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BLOG: Three reasons physician extenders are here to stay in ophthalmology practices
Large and progressive eye practices, such as the Eye Institute of West Florida highlighted in the cover story of this issue of OSN, have a lot to teach us about better ways to practice. We learn from this practice that physician extenders, particularly physician assistants, while a new concept to most ophthalmologists, have great potential value. Here are three reasons most practices might consider adding such extra help:
1. Create efficiency. Physician assistants (PAs) can perform preoperative history and physicals (H&Ps) for patients preparing for surgery. Rather than coordinating these visits with primary care physicians, they can be performed directly in the ophthalmologist’s office, so there is no lag time in relating information to the practice and to the surgery center. Patients love one-stop shopping before surgery because these visits can be tied to their biometry exam. Naturally, these visits can be billed, providing a new source of revenue to the practice. In my practice, we recently surveyed local primary care physicians to find out whether they objected to eye surgeons’ offices performing their own H&Ps, and uniformly they were in favor of us independently performing these services. H&Ps are otherwise seen as a low-value service to their own practices.
2. Enhanced depth of care. Many ophthalmology practices use PAs to treat patients who have eye conditions that can be time-consuming yet don’t require an ophthalmologist’s experience. Dry eye patients, those with chalazia, allergic conjunctivitis patients and others would be well served by PAs. TearScience recently conducted a study showing that the typical ophthalmologist spends 10% of his time working with patients with dry eye but makes only 2% of his revenue from this diagnosis. It makes much more sense to have these patients cared for by a physician extender who is happy to spend the time these challenging patients need. In my practice, Harvard Eye Associates, where an optometrist performs these services, we get uniformly very positive feedback from patients. There is no reason, however, that a PA couldn’t do the same.
3. Fill office downtime. Many doctors in solo practice have their office sitting idle while they are in surgery or take a day off. There is no reason a physician extender couldn’t use the facility for revenue-producing activity during this time. Aside from the pay rate of the physician extender, there is little added cost in using the office this way because other employees are typically on-site doing less productive work.
As times change, so must practice patterns, and most of us physicians have learned that we do best by sticking close to the tasks that demand our top skill — performing surgery. Any time we can delegate other office tasks to other professionals, we make ourselves available to do more of what we do best. Whether your practice is small or large, consider adding physician extenders to move your professional environment to a higher level.
Disclosure: No products or companies that would require financial disclosure are mentioned in this article.