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Improving Practice Efficiency for the Baby Boomer Generation

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The “baby boom” generation, nearly 80 million strong, was born between 1946 and 1964. That means that by 2011 the first of those boomers will be 65 years old and eligible for Medicare. Additionally, by 2030, this soon-to-be over-65 population will double what it was in 2000. This equates to approximately 70 million people over the age of 65.

Historically, this group has a profile of high use and high demands for care, whereas seniors previously have typically underused eye medical care services. What this “graying” of society means for ophthalmology is that we can expect to see a large influx of patients in the very near future … and we are currently unprepared to handle them efficiently and effectively.

There are three reasons for this. First, the number of U.S ophthalmologists is not expected to increase over the next 20 years. Second, ophthalmologists will soon retire faster than they are being trained. And, third, in recent years, residency positions have been essentially flat in number.

In a nutshell, this means that there will be significantly more patients than doctors to treat them. This is a problem.

In an effort to address these concerns, the Academy established a task force on practice efficiency to look at the problem and create white papers that provide suggestions on how to handle the glut of patients and scarcity of physicians.

Practice Efficiency is a Matter of Style
After much discussion, the task force created white papers that explore three modes of increased practice efficiency. Each mode is based on a different type of practice style.

In all cases, the task force looked at the “throughput,” or number of patients put through the system with efficiency while still maintaining a high quality of care. In other words, we looked at how we can see the largest number of patients in a short period of time and still provide great quality of care.

The Future Lies with the YOs
This population shift will be most relevant to the young ophthalmologist. You have the opportunity to join or even create practices that can operate the “throughput” the best. More importantly, you don’t have to change your business model. You can establish it based on what is coming down the road and preparing for the coming changes. But the only way to truly and effectively achieve this is to have the right mindset and be flexible.

Fortunately, you can weather this storm successfully by being proactive rather than reactive. Ask yourself if your practice has enough patient demand to increase patient flow enough to pay for increased costs. What is the long-term plan of the practice? At what pace do the ophthalmologists work? Is the practice capable of handling additional management complexities?

By answering these types of questions, you will know if your current practice or the one you are looking to join or establish will be prepared to handle the “throughput” of the aging boomer population.

Another thing to consider is the area you live and practice in. The more populated the area, the more this shift in demographics applies to you. However, if the area is more sparsely populated, you may need to rely on optometrists as partners, due to population destiny, as you will likely not be able to see people efficiently.

Embrace the Opportunity
While this change could be seen a troublesome and anxiety inducing, I think that young ophthalmologists have a great opportunity in the near term to provide quality care to an aging population. The challenge will be to do so with increased volume and likely reduced reimbursement per service provided. But if you can view the future, prepare for it, then react to the changes as needed, you will find yourself in a very enviable position.

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About the author: Samuel Masket, MD, is a clinical professor of ophthalmology at the Geffen School of Medicine–UCLA, past president of the American Society of Cataract and Refractive Surgery and a former member of the Academy Board of Trustees. Most recently, Dr. Masket has served as the chairman of the task force on practice efficiency for the Academy.