As the owner of a multi-doctor clinic, you must define the standard of care for your practice.
When optometry owners bring in an associate OD to work as a long-term associate or future owner, they often assume the new OD is familiar with the standards of care the existing doctors are using. This is usually not the case. Communicating boundaries and guidelines to your new optometrists will help the transition to your practice.
As the leading optometrist, you must decide if the standard guidelines published by the American Optometric Association, the American Academy of Ophthalmology and Wills Eye Manual are appropriate for your patient care. For instance, a rural optometrist may manage a retinal pathology a little longer than an optometrist in a city that has a retinologist two miles away.
Giving specific guidelines to your associate optometrists is a great way to help them practice with confidence and a good way for the practice to guard against liability.
Questions to define your practice’s “standard of care”
- Glaucoma Suspect
- How many times should a visual field be done in a year?
- Is a 30–2 appropriate every time or should 24-2 be done at least once a year with one 10-2 once a year?
- OCT – Should this be done every 3 years or once a year?
- Gonioscopy – Did you know some optometrists managing glaucoma have not done this since optometry school? Are you OK with that?
- Serial Tonometry – Did you know some optometrists never do this? Are you OK as the owner if an associate OD chooses to never do serial tonometry?
- Vitreous Detachment
- Is it OK to see the patient for the initial visit and not do a follow up?
- Are you OK with a 3 month follow-up after an initial visit?
- Is it OK if 3 doctors in the practice manage posterior vitreous detachment (PVD) in three different ways?
- Contact Lenses
- Is it OK if an optometrist in your practice does not require that the contact lens be evaluated on the eye yearly to renew the contact lens prescription?
- Is it acceptable for your associate OD to fit teenagers into 30-day continuous-wear contact lenses?
Guidelines published by our national associations are meant to be the minimum standard of care for all optometrists. Some doctors who have been practicing for a decade or two have eased off their once-stringent guidelines, and any associate optometrists working with them are getting no real-world guidance.
As the leader of the optometry practice, it is your responsibility to ensure that all doctors in your practice are delivering a defined standard of care. Ultimately, this not only protects from malpractice liabilities, but it also ensures that patients receive the level of care that the practice has a history of providing.
