Ajamian: Pioneer of the comanagement concept

Paul Ajamian, OD, FAAO, is credited with contributions that gave rise to a number of optometrist-run referral centers and residencies.

Issue: March 2015

As part of Primary Care Optometry News’ 20th anniversary celebration, in each issue throughout 2015 we will profile a “Pioneer in Optometry” as chosen by the PCON Editorial Board.

In this issue we feature Paul Ajamian, OD, FAAO, the center director of Omni Eye Services of Atlanta and the education chair of SECO International.

“Paul is one of the visionaries of optometry who has, to a large degree, created what we are today as clinicians,” PCON Editorial Board member J. James Thimons, OD, FAAO, told PCON. “His work in the arena of comanagement should, by itself, mark him as one of the great contributors of all time, but add to that his insatiable efforts on the legislative front and his remarkable contributions to organized optometry and you will understand why he is one of a kind and someone whom I am honored to call a friend.”

“Dr. Ajamian has been a leader in our profession in so many capacities,” PCON Editorial Board member Christopher Quinn, OD, FAAO, shared. “He is a stalwart supporter of political optometry as a leader of the Georgia Optometric Association (GOA), the American Optometric Association and the newly formed American Board of Optometry (ABO), always with the goal of advancing the profession of optometry. More importantly, his role in optometric education is unparalleled. He has shepherded an entire generation of optometrists through the great transition of our profession into medical eye care and comanagement of surgical care. He has provided important clinical education to optometry students, optometry residents and community optometrists both personally and in his role as education chair of SECO.”

He continued: “Considered by many to be the father of comanagement, Dr. Ajamian helped establish the first referral center practice (Omni Eye Services), which marked the beginning of our profession’s recognition that they could control their relationship with ophthalmology for better care coordination and excellent patient outcomes of optometrists’ patients.”

Bill Sharpton, OD, FAAO, also sent praise, recalling when he received a call decades ago regarding the possibility of an optometric referral center.

Ajamian serves as education chair for SECO.

Ajamian at the AOA Distinguished Service Award ceremony with (left) his daughter Natalie and (right) his wife of 28 years, Susan.

Ajamian shakes Gov. Sonny Perdue’s hand after Perdue signs the Georgia oral medication amplification bill in 2007.

Ajamian looks forward to skiing with his 14 original Omni comanagement friends every year.

Images: Ajamian P

“Paul was instrumental in the launch of the first optometric referral center, which was eventually named Omni Eye Services,” Sharpton told PCON. “Omni grew into what I consider the best place that I and many other ODs in the greater Atlanta area could safely refer our patients for the very best care.

“I am glad to call Paul Ajamian a close personal friend who I feel is one of the greatest optometrists in history,” he added.

In an interview with PCON, Ajamian shared his beginnings in optometry and what he considers to be his most significant contributions to the profession.

PCON: Why did you choose optometry as a career path?

Ajamian: The eye interested me from my younger years, when I failed my first school vision screening and truly thought I was going blind. My interest in the visual system remained strong over time, so I applied to one school – the New England College of Optometry (NECO) – and despite some pretty weak OCAT [optometry college admission test] science scores, they let me in! I lived at home to save money (tuition had “jumped” to $3,300 per year) and commuted to school each day on the “T.” It was a wonderful experience, with a great faculty and 85 amazing classmates, many of whom I still see on a regular basis as I travel the country speaking.

PCON: How has your career unfolded?

Ajamian: The leadership at NECO forged what was at that time an unheard-of relationship with ophthalmology at the Bascom Palmer Eye Institute in Miami, and I was the second student to intern there. That led to a residency and staff position, which exposed me to a high concentration of ocular disease. This training opened the door to a position at the VEF Referral Center in Atlanta. The concept was the brainchild of the late Dr. Bill Cuthbertson. Georgia optometrists were tired of one-way referrals and wanted a practice they could safely send to and learn from, knowing that they would get their long-time patients back. We ramped up quickly and then opened 14 similar centers that became the blueprint for true comanagement nationwide.

PCON: What are you doing now?

Ajamian: I am still the director of the same practice, called Omni Eye Services, and have been since 1984. We are in our 34th year and continue to adhere to our founding principles: referral only, no primary care or dispensing, and support of the profession through state-of-the-art clinical care, educational opportunities and legislative involvement. We have four board-certified surgeons, two ABO-certified optometrists and an optometric residency and externship program. We have trained more than 1,000 externs and 50 residents in my 34 years. We recently switched to electronic medical records, and that went about as well as it could have, given the complexities of the conversion and my advancing age.

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PCON: What have you learned?

Ajamian: That it is good to be an underdog sometimes. When I was in school, diagnostic drugs were locked in a secret cabinet, and only the MD had the key. Therapeutics were almost science fiction. But as I watched my mentors in Florida and then Georgia begin to fight for scope expansion, I knew we needed that key and that as underdogs we would have to fight hard for it. When I became involved with SECO, I was exposed to a group of doctors in the south who were truly pushing us forward through education and then legislation. I wanted to be part of it. I have learned that what distinguishes a profession from a job is involvement, and the rewards you reap from giving back are countless.

PCON: What is your most significant accomplishment?

Ajamian: This past summer, I was truly humbled when I learned that I was receiving the AOA’s Distinguished Service Award for lifetime achievement. In my acceptance remarks, I dedicated the award to the many families who gave me the opportunity to do my small part – the AOA, GOA, SECO, ABO, my fellow comanagement center directors and most of all to my immediate family, my wife Susan and daughter Natalie, who have loved me and embraced my love of our profession as if it were their own.

PCON: What have you contributed to optometry?

Ajamian: Looking back, I hope that my efforts made an impact in three areas. The first is the way that optometry and ophthalmology work together. The two professions cooperate more now than ever, but there is still work to be done. The second is in the legislative arena, which I entered as a naïve and inexperienced volunteer and suddenly was elevated to legislative chairman. I was truly blessed to work with then-GOA executive director Georgianne Bearden, who taught me the ropes at the Capitol. Armed with the best state leadership team anyone could ask for, we passed our oral narcotics and glaucoma bill in 1993. The third area was my involvement with the American Board of Optometry, where together with some very talented people, we started a board certification program from scratch. Nearly 3,000 ODs have recognized the value of demonstrating lifelong learning, and optometry can be proud that we have a process in place that meets governmental and professional accreditation standards.

PCON: What do you enjoy most about optometry?

Ajamian: Lecturing and planning CE programs are what I consider to be my “hobby.” SECO International is the most enjoyable part of that, mostly because of the amazing volunteers and staff, and loyal attendees who really appreciate what we do year after year to help keep CE creative and current. I have been blessed with a wonderful lecturing career, inspired in my early years by mentors like Paul Shulman, Lou Catania and Jimmy Bartlett. I like to keep it light, but at the same time bring new information to my colleagues based on actual experience. As long as I am seeing patients, I hope I have something to share.

PCON: What do you wish for the future of optometry?

Ajamian: I just want to be sure that the gains we have made in optometry are not only preserved by legislative activism, but that we practice to the fullest extent of the law. We must always demonstrate that we are embracing our role as true primary care eye doctors. If we don’t, I am afraid that others will be waiting in the wings to provide the care that we are abdicating, including glaucoma and post-op cataract follow-up. Every OD should ask himself or herself: “Am I taking care of every patient I can and not just handling the easy cases and ‘turfing’ the rest?” If your answer is yes, our future is very bright! – by Chelsea Frajerman