New York City—The medical model can help make your practice more profitable and serve your patients better—a few changes to the way you practice can make a big difference, says Scot Morris, OD, FAAO, during a session at Vision Expo East.
“When I say, ‘building the medical model,’ it’s a little tongue in cheek because, really, is there any other way to practice?” says Dr. Morris. He says that the most common diseases ODs see in their practices are myopia, astigmatism, presbyopia, hyperopia, and dry eye. (Yes, he says, those are diseases—if there’s an ICD-10 code for it, it’s a disease.)
“You see them, you listen, you test, you diagnose, you treat—you guys are all medical experts,” he says. “You already do that every day, it’s just going to be a different diagnostic code.”
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Why would an optometrist shy away from the medical model? Dr. Morris says it sometimes comes down to fear—of change, of the legal ramifications, or of managed care participation. Or it could be the cost of time and labor or the investment in technology. Sometimes it comes down to lack of training or education or intimidation with medical billing and coding. Then there are the ODs who feel like they’re busy enough and don’t need to take on medical.
Once you decide to embrace the medical model, there may be some changes you and your staff need to make in order to operate efficiently and provide the best care for your patients.
Developing your staff
Your staff is your biggest asset, and in order to be successful with the medical model, you’ll need to work as a team.
Dr. Morris asked if ODs really know what goes on in their offices. For example, he asked, how would your staff answer the phone at your practice? Communication between you, your staff, and your patients is a big factor for medical model success.
In your own practice, do you and your staff know:
• Who says what?
• What do they say?
• To whom are they saying it?
• When do they say it?
• How do they say it?
Take the time to educate your staff on various disease states and their treatments. Dr. Morris recommends holding a five-minute staff meeting every day to educate your staff. In one session, teach them the signs and symptoms of ocular allergies. Next session, tackle any testing you perform during your exam. Then, talk about the treatments you prescribe. These brief sessions will help your staff retain more information than trying to teach at once them everything there is to know about ocular disease.
“Then, by the end of the week, you’ll be amazed at how many of your patients suddenly have allergies,” says Dr. Morris.
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Then, work together with your staff to develop scripts for what staffers should say to patients about various diseases—dry eye, allergies, etc. Write down the script and practice it as a team through roleplaying exercises. Refine the message until everyone is one the same page. (This goes for you, too—are you communicating with your staff and patients in the best way?)
“You can delegate to staff only if you motivate staff,” says Dr. Morris.
Preparing for copay concerns
One of the bigger concerns raised by ODs about embracing the medical model was how to get patients on board with paying for services not covered by their insurance.
It’s not unusual to hear, “I came in for a regular exam, and now there’s something I need to use my medical insurance for and I have to pay a copay?”
“And these days, it’s not just a copay, patients also haven’t met their deductible,” says Dr. Morris. “The average deductible in the United States is around $7,000, so we are really telling them they have to pay in cash. By the way, what’s your favorite form of payment? Cash.”
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Because of that high deductible, the patient would likely pay out of pocket no matter where he chose to receive his care. And he might as well get his care from you because you’re the best, right?
“People are willing to pay you cash if you provide a valuable service that’s better than everybody else—if you’re not better than everybody else, they’re going to want to go somewhere where the insurance pays,” says Dr. Morris.
If you have a patient who gets to the front desk after an exam only to have your staff discover that the patient cannot pay, then something has gone wrong in your practice’s process.
“This is a process problem. Why did the patients get past your front desk if he didn’t have a form of payment with him?” says Dr. Morris. “Think about it—when you go into a general practitioner’s office, what’s the first thing you are asked? Form of identification and a credit card to pay your copay. It is your responsibility 100 percent of the time—legally and ethically—to collect the copay.”