I love the courtyard and gazebo at Salus University/PCO, almost making me wish at times that I was back at my old stomping grounds. The College has an extern program that is one of the oldest, if not the most long-standing extern programs in the country. Doctors of Optometry who take on externs are known as preceptors, and the College recently held its first Preceptor Fair bringing together docs with prospective externs.
It’s a great program, and I have enjoyed having the students rotate through our practice for quite a few years now. One area that we emphasize is a pet peeve that I have not with the externs or the College, but with terminology used in our field in general. In fact it even shows up in print, from practice management experts who I highly regard. The concept is that any testing not done by the doctor is called “pretesting”.
The “pre” in the term comes from preliminary testing, and its orginal intent was merely to describe tests conducted prior to seeing the doctor. But the term has taken on a life of its own, and delegation risks detracting from its value if the presentation is poor. It isn’t uncommon for staff to say: “I’m just going to be doing some pretesting” — as if it’s a holding pattern to keep the patient busy, or tread water until the doctor is ready to see them.
Let me give you an example. If you’re in a dental office, and a hygienist takes X-rays, would she greet you by saying that “”I’m just going to be doing some pretesting for Dr. X”?
We have precedence for the significance of terminology in eyecare adding or detracting value. Take contact lenses, for example. Colleagues now refer to “diagnostic lenses” rather than “trial lenses”. Trial implies uncertainty, and also diminishes the value of the lenses and their purpose. This is certainly the case in vision therapy testing, where we avail ourselves of alot of diagnostic technology. So whether we use a Readalyzer, an open view auto-refractor for refraction and accommodation, a Stereo Optical device for binocular profiles, an automated perimeter, or even a stereo booklet test or cheiroscopic tracings — the person gathering the data is performing a vital test.
At the suggestion of my son, Dr. Daniel Press, we should replace the term “Pretesting” with Diagnostic Testing. So the individual performing the test, be it an extern or any staff person, is not just doing pretesting. She or he is doing diagnostic testing that provides the doctor with a very important set of data that is essential at arriving at a differential diagnosis, or to objectively monitor a patent’s progress.
The extern in our practice therefore masters all phases of diagnostic testing, not to become a “super tech”, but to experience the pattern of how reliable data is gathered, and how it is interpreted and applied. It is a crucial component of the educational process, far more than “just pretesting”.
– Leonard J. Press, O.D, FCOVD, FAAO