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BLOG: Don't always expect new changes to make sense
The road to health care reform is not a straight line. There are twists and turns in the road, and even some dead ends and detours. With the amount of time and paperwork required, it would be nice if things could be better organized.
As optometrists, very few of the rules and regulations related to compliance are designed with us in mind. There are too few of us in administration and management roles and, instead, it is often those who have stopped practicing or perhaps were never involved in clinical care.
I was frustrated this month by the requirements to maintain my local hospital staff privileges. I have had privileges in this hospital for more than 35 years and, in that time, they have never quite figured out where optometry fits into their organizational structure. They understand ophthalmology and that they are a surgical specialty, and, as such, ophthalmology fits nicely into the department of surgery.
Back in the late 1970s, when they were first considering my application, I was affiliated with an ophthalmology group and I think that they assumed that I was kind of like a physician assistant, so optometry became a subgroup of ophthalmology and was housed in the department of surgery.
But times changed dramatically for eye care providers in a hospital setting. First, the ophthalmologists stopped doing surgery in the hospital surgical suite, and then they left the building completely and moved out to be closer to their ambulatory surgical center. Optometrists expanded their scope of practice and started providing medical eye care and then started to play an expanding role in systemic medical care and ordering more laboratory tests. My practice split from the ophthalmology group and rented space directly from the hospital and added more optometrists to the staff.
The requirements to maintain a staff position also changed. Initially, it was just a required flu shot each year, which made sense, but then web-based technology became available. The hospital, always wanting to stay a step ahead, developed a required online curriculum and test to be completed to keep the staff fresh and up-to-date. Again, this was a great idea from the 100,000-foot level but, as with most great ideas, the “devil is in the details.” So, last year, the first course came out for optometrists to maintain our staff privileges. You might have guessed it by now, “Safe procedures in the operating room.”
Now, neither me nor any of my optometry colleagues at this hospital have even been to the operating room. I am not sure I could find it on a map. So, being the senior optometry member, I wrote a nice letter to the medical staff. I explained that optometry was not a surgical care profession and that we would be more in line with primary care. I politely explained that housing us in the department of surgery was probably based on ancient history and that we should be re-classified or at least be re-certified with web-based education suited to our specially.
The medical staff secretary thought that it was an excellent suggestion and that the executive council would be meeting that very month and she would be sure that they would review my letter and that the primary care courses that I suggested were readily available.
So, with renewal time again at the end of this month, I eagerly opened my email to see my course assignment and get ready to tune-up my primary care skills. You probably guessed it right again, “Safe procedures in the operating room – 2017.” The least they could have done would have been to include a map!