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Integrated patient care is best
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As is true in many aspects of life, the pendulum continues to swing. And it swung swiftly and to an extreme in 2004, when the American Academy of Ophthalmology instituted its policy to effectively ban optometrists from attending the AAO’s annual meeting. The academy’s decision was followed shortly thereafter by the American Society of Cataract and Refractive Surgery’s implementation of a similar policy.
For many of us involved in collaborative OD-MD efforts, these mandates were nothing short of stunning. After all, in the years leading up to 2004 there seemed to be a trend toward increased collegiality. Joint OD-MD clinical research projects, educational symposia and – most importantly – patient care initiatives had become increasingly commonplace. It was a trend that existed for good reason, as our combined efforts spawned new technologies, fostered a healthy exchange of ideas and provided greater continuity in patient care. At least on the surface, “the ban” just did not make sense.
In retrospect, AAO’s and ASCRS’s decisions should not come as a surprise. Politics inadvertently played a role. Organized ophthalmology was concerned that ODs would attend its annual meeting, acquire knowledge, then use it to advance optometry’s cause in legislative arenas around the country. Right or wrong, it was a legitimate concern.
On the other side, optometry’s concern was that restricting the flow of information and knowledge could never benefit the public we all serve. Perceived or actual, its concern was equally legitimate. In the final analysis, whether one is “pro-ophthalmology” or “pro-optometry” may be a moot point, as emerging external factors could very well dictate our collective fates.
At no other time in our country’s history has health (and eye) care faced such a convergence of factors: Life expectancy has never been higher; baby-boomers are aging; extensive computer use is the norm and educational mandates are increasing. In short, Americans live longer and have greater visual demands than ever before.
This is borne out every day of our professional lives. ODs and MDs alike are inundated with cataracts, age-related macular degeneration, glaucoma, diabetic eye disease, ocular surface disease, presbyopia and myopia. These demands will only increase.
The problem we – optometrists and ophthalmologists – face is one of limited time and resources. In fact, with health care costs skyrocketing, corporate America, insurers and our government are all demanding a more efficient delivery model. This is an opportunity for ODs and MDs to collaboratively provide a solution.
In this spirit, Dr. Richard Lindstrom convened a group of ODs and MDs for a symposium at this year’s ASCRS meeting to address these issues (see “ODs, MDs tout benefits of working together,”). With an emphasis on increased collaboration between the two professions, the group discussed a variety of initiatives – including the concept of an integrated eye care delivery system – for improving efficiency and quality of care. While the ASCRS symposium is just the first step, it is an essential one nonetheless.
So, the pendulum swings again. The timing could not be better, because if optometry and ophthalmology cannot collectively figure this out, someone else will. That, more than likely, will not be good for either profession or for the patients we serve.