Vaudeville ophthalmology – Frustrated stand up comedians should not be eye doctors.

This blog will be balanced but positive in it’s tone.  This post is the exception.  We all are allowed the occasional rant.

Thanks to moving, my disease and having kids, we have had to seek referrals to medical practitioners many times over the last few years.  Almost all have been excellent.  One was not.

Vision issues are a common manifestation of multiple sclerosis.  During the process of trying to determine what was causing the tingling in my leg, my primary care physician referred me to several other professionals.  To check my vision for possible MS, he sent me to an ophthalmologist a few floors up in his building.  We will call him Oph.

I wasn’t having any unusual issues with my vision but I knew that I needed new reading glasses anyway so this might be an opportunity to kill two birds with one stone.

First off, Oph is a glaucoma doctor.  But that didn’t stop him and my primary from deciding to have him check me out for signs of MS.  I went for my appointment and waited 45 minutes before being brought in for an exam by an assistant.  I noticed that the equipment all looked like it was from the 1950s.  Then I was moved off into another room with eight other patients to wait for the doctor to make a presentation.

For the next twenty minutes, a son of a glaucoma patient asked me in as many different ways that he could think of, why I was there.  I matched each iteration with my own modifications of “it’s none of your business”.  One poor guy in the room wasn’t even a patient.  He had given his friend a ride to the office and the nurses grabbed him and shepherded him in with us.

Then Oph showed up.  He explained that he started having the patients sit through his presentation a few years ago because it saved time.  Otherwise, he would have to give the same talk individually for each.  I was starting to get annoyed.

His half hour presentation was on the basics of the eyeball and glaucoma.  The former I learned in junior high school.  The latter was of no interest to me.  The speech was a very well rehearsed and scripted barrage of non-stop eye jokes and glaucoma trivia.  For example, I learned that cataracts means waterfalls in latin.  Or maybe it was Greek.  Whatever.  Every other sentence was a statement repeating the theme that he was an MD and optometrists are just guys who sell eyeglasses.  Anyway, he was clearly having the time of his life performing for us.

Mind you, this was in the middle of the work day.  My cell was buzzing non-stop during his act.  At one point, I was getting so annoyed with the waste of my time that I turned the ringer back on just so he could realize that some of us might be busy with other things too.

After the comedy show, I was moved back into an examination room.  Oph walked in just in time to hear me on the phone complaining to my assistant that I had been there two hours already and had not yet seen the eye doctor and to please push back a meeting and two conference calls that I was clearly going to be late for.  Oph started his exam with his antiquated equipment.

My eyes checked out fine.  No signs of neurological issues.  Oph then decides to try his hand at diagnosing ms.  Me in a chair, him standing next to me, he snapped my head back quickly.  He said that you tell if someone has MS by doing this and seeing if their eyes flutter.  What??  Are we done?  No offense, but I will trust my neurologist and MRIs to figure that out.

Actually no.  The second part of the exam was going to take another hour or more.  He had heard my phone call and asked if I needed to come back another time to finish it?  Yes.  I made a point to mention that I really needed new eyeglasses for reading and that he could help me with that next time as well, just to set him off on his “I’m an MD and they aren’t, and doing eyeglasses is beneath me” script again.

I came back for my follow up appointment the next week.  Luckily they did not make me sit through a rerun of the comedy act this time.  One of his assistants had me do more tests and let me know that everything checked out fine.

Then she looked at the chart and said “Didn’t the doctor dilate your eyes the other day?”  No, he hadn’t.  “Ok, he still needs to do that then”.  Ok, let’s do it.  “Well, the doctor isn’t here today.  He doesn’t work Wednesdays.”

What???  First they had me waste three hours in the middle of the work day and then they schedule me for a follow up appointment on a day when the doctor doesn’t even work?  The assistant said that I would need to schedule another appointment to come back.  This is on top of having to do another appointment with an optometrist because writing eyeglass prescriptions is beneath him.  An eye exam should not take four appointments.

I went on yelp and found a great optometrist.  Yes, he is not an MD.  But he had modern computerized equipment that I personally had more confidence in than I did in Oph.  And he did what I needed in one session.  I never went back for part 3 of my exam with Oph.  I did let my primary care Dr know about the experience.

A word of advice to Oph or any other doctors with a similar m.o.  If you are doing something  solely because it saves you time and effort, you are putting your concerns ahead of your patients. That’s not what we pay you for.  Please respect our time as well and understand that we come to you for personalized advice and care that is relevant to our situation.  And if you are a frustrated comedian, express it on stage during amateur night at the local comedy club.  Don’t force your patients to be your audience, especially businessmen during a workday.

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