title: A comparative study of the impact of certified and noncertified ophthalmic medical personnel on practice quality and productivity.
abstract: OBJECTIVE
  To compare ophthalmic practice productivity and performance attributes, as rated by employing ophthalmologists, of noncertified and three levels of certified ophthalmic medical personnel.
  
  
  METHODS
  Three hundred eighty-five American and Canadian ophthalmologists in a clinic-based, stratified, random sample were surveyed regarding productivity performance and attributes of the ophthalmic medical personnel they employ. Instrument scales assessed 14 desirable professional attributes and 10 practice productivity measures. The attributes were credibility, reliability, competence, quality assurance, quality of patient care, knowledge base to make adjustments, increased skills (expertise), ability to work independently, broader knowledge base, ability to detect errors, ability to be trained to perform multiple roles in the practice, professional image, good judgment, and initiative and drive. The productivity measures were patient satisfaction, doctor productivity, trouble-shooting rapport, triage screening, effective patient flow, reduced patient complaints, increased referrals, number of patients per hour, revenue per patient, and patient follow-up. Participants indicated whether certified personnel more often showed these attributes and contributed to practice productivity measures as compared to noncertified personnel or whether there was no difference. Results were analyzed with a chi-square goodness-of-fit test. Survey reliability and validity were evaluated.
  
  
  RESULTS
  Significantly more ophthalmologists responded that the three levels of certified personnel contributed more to 5 of the 10 practice productivity measures (i.e., doctor productivity, trouble-shooting rapport, triage screening, effective patient flow, and number of patients per hour). A statistically significant number of ophthalmologists also believed that certified personnel showed more of all 14 of the personal attributes considered desirable compared to noncertified ophthalmic medical personnel.
  
  
  CONCLUSIONS
  Compared to noncertified personnel, the employment of certified ophthalmic personnel enhances the quality and productivity of an ophthalmic practice. Overall practice productivity is increased with certified ophthalmic medical personnel.
authors.affiliation: Kentucky Eye Institute, Lexington, KY, USA.
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Woodworth
authors.forename: Peter C
authors.initials: PC
authors.lastname: Donshik
authors.forename: William H
authors.initials: WH
authors.lastname: Ehlers
authors.forename: David J
authors.initials: DJ
authors.lastname: Pucel
authors.forename: Lynn D
authors.initials: LD
authors.lastname: Anderson
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D002568:Certification; D002983:Clinical Competence / Q000592:standards*; D003695:Delivery of Health Care / Q000592:standards*; D004526:Efficiency; D006801:Humans; D008875:Middle Aged; D009885:Ophthalmology / Q000193:education / Q000592:standards*; D011795:Surveys and Questionnaires; D014481:United States