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Every script counts
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It's that time of year. The time for political jousting, for appreciating democracy and for casting your vote. Because, after all, every vote counts. As optometrists, we know politics all too well. We have debated adversaries. We have witnessed (for better or for worse) the democratic process. And we know how important every vote can be.
The fruits of our political efforts have been bountiful. Our profession has grown intellectually, expanded its scope of practice and secured a rightful place as primary eye care providers. In many respects, we are proud of these achievements. Yet, in one regard, these accomplishments seem hollow.
Yes, there's the issue of how we are perceived by our fellow health care providers. It is understandable that physicians, pharmacists, insurers and pharmaceutical manufacturers question how well optometry is embracing its expanded role. After all, change is often slow and difficult to measure. For the medical community, one tangible measure - right or wrong - involves monitoring optometry's prescribing habits.
Prescribe competently
Whether prescribing therapeutics is synonymous with primary care optometry is a debate unto itself. However, the arguments are compelling. For ophthalmologists to comfortably comanage and primary care physicians to confidently refer, it is essential we exhibit a core competency in prescribing. For insurers to recognize and compensate optometry as a full scope profession, it is imperative we treat a variety of ophthalmic conditions. And for pharmaceutical manufacturers to service our offices, support our educational endeavors and solicit our opinions regarding new product development, we must simply prescribe. In short, show them the scripts.
I realize many of you (like me) are growing weary of this dilemma. We are all too familiar with the deficiencies - as they relate to optometry - of current prescription tracking services. And, to complicate matters, until optometry has a national formulary in which every provider has a DEA number or until the government assigns National Provider Identifiers, it's unlikely that our scripts will be accurately tabulated.
Practice full scope
So, how do we demonstrate our ability and communicate our willingness to practice full scope optometry?
First, and foremost, prescribe. This is not about prescribing for the sake of prescribing. This is about treating conditions with which you are familiar, using medications competently and doing what's best for your patient. This is also about using samples judiciously, relying less on comanaging physicians and putting your name on the prescription pad. Of course, you are assuming a greater responsibility in managing your patients' care. But isn't this how you would want it anyway?
Second, communicate. A quick letter to a referring primary care physician detailing his or her patient's diagnosis and treatment is an invaluable tool. Additionally, telephoning the pharmacist when prescribing a new ophthalmic medication is often perceived as both courteous and professional.
Third, educate. If we don't inform insurers of optometry's capabilities, who will? To practice in accordance with our licensure scope we must continually and aggressively address this issue. Likewise, discuss prescribing habits with your pharmaceutical sales representatives. Be sure they understand your product preferences, your willingness to treat and - whenever possible - your prescribing volume. Your efforts will only benefit the pharmaceutical manufacturer interested in understanding optometry. Further more, until prescription tracking services more accurately reflect our commitment, a grassroots advocacy is essential.
To a great degree these strategies are intuitive. Unfortunately, we do not practice in a vacuum and our fate is influenced by many forces within health care. So, we must remember to communicate. We must remember to educate. And, we must remember that every script counts.