BLOG: Three reasons to hire a glaucoma specialist

ByJohn A. Hovanesian, MD, FACS

Whether you’re a solo practitioner or a group practice, it can be difficult to decide when and how to hire additional physicians. Hiring is neither easy, nor does every new doctor stay forever. Recruiters say only 40% of fellowship graduates will stay permanently with their first job out of training. It’s also difficult to decide when there’s enough demand. And, of course, finding a future partner is like finding a spouse; you have to “kiss a lot of frogs” in interviews.

But hiring and cultivating a new physician in your practice can also be one of your proudest professional accomplishments. The right person who truly adds a new dimension will modernize your practice, boost your income and invigorate your staff.

Hiring a fellowship-trained subspecialist is always viewed well by the community, and glaucoma is a desirable choice for three reasons:

1. An evolving field. With new drugs and MIGS devices every year changing the way we think about treating early to moderate glaucoma, this subspecialty is advancing more quickly than any other. Taking on new techniques like angle-based surgery is unnecessary for established physicians if you have a young glaucoma specialist. And there are more techniques to come. Suprachoroidal stents will likely return with the iStent Supra (Glaukos). Sight Sciences’ Omni device, already approved for angle-based surgery, should soon have FDA data to support its broad use in open-angle glaucoma. Rather than feeling stressed about having to take on these new surgical challenges, senior ophthalmologists can feel relieved that a new glaucoma specialist will tackle them with confidence and expertise.

2. A fast ramp in collections. Regardless of your practice size, you probably have more glaucoma patients than you think. New glaucoma specialists are among the fastest physicians to build their collections, partly because of frequent visits with existing patients; while a senior doctor may only see routine glaucoma patients every 6 months, glaucoma specialists typically will see them more often, rendering more revenue for the same patient who is referred. This is both good care for patients and healthy for the new doctor’s professional growth. A glaucoma specialist may also introduce new diagnostic tests. Although these may involve some capital outlay, they will almost certainly pay for themselves quickly. You’ll also find referrals for this new specialist in a number of patients you see already: those with asymmetric or “funny-looking” optic nerves, those with optic neuropathy or visual field defects from any cause.

3. Shift your own focus to what you desire. As many ophthalmologists grow more “senior,” they’d like to spend their time performing more routine surgery, leaving challenging cases that require new techniques to the freshly trained associate. Most properly trained glaucoma specialists seek these kinds of cases, giving the senior partner(s) the chance to reduce their office hours and actually perform more, not less, routine surgery. When everyone sees the kinds of patients they want, everyone wins, and removing stressful cases from your life may keep you working longer and more happily. And by seeing smaller numbers of patients, you allow the new doctors to grow faster.

Featured in the cover story of this issue of OSN is my young partner, Sev Teymoorian. Seeing his prominence grow from a new hire to a national key opinion leader has been one of the highlights of my own career. All credit for his success goes to him. While my other partners and I continue to do MIGS and other complex procedures, we love having a world-class expert oversee the care of many of our glaucoma patients. For my colleagues in other practices, whatever changes you make in your own career, I hope that you enjoy similar fulfillment in bringing on a new specialist in glaucoma — the specialty of the future.

Disclosure: Hovanesian reports he is a consultant and/or shareholder to Glaukos and Sight Sciences.