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Eye M.D.-Led Eye Care Teams: A Preview of the Mid-Year Forum’s Hot Topics

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With an economic gloom that seems to deepen every week, it might seem a little counterintuitive to be preparing for increased workloads. Yet that’s one of the key topics Academy, state and subspecialty society leaders attending next month’s Mid-Year Forum will be looking at: what the coming influx of baby boomer patients means for practices. In particular, the forum’s closing session, “Physicians First: A Team Approach to Primary Eye Care,” will explore the importance of closely integrated, collaborative eye care teams led by ophthalmologists.

Other changes covered at the Mid-Year Forum will include successfully integrating electronic health records into your practice and initiating e-prescribing, recent changes to standards for physician-industry relationships, communication in the 21st century and the increase in surgical scope battles. Here’s a more detailed preview of a few of the forum’s highlights.

The Eye M.D.-Led Eye Care Team
The basic team structure examined in the closing session, though various practice models will be discussed, is that of “a primary eye-care practice that incorporates a multi-dimensional array of services,” says Academy President Michael W. Brennan, MD. According to Dr. Brennan, all of the research shows that “those practices, by-and-large, do better.”

Considering one of the most common pieces of investment advice is to diversify one’s portfolio, this finding is not surprising. After all, a “multi-dimensional practice” will be able to meet a variety of needs and serve a more diverse base of patients. Provide patients with the accessibility and wide range of services they need, and you can establish a relationship that spans the life cycle of a patient’s eye care needs, from youth to retirement.

“You want to meet the decision-maker in the family early,” Dr. Brennan says. “Then you will be able to be part of their plan for continued eye care — for their children, for their parents, their eye trauma, their surgery.” If there are parts of care you can distribute or delegate, Dr. Brennan says you can use other members of the eye care team in your office: well-educated and certified technicians and optometrists, if you don’t currently employ them. The key, however, is to foster an ongoing relationship with patients.

“In the training environment, the first rule is, ‘Be a good doctor,’” Dr. Brennan says. “But pretty soon you realize you have to be a good friend too. It takes a while, but that works.”

A recent New York Times health article, by a man whose life was saved by quintuple bypass surgery a decade ago, underscores the connection between relationship and quality-of-care. The author reports he had none of the typical risk factors for heart disease. “Two doctors who examined me, including a cardiologist, saw no urgency in my condition. It remained for a lifelong friend, another cardiologist, to get the diagnosis right, and this by phone from 3,000 miles away. … Why? Because he knew me, because he listened to me carefully and because he could place my new symptoms in the context of my overall story.”

Knowing a patient’s story is far more possible when care is exclusively handled within the type of multi-dimensional practice Dr. Brennan advocates, rather than shared among different eye care facilities that refer to each other as a patient’s condition requires it.

Influential Input
The Mid-Year Forum session will also look more closely at the differences in care between such situations, as well as other advantages to an ophthalmologist-led primary eye care team. And, in a distinctive component shared by all other forum sessions, there will be a time for questions and answers. That’s one thing the sets the annual Mid-Year Forum, begun in 1993, apart from the Annual Meeting, says Gail Schmidt, the Academy’s director of ophthalmic society relations. “There’s an opportunity for input and cross fertilization of ideas from leaders in ophthalmology across the country,” explains Schmidt.

That input, of course, extends to Congressional Advocacy Day, where participants’ meetings with legislators and their staffs have brought results. During last year’s event, for example, Schmidt says ophthalmologists lobbied for increases to NEI funding. The recent appropriations bill, if passed, would increase funding for both the NEI and NIH by 3.2 percent per agency — an increase on top of the $10.4 billion increase provided by the stimulus package.

Make the Most of Not Attending
The best part about this year’s forum is, you don’t have to attend to start practicing three key things Dr. Brennan says he hopes YOs will glean from the closing session: observe best practices, find a mentor, and “keep comprehensive ophthalmology as a distinctive specialty opportunity — it is a specialty.”

  • Observe: “While you are in training, or while you are a junior partner, watch the dynamics of your technicians and your administrator and, if they are engaged in your practice, your optometrist,” Dr. Brennan says. “Develop some professional relationships. Respect your staff.”
  • Find a mentor: One way to get a good sense of how a well-integrated eye care team functions is by finding a mentor, Dr. Brennan says. “Ask your chairman or one of your faculty to arrange a Friday with a community, comprehensive ophthalmologist,” he advises. Such a connection could also be arranged through your state society. Once there, “Get acquainted with the nature of their practice, so you see it firsthand. And while you’re there, watch the dynamics of their staff: how the technician is integrated with physician services, the integration of optical services and the overarching role of the practice administrator.”
  • Consider comprehensive ophthalmology: “Not everyone needs to be a retina or cornea surgeon,” Dr. Brennan says. “Comprehensive ophthalmology is very rewarding.” And with surgical share of revenue having shrunk from 65 percent in 1997 to 35 percent in 2008, comprehensive practices stand to be more economically stable in the coming years.

In Summary
Clearly, this year’s Mid-Year Forum and Advocacy Day will provide a wealth of information and terrific opportunities for all who attend. Register today if you haven’t yet secured your place.

And even if you cannot attend, you can still represent ophthalmology’s interests. One of the best ways to do so is by joining your state ophthalmology society and learning about the challenges confronting your local professional peers. Legislative threats to patient safety have increased 50 percent over last year, with bills in 21 different states. Is yours one of them? Join your society to find out and help them educate your community about the unique skills and education of ophthalmologists.

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About the author: Christi A. Foist is the managing editor for YO Info and the Web and Member Communications Editor for the Academy.