My Opthamology Visit- What the?!

[WinniWoman]

So- I have been going to eye doctors since I was a little girl as I pretty much wore glasses my whole life. I loved the eye doctor I grew up using, but when we moved away it was too far to continue with him. He eventually retired, but my husband has been lucky enough to use his son, who acquired the practice and is just as skillful as his dad was.

I, on the other hand, have had to switch docs a few times, eventually settling on one nearby to where I used to work for the convenience and also her reputation as an excellent eye surgeon. Even my primary doctor recommended her as he used to work in the same medical group as she.

I like her ok, though she is quick and a bit detached (but surgeons can be like that), and I was familiar with her staff from my job. But over the years things seemed to deteriorate at the office as she brought in a couple of more additional docs and staff changed over. She also began to delegate tasks to the staff that she used to do.

You may recall when eye docs started charging separately for refraction instead of it being included in the exam. The doc steering me to her eye glass dept. etc. Staff doing tasks the doctor used to perform. OK. I have to deal with it.

Then- two years ago when I was there, she recommended an eye drop prescription for my severe dry eyes that was $250 out of pocket per month for me- though she had insisted I would get it free with this coupon a rep gave her. Well- it simply was not the case, so I went back to her office and the desk person made a note of it and told me there was nothing else available that I could use. Great. (note- did not ask the doctor).

So I try everything on the over the counter market. My eyelids are still "glued" shut over night and I have to tap them gently to get them to open.

Fast forward- I decide to make an eye appt now since we will be moving and it has been two years from the last. I hesitated to make it with her again for two reasons: 1) I am no longer working and it is a farther drive for me and 2) I have not been impressed with the staff she has doing things that she used to do. Plus the waiting! I make an appt with another doc I have never been to that is 10 minutes from here, but decide to cancel it after reading YELP reviews of the long wait times. So I decide to just go back to her since this will be my last time anyway.

Half hour wait. OK. Then it starts. Staff with literally no credentials. One young woman puts drops in my eyes. Has me read 3 lines on a chart with each eye. Then takes my glasses and does something with them and asks me if they are bifocals and leaves the room. Comes back and asks me if I want new glasses. "Huh? Well- do I need new glasses?" She smiles. She says well if I want them. ?? She - or the doctor I might add- hasn't done a complete eye exam yet for glasses. I tell her I will probably get them on line if I do need them because I can get them cheaper than at their place. She goes back out and comes back with another young woman.

This woman proceeds to tell me they can do refraction and I would have to sign a waiver and they would submit it to the insurance company and see if they pay it. I stop her cold and tell her I have a high deductible health plan and pay everything out of pocket anyway. Then she asks me if I want cataract surgery! I kid you not! I was like- "WHAT?!!". I ask her "shouldn't the doctor determine that? I have not seen the doctor yet or had my eyes examined for cataracts or glasses today!"

She smiles and says they usually leave it up to the patients. If their eyesight is not affecting their lifestyle then they may choose to forgo cataract surgery. They could do a dry eye test with a video of the eyes- but would need a waiver signed as they will submit to the insurance company to see if it is paid. Again I mention I have a high deductible plan anyway so I know I would have to pay. But I already know I have dry eyes so why would I need a test? Twice they asked me how often I put drops in my eyes. I tell them once every 4 hours. They ask me how many drops and how often? I tell them one or two drops every 4 hours and a gel at night time. What brand? I tell them all brands- whatever I buy. After a little more discussion they ask me "So you want as little done as possible today?" By now, my head is spinning and I am getting tired. I am not understanding this process. I tell them- yes. I am not going to agree to anything at this point. I just want the doctor to examine my eyes and make sure I have no eye disease or whatever. This whole visit seems so strange.

I tell them I will be moving next year also. "Oh- so Dr "D" would not be doing your surgery anyway". I tell them- "Not unless she thought I needed it right now!"

Just before putting more drops in my eyes for dilating one of them says to the other- shouldn't we do this and that first? I ask if they have reverse drops for when I have to drive home. They tell me no, but I can use sunglasses or they can give me the temp ones. Walk me to another waiting area. I am sitting with several other people my age- all stating they almost did not come because they hate the office process before seeing the doctor. They tell me if it weren't that she is such a good doctor and they needed surgery- they would not be there.

One guy had a melanoma and has to come there every 6 months. Another lady had cornea transplants and practically lives there. Another- for laser surgery. Ok- so it is not only me that feels this way. I'm not crazy.

I finally get in to see the doctor. She puts more drops in my eyes now. She reads my chart. "You only put drops in once per day? " she asks. "Uh- no! I put them in every 4 hours!". SMH....

She then asks about my dry eyes and I explain about my eyelids not opening in the morning. During the day they usually don't bother me but I do put saline in anyway every 4 hours. She proceeds to look at my eyes and calls out some numbers to another assistant there in the room to write in my chart. Says my cataract has "advanced". Says my eyes are very dry. Asks where I am moving. Wishes me luck and leaves.

Needless to say I was not anywhere near happy with this visit. I don't know what anyone else's experience is with eye doctors but this visit was bizarre to say the least and I got nothing out of it other than the doc saying my cataract had advanced but no mention of surgery and that my eyes were dry (which I already knew and she told me two years ago as well)- and she was able to tell me without an expensive dry eye video test. Nor did she make any suggestions to help me with the dry eye issue.

As for my eyesight- well I have had a better eye test at the DMV than here. I mean- really? Reading 3 lines n a chart and that's it? Used to have an extensive eye test with charts and all kinds of things and instruments to compare with the current eye glass prescription.

This is the state of medical care today. Here's to hoping I can find a good eye doctor in New Hampshire. Just unbelievable...

 

[Panina]

So- I have been going to eye doctors since I was a little girl as I pretty much wore glasses my whole life. I loved the eye doctor I grew up using, but when we moved away it was too far to continue with him. He eventually retired, but my husband has been lucky enough to use his son, who acquired the practice and is just as skillful as his dad was.

I, on the other hand, have had to switch docs a few times, eventually settling on one nearby to where I used to work for the convenience and also her reputation as an excellent eye surgeon. Even my primary doctor recommended her as he used to work in the same medical group as she.

I like her ok, though she is quick and a bit detached (but surgeons can be like that), and I was familiar with her staff from my job. But over the years things seemed to deteriorate at the office as she brought in a couple of more additional docs and staff changed over. She also began to delegate tasks to the staff that she used to do.

You may recall when eye docs started charging separately for refraction instead of it being included in the exam. The doc steering me to her eye glass dept. etc. Staff doing tasks the doctor used to perform. OK. I have to deal with it.

Then- two years ago when I was there, she recommended an eye drop prescription for my severe dry eyes that was $250 out of pocket per month for me- though she had insisted I would get it free with this coupon a rep gave her. Well- it simply was not the case, so I went back to her office and the desk person made a note of it and told me there was nothing else available that I could use. Great. (note- did not ask the doctor).

So I try everything on the over the counter market. My eyelids are still "glued" shut over night and I have to tap them gently to get them to open.

Fast forward- I decide to make an eye appt now since we will be moving and it has been two years from the last. I hesitated to make it with her again for two reasons: 1) I am no longer working and it is a farther drive for me and 2) I have not been impressed with the staff she has doing things that she used to do. Plus the waiting! I make an appt with another doc I have never been to that is 10 minutes from here, but decide to cancel it after reading YELP reviews of the long wait times. So I decide to just go back to her since this will be my last time anyway.

Half hour wait. OK. Then it starts. Staff with literally no credentials. One young woman puts drops in my eyes. Has me read 3 lines on a chart with each eye. Then takes my glasses and does something with them and asks me if they are bifocals and leaves the room. Comes back and asks me if I want new glasses. "Huh? Well- do I need new glasses?" She smiles. She says well if I want them. ?? She - or the doctor I might add- hasn't done a complete eye exam yet for glasses. I tell her I will probably get them on line if I do need them because I can get them cheaper than at their place. She goes back out and comes back with another young woman.

This woman proceeds to tell me they can do refraction and I would have to sign a waiver and they would submit it to the insurance company and see if they pay it. I stop her cold and tell her I have a high deductible health plan and pay everything out of pocket anyway. Then she asks me if I want cataract surgery! I kid you not! I was like- "WHAT?!!". I ask her "shouldn't the doctor determine that? I have not seen the doctor yet or had my eyes examined for cataracts or glasses today!"

She smiles and says they usually leave it up to the patients. If their eyesight is not affecting their lifestyle then they may choose to forgo cataract surgery. They could do a dry eye test with a video of the eyes- but would need a waiver signed as they will submit to the insurance company to see if it is paid. Again I mention I have a high deductible plan anyway so I know I would have to pay. But I already know I have dry eyes so why would I need a test? Twice they asked me how often I put drops in my eyes. I tell them once every 4 hours. They ask me how many drops and how often? I tell them one or two drops every 4 hours and a gel at night time. What brand? I tell them all brands- whatever I buy. After a little more discussion they ask me "So you want as little done as possible today?" By now, my head is spinning and I am getting tired. I am not understanding this process. I tell them- yes. I am not going to agree to anything at this point. I just want the doctor to examine my eyes and make sure I have no eye disease or whatever. This whole visit seems so strange.

I tell them I will be moving next year also. "Oh- so Dr "D" would not be doing your surgery anyway". I tell them- "Not unless she thought I needed it right now!"

Just before putting more drops in my eyes for dilating one of them says to the other- shouldn't we do this and that first? I ask if they have reverse drops for when I have to drive home. They tell me no, but I can use sunglasses or they can give me the temp ones. Walk me to another waiting area. I am sitting with several other people my age- all stating they almost did not come because they hate the office process before seeing the doctor. They tell me if it weren't that she is such a good doctor and they needed surgery- they would not be there.

One guy had a melanoma and has to come there every 6 months. Another lady had cornea transplants and practically lives there. Another- for laser surgery. Ok- so it is not only me that feels this way. I'm not crazy.

I finally get in to see the doctor. She puts more drops in my eyes now. She reads my chart. "You only put drops in once per day? " she asks. "Uh- no! I put them in every 4 hours!". SMH....

She then asks about my dry eyes and I explain about my eyelids not opening in the morning. During the day they usually don't bother me but I do put saline in anyway every 4 hours. She proceeds to look at my eyes and calls out some numbers to another assistant there in the room to write in my chart. Says my cataract has "advanced". Says my eyes are very dry. Asks where I am moving. Wishes me luck and leaves.

Needless to say I was not anywhere near happy with this visit. I don't know what anyone else's experience is with eye doctors but this visit was bizarre to say the least and I got nothing out of it other than the doc saying my cataract had advanced but no mention of surgery and that my eyes were dry (which I already knew and she told me two years ago as well)- and she was able to tell me without an expensive dry eye video test. Nor did she make any suggestions for me to help me with the dry eye issue.

As for my eyesight- well I have had a better eye test at the DMV than here. I mean- really? Reading 3 lines n a chart and that's it? Used to have an extensive eye test with charts and all kinds of things and instruments to compare with the current eye glass prescription.

This is the state of medical care today. Here's to hoping I can find a good eye doctor in new Hampshire. Just unbelievable...

yes, unbelievable. There are good eye doctors out there. I have one. You can find a good one where you move.

 

[wackymother]

That is not how eye doctors and staff are supposed to behave. I might...MIGHT email the doctor to describe my visit and my frustrations. Or I might call and ask to speak to the office manager. But you're moving anyway, so you'll find someone better in the new place.

 

[WinniWoman]

I might also add that previously she did a glaucoma test and found I have slight glaucoma. No mention of this or a test this time.

 

[DaveNV]

Find a new doctor you like and leave this one to your past. It's obvious this one is all about being paid for every little thing. Medical care is more than checking the boxes so they can bill your insurance for this or that procedure code. Sometimes interacting with the patient is important, as it is with you.

Dave

 

[rapmarks]

I had my eye exam on Tuesday and it was so different hate being treated like a cash register

 

[VacationForever]

No, this should not be a typical experience. I am sorry for what sounds like a $ mill at that office. I am very familiar with what ought to be a typical ophthalmology visit.
- reading numbers/letters
- eye pressure
- glaucoma check
- peripheral vision
- signs of bleeding
- macular degeneration
- cataracts

Ask your (new) PCP to recommend someone good.

 

[bogey21]

Mary Ann - Loved your post. It really hit home. My Opthamologist is part of a large group. During the course of the year they manage to jam in every test they can that Medicare will pay for. Why do I keep going? Just to see if by chance they come up with something startling and to get my prescription for the eye drops that control the pressure in my eyes. But all in all it is long waits, first to get the process started then at each station in the assembly line they hand me off to...

George

 

[pittle]

I used to go to an Ophthalmologist, but changed over to an Optometrist when we moved to Phoenix 11 years ago. The one I use is very thorough and spends a lot of time with me. She checks for glaucoma and cataracts. I go every year because our vision plan pays for it and new glasses each year. They have an Ophthalmologist available when needed for surgery. The one that they have is one of the best in the Phoenix area and comes to our local office once a month and if you need to see him, they set you up with an appointment. The prices for exams are reasonable, but we also buy our glasses online as they are less expensive.

 

[rapmarks]

I used to complain that a tiny bottle of lotemax was fifty dollars, it just went up to one hundred copay

 

["Roger"]

Unbelievable.

This comes after we had a talk at church last Sunday by a member who is an ophthalmologist. Not only did he mention checking for the more obvious things (glaucoma, cataracts) but a host of other things that he has seen. I asked him, have you really seen all those things that you talked about. His answer was that when he was going to school, he thought that he never see a lot of things that they trained him for. In actual practice, he has seen almost everything. The one thing that he emphasized was get your eyes checked every year. You might not think that you are having any eye problems, but he has often caught problems that people were not aware of, sometimes in the nick of time.

 

[bizaro86]

I go to an optometrist practice in my local grocery store (which sells glasses) they are 10x better than that.

Since you're moving anyway I would detail your experience in online reviews (google/yelp) as it might help others make a better decision on who to use.

 

[Janann]

Your severe dry eyes sound miserable. Have you tried autologous serum eye drops? They work extremely well for my husband, but I have no idea if they work in other situations.

https://tec.sco.edu/autologous-serum-eye-drops

 

[jackio]

What an awful experience for you! I am very happy with my ophthalmologist, but the wait in her office is so long. I have thought about changing, but then I hear horror stories like yours and figure she's worth the wait. My husband uses her also. He has dry eyes, that she says is a result of scarring from previous Lasik surgery. He uses Restasis, with a $150 copay for 3 month supply. She told him there is really nothing comparable to it.

 

[clifffaith]

Bizarro World eye doctor for sure! I'd be writing a Yelp review.

Reminds me a bit of a trip to a new dentist about 25 years ago. Office staff wanted me to sign paperwork saying I agree to the procedures. What procedures? I'm here to have a checkup and if I need something more I'll sign it then. Then dentist comes in and first words out of his mouth are "What don't you like about your teeth?" Totally turned me off because I knew he was going to try to sell me something based on my response so I just said "they're fine". I let them set me up for a return in 6 months and the signature for a mystery procedure and question about what I don't like were the same. Cliff was laid off that year, and as soon as Boeing hired him back we changed dentists and have been happy with her ever since. Happy except that she's a half hour away, so as soon as the oral surgeon releases me back to her for the implant and I get that done, I'll go closer to home until we move and have to change again.

 

[WalnutBaron]

Shocking. Truly. I live in a small town, but my opthalmologist is a teaching professor at the University of California--and he's outstanding. Until I'd read this, I admit I've kind of taken for granted the excellent care he has given me over the years.

I do have a suggestion, both to allow you to place a scathing review of the so-called doctor you wrote about, as well as to help guide you to a real one in your new town in New Hampshire: go to Healthgrades. You will see reviews placed on the site by patients like you and me, and they typically provide excellent insight.

 

[amycurl]

Personally? I would email the doctor a link of this thread, and if there is not a satisfactory response, I would send an email with a link to this thread here:
https://abop.org/about/people/board-of-directors/

This is the board that certifies them. They have a public member whose role it is to represent the interests of patients, and they should have a process for how to handle complaints--just like this one--from patients. (Now, if this doc isn't board certified, then that's another issue....)

 

[heathpack]

Before you post to any review site, you really need to give the doctor your feedback and an opportunity to respond. Tell her about your experience, preferably in writing. Detail what you experienced, with no drama, and tell her you feel like you did not have an appointment that met your expectation of a valid patient-doctor interaction, which means the doctor examines you, reviews your medical history, makes a diagnosis and then outlines treatment options including making recommendations.

Tell her you want your money back, since you are paying for her expertise and don’t feel like that’s what you got.

See what her response is as the first step.

 

[rapmarks]

What an awful experience for you! I am very happy with my ophthalmologist, but the wait in her office is so long. I have thought about changing, but then I hear horror stories like yours and figure she's worth the wait. My husband uses her also. He has dry eyes, that she says is a result of scarring from previous Lasik surgery. He uses Restasis, with a $150 copay for 3 month supply. She told him there is really nothing comparable to it.

I use restasis and I have plugs in my eyes and I still have extremely painful dry eye and my eyes won’t open it the morning. I pay that amount also.

 

[DrQ]

The place you went to sounds like some type of "mill" where the doctor is just moving patients through the process like Perdue does chickens. Run away.

In my case, my examination proceeds like this:

• Automatic refraction test machine (technician)
• Peripheral vision test (technician)
• Retinal image photography (technician)
• Glaucoma test (doctor)
• Manual refraction test (doctor)
• General examination of the eye (doctor)
• Evaluate the results of the retinal image (doctor)
• Discuss the results (doctor)

My doctor, an optometrist, has been through several practices and now has his own one man shop. I have followed him for 20+ years.

The Retinal image photography is really important:

• You don't have to have your eyes dilated
• You have a digital record of the blood vessels in the eye for comparison from year to year.

If I had to change doctors, my first filter would be having a retinal image photography machine. I would then call and have them explain their examination process and who performs the test. If they can't be bothered, move on.

Another thought is to maybe look for a good optometrist as opposed to an ophthalmologist. If you need surgery, the optometrist can be a filter to choose the proper surgeon.

 

["Roger"]

My experience at the eye doctor pretty much mirrors DrQ's with one exception - the glaucoma test is performed by a technician. The one thing that I thought that I should mention, and the main reason for posting, is that cost of the retinal image photography is not covered by my medical insurance. Still highly recommended. The cost, I believe, is fifty dollars.

 

[rapmarks]

The technician should not be mentioning cataract surgery. They really overstepped

 

[Patri]

I go to an optometrist, and his exam is on par with the best of ophthalmologists. He makes referrals as needed and has an excellent reputation. Your experience was horrible and you should not pay a dime.

 

[pedro47]

Sounds liked VacationForever and I have the same Ophthalmologist. I have two (2) eye examination per year or every six months because I am a diabetic. A technician performed the glaucoma test, nuclear field tests and a series of others eye tests. Before I see my Ophthalmologist.
But my Ophthalmologist reviews the technician findings, then he also checked my eyes, pressure reading, cataracts, etc., in both eyes and his assistant records everything during the final examination. My doctor is a Broad Certificate Ophthalmologist in Virginia.

He also discussed the tests results and his recommendations before I leave the examination room.

My exams are covered under my secondary insurance plan.

 

[WinniWoman]

I use restasis and I have plugs in my eyes and I still have extremely painful dry eye and my eyes won’t open it the morning. I pay that amount also.

There is XIIDRA. That was the one I would have had to pay a $250 copay for.

I am lucky I do not have pain at least.

I read about those plugs and was wondering why it was not mentioned as an option by my doc. Maybe it is best for me to leave well enough alone unless I have a more serious issue arise.

Sorry you still have pain. That must be awful.