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Real-life office policies for ODs


I thought I would create office policies to control my office life because the patients will follow my long list of rules just like my children listen to rules at home. Feel free to use it at your office.

The views expressed here belong to the author. They do not necessarily represent the views of Optometry Times or UBM Medica.


Ever wish we could control our day as ODs? As a working mom, I remember when I could actually complete a to-do-list in one day. I typically get hung up on patients, children, puppy accidents, severe weather, or doctor appointments.

I thought I would create office policies to control my office life because the patients will follow my long list of rules just like my children listen to rules at home. Feel free to use it at your office.

Previously from Dr. Schroeder-Swartz: Diet review: Picking the best diet for your patients

Dear Patients,

Welcome to <insert your practice name here; but I will use> World’s Best Optometric Office (WBOO). We are happy to have you as a patient. Here at the WBOO, we aim to meet your expectations and arrive home in time to watch our child’s baseball game, pick up our other child from gymnastics, make dinner, grocery shop, do laundry, and read my youngest child a story before bedtime. In an effort to accomplish this, we have created some guidelines to establish appropriate boundaries and enable us to keep your eyes healthy during bankers’ hours.

1. Office hours are 8 a.m. to 5 p.m. Monday through Friday. Please plan your eye injuries and/or infections during these hours.

2. Our office staff takes lunch from 1 to 2 p.m. daily. Lunch is required for the mental health of our staff, and it may not be interrupted. Note: All staff needs food, even the sweet staff member helping you choose your eyewear or finish your contact lens class. Please complete all tasks by 12:45 p.m. Your understanding is appreciated. Failure to leave will result in a live reenactment of a modern Snickers commercial.

Related: Risks associated with omega-3 supplementation


3. Please review your insurance coverage prior to arriving at the office. There is a difference between medical office visits and vision office visits. We realize this is confusing, but office visits are dictated by your insurance company, not our office. Vision insurance covers the eye exam required to determine your spectacle or contact lens prescription. Medical visits include those where you present our staff with a problem unrelated to your spectacle or contact lens vision. Glaucoma, infections, eye pain, eye turns, lazy eye, eye lid problems, and injuries will be billed to your medical insurance.

• Your vision care plan cannot be billed for repeated visits when you sleep in your contact lenses-no matter how you argue that it should.

• Although it makes sense to you and us, your headaches will not get your eye exam reimbursed by your medical insurance. Medical insurance companies do not think that headaches warrant a comprehensive eye exam. We agree with you that this is preposterous.

• In most cases, an eye turn (strabismus) and/or lazy eye (amblyopia) will be medical diagnoses.

Related: Practicing cultural sensitivity in the office

4. Your copay will be collected upon checking in for your appointment. You do not go to the grocery store with no money, so please do not come to our office without a method of payment.

5. We apologize for our office paperwork. Current meaningful use guidelines require this information. This information includes:

• Weight

• Height

• Smoking history

• Sexual history

• Medications

• Allergies

• Birth order

We do not know why, either.

6. When in doubt, put your face in the machine. Do not blink, squint, or cough. Stare at the light until we instruct you to relax (which is code for taking your face out of the machine).

7. When measuring your child for glasses, we can tell if he/she is lying. We have the power.

Related: 5 ways to fire a patient

8. If your child breaks the equipment or covers our lenses with fingerprints, you will be billed three times the amount of replacement or repair. This is done to cover our costs and ensure you never, ever return.

9. We will ask you to compare two views of the eye chart. Please do not read every letter on the eye chart every time we ask you to read the letters. Note: We went to school for four years to come up with the perfect way to ask you, “Which do you prefer, one (click) or two (click)” and will repeat each comparison only twice. Refraction time is limited to five minutes. For each minute over five minutes of refraction, you will be assessed a fee of $10 per minute. This fee is not covered by your principal vision insurance.

10. We do not use the air puff test. We promise.


11. We do dilate our patients’ eyes because we feel this is the best way to see the inside of your eyes. If I can’t see the retinal detachment, I can’t fix it. It is not that big of a deal, and whining about it won’t help. We will give you some exceptionally attractive sunglasses so everyone will know you got an eye exam.

12. If you can see at the end of the examination, you did not get an adequate eye exam.

13. At the end of the visit, our doctor will make recommendations regarding your spectacles, contact lenses, medications, and return visit. Please follow these instructions. If you return to the office reporting no improvement, and you have not followed our instructions, you will be assessed a $75 fee. This fee is not covered by insurance, either.

14. Please request refills for medications at the time of your visit. Some medications require periodic visits to the office to assess your ocular health, and these cannot be billed to your vision care plan. Medical copay applies.

Related: Why opticals must exceed, not meet, expectations

15. If your medication requires a prior authorization from your medical insurance company, we will supply the information to them; however, prior authorizations are dictated by your insurance. Do not leave us a bad review if your prior authorization is not approved. This process makes us cranky, too. We cannot be held responsible for annoying insurance limitations. Please see item number three to assess if you have coverage for branded medications. Branded medications are not generic medications. Note: Just because it is a generic drug, it may still be quite expensive and you should complain about this to your pharmacist for 10 minutes, not us.

16. We do not have samples. We did 10 years ago, but now we do not. Begging will not make them magically appear.

17. If your check is returned, you will be assessed a fee of $50.

Your signature indicates you have read these policies and will follow them. Failure to follow these policies may result in you being referred to a doctor we do not like.


      Most Understanding Patient’s Name                                 The Date Pigs Fly



I am sure this will work as well as the chore chart I use at home. 

Read more from Dr. Schroeder-Swartz here

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