practice.

THE FOUNDER OF THE HAYES CENTER FOR PRACTICE EXCELLENCE AT SOUTHERN COLLEGE OF OPTOMETRY IN MEMPHIS, DR. HAYES IS A REGULAR CONTRIBUTOR TO OM. E-MAIL HIM AT JHAYES@HAYESCONSULTING.COM.