New Scribe/Tech Position Allows More Quality Care at Bedford Family Eye Care

Have you ever wondered why doctors seems to always run behind? Well, because of this conundrum, Bedford Family Eye Care has made some new changes that we are super excited about! As health care continues to evolve, computers and technology continue to add layers of complexity but also some super handy features that improve care. While we embrace this new technology at our office, we also are finding out new ways to innovate in the office in terms of staffing to provide the highest level of patient satisfaction given these changes. We are happy to announce that starting in this

March, we have added a new position of Scribe/Tech to our exams to assist in patient flow, documentation, special testing, management, scheduling, etc. This allows me (Dr. Quesenberry) much greater efficiency in the exam room, less time documenting and more time focused on you and your eyes and the consultation experience. Since implementing this simple change we have noticed a nice improvement in our exam times....  This means you get better care and quality time with the doctor and spend less time waiting!

One of my colleagues wrote an excellent piece as a primary care provider on why she always runs late. I truly think it deserves every minute of your time to read this short article: Check it out.


I feel the same way. When I run late it bothers me. It bothers me really bad. I was asked several weeks ago a very honest and direct question by a new patient who was perturbed by his wait time. He remarked,
         "Can I ask you a question, ...is this normal - I mean, I've been here over an hour and I'm just now seeing you?" His tone wasn't hostile, and I could tell his question was genuine. I sat down looking him in the eye and apologized for his wait.
         "To be honest, no - this is not normal... and it should never be normal. My goal for a comprehensive exam with dilation is to have you in and out in just under an hour, and right now I'm 30 minutes behind. I am really sorry, I hope I'm not messing you up too bad. I try to give each patient the time they need and I'll be sure to give you the same attention." I added. He was my last patient of the morning.
The truth is that I had an emergency foreign body in the office earlier that morning and another of my patients' had been late getting his forms filled out. One had showed up for her contact lens check without her contacts and rather than make her reschedule (she has a busy schedule and to make it in is difficult) as I should have I let her put them in and wait 20 minutes and rechecked them after seeing another patient while they settled a bit. It still put me behind.

Infrared image of "Benign neoplasm of the choroid"

I began his exam. Halfway through the retinal exam I noted a choroidal nevus with ever-so-slight elevation and overlying drusen. It was nasal to his optic nerve and was about 2.5 disc diameters round. I asked him if anyone had ever mentioned anything about that eye and he said no. He had had trauma to his eye and ever since childhood had been getting his eyes checked. He said "No, no one ever mentioned anything to me." I was shocked. Typically a choroidal nevus will be congenital, meaning you're born with it. About 7% of the population has a congenital choroidal nevus and only about 1 in 160,000 of those who have it will develop choroidal melanoma from a choroidal nevus, so problems from these are extremely rare. However, because its on the inside of the eye and there is nothing the patient can do to monitor for change, its standard of care to photo document and follow at least annually if stable. We discussed this in detail and after finishing his exam and discussing all his exam findings we moved to the retinal camera and OCT to document this finding. Normally my technician who is very well trained would take the photos and retinal OCT and schedule him for his follow up but because of its difficult location I was particularly needed to orient the camera and fixation light. My patient was just shocked that I had discovered something new, remarking about how thorough my exam was. I looked at my patient and joked, "I guess this is partly why I get behind" and we both laughed a bit. I could tell the news of this nevus bothered him though and I spent that extra bit of time to discuss our protocol for this and to schedule a follow up in 3 months. He appeared to me to be very appreciative and he shook my hand hard and remarked, "Its really nice to meet you. Thanks so much. Will see you in 3 months." He walked out of the door and I looked down at his EHR timer which read 90 minutes.

While I felt after leaving him that I had perhaps redeemed his perception of my office by adding value to his visit, I couldn't help but feel that I was failing. It was then that I decided to take the lead from my primary care colleagues and incorporate the changes I mentioned above regarding a scribe/tech. Since making this change, we have managed to remain on time for the most part even with the things that come up during the day and I find I have more quality time with each patient and less time at the end of the day catching up on letters and paperwork. I look forward to seeing you next and hearing your opinion on the changes we have made. Let me know what you think below! Click the link here to go to our online appointment scheduler.