The Independent Advantage S01 E05: Comanagement as a two-way street

In the last episode of Season 1 of The Independent Advantage, the conversation between Diana Canto-Sims, OD, and Giannie Castellanos, OD, centers on how optometrists and ophthalmologists can build stronger, more collaborative relationships to improve patient care, with a special focus on referrals, communication, and shared responsibility.

Canto-Sims asked Castellanos what they are doing next to strengthen relationships with ophthalmologists. Castellanos explained that, thanks to strong networking and an established patient base, they have arranged for an ophthalmologist to come in-house to perform cataract surgeries. This arrangement offers patients convenience and continuity because care happens in a familiar setting and within a trusted practice.

From there, the discussion zoomed out to the broader profession. Castellanos emphasized that optometrists need to rethink what’s possible: with the right relationships, “the sky’s the limit.” She described various models where ophthalmologists use optometry offices for medical care on days when they are not in their own practices. This approach leverages the optometrist’s existing patient base and infrastructure, making care more accessible and efficient.

A major theme is the responsibility of optometrists to educate patients. Castellanos stressed that ODs are often the first point of contact, so they should have a powerful impact on guiding patients—both in choosing surgeons and in understanding why regular eye exams matter. She argued that the profession often falls short in marketing and patient education about the value of seeing an optometrist.

The conversation then shifts to relationships with primary care physicians (PCPs) and pediatricians. Canto-Sims shared a frustrating experience of outreach that yielded little response. Castellanos countered that persistence and consistency are crucial: relationships can stall for many reasons (staff changes, vacations, bad timing), and ODs must stay top-of-mind with both clinicians and their staff. Small gestures—even something as simple as bringing pastries—can help people remember you.

In the final segment, both speakers get very practical. For optometrists, Castellanos recommended calling ophthalmologists, requesting their business cards, and actively circulating them, then monitoring whether new referrals result. For ophthalmologists, she suggests placing optometrists’ cards at the front desk, committing to referring at least one patient per week back to an OD, and improving responsiveness—returning medical records quickly, ensuring phone access for urgent cases, and calling optometrists to say “thank you” for shared patient care.

Canto-Sims closes by framing this as a nationwide coordination problem. Both ODs and MDs share responsibility to improve systems, communication, and mutual support. Stronger, reciprocal partnerships ultimately raise the standard of care for patients who trust both professions with their vision.