Can ophthalmic practices improve efficiency and boost revenues through co-management or diversification?

Co-management streamlines patient care

Incorporation of optometrists into your practice can be a great help in streamlining the efficiency of patient care while improving profitability. A well-trained OD in general ophthalmic and postoperative care is critical. This way, the OD in your practice can refer any patient deemed appropriate for surgical consultation and be available for that patient’s postoperative care.

Stephen S. Lane

What this does is streamline the efficiency of practice in that the MD can see more pathology rather than having to see a large number of postoperative patients and patients requesting routine eye care, freeing up the most valuable resource we all have too little of — time. The determination of the MD seeing all or no postoperative or routine eye care patients becomes flexible and can be titrated according to the practice pattern of each unique surgeon. In the case of internal referrals, the OD-patient relationship is maintained, as continuity of care is protected and safeguards are in place as the operating MD is readily available for postoperative evaluation. I think this is an enhancement of practice patterns, from the ophthalmologist’s standpoint, from the optometrist’s standpoint and, most importantly, from the patient’s standpoint. Each ophthalmic professional is utilized in a way commensurate with their training, time is optimized, and patients receive great care. In this scenario, everybody comes out a winner.

Each practice will need to look at the incorporation of optometry into their system depending upon the makeup and goals of that specific practice. We have found the integration of optometry in our practice to be fulfilling for both our MDs and ODs. Our practice has grown, and importantly, patients receive exceptional care in a timely fashion. We plan to continue to grow our practice by adding ODs as our demands dictate.

Stephen S. Lane, MD, is a cataract surgeon practicing at Associated Eye Care in Stillwater, Minn.

Diversification benefits outcomes and bottom lines

Scott MacRae

I think one of the options for practitioners is to expand their repertoire by offering phakic IOLs and premium IOLs. That can help significantly in terms of diversifying their procedures. It also helps in terms of the seasonal variations. In the northern United States, surgeons are busier on the premium IOL side during the spring, summer and fall months. In contrast, IOL procedures slow in the winter while refractive surgeries tend to increase. The IOL market continues to consistently grow, 3% in the second quarter of this year, while the refractive market dipped 24% with the economic downturn, according to Market Scope.

Diversification can help you in two different ways: balancing your practice in terms of diversity and also seasonal trends. The two actually have a synergistic effect, where often if patients are successfully treated with LASIK or PRK, they will refer either friends or relatives to you as a result of their good experience with refractive surgery. So there is a lot of synergy that goes on when patients have good results. Refractive surgery allows one to transition into the premium IOL field with greater flexibility.

Premium IOL surgery is becoming much more of an optically intense form of cataract surgery. In premium IOL surgery, there is more emphasis on refractive outcomes, and refractive surgeons are focused on optimizing high-quality refractive outcomes. In a premium IOL patient, the implant is doing most of the heavy lifting in terms of refraction, but corneal refractive surgery is doing the surgical light lifting and fine-tuning. It gives these patients the kind of outcome that they want. The two are synergistic.

Scott MacRae, MD, is a refractive surgeon practicing at Strong Vision – University of Rochester Eye Institute in Rochester, N.Y.