Street Smarts

What Are Your Techs Really Doing?

By Dan Beck, OD Leland, N.C.

RECENTLY, I DECIDED to observe the technicians in our office during pre-exam workups to see what was actually being said and going on in the pre-testing rooms. While my partner performed all of the patient encounters for the day, I sat, watched and took notes.

Eye-opening Experience

The first patient of the day was escorted to a pre-test room by technician Molly (not her real name). After thoroughly confirming the patient's medical history and chief complaints, Molly proceeded to test visual acuity. Every few seconds during the test, Molly reminded the patient to blink. I was taken aback by the difference that simple reminder made. The patient went from reading 20/40 to reading some of the 20/25 line just by blinking. Not only did this simple measure provide a more accurate visual acuity, it also revealed that the patient had some form of dry eye. Molly went back to the question about dryness that she had asked before, and the patient admitted her eyes felt dry and scratchy at work.

Once all of the additional testing was finished, Molly seated the patient in the exam chair and dialed her current eyeglass correction into the phoropter. She told the patient the doctor would be in soon, then left the room.

From my vantage point, it appeared that Molly had done an outstanding job.

As I got up to leave, I quickly checked the phoropter. The patient was wearing -3.25 spherical correction in both eyes, yet the phoropter was set at +3.25. That small mistake could be a big problem during the refraction.

Next, I sat in with technician Natasha (not her real name), who has a warm, bubbly personality. After peforming her usual duties, Natasha eloquently explained the importance of our Optos imaging system and that the patient's insurance wouldn't cover the fee. The patient immediately agreed to the out-of-pocket cost without question. Natasha's explanation was flawless and the images she took were excellent.

Again, I followed the tech into the exam room. Natasha cleaned everything in front of the patient and set up the phoropter with the correct patient refractive error. She left the room with the patient smiling from the chair. Her entire performance seemed perfect — until I reviewed the chart. She had failed to enter any of the patient's allergies and, after I thought back, I realized she'd never asked about allergies. It turned out the patient was allergic to erythromycin and penicillin. That little tidbit of information could have proved critical had I or my partner not asked.

Had a Bad Day

Lastly, I accompanied Maggie (not her real name) and the next patient into the screening rooms. Maggie is usually very pleasant but something was clearly wrong that day. She was very direct with her questions and didn't even look at the patient for the first 5 minutes of testing. Although she properly performed all of the testing, her demeanor kept the patient quiet and reserved.

Things did not improve in the exam room. Maggie rushed though the remaining tests and proceeded to leave the room, explaining that the doctor would be in shortly while her back was facing the patient. Although Maggie performed all of the testing without error, I can't help but think the patient probably felt more like a chart number than a person.

Observation is Key

Unless you actually watch your technicians, it's virtually impossible to have a good sense of what's going on in your screening rooms. The way your staff treats your patients is a direct reflection on you and your practice. Taking the time to observe your staff will give you a much better understanding of the overall patient experience. In my opinion, it's well worth it. nOD