Eyeworld

January 2011 son said, is that optometry is a regu- lated profession, yet there's no uni- versal agreement among the states as to what an optometrist can and can- not do. "Because I have lived and practiced in different states, I've seen the legislative battles in all of them, and I'm a little cynical on the process," Dr. Jackson said. "Optome- try as a profession is continually going back to the legislature to deal with advancements and how to allow the physicians to change and grow." He adds that legislative bat- tles are only about patient care and not monetarily based "is complete baloney. There are scores of practi- tioners who get along wonderfully well, but in the hierarchy there are some fundamental differences." On the other hand, continuing to define optometry "as a non-surgi- cal profession and I don't have a problem with that," Dr. Rickard said. "Some optometrists out there don't feel we should be that limited, but the vast majority are okay with the laws the way they are. Of course, there are some ophthalmologists who begrudge optometrists for what we're allowed to do. Some, not most, but some." Moving forward Dr. Fu believes integrated eye care will continue to gain in popularity, mainly because optometrists "can learn quite a bit by being that much closer to the specialist, and can be- come more comfortable with patient care because of that relationship. The ophthalmologists in our prac- tice have helped make us all better diagnosticians." Overall, he said op- tometrists are not trying to "steal" anyone's patients; they're comfort- able "treating what we treat and we know when we need a second opin- ion or something is out of our com- fort zone." Co-managing patient care is "the most cost-efficient care model for the patient," Dr. Jackson said, based on the greater geographic dis- tribution of ODs in general. "There's going to be a greater in- terest in co-management because it makes fiscal sense for the overall healthcare system," he said. "There's always going to be patients who need to be referred out. No matter how good an individual state law is, and no matter how comfortable an optometrist is performing various procedures, there are patients who are going to need secondary and ter- tiary care." With patient loyalty dictated more by insurance company cover- age than actual quality of care these days, "if you tell a patient they've been diagnosed with X, 'here are some practices I work with for you to go see,' the patient isn't going to feel you're involved in their disease management. You're not helping them navigate the surgical aspects of their disease. If, however, you refer the patient to an individual doctor, or tell them you've created a lists of people who can provide the best care for their diagnosis but you will be the point person and provide all the pre- and post-op care, you're in essence doing what you can to foster some sort of patient loyalty." Any business model that can "improve efficiencies in the delivery of care is going to succeed," Dr. Rickard said. In the future, he envi- sions practices vying or bidding for government contracts and inte- grated eye care groups will be better positioned to compete in that sce- nario than a typical co-managed practice. Saying a colleague of his noted optometry "is no longer just on the menu, we're on the table," Dr. Maino said, "our associations have spoken to lawmakers. Because op- tometry has taken such an approach to our involvement of healthcare at state and national levels, I hope our ophthalmic colleagues will realize working together is the only way to achieve good patient care." He firmly believes that if the two professions do not work to- gether to provide patient care, "law- makers will gobble us up. They'll dictate to us what system they want for eye care delivery and they'll de- termine who's the least expensive to provide it." Dr. Jackson agreed, "To be true partners with ophthalmologists is the ultimate. That being said, a lot of optometrists and ophthalmolo- gists go into practice because of the autonomy. You will give up some of that when you join an integrated practice. One of the beauties of our profession is that it's so broad and there are so many options available to us, we do have the best of all worlds." EW Editor's note: No one had a financial interest to disclose aside from a vested interest in his practice. Contact information: Fu: (978) 537-3900; michael.fu@dambro- sioeyecare.com Jackson: (303) 665-7577; jimmy@insight- lasik.com Maino: (312) 949-7280; dmaino@ico.edu Rickard: (814) 849-8344; gsr849@aol.com www.ASOA.org I trust my business to ASOA. In today's economic climate... The Physician's PERSPECTIVE day o In t onomic clima c s e 's e day ... e t onomic clima

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