Viewpoint

Strength in Numbers

Larry E. Patterson, MD
FROM THE CHIEF MEDICAL EDITOR

A recent study on future manpower needs in ophthalmology, prepared by Market Scope, had a significant result: from 2008 to 2015, the need for ophthalmologists will skyrocket 18.1 percent. This is no great surprise — we've been hearing for some time that the future demand for health care would rise, fueled by the aging of the baby boomers. But the second part got my attention: the number of ophthalmologists is expected to grow by only 0.67 percent during that same period.

Those of us still in practice by 2015 have our work cut out. If you have any fears about the future, fewer patients should not be one of them. I know some of you wouldn't mind an 18 percent increase in your workload. I know many more who have no idea where they would fit these extra patients.

And in all the talk of health care reform, the solution usually comes down to this: “Even after years of decreasing reimbursement, you doctors still make too much money, so we'll fix the problem by giving you more work and paying you less. ” Or something like that.

The Market Scope report concludes that ophthalmologists will have to improve efficiencies and delegate more patient care. We've seen this writing on the wall for some time, and the pages of Ophthalmology Management have been filled with ideas helping you do just that. In fact, this month's cover story addresses the study's conclusions in detail. But let me give you a pearl to help reach this goal: add optometrists to your staff.

My practice consists of me and a part time medical ophthalmologist. I also have six optometrists. I've seen practices with six ophthalmologists and one or two optometrists. But I believe an argument can be made for reversing that order. Now I know some of you hate optometry, and surely some ODs hate us. Whatever. You may know optometrists who have poor clinical skills. So do I. We've got a quack in a nearby town who believes everything can be treated with vision therapy. He's probably treating some teenager's acne with reading exercises right now.

But come on, be honest. There are a few sub-prime eye MDs out there as well. You know it, I know it. We see good and bad in both fields. I can tell you that the six optometrists working with me are fantastic. They all have individual skill and comfort levels, yet I've never seen any of them do anything compromising patient care. With optometrists working alongside ophthalmologists, we can use each other's expertise to our patient's best interest. The quote at the top of this column sounds like a pretty good strategy to close the manpower gap without shortchanging our patients or overburdening ourselves.

Manage your practice the way you think best. Just know lots more patients are heading your way in the next few years.