Eyeworld

EW NEWS & OPINION 14 February 2017 Patients would disappear into the black hole of the waiting room to re- turn upset that their visit was taking longer than expected. Empower your staff to order the appropriate tests for patients. A cataract workup has an osmolarity, refraction, biometry, topography, and a macula OCT prior to my examination. The testing allows me to make a better diagno- sis more efficiently and spend more time talking to the patient about treatment. If the tests are not war- ranted, they are not billed. Sending the patient out for additional testing reduces efficiency and prolongs the patient visit, which reduces patient satisfaction. If you are inclined, consider embracing patient shared billing opportunities you think are good for patients such as LASIK, refractive IOLs, corneal inlays, oculoplastics, and FLACS. Seeing fewer patients, improving their quality of life, and being reimbursed for your time and effort is better than trying to see as many patients as possible and rely- ing on insurance reimbursement. Finally, the key to practicing smarter rather than harder is to sur- round yourself with the best people. Seek out the best eyecare profession- als and make your goal that they be as successful as possible. Most importantly, hire and nurture great staff; they are invaluable and should be appreciated. Your staff determines the patient experience and your quality of life. EW Contact information Donnenfeld: ericdonnenfeld@gmail.com Chief medical editor's corner of the world by Eric Donnenfeld, MD, EyeWorld chief medical editor I only do the things in my practice that I can do better than a technician, optometrist, or other staff. That means I rarely perform a refraction, testing, or an IOP. That brings me to the topic of electronic health records (EHR). I continue to maintain that this is a work pro- gram initiated by our government in which physicians pay the cost. Despite the fact that I adopted EHR kicking and screaming, we have transformed our offices. I now begrudgingly find it useful. We have hired well-trained scribes, I never write a note, and I rarely look at the monitor. I make eye contact with the patients rather than looking at a keyboard. I spend less time but more quality time with every patient. I also avoid seeing a patient twice during the same visit. In the past I would examine a patient and then order the tests deemed relevant. Advice for working more efficiently for the sake of your patients as well as your own well-being T here is a natural tendency for type A individuals— which includes just about every ophthalmologist I know—when confronted with a problem to work harder. If you are not certain whether you are a type A practicing ophthalmologist, take my word for it, you are. Other- wise you would not have been a top student in high school, college, and medical school. Try and remember the last time you actually failed in any activity. The reason I bring this up is that we are now living in an environ- ment in which insurance reimburse- ment will continue to dwindle. Our natural reaction is often to continue to do what we have been doing for years but try to work a little faster and for more hours. This simply cannot continue, and being a type A personality can work against us in this case. We have to start working smarter and not just continue to work harder. The goal of working smarter is to take great care of patients, con- nect with them, and make it an en- joyable process for the patient and physician. The best practice advice I ever received was to make my prac- tice what I wanted it to be. See the patients you enjoy seeing, and try to refer out the patients you don't enjoy. I concentrate on anterior segment pathology and refer retina, complex glaucoma, and oculoplas- tics to my partners. I enjoy refractive cataract and cornea, so that is what I concentrate on. Working smarter, not harder Eric Donnenfeld, MD

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