allergy

The Key to Medical Team Membership: Ocular Allergy

By showing consumers and non-eyecare practitioners you can treat ocular allergy, you'll become an official member of the medical team.

STEVEN J. GRADOWSKI, O.D., F.A.A.O., Omaha, Neb.

Ask any non-eyecare health provider whether an optometrist can prescribe medications, and more times than not, they'll answer: "Optometrists only prescribe glasses and contact lenses." It is this very prevalent misconception that has resulted in a lack of referrals for O.D.s from other healthcare providers for medical eye care, such as glaucoma evaluations and treatment.

So, how do we dispel this misconception? The answer is by showing other healthcare providers that we have the ability to treat ocular allergy. After all, once we show them we have the expertise to treat this medical eye problem, they're likely to refer their patients to us for other medical eye conditions. Many of you are no doubt wondering: "Why show them we can treat ocular allergy, as opposed to another medical eye condition?" The answer: Every medical specialty is likely to have patients who have allergic rhinitis — a condition strongly associated with ocular allergies. In fact, allergic rhinitis is estimated to affect approximately 60 million people in the United States, and its prevalence is increasing, according to the American Academy of Allergy, Asthma & Immunology. As a result, it makes perfect sense to use ocular allergy as a means of becoming part of the medical team.

Here, I explain how you can garner ocular allergy patients from other healthcare professionals and as a result, grow the medical side of your practice.

Treat patients

The first step to garnering medical eyecare referrals from other healthcare professionals, such as primary-care physicians (PCPs) and pediatricians, is to treat patients for ocular allergy and then notify their other healthcare providers that you've treated the patient. In other words, you want to use the patient encounter to show their PCP, for instance, that you have the expertise to both diagnose and treat ocular allergy.

I fax a simple one-page report to my patients' other healthcare providers (see "Report of Ocular Health Examination," below.) The doctors to whom I've sent this report have not only thanked me for keeping them in the loop regarding their patient's care, but have also told me they've appreciated not having to pour over a lengthy report or return a phone call. I'm happy to say that, in many cases, establishing this type of communication has indeed blossomed into referrals for not only other suspected ocular allergy patients, but also other ocular conditions, such as age-related macular degeneration and glaucoma, among others.

To treat patients, however, you must first educate them about the signs and symptoms of ocular allergy and that ocular allergy is one of the services you provide. You can do this by including allergy-related literature and posters in both your reception room and exam rooms, adding a question in your patient history form regarding whether the patient experiences the symptoms of ocular allergy (e.g. itchy, watery, burning eyes) and when, and by using electronic communication.

Electronic communication is a must for the progressive optometric practice, as this is how consumers now obtain and send information. I suggest you update your home pages in the spring and fall to promote your ability to treat ocular allergy. Adding links to specific issues, such as allergic conjunctivitis, leads patients right to your front door. In fact, don't be surprised if patients present with a print-out of one or more of the links you posted.

Although a practice website was once considered the be all and end all of an electronic presence, this is no longer the case, as several social media platforms, such as Facebook, MySpace and Twitter have popped up. In fact, I'm currently in the process of asking many of my "younger" staff members to research getting our practice on Facebook and Twitter as yet another means of educating both current and perspective patients on the services my practice offers.

Meet and greet other docs

Another effective way of culling referrals from other healthcare professionals regarding ocular allergy is the "meet and greet" approach. To do this, first make a list of other healthcare professionals within your area by typing healthcare specialties, such as "pediatrician," on the Internet as well as the name of the town in which you practice. Next, choose days in which to either call to set up a meeting with this healthcare provider, or personally stop by to say hello and leave your business card or your personal practice brochure, which outlines your ability to treat ocular allergy, among other eye conditions.

In doing this myself, I've found that this step has led to very strong referral networks. For instance, I recently introduced myself to the doctors at a large cosmetic surgery practice near my own practice. As a result, they've been referring dermatochalasis patients for visual fields testing. In fact, we now receive all their pre-op blepharoplasty patients to determine whether their condition has a visual component.

It may seem time consuming to make these one-on-one encounters, but the extra effort and personal contacts definitely pay dividends in the future.

Additionally, having the unique opportunity with three of my optometric colleagues to have a hospital-based satellite practice, I've had to continually educate the medical community we interact with of our skills and abilities to diagnose and treat a vast array of ocular conditions. Putting it simply, they just don't know. Once we establish our role in the care of in-patient or referred ocular conditions, however, it becomes much easier to work side by side with other providers in many medical specialties.

Although our scope of practice far exceeds the prescribing of spectacles, I've found that most non-eyecare health providers remain unaware of this fact, particularly of our ability to prescribe drugs. This has resulted in a lack of referrals from these colleagues for medical eye care. To change this mind-set, and, therefore garner these referrals and become a part of the medical team, ocular allergy — given it's prevalence — is the perfect condition to acquire your medical team jersey. OM

Dr. Gradowski is part of a private practice in Omaha and clinical instructor in the Department of Surgery at Creighton University School of Medicine in Omaha. Also, he's a privileged staff member at Creighton University Medical Center, where he's part of a hospital-based practice. E-mail him at sjgod@eyecarewest.com.