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Integrated eye care model helps meet future challenges
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I believe that an ophthalmologist-led integrated eye care model that incorporates the joint skills of ophthalmic surgeons, medical ophthalmologists, optometrists, ophthalmic technologists/technicians/assistants, opticians and a certified ophthalmic administrator is well suited to the environmental challenges of the future. Such a practice will in most cases include an ASC and optical dispensary.
 Richard L. Lindstrom |
The population is aging, as the first of the 78 million baby boomers are slated to turn 65 in 2010. Patients older than 65 years consume 10 times the eye care compared with those under 65, and their near universal access to Medicare insurance reduces the financial barrier to seeking treatment. Thus, we can anticipate a significant increase in demand as the number of patients with age-related diseases such as cataract, glaucoma, age-related macular degeneration, ocular surface disease, diabetic eye disease and presbyopia present over the next 3 decades. In the face of this growing demand, there will be a shrinking number of ophthalmologists.
Assuming a 30-year career for the approximately 20,000 U.S. ophthalmologists, we can anticipate that 600 to 650 will retire every year. We are now graduating only 450 ophthalmologists from American residency programs each year. In addition, it is unlikely that most younger ophthalmologists will seek the 60-hour workweek that many of those retiring typically pursued. These significant increases in demand in the face of a progressively smaller ophthalmologist work force will challenge us all to meet the demand for quality eye care in our communities in the next decade and beyond.
I believe one care model that will help us meet this demand is the ophthalmologist-led integrated eye care delivery model,
and optometrists working together collegially with ophthalmologists is the key to success. This is not co-management, but a collegial constructive integration of the skills of ophthalmologists and optometrists in one organization committed to the best interests of their patients and community.
In order to build and lead a successful integrated eye care practice, the ophthalmologist must trust and respect the skills and abilities of each member of his or her team and be willing to delegate appropriate eye care tasks to each of them. The integrated eye care practice must be patient-centered and always put the best interests of the patient first. Continuous incremental improvement of the knowledge and skills of each caregiver is critical. Ophthalmologists can and must educate one another and their colleague optometrists for this care model to flourish and best serve its patients.
The successful integrated eye care practice will put patients first, working together in an environment of mutual trust and respect, with a focus on continuous incremental improvement of each team member and every aspect of patient care. This integrated eye care practice will bring extraordinary value to the individual patient and community where it is located, and all caregivers will enjoy a rewarding career.