BEI: WHY DOES IT TAKE SO “LONG”?
Today, we have an atypical topic of conversation – why must we wait at the doctor’s office? First, we wait in a common room. Then we’re assigned to another, they quickly do something, and again we wait and wait and wait. Now, Arthur Benjamin will lift the veil of secrecy.
Let’s look at a variety of complaints. One of your patients, let’s call him Sigizmund, told me in secret, “You wait a long time at Dr. Benjamin’s. Not like Dr. N’s where you barely got there and he’s already done with you.” How do you answer this question?
Usually they say, “Doctor, we’ve known you for 17 years, and it wasn’t like this before. What’s changed? Is it because you have more patients now? There are more employees now, and the office is bigger. Why do these visits span an hour or hour-and-a-half? We only have two eyes. With some other doctors everything is straight-forward, and the results seem to be the same.” And there it is, the results ARE NOT the same. For the last 20 years, there have been huge changes in ophthalmology. Now we have these new medicines and procedures at our disposal, which enable people to live longer and see better. Even 10 years ago, it was impossible to save eyes with wet macular degeneration. They’d just pat them on the head and say, “It’s OK, at least you have another eye.” Now there are retina specialists that offer injections that can save their eyesight.
And things have gotten better with glaucoma?
Previously, you had to wait until the patient started to really lose their eyesight before giving a diagnosis of glaucoma, and then it was often too late. We at Benjamin Eye Institute are at the forefront, and are aware of the latest developments. In order to make the correct diagnosis and preserve the patient’s vision for life, it requires certain non-invasive diagnostic procedures, scanning, and measurements. The test occasionally doesn’t yield anything, but it’s necessary to link all these things together, to identify the correlation between different parameters, and then put this into the computer program as well as your electronic dossier.
New data, as I understand it, is needed
Let’s start with their arrival. It immediately takes some time, as it’s a question of insurance, and this isn’t just a whim; it’s a requirement of the federal government. We need to get the green light in order to examine the patient, and all of this investigation occurs in real time. Then the assistant invites the patient into the interior of the office, where they perform some procedures. But in the morning, before the patients are there, we get together with all the employees and look at the schedule. If the patient has been with us before, we look at their file. The principle is that the more often you’ve visited, the deeper our knowledge of you. But we have thousands of patients, and we don’t remember everything about everyone, so the doctor and other employees have to study the file and make a plan.
So for example, I come in with glaucoma. What’s next?
We look at when was the last time you had your vision checked, the last scan of your optic nerve, and what the thickness of the nerve tissue was, for which you must have the pressure. Many people know that the normal range is 10 to 20, but there are also patients who have a pressure of 15 where it’s too high, and in their case they are continuing to lose vision! In some other offices, they only look to see if you’ve hit that range, and then NEXT. We check everything. Glaucoma is only one of many diagnoses that we encounter, and I know that it isn’t uncommon to find it alongside other dangerous problems, including diabetes. We should ignore that?
So it turns out that you spend a lot of time on the patient, but they have no clue.
This being said, everyone understands that there are many employees who first receive the patient, but the doctor is only one person. Therefore, the plan is made in advance. We have to add all the results from these tests in a file, but also statistically tie together all that received information into a single picture.
(to be continued)
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