Fix This Practice
A Look at O.D.-M.D. Relationships
Time has bridged the gap between the two O's. Here's how it can benefit you.

Richard S. Kattouf, O.D.

Q Not too many years ago, O.D.s had employment relationships with M.D.s. Do you see this trend changing?

K. C. Stores, O.D., Via e-mail

A: State laws and regulations have changed, making it legal for both professions to maintain ownership in one practice. Other important factors that led to these current trends are:

Mutual respect. O.D.s have always shown respect for ophthalmology. And in the last 5 years, ophthalmology has opened its C.E. conferences to O.D. faculty.

Realization that the other party isn't the enemy. Both professions have common problems, including the following:

• managed care medical plans
• fixed-fee vision plans
• increased competition.

Optometry's strong position. M.D.s need O.D. referrals more now than ever. A common theme in ophthalmology journals is that in the next 5 to 10 years, only 20% of surgeons will perform 80% of all eye surgeries. This is because of the rapid development of huge surgical centers that network with hundreds of O.D.s. These centers only require a handful of specialists, leaving the independent M.D. short on referrals.

ILLUSTRATION BY GERAD TAYLOR

Co-management. O.D.s who use their TPA licensure to the fullest perform all pre- and post-op procedures. They see patients one day post-op and prescribe all medications. This extensive level of medical service has raised the levels of integrity and competence for optometry in the eyes of M.D.s.

O.D.s hiring M.D.s. Large optometric practices such as the one I have with my son have M.D.s join the practice and pay significant rent.

M.D.s adding optical departments to their practices. M.D.s have little optics background and no retail training. Adding an optical department makes the O.D.-M.D. merger a more attractive option.

Meeting on common ground

These trends have affected the atmosphere between the two professions, and both sides can see the benefits everywhere.

These trends are even obvious in the consulting business. When I created my first consulting company 20 years ago, my thoughts were with O.D.s. At that time, ophthalmology practices were so financially heavy that M.D.s weren't interested in consulting services.

But 10 years ago, when Medicare started cutting M.D.s' fees, many M.D.s requested management and consulting services. This new trend led me to develop a new company geared toward the needs of M.D.s. Now my clients are split 50% O.D. and 50% M.D., reflecting a changed climate and a mutual respect between the professions.

Bountiful benefits

This is a tremendous opportunity. Here's what you might gain if you take advantage of these trends:

• "Real doctor" respect from your patients and your community.
• Greater financial rewards. (Higher net income.)
• Increased equity position.
• Protection from burnout in a fixed-fee marketplace.

Use your referrals to make mutually beneficial relationships with your M.D. counterparts.

DR. KATTOUF IS IN PRIVATE PRACTICE IN WARREN, OHIO, AND HE'S PRESIDENT AND FOUNDER OF TWO MANAGEMENT AND CONSULTING COMPANIES. FOR INFORMATION, CALL (800) 745-EYES OR E-MAIL HIM AT ADVANCEDEYECARE@HOTMAIL.COM.  THE INFORMATION IN THIS COLUMN IS BASED ON ACTUAL CONSULTING CASE FILES.