Viewpoint

Increasing efficiency, reducing animosity

FROM THE CHIEF MEDICAL EDITOR

Larry E. Patterson, MD

In 2009, I wrote about a study whose authors predicted that society would need 18% more ophthalmologists by 2015, even though they also determined there would be no increase in the number of practitioners. Judging by my practice, they were right: Here at Eye Centers of Tennessee, we’ve had a 19% increase in patient visits since 2009, with virtually no external marketing to attract them. I didn’t need to. I long ago had taken my own advice, and have kept doing so.

In 2009, I recommended that you delegate your patient care responsibilities by adding optometrists to your practices (http://tinyurl.com/j4vpbxb).

LEARNING TO DELEGATE

You can increase efficiencies using other methods, including hiring more technicians and assistants. But they can only help you see more patients, whereas optometrists see their own patients.

If you’ve not gone down this road, perhaps reading about my story would help.

Around 15 years ago, we acquired an independent optometric practice. One of those optometrists spent two days a week in our facility. Initially, since my name was on the building, everyone in the community knew and tended to want to see me.

I needed to provide incentives to have certain patients see the optometrist instead. I started paring patient groups I wasn’t overly fond of: contact lens wearers and children. When those patients asked for me, they were told that I didn’t do those types of exams. It worked well for a while. But as time went on, we added more practices and optometrists, and I needed to delegate patient types even further.

Eventually I turned over most routine exams to the optometrists. Taking a cue from a now-retired colleague in the area, I significantly increased my fee for routine eye exams and no longer saw patients with “eye exam” insurance. Over time I only saw patients looking for a surgical consultation and those who needed a medical exam for various ophthalmic diseases.

I no longer see the same number of patients per day as I once did. Why? Because it takes more time to see patients with end-stage glaucoma, diabetic retinopathy and those who need cataract evaluations.

ARETHA FRANKLIN MUST BE AN OPTOMETRIST

But I learned there’s another reason to work with ODs. Working together helps eliminate the animosity our professions can feel towards one another. It’s hard to have negative feelings about a group when one has a practice down the hall from you. And if your ODs are of the same caliber that mine are — excellent — you’ll end up respecting their skills. As Dick Lindstrom told me after reading that 2009 editorial, “’Larry, if every ophthalmologist would just hire as many optometrists as you have, our MD-OD fights would be over!’” OM