ODs at ASCRS, take two

A few days ago, I returned from Boston where I attended the IOMED program at the 40^th annual American Society of Cataract and Refractive Surgery (ASCRS) meeting. Before I began writing this editorial, I reread what I had written after last year’s meeting (“Optometry at the ASCRS meeting,” May 2013). I had closed with, “I hope next year’s meeting builds on what took place in San Francisco, with a big emphasis on partnering, not employing.”

I am happy to report that I did hear more about partnering than employing. In fact, several MDs had questions about partnering after the ASCRS/ASOA joint panel discussion, “The Integrated Eyecare Model: Should I or Shouldn’t I?” But I’m getting ahead of myself.

As a reminder, the IOMED program consists of a half-day symposium planned by the ASCRS IOMED committee, plus additional specific ASCRS courses selected for COPE approval. 

By a show of hands, it appeared that this year’s symposium attracted more ODs than last year. And just like last year, more MDs walked in to hear the practice management session. However, I felt a noticeable lack of buzz this time around. The room didn’t feel as filled with energy. It felt flat. The speakers were great, the content shared was informative, but the dynamic in the room felt different.

By contrast, the “Should I or Shouldn’t I” panel discussion I mentioned did feel energetic, vital, and dynamic. The panel included 8 participants: 4 practice administrators, 3 MDs, and, interestingly, only 1 OD; and the majority of attendees were MDs. Each panelist gave short presentation, then the floor was opened for questions.

In a session geared to promote cooperation between ODs and MDs, D. Brian Kim, MD, was a strong voice urging ophthalmology to partner with optometry.

Following are verbatim comments Dr. Kim made during his talk, and I think they’re worth sharing.

• Most ODs are not trying to replace us-a small subset has a large megaphone.

• There is a right way and a wrong way to comanage.

• Staff needs to buy in. It's a top-down approach. Everyone needs to create a buy-in environment in which the OD feels loved, valued, and respected so he can do what he does best.

• ODs are an important part of the eyecare team. There are no egos when it comes to caring for people’s health. When egos do take a primary role, bad things happen to patients. 

IOMED Committee member Derek Cunningham, OD, FAAO, represented optometry on the panel. He was last to present, and he immediately put attendees at ease by opening with a few funny comments. He also pointed out that an OD organization has never petitioned for OR surgical rights. He shared three concerns ODs have when working with MDs in an integrated model: limited autonomy, limitations for advancement or partnership, and financial limitations. The lifespan of an OD in an MD office can be 5 years before something needs to change, he said, such as a partnership offer or the OD leaving. He noted that surgeons are seen as OD friendly if they have an OD in their practices.

Following the panel discussion, a line formed at the mike for questions. I was pleased to see not only interactivity in the session but that MDs were interested enough to ask questions and learn more. Questions surrounded how to find an OD in areas without optometry schools; how to create partnership opportunities for ODs; how to work with ODs within the practice, including division of duties and using techs and scribes. The energy in the room changed when one attendee shared, quite vehemently, her feelings about a recent Nebraska law (see “AZ, NE, TN see legislative changes,” on the cover). Dr. Cunningham suggested that the session wasn’t the place for such a discussion, and the last attendee up at the mike brought us full circle with his comment, “We have more in common than differences, and the real enemy is the insurance companies.”

I was disheartened to hear the term “super tech” mentioned several times as a possible description for optometrists. Although panelist Thomas Harvey, MD, pointed out that using an OD as a super tech is an expensive entity, we have some work to do in order to disassociate that term from optometry.

Next year, the IOMED Committee needs to bring something new to the table to recapture that dynamic vibe once again in the general session.ODT