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The new team for optometry in health care reform
Since the first therapeutic drug bill became a law, most optometrists have considered themselves a critical part of the medical care delivery system. As “eye doctors,” we naturally gravitated to the team of eye care providers and considered ourselves specialists in eye care. Within the eye care delivery system, however, we were the entry point and thus termed our role as “primary eye care.” As health care reform unfolds, optometrists must reconsider that role.
The fundamental building block of health care reform is primary health care, which means evaluating the basic health indicators: height, weight, body mass index, blood pressure, pulse rate, health history and family history, followed by triage, health education and advice. It is the goal of health care reform to have these basic health elements on all citizens and to have the data early enough to intervene and prevent the expression of chronic health problems such as hypertension and diabetes. Obesity, once considered a risk factor, is now considered a disease.
The largest barrier for health care reform in attaining this goal is the shortage of primary health care providers. Everyone agrees that there are not enough primary care physicians to meet this need, and it has been suggested that the addition of physicians’ assistants and nurse practitioners can solve the problem. However, the problem is that these providers use the same physical space as the physician.
The addition of optometrists to the team of primary health care providers greatly increases the access to these vital services. Optometrists are trained to effectively provide these basic services, and many already provide this care as part of the comprehensive eye examination. In spite of this, optometrists rarely consider themselves part of the primary health care team. One of the reasons for this is that the optometrist seldom conveys this critical data to the primary care physician responsible for the patient’s overall care.
Electronic medical records are poised to resolve this problem. The data is collected electronically and shortly will be easily transferred to the physician. New delivery models are already on the drawing board to include optometrists as primary health care provider. California has ground-breaking legislation pending to formalize this model.
So, all optometrist must evaluate their practices and their relationships with area primary care physicians. Open the communication and gear up to be ready to be a key player on the new team.