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Premium surgeons should help patients navigate vicious maze of care access
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Premium surgeons face challenges regarding patient care access daily, from access to certain eye drop pharmaceuticals to a growing population of aging patients living longer and the cataract pool ever-enlarging to the health insurance industry making decisions about patient care from a desktop in some remote building overseas. Adding affordability to this vicious maze of increasing out-of-pocket costs and high deductibles and co-pays makes even it more prohibitive for patients to have access to our premium technologies. The end result: Patients delay their eye health care and end up at our offices with more complex cataracts, more advanced-stage glaucoma and retinal conditions such as diabetic retinopathy that are too severe to save vision. And the vicious maze continues as these more advanced eye conditions lead to more surgical procedures needed to save sight, resulting in even higher costs to the health care industry. Patient access is just one of the triad critical to the success of what we do as premium surgeons; patient engagement and satisfaction are the other two key ingredients.
Recent surveys show that the eye care professional workforce is shrinking in that there will be no growth in the number of ophthalmologists from 2014 to 2020, keeping the number roughly at 18,000, and optometrists only growing in that same period from 41,000 to 46,000. And only a handful of the 18,000 ophthalmologists offer premium services, making access even more challenging. Not only will patient wait times to see a premium surgeon be delayed as we move further into the future, patient dissatisfaction will continue to rise, and costs will also continue to rise, enhancing the vicious maze.
There are other daunting statistics. Cataracts affect more than 24 million Americans by age 40 or older, and by age 75, about 50% of all Americans have cataracts. Glaucoma currently affects 2.7 million Americans age 40 and older. Nearly 2.1 million Americans age 50 and older have late age-related macular degeneration, and 9.1 million have early AMD. Diabetic retinopathy affects nearly 7.7 million Americans age 40 and older, and 8.1 million Americans do not know they even have diabetes. These statistics will just continue to multiply, and by 2020, it will be difficult for us as premium surgeons to maintain 20/20 vision for many of our patients.
Strategies to improve health care access for our patients are critical, and organizations such as the American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Cornea Society, Refractive Surgery Alliance and CEDARS/ASPENS are already leading the charge and working with industry, CMS and the health care insurance conglomerates by improving the communication channels.
On a local level in each of our offices and surgery centers, strategies include enhancing our digital communication strategies for patient access with improved appointment scheduling and introducing telemedicine via video conferencing, especially for patients in rural areas. Expanding and supporting our premium surgeon workforce is a critical next step as well, as many eye care and overall health care professionals have reported increasing job dissatisfactions and plans to retire early. Ultimately, patients lose out in this latter scenario due to a lack of providers. Non-physician providers (NPPs) can be a solution, as seen in family medicine with nurse practitioners and physician assistants becoming extenders of health care. Many ophthalmologists are already employing NPPs to help with medical clearance for cataract surgeries at their freestanding ASCs.
Lastly, making health care for our patients truly affordable is one final step we as premium surgeons can take to slow down this vicious maze. Address patient financial needs to ensure payment, especially for premium services, by offering payment plans in terms of financing companies such as CareCredit and Alphaeon Credit to help offset the sticker shock that patients encounter with advanced IOL technology, for example. Price transparency is the new way we should be delivering high-end technology to our patients.
In the end, the vicious maze limiting patient care access can be slowed down tremendously, and it is our time to help as responsible premium surgeons by being transparent in our availability to patients, helping with pricing and being flexible in utilizing health care extenders.
- References:
- Age-related macular degeneration. National Eye Institute. www.nei.nih.gov/eyedata/amd.
- Cataracts. National Eye Institute. www.nei.nih.gov/eyedata/cataract.
- Diabetic retinopathy. National Eye Institute. www.nei.nih.gov/eyedata/diabetic.
- Glaucoma, open-angle. National Eye Institute. www.nei.nih.gov/eyedata/glaucoma.
- Rein DB, et al. Arch Ophthalmol. 2009;doi:10.1001/archophthalmol.2009.58.
- For more information:
- Mitchell A. Jackson, MD, can be reached at Jacksoneye, 300 N. Milwaukee Ave., Suite L, Lake Villa, IL 60046; email: mjlaserdoc@msn.com.
Disclosure: Jackson reports no relevant financial disclosures.