There couldn’t be a better time for optometrists to step up our collaborative efforts with ophthalmology colleagues to meet the needs of our shared patients. With the predicted physician shortage by the year 2032,1 ophthalmologists will need to spend more time in the OR and attending to surgical consults, leaving it up to optometrists to take the lead in medical and comanaged surgical care. Add to this the efforts of the American Optometric Association and numerous state affiliates to expand scope of practice legislation, and optometrists are increasingly able to take the helm as primary eye care providers in managing all ocular conditions to the fullest extent of our licensure.
In our referral center, we aim to seamlessly assimilate optometry with all ophthalmology subspecialties to maximize efficiency while enhancing the clinical experience of our patients. When eye care practitioners embrace their training and focus on what they do best, patients receive the highest quality care delivered most efficiently.
In order to build a network in which patients can move effortlessly between their primary optometrists and multidisciplinary eye care offices for higher-level medical and surgical consultation, optometrists should feel comfortable and confident that when they make a referral, their patients will have an easy and smooth transition to their colleagues’ offices. This article offers tips on how to build trust between collaborative practices.
The first tenet to building trust between referring doctors and our offices is education. We conduct regular continuing education seminars throughout the year to keep our network informed of the latest technologies and trends in eye care that we are implementing in our practices and with patients.
We also arrange more casual lunch-and-learn meetings with individual doctors or practices and their staff. At these meetings we reiterate the medical and clinical highlights from our formal continuing education seminars mentioned above, while reviewing the operational logistics of our staff assisting with getting patients to our office.
Further, keeping an open line of communication between both optometrists and surgeons in our offices and our referral network also helps to enhance the seamless referral process. It also serves as an educational component, because we are able to provide chairside consultation to doctors who may need triage assistance with a patient in a timely fashion. This offers referring doctors the added security of knowing that they have a clear path to our office. Educating in this manner truly allows our colleagues to feel empowered by knowing that they are providing full-scope care to their patients in all clinical scenarios.
BE PREPARED TO CUSTOMIZE
In my opinion, one of the best aspects of optometry is the flexibility our profession affords us as practitioners. The various modes of practice allow doctors to concentrate or specialize in specific areas of eye care. When building a referral network, it is therefore important to realize that not every referring doctor is set up to comanage every patient the same way. For example, an OD in a commercial setting may not be equipped with a visual field analyzer or an OCT unit and may not even bill medical insurance. Conversely, a pediatric or vision therapy specialist may not feel comfortable comanaging a patient in need of cataract surgery.
In managing our network of referring optometrists, we realize that each doctor practices uniquely and that a one-size-fits-all approach to meeting our colleagues’ needs won’t work. It has therefore become a priority to personalize our referral protocols to meet the specific needs of each of our network doctors. These custom protocols typically require an initial in-person meeting with a potential referral practice and its staff to establish their wants and needs from us as a referral center. Once we determine the extent to which that doctor wants to participate in patient care, we take that information back to our office and educate our own staff, including surgical coordinators and doctors. Making certain that our internal protocols meet the distinctive needs of our referral source will maintain the continuity of the patient experience as we share care between offices.
In some cases, this can be quite challenging, as different referring doctors, even within the same practice, may have different comfort levels clinically and may require our practice to maintain individual protocols for doctors at the same location. For example, Dr. Smith may like to see day 1 postoperative cataract patients herself, but her partner may not want to see patients back until they are ready for their 1-month postoperative refraction.
Although maintaining this personal approach and constant communication between offices may be difficult and even laborious at times, we have found that making the extra effort to customize care for our referral network has only enhanced our relationships with our referral doctors and their patients alike.
KNOW YOUR NUMBERS
We keep track of our referrals so that we know which doctors in our network send us patients. We analyze these numbers on a monthly, quarterly, and annual basis so that we can spot trends and adjust our communication with individual doctors as needed. We even examine our data to determine exactly the types of patients a referral source may be sending us.
For example, the number of Dr. Smith’s new patient cataract consults may have increased, but her referrals to the retina specialist have declined. This would prompt us to touch base with Dr. Smith to find out if something has changed in her office, or if there is something that we can help her with to make it easier for her to share her retina patients. Having this constant feedback helps us to guide our short and long-term planning efforts as they relate to our referral network.
KEYS TO COLLABORATION
As optometry continues to take the lead in managing the refractive, medical, and perioperative care of patients, the need to vertically integrate with our ophthalmology colleagues couldn’t be more apparent. Part of this collaboration requires referral centers to work jointly with primary care optometrists in order to care for patients’ needs.
We are constantly striving to enhance this relationship by communicating with and educating our referring doctors to ensure that they feel comfortable practicing to the fullest extent of their licensure. We also make an effort to show that our practice serves as an extension of their practice, allowing a seamless movement of patients between offices. This is truly the backbone of a functioning network.
1. Desperately seeking surgeons. Association of American Medical Colleges. April 26, 2019. www.aamc.org/news-insights/desperately-seeking-surgeons. Accessed December 31, 2019.