Getting Comfortable With Medical Eyecare

We sat down with Dr. Scot Morris, OD, FAAO and Patricia Fulmer, OD, FAAO at Vision Expo West 2018 to discuss what it means to be involved in medical eyecare and what you can do to feel comfortable getting started treating ocular disease.

There is often a distinction made between eyecare and medical care, but “everything we do is medical care.” Morris says. “The most common ICD-10 diagnosis that exists…is refractive error.” Ultimately, optometrists and other medical professionals work to solve their patient’s problems, and for ODs wary of “medical” eyecare, that work just involves a different diagnosis and a different treatment.

While new grads may feel daunted when they come face to face with ocular disease in the wild, Morris reaffirms that “new grads are better trained on medical eyecare by the time [they] get out of school than my generation was ten years out!” While there are fears of working with more medically-oriented treatments and diagnoses, they are shared by ODs across the board, and it’s never been a better time to get started.

A common concern among doctors that are not familiar with treating medical cases is the price tag. Building up shining new equipment can be pricey, sure, but if you have a slit lamp, you can start today! If you use the tools at your disposal, you can start making more money, more quickly than you would by performing regular vision exams. For example, a vision appointment may take twenty minutes and you’ll receive a $50 reimbursement. Compare that to an average, ten-minute medical diagnostic exam that will bring in a $75 reimbursement.

The technology that you “need” is secondary. You are more than qualified to start diagnosing and offering treatment solutions to patients with dry eye or allergy issues, and if you truly do not feel you are, take the time to brush up!

Medical optometry has a financial stigma surrounding it. Medical optometry is viewed as being expensive. As we mentioned above, most practices can get started today with the technology they have on hand, but the next step in the cost equation is the patient. When it comes time to discuss prescriptions or treatment options for ocular disease, a barrier is built. You may feel like you’re selling to your patient when you have something with a larger price tag, and you are! But the key to this is understanding why.

If you don’t feel there is a good reason to make a sale, and it feels like a sale for the sake of it, you shouldn’t be selling to that patient. On the other hand, if you’re doing it for the consumer and in the patient’s best interest, then you’re doing it for the right reasons. Most doctors become experts at discussing new glasses technology—discussing $800 frames with $400 lenses—and extending that ability to medical treatment options should be a breeze.

As their doctor, you are providing them a solution to their problem! If your patient sees the treatment option as an extra expense, educate them! If they purchase this $1200+ pair of glasses, but their vision is still fluctuating after every blink, then they’ve not made the right choice. Morris offers a counterexample to this: “Allergan’s True TearsⓇ won’t come close to that [premium price point] in a three year period! They’ll be replacing their premium glasses two or three times before they reach that value paying for True TearsⓇ.”

You are responsible for learning and developing as a healthcare professional, and if you want your practice to develop, you must be learning constantly. Educating yourself will allow you to not only improve your practice and expand your knowledge, but it will also allow you to better serve your patients. Patients are more educated now than they’ve ever been, but their knowledge only goes so far!

While they may be an educated shopper, they aren’t always a properly informed purchaser. It is your job to serve as their consultant, and sometimes you need to advocate for them because of them. If you are able to offer them new options and information, they can then make their own product decisions, and then when they’re ready, they’ll come to you.

“I don’t have an OCT. How can I treat glaucoma?” We worked to treat glaucoma—albeit a little less effectively—for nearly a century before we had OCTs. Even today, owning your own technology isn’t your only option. If you don’t have an OCT on-site, refer your patient to another doctor who might! Establishing a relationship with another practice in the area is a win-win.

They will be able to evaluate, and the patient can return to you for treatment and prescriptions. “You don’t always have to refer to an ophthalmologist. You can work with another OD.” Fulmer says. “Even outside of referrals, you can find things that you don’t love doing. That doctor may have things that they don’t love doing, and you can build that relationship and work with each other.”

You have the knowledge, you have access to the technology (even if it isn’t your own), and now you need the right products to offer your patients, so how do you get them? Meeting with sales reps from various companies can get you set up, but at the end of the day, it will come down to you writing up prescriptions that you know are right for your patients.

While reps can offer you samples to hand out, it’s important to not become dependent on them. If you want a patient to do something, write them a prescription. “If you give something away, it has no value,” Morris adds. Keep your patients compliant with their treatment regimens by prescribing medication that you know they need. Remember, you’re their advocate and the informed party. They will take your advice.

If you still feel unsure about getting started with medical optometry, check out Allergan’s Jumpstart program! It’s designed to keep new grads in the loop about what’s new in medical optometry, and they can provide access to tools, samples, and even mentorship opportunities to help you grow your practice.

No matter how you choose to get started, there will be some mistakes made. Just remember that it’s okay to make them. As a medical professional, you never stop learning, and the more you know, the more you can continue to grow and the more lives you can change.