reflections

I Don't Get No Respect

The public will never see O.D.s as "real" doctors until optometry stops devaluing its services.

MICHAEL SILVERMAN, O.D. CORAL SPRINGS, FLA.

Just like the late, very great comedian, Rodney Dangerfield used to say — "I don't get no respect." My most memorable disrespectful moments:

You won't treat my dog?

Late one night as I was about to close our practice, a patient presented with her 10-year-old Shetland Sheepdog, Mitzi.

"Would you take a look at my dog's left eye?" she kindly asked. "It's been red for about a week with mucous discharge."

I told her Mitzi probably had an infection and needed to see a veterinarian.

"Can't you just write an antibiotic prescription in my name, that I can give to my dog?" she replied.

I explained that I wasn't trained to treat animals. I further told her that having worked at a vet's office during my summers between college, I'd heard that certain antibiotics for humans were contraindicated in animals and that I wasn't sure about which ones. Then, I asked her why she didn't take Mitzi to a vet initially.

Dr. Silverman doesn't get no respect.

"Oh," she said. "I figured you'd be much cheaper."

I tell ya. I don't get no respect.

Discounts are for "Real" doctors

I presented for a visit with an orthopedic surgeon for some advise on a twisted knee. While checking out at the front desk and making a follow-up appointment, the receptionist politely told me that the practice didn't charge insurance co-payments for other doctors.

"What kind of doctor are you?" she asked.

"Optometrist," I proudly told her.

"That'll be $35.00 for the co-payment," she replied.

I tell ya. I get no respect.

O.D.s can't diagnose disease

A black, 54-year-old male with chronic asthma presented with a diagnosis of lung scarring and chronic cough, which he said his pulmonary doctor was treating. The eye exam revealed yellowish lesions on the lower and upper palpebral conjunctiva OU. The patient also showed me skin lesions on both forearms, and he reported a history of chronic fever.

"I believe you may have sarcoidosis," I told him. I wrote a detailed letter to his pulmonary- and primary-care doctors requesting lab work to confirm my suspicion. I concurrently referred the patient to a dermatologist and requested an exam and biopsy of the skin lesions. The patient's pulmonary and primary-care doctors refused my request, though the dermatologist did biopsy the skin lesions. The result: granulomatous tissue with a tentative diagnosis of sarcoidosis. When the dermatologist requested a sarcoidosis lab work-up from the patient's primary-care doctor, he immediately acquiesced. The patient was diagnosed with sarcoidosis and had granulomas on his heart and lungs.

I tell ya. I get no respect.

I believe patients and other healthcare practitioners disrespect optometry because many in the profession have caused the public to devalue our services. How so? By offering free or discounted eye exams and including exams with the price of spectacles. Until those in the profession recognize the detriment of and cease these actions, I fear I'll never get the respect I and other O.D.s deserve. Until then Rodney, wherever you are — I know how you feel! OM

DO YOU HAVE A MEMORABLE EXPERIENCE YOU'D LIKE TO SHARE? DISCUSS YOUR STORY WITH JENNIFER KIRBY, SENIOR ASSOCIATE EDITOR OF OPTOMETRIC MANAGEMENT, AT (215) 643-8139, OR -KIRBYJ@LWWVISIONCARE.COM. OM OFFERS AN HONORARIUM FOR PUBLISHED SUBMISSIONS.