Optometry: The invisible profession

Key Points

We are, in fact, eye physicians and have earned the right to call ourselves doctors and treat our patients with all the skills that we have at our disposal. Many forward-thinking men and women fought political and educational battles for years to provide our profession with the title doctor of optometry.

This dichotomy in perception versus reality needn't exist at all if we act the role that we are trained for: helping our patients. Optometrists are the best-equipped professionals to diagnose and treat all eye-related conditions. When a patient is seen in your office, that patient is there for a comprehensive evaluation of his or her visual system. Although the patient may be on your schedule for an annual eye exam-or triennial, as is most likely the case-he or she wants you to evaluate and diagnose. We are great refractionists. We are great retailers. We need to be great diagnosticians.

First and foremost, all ODs should belong to medical management plans. As altruistic as we can be, the notion of doing our job gratis is not a noble one. Patients who have vision service-related insurance plans also are on a medical insurance plan. When we are faced with deciding on billing our patients' medical insurance for a medically necessary diagnosis, however, too often we provide those services under the vision plan. This approach only serves to undermine the treatment that we provide. Moreover, we are diluting the medical billing abilities that we should share with other physicians. Admittedly, we are not great at working with third-party insurers, so we should outsource billing to specialized service providers.

Once you have joined plans and have a billing service to help you with coding and accreditation, you need to talk with your patients about common symptoms, describing impending medical situations (such as cataracts, family histories of disease, diabetes, etc.). Routinely following up with your patients will help to solidify this medical-minded mentality in their minds.

The entire office needs to "walk the walk and talk the talk." Routinely following your patients' progress and appropriately billing their medical insurance plans are in your patients' best interest. Treating dry eye or following a cataract should hold the same importance as glaucoma. You would not diagnose glaucoma and then tell the patient, "I will see you next year." The same diligence that we give with conditions such as glaucoma should be applied to all of your diagnoses. The same level of gratification we achieve after a patient can see 20/15 with a new prescription is possible with treating an eye condition.

Further, with any medical condition, it is important to follow your patient to the resolution of his or her condition. Because not all of our treatment recommendations are effective, we need to alter or adjust the treatment as deemed necessary. How are you going to know that if you don't insist on seeing the patient for a follow-up visit?

Advertising that you treat common eye-related conditions-such as dry eye or conjunctivitis-and that you co-manage cataracts and refractive surgery, and welcoming ocular emergencies are other ways to make sure the public knows that you are an eye doctor. Ensuring that your patients can reach you off hours or guiding them to a colleague will further reinforce with them your desire to be their eye doctor, not just the person who prescribes their contact lenses.

Every day that we go into the office, we witness firsthand the advancements that our profession has worked hard to achieve. It appears, however, that the public has not been as quick to recognize those changes.

Whenever we refer a patient with a common eye-related condition to another physician, we muddy the waters. Each time we let the pharmacist make treatment recommendations, we dilute the reality.

The take on our profession should be that optometrists are the first eye doctor a patient should see for all ocular conditions and the last doctor they ever need to see.

Every day, we can work to make that vision a reality.

Marc R. Bloomenstein, OD, FAAO, is director of optometric services, Schwartz Laser Eye Center, Scottsdale, AZ. He may be contacted at 480/483-3937 or drbloomenstein@schwartzlaser.com
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