How has co-managed care with LASIK and Cataract Surgery
affected your practice?
I don't co-manage LASIK very much but I co-manage all of
my cataract patients receiving IOLs. I've been
co-managing patients so long I don't remember what it would
be like to not do it. Patients are generally nervous about
any kind of surgery. Knowing they will be back in my
office a few days to a week after the procedure is
comforting. They appreciate the continuity in care.
Financially it is excellent as well. I'm fairly paid for the
post operative care by the insurer.
Do you think opticians should be allowed to refract?
Refracting opticians are a controversial topic for
optometrists. Refraction is an art requiring
significant understanding of psychological and physiologic
optics. Relating visual symptoms to prescriptions
requires significant study in these areas. The lack of
education can be seen in the poor results of many
technicians refracting in ophthalmologist’s
offices. If opticians are to begin refracting, they
should strive as an organization to make certain they get
the proper education and not allow themselves to become
refracting technicians.
The education will certainly require additional time in
receiving their degree. Another major issue or obstacle
is whether or not properly trained opticians should be
allowed to have independent offices and charge refraction
fees or only practice refraction under the direct
supervision of optometrists or ophthalmologists. This
discussion would require more space then I have been
allotted.
What do you think the future holds for independent
dispensaries?
My feeling is that if an independent dispensary, which I
would define as optician owned, is to survive it absolutely
must have a dedicated optometrist associated with it. The
association must be one in which the optometrist is making
every effort to build his practice using the full scope of
optometric services. Optometrists coming into an
optical dispensary one or two half days a week to see the
refractions the optician has arranged will not be enough to
build a successful dispensary. Patient loyalty and
referrals, the key to a successful practice, can only be
achieved by offering personal, full service by caring
professionals.
