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I just returned from spending some time at the American Society of Cataract and Refractive Surgery (ASCRS) Integrated Ophthalmic Managed Eyecare Delivery Model (IOMED) symposium in San Francisco. Whew, that’s a mouthful.
I saw a room full of ODs and MDs learning side by side. I saw several sessions featuring both ODs and MDs on panels. In fact, ODs moderated the panel sessions!
The practice management strategies session was quite interesting to hear. A show of hands indicated that mainly MDs were in the audience during this session. In addition to other presenters on the panel, two MDs shared how their practices were set up to include optometrists in the patient-care delivery system. Plus, one MD noted that the optometrists in his practice were partners in the practice, not just employees. I’d like to see more discussion around how to partner with optometrists instead of how to employ them.
The final panel discussion in the half-day symposium exemplified the driving force behind this meeting. Titled “Challenging Cases in an Integrated Eyecare Setting: How We Manage Them,” this panel featured Howard Fine, MD, and Derek Cunningham, OD, as moderators. On the panel were Jeff Azus, OD; Stephen Lane, MD; and Walt Whitley, OD. Dr. Cunningham presented a small summary of each case, and Drs. Whitley and Azus discussed how they would manage these patients. Drs. Fine and Lane chimed in with their impressions.
At the start of the session, Dr. Fine said, “I have never worked in an integrated setting, but I am 100% convinced that this is going to be the future.” At times he didn’t appear quite so convinced as he grilled the ODs on the panel about their experience and knowledge, stating that the MDs in the audience needed to believe in the ODs working with them.
However, the interaction among Drs. Azus, Fine, Lane, and Whitley showed eye care at its finest by discussing what was best for the patient in question, how to more efficiently utilize ophthalmology and optometry in a combined setting, and ultimately make sound clinical decisions.
By contrast, Bithika Kheterpal, MD, appeared to be more interested in ensuring that any optometrist she works with follows prescribed triage guidelines. Don’t get me wrong, knowing when to punt is important for any optometrist, regardless of practice setting. But claiming that quality of care is dependent on MD presence (“The more available the ophthalmologist, the higher the quality of care”) may not smooth the path to integrated patient care.
This meeting was a good first step on the road to better collaboration between optometry and ophthalmology. I hope next year’s meeting builds on what took place in San Francisco, with a big emphasis on partnering, not employing.ODT