BLOG: The case for wellness care

The majority of patients seen by optometrists are well. They present to our offices with vision-related symptoms. Blurred vision at distance, near or both is, by far, the most common entering complaint.

Unlike most other health care providers, we have our own insurance industry that promotes wellness vision examinations. This industry is second only to dental insurance in ancillary health care benefits.

Medical insurance is not like vision insurance. It does not cover wellness or routine maintenance health care. Patients must have a symptom or known medical diagnosis to use medical insurance for health care services. As such, physicians are not in a position to provide wellness or preventive health services. Although health maintenance organizations and other managed care organizations have made efforts to change this paradigm, Americans, by and large, do not seek wellness or preventive health services. Many experts believe that this is the source of poor performance of the American health care system on the world stage (Peterson-Kaiser).

Although optometry has been slow to embrace the opportunity for wellness care in traditional practice, this is starting to change. I recently became a member of the Ocular Wellness and Nutrition and Society. Founded in 2008, this organization is led by Stuart Richer, OD, PhD, and provides a wealth of information to help the practicing optometrist adopt and integrate wellness and nutrition programs into private practice. The organization has developed a liaison with several schools and colleges of optometry and provides evidence-based education opportunities and a fellowship program. This mission speaks to the role of nutritional support as it related to vision and eye health.

Wellness care in general is a good idea for everyone. According to the Global Wellness Institute, the wellness economy is a $4.2 trillion industry. In the U.S. alone it was reported at over $170 billion in 2018 (Statista). It is worth noting that the current traditional optometry industry is only $16 billion (IbisWorld).

Wellness consultation and strategies, however, when applied to patients at risk to develop chronic medical problems, are more than just a good idea. It is primary medical care and the missing link in the American health care system. Optometrists who provide wellness care for their patients who have a positive family history, unfavorable vital signs or poor social habits may prevent the loss of vision from diabetic retinopathy, retinal vascular occlusions, hemianopia and age-related macular degeneration. These blinding conditions are all associated with diabetes, hypertension and dyslipidemia that can be reduced or eliminated with an effective wellness program executed before the onset of disease.

Here are a few simple steps that can help you integrate prevention and wellness strategies into your practice:

--Measure vital signs and discuss these at the end of the examination. Bring them into your management plan as appropriate.

--Increase your knowledge in nutrition as it related to the eye and visual system and make recommendations when indicated

--Talk to your patients about regular physical exercise and the risks of a sedentary lifestyle.

--Provide patient education material about health, wellness and prevention as it relates to a lifetime of good vision.

--Provide an opportunity for patients to purchase wellness items such as nutritional supplements, health foods, fitness trackers, personal care items or books either directly in your office, via your website or with a referral to a formal wellness program.

Optometry’s entry into primary care is not about changes in state law to allow treatment of systemic disease. It is about adopting a philosophy of wellness and prevention that is the beginning of the continuum of the health care services. As health care reform is working to push this philosophy forward, optometry is poised to play a key role.

References:

IbisWorld. Optometrists industry in the U.S. December 2018. Accessed June 17, 2019.

McGroarty B. Global Wellness Institute. Forces shaping the now $4.2 trillion wellness economy. Posted October 23, 2018. Accessed June 17, 2019.

Ocular Wellness & Nutrition Society.

Peterson-Kaiser Health System Tracker. Posted March 28, 2019. Accessed June 17, 2019.

Statista. Market value of health and wellness in the United States from 2015 to 2020. Updated April 24, 2019. Accessed June 17, 2019.