The Perils of Improper Training in Eye Care
By Keli O'Connor, COMT, ABOC March 26, 2021
Optometric and ophthalmic assistants and technicians are an essential part of any eye care office, but eye care is one of the few fields in healthcare in which they are not legally required to hold any certification or degree. Because of the lack of national standards or uniform training protocols, eye exams can differ from one exam room to the next. Improperly trained staff can cause substantial damage, both physically to patients and financially to the practice.
This is because if an ophthalmic assistant skips some components of a patient’s eye testing, they are not only delivering a subpar preliminary eye exam but also potentially committing insurance fraud. When techs fill in parts of the chart without performing the tests that correspond with it to meet the charting standards set up by their physicians or office manager, they are committing insurance fraud. When caught, insurance fraud can be punishable with fines that can cost the office substantially – from $5,000 to $15,000 or more – and even jail time if offenses are perpetually committed. Skipped testing can also result in physically hurting the patient or delaying diagnosis. This can be dangerous to the patient, such as incidences like an anterior chamber angle check being skipped and the patient subsequently being sent into angle closure when dilated.
Additionally, staff members may be committing HIPAA violations without even knowing it. Leaving a computer unattended without logging out of it first, even if it is in an area where patients may not typically frequent, like behind the check-in desk, is a violation that can cost your office up to $50,000 in fines.
According to a 2010 healthcare finance report, medical mistakes can cost the industry about $1 trillion a year. In ophthalmology specifically, the occurrence of endophthalmitis after surgical procedures or injections resulting from contaminated instruments, be it from improper sterilization, mishandling them during set up or soiling them during the procedure itself, can cause permanent blindness and even death if it spreads throughout the bloodstream. These issues and much more could cost an eye care practice millions of dollars in fines and lawsuits.
Poorly training staff during their onboarding can also cost the business additional money down the road when an improperly trained assistant needs further training to correct what was missed initially. First, the employer must pay the employee during their retraining. Second, the employer must pay someone to train the employee. Third, the employer must ensure that there are enough technicians to work for the physicians that day in addition to the two who will not be seeing the patients.
Going back to the angle-closure status post-dilation example, when a technician is responsible for a medical error or malpractice issue, the physician and office are responsible for reparations. If an assistant were to mess up something during their patient exams consistently, the physician and practice would ultimately be responsible for paying for the damages incurred. Physicians will want to employ a staff member that cannot do the job and hurts the patient, especially one that consistently makes mistake after mistake. Rightfully so, employing such a person would be a liability—a costly one at that.
The quality of education that eye care personnel receive directly correlates with the care they provide their patients and, in turn, how successful the practice is. With proper education, staff could potentially make fewer mistakes within the office.