COMPLAINT SUMMARY: COMMUNICATION BREAKDOWN & CONTACT LENS THERAPY DEFICIENCIES
This complaint illustrates the importance of clear communication between a practitioner and patient. Failing to properly communicate vital information can damage the doctor–patient relationship and destroy a patient's confidence in services received.
A patient wrote a letter of complaint to the College: the eye exam provided by his optometrist felt rushed; the optometrist had written a spectacle prescription in a matter of minutes. The patient had told the optometrist he was interested in a prescription for contact lenses. The optometrist confirmed the brand of lenses the patient used and wrote another prescription. When the patient questioned a change in the prescription, the optometrist tore it up and asked the patient what he wanted. The patient realized that he was not going to receive a proper exam, so he thanked the optometrist and left.
In his response to the complaint, the optometrist said his understanding was that he would be responsible for the fitting and comfort of the contact lenses if he provided contact lens specifications. The optometrist felt it would be irresponsible to provide them if he was not performing the actual fitting. The patient did not indicate a problem with his previous lenses and the exam findings confirmed clear corneas and conjunctiva. The optometrist assumed that the patient was going to take the specifications to his previous supplier and reorder lenses there.
The Panel of the Inquiries, Complaints and Reports Committee (Panel) was concerned about the manner in which the optometrist managed the interaction and communication with the patient. As a health care provider, the optometrist is expected to offer counseling and information to his patients to allow them to make informed decisions about their eye care. The inadequate communication and interaction between the optometrist and the patient damaged the relationship and resulted in the patient’s loss of confidence in the eye exam and resulting prescriptions. At a minimum, the optometrist should have explained the reasons for the change in the prescription and counseled the patient in the use of the prescribed therapy.
The Panel considered the quality of care provided to the patient. It appeared that the optometrist issued a prescription without ever verifying or assessing the contact lens fit. In the Panel’s opinion, the optometrist demonstrated gaps in his knowledge, skills, and/or judgment in the area of contact lens therapy and patient communications. The Panel believed that the optometrist would benefit from completing a remedial program, working with a coach, in the following areas:
Contact lens therapy
Appropriate and effective communication with patients
The optometrist signed an Agreement and Undertaking with the College to complete the remedial program, the costs of which were his own responsibility. The College monitors the completion of the Undertaking and any breach of it is a serious matter that could result in disciplinary action. The Panel believed that by having the optometrist successfully complete the remedial activities specified in the Undertaking, the issues raised in this complaint would be appropriately addressed. It also reassured the Panel that the public interest would be adequately protected and that the optometrist is now better equipped to handle similar situations in the future.