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2 Patients Collided in This OD’s Parking Lot — Is He Liable for Anything? Here’s Your Chance to Weigh In …




DR. PHILBIN’S PRIVATE practice served several towns in southern Arizona. The day was winding down when a staff member pulled him aside. “Derek just showed up. We had him booked at 3:40. Do you still want to see him or should we reschedule?” she asked. “He does have an outstanding balance of $340, by the way.”


Real Deal scenarios are inspired by true stories but are changed to sharpen the dilemmas involved and should not be confused with real people or places. Responses are peer-sourced opinions and are not a substitute for professional legal advice. Please contact your attorney if you have any questions about an employee or customer situation in your own business.


NATALIE TAYLOR is owner of Artisan Eyewear in Meredith, NH. She offers regional private practice consulting and ABO/COPE approved presentations. Email her at

Derek was a longtime patient and the childhood best friend of Dr. Philbin’s son. He sighed dramatically, smiled and nodded. “I’ll see him.”

Moments later they met in an exam room. “Thanks for seeing me Dr. Philbin,” said Derek. “How’s Bugs?”

Dr. Philbin took a second to recall the ancient nickname his son used to have. “Oh, fine. He graduated college last year and lives in Houston,” he replied. “What are we doing today?”


Derek pulled a form out of his back pocket. “I was hoping you could help me get a tint for my car windows, since I have such sensitive eyes,” he explained. “A letter from a doctor is all I need.”

“Oh, Derek buddy, it’s so rare for someone to have a true medical need for that, and I can tell you right now you don’t qualify. You’d need to be a danger to others on the road,” he said. “I’d recommend a great pair of wraparound sunglasses; do you have those?”

“I hate wearing sunglasses, they bother my nose,” he said, throwing his head back in exasperation. “There’s no test you can do? I’m sure I won’t pass.”

“Sorry bud,” said Dr. Philbin, “but it was great seeing you. Tell your parents I said hello,” shaking the young man’s hand.

Ten minutes later Dr. Philbin was at his desk reviewing e-mails when a receptionist paged him to the front. Patients and staff members were gathered near windows facing the parking lot. He could hear the receptionist behind him: “It’s a fender bender.”

Just then Derek entered the building followed by Sister Bethany. Dr. Philbin was eyecare provider to many of the nuns at the local convent.


Her appointment that day had been for a dilated fundus exam. Eager to avoid a spectacle, he herded them both into his office.

“Is everyone okay?” he asked worriedly.

“Oh, I’m okay,” the elderly nun said magnanimously. She was still wearing her roll-up dilation glasses.

“Well, what happened?”

Derek spoke up: “I was backing out of my spot, but the sun was in my eyes and I couldn’t see her behind me.”

“These things happen,” she said, patting his shoulder. “It is very bright out there.”


“I guess you’ll need to exchange insurance information?” Dr. Philbin suggested.

Both parties paused and looked at each other, and Sister Bethany spoke slowly, delicately. “The last time one of us had an accident it was preferred to work things out privately, directly with the church.”

“That’s good for me too,” said Derek quickly. “That’s what I did last time, I’m fine with that.”

Dr. Philbin struggled to stay quiet as they exchanged contact info. As they were leaving Derek mused aloud: “This seems like a pretty good reason for tinted windows!”

The Big Questions

  • Dr. Philbin is concerned about Derek’s willingness or ability to pay the church. Is it his place to volunteer these concerns?
  • Considering Sister Bethany’s eyes are dilated and the accident happened on company property, what (if any) actions should the practice take?
  • If you were Derek’s doctor, how would his last comment affect your behavior?
Minh T.
Decatur, GA

1. There’s nothing wrong with handling accidents privately vs. having insurance involved.
2. The parking lot is not the office so practice has nothing to worry about.
3. Tinting windows is no big deal if not less than 35 percent transmittance … tinting the front windshield is what matters; each state has their own rules regarding such. Refer to that for proper protocols.

David G.
Newport Beach, CA

Dr. Philbin shouldn’t volunteer any concerns regarding ability to pay the church. It’s likely Derek’s unpaid balance is due to his relationship to the owner. A simple explanation of the effects of dilation isn’t enough. The practice should implement a written dilation “waiver” to explain the side-effects. Ironically though, it doesn’t sound like Sister Bethany was at fault and the practice was proactive in giving her dilation sunglasses. Dr. Philbin should have performed a light sensitivity/glare test to affirm his reasoning, then brought Derek to his optician to find some comfortable sunglasses. Derek’s lack of education and testing led to his unfortunate remark.

Melania N.

1. It’s not the OD’s place to voice his concerns.
2. The practice should take no action; they’re not responsible for what happened. I wouldn’t have even brought them back in for discussion in the first place.
3. I would have replied with “Sunglasses would have prevented this from happening as I had recommended.”

Lisa Lynne M.

This is why it is critical to have all patients sign a dilation consent form stating “we recommend you bring a driver.” If the patient chooses to drive dilated, they assume the risk.

Dave G.
Lansing, MI

I would not mention anyone’s ability to pay to another, but I would have asked for a payment against his balance “…while you’re here.” When he asked about testing, I would have explained the costs and left it to him to decide if he wanted to pay for it. To protect the practice, some form of documentation should be taken. If not a police report, have each party write their version of the incident.

What’s the Brain Squad?

If you’re the owner or top manager of a U.S. eyecare business serving the public, you’re invited to join the INVISION Brain Squad. By taking one five-minute quiz a month, you can get a free t-shirt, be featured prominently in this magazine, and make your voice heard on key issues affecting eyecare professionals. Good deal, right? Sign up here.

Natalie Taylor is an experienced optometry practice manager for Advanced Care Vision Network and a consultant with Taylor Vision. Learn more at


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