READERS VOICE THEIR OPINIONS

How long should a patient's visit to the O.D. last?

✉ A recent article in the Boston Globe (November 16, 2009) entitled "Office Visits Get Longer, Better" focused on the results of a study published in the November 9, 2009 issue of the "Archives of Internal Medicine." This survey/study took place between 1997 and 2005, and concluded that primary care visits "last longer and are higher in quality than a decade ago."

Though I respect Dr. Gerber's analysis ("The Doctor Will Finally See You," OM October 2009), I feel that if a patient's insurance only covers an exam once every two years, most patients will enjoy having a thorough and attentive exam of at least 30 minutes. During their bi-annual visits, patients greatly appreciate having sufficient time to discuss their vision issues, note changes in their health status, and raise questions.

When we devote sufficient time to interact with our patients, we can ensure a high quality of care and develop a long-term professional relationship with our patients. Given that patients have infrequent eye exams, it is not prudent to shortchange a patient�s exam in an effort to squeeze in an extra patient before closing time.

Lynn M. Brandes, O.D., F.A.A.O.
Sharon, Mass.
lynnbrandes@comcast.net

The author replies: Thanks for your letter. I am in agreement with your points that patients enjoy a thorough and attentive examination and want time to have their questions asked and answered. I would however question two other things you wrote.

First, I wouldn't let insurance company reimbursement frequency dictate how I think about the above concept. If insurance covered patients every four years, should they now have an hour of our time? My point is here is that you should take as long as you deem clinically appropriate for each patient, regardless of their insurance coverage — which I'm sure you already do.

Second, your "at least 30 minutes" comment is interesting. If patients can get the same quality service and attention and it can happen in less time, say 20 minutes, patients shouldn't feel short changed. Of course, there does come a point below which patients might not feel fulfilled, but "at least 30 minutes" in our experience with patient exit interviews doesn't appear to be valid.

Finally, we have to remember the optical side of our practices. That "shopping experience" can be less enjoyable if patients have already spent too much time in our offices. Right or wrong, patients consider the time taken for their "eye examination" to include the frame buying experience and that by itself will usually take at least 20 minutes (often much longer). Couple this with some paperwork and waiting time and patients can be in some practices for nearly two hours. At that point, nearly all will express some level of dissatisfaction with the time spent in the office for their "exam."

If you're not already doing so, the best way to determine what your patients think of the time spent in your practice is to do what we do with our clients' patients — ask them!

Thanks again for reading my column and your letter! OM

Gary Gerber, O.D.
President
The Power Practice
DrGerber@PowerPractice.com