This article is more than 5 years old. Information may no longer be current.
BLOG: 'Keeping an eye on your health'
In keeping with my new practice focus of primary health care, I present myself and gear my patient care to a more holistic attitude.
Starting with the history, I ask about family medical problems and do a review of systems to understand the patient’s total health profile. This sets the tone for a broader examination and provides a backdrop for my overlying health care philosophy that the eyes and the body are part of the same picture of overall health and wellness. The eye exam can reveal evidence of general medical problems, and chronic disease will ultimately affect vision and visual performance.
The title of this blog is a trademarked motto of March Vision Care. I have been a senior member of this eye care company since it started as a concept in the dining room at the home of Drs. Glen and Cabrini March at the tail end of the last century. I currently serve as the chief medical officer of this company and have been proud to move their products away from the traditional “eyeglass plan” of last century and into a more medical, more holistic eye and vision approach to routine eye care.
The company focuses on government-sponsored health systems, with many of their contracted lives in the Medicaid and low-income space. Our holistic eye care is particularly important to this population, as the eye exam may be the only health care these people receive on a regular basis.
Last month, we published a clinical newsletter with an update on our quality assurance program. This program has always been progressive and includes a more rigid standard for pupil dilation and other medical examination points rather than just the refraction for eyeglasses. The recent issue included a new addition to the required elements of an eye examination, one for the collection and documentation of vital signs. This includes height, weight, blood pressure, pulse and the calculation of body mass index.
The addition of this element, as published in the newsletter, has prompted more phone calls, emails and questions than any of the items that I have ever published. I was a bit surprised by this, as the training for the measurement of blood pressure by optometrists dates well back to the 1970s.
In addition to the basic training, the government published this standard back in 2012 as part of Medicare and Medicaid standards for the implementation of electronic health records. This is measure four of the 17 core measures of stage 2 meaningful use. Here in 2015, if an eligible provider has not attested to meeting these requirements, the payment for services to some government-sponsored programs will be reduced.
As I fielded calls and had conversations on this topic, I learned that many eye care providers were unaware of the sweeping changes in health care and did not think that any of the “buzz” related to health care reform would affect eye care. Most reported that March Vision was the first company to implement this type of change. I must say that I am a bit proud of this and to be associated with such a progressive company. Although we may have been the first to reveal this, I note that the straight Medicare program is not far behind, as their first wave of letters about fee reductions went out this month.
And so the time for rhetoric and philosophy related to the latest trend in health care reform is over, and the change is now being implemented. If you don’t “step up” to a more primary health care delivery model, you will feel it in the wallet. I hope that you can join this movement to broaden your scope so you will be able to also to say to your patients: “I am going to be keeping an eye on your health.”