This article is more than 5 years old. Information may no longer be current.
What does the patient think of comanagement?
Controversy is ubiquitous. It permeates virtually every aspect of our lives, both personally and professionally. Occasionally, controversy is healthy and constructive. Other times it is without resolution. In short, many controversies simply wax and wane, occasionally erupt and are more destructive than beneficial.
As an eye care community, we know our share of controversy. We debate clinical issues, such as treatment efficacies, in the name of expedient patient care. We debate socioeconomic issues, such as managed care, in the name of cost effective patient care. And we debate political issues, such as comanagement, in the name of what?
As all of you know, the issue of comanagement has again resurfaced in recent months. Various ophthalmic and optometric organizations have rendered position papers and opinions. And the controversy continues.
Fee splitting?
Comanagement antagonists contend that this long-practiced aspect of health care is merely a thinly veiled attempt to conceal fee splitting. Proponents counter that comanagement proportionately distributes professional fees according to services provided and does nothing to increase the cost of health care to the patient or the system.
Opponents of comanagement maintain that it’s a surgeon’s ethical, moral and legal obligation to follow a patient from start to finish. Proponents point out that the referring provider – whether optometrist or ophthalmologist – often has a longstanding relationship with the patient, thereby providing a valuable perspective during the perioperative period. And if the busy ophthalmic surgeon is unable to personally render all postoperative care and delegates this responsibility to another provider, is this really any different than comanagement? You get the picture, it goes on and on.
Ongoing debate
Obviously, the comanagement debate won’t end with this column – or any time soon for that matter. However, it might be time for us to consider the opinion of a third party. An individual intimately involved and yet, curiously enough, never consulted: the patient.
Regardless of where we stand on this controversy, it’s imperative we understand one thing. Patients are not merely pawns. They are the sole reason for our professional existence and, as such, deserve our utmost attention and are entitled to an opinion. Why not ask our patients what they think about comanagement? We may or may not be surprised by what we hear, but at least we’ll be enlightened.