Practice pulse TIPS, TRENDS & NEWS YOU CAN USE

SURVEY REVEALS PATIENTS ARE HAPPY WITH OPTOMETRIC PRACTICES

Optometry Makes Top 10 List for Patient Satisfaction

■ A survey of more than 3.1 million patients in 2010 reveals that optometric practices rank #5 for patient satisfaction with a rating of 91.81 out of a 100-point scale. The rankings were based on the evaluation of 99 different medical practice specialties.

“It's clear that medical practices are working hard to improve the patient experience,” says Patty Riskind, senior vice president of medical services at Press Ganey Associates, Inc., the company that conducted the survey. “With the recent launch of the Physician Compare website (www.medicare.gov/find-a-doctor/provider-search.aspx) and the likelihood that patient satisfaction will become part of public reporting and future pay-for-performance programs, we've been pleased to see that our medical practice clients who have started measuring the patient experience are already making significant improvements.”

The top 10 consists of Medical Oncology (92.76), Gynecological Oncology (92.39), Interventional Cardiology (92.01), Cardiovascular Disease (91.99), Optometry (91.81), Hematology (91.77), Geriatric Internal Medicine (91.37), Gynecology (91.32) Nephrology (91.29) and Family Medicine (90.76).

“It is great to see optometry in the top 10 list of medical specialties for patient satisfaction,” says Neil Gailmard, O.D., who practices in Munster, Ind. and writes OM's Practice Management Tip of the Week. “In order to make the list again next year, I recommend that optometrists (1) tell patients in advance about fees, payments and insurance, (2) have a great record for punctuality for appointments and (3) offer convenient office hours, including evenings and Saturdays.”

Press Ganey (www.pressganey.com) is a South Bend, Ind. company that specializes in healthcare performance improvement. It works with U.S. healthcare organizations to improve clinical and business results.

DRUG COMPANY MAINTAINS ITS FDA-APPROVED DRUG IS BETTER THAN ITS OFF-LABEL DRUG

Study Concludes Avastin is as Effective as Lucentis in Treating AMD

■ On the heels of the first-year results of the Comparison of AMD Treatments Trial (CATT), which revealed Bevacizumab (Avastin, Genentech), a cancer drug used off-label to treat AMD, appears just as effective as ranibizumab (Lucentis, Genentech) an FDA-approved AMD drug, Genentech maintains that Lucentis is better than Avastin for the treatment of AMD.

“Avastin and Lucentis are different medicines. We specifically designed Lucentis to be cleared more quickly from the bloodstream to minimize side effects,” says a statement from Genentech. “The data reported by [the study] state that ‘the rate of serious adverse events, primarily hospitalizations, was higher among bevacizumab-treated patients than among ranibizumab-treated patients.’ These findings from CATT add to an emerging body of evidence from much larger analyses that suggest the risk of systemic adverse events may be higher when injecting Avastin into a person's eye compared to Lucentis.”

Genentech adds that the CATT trial also showed Lucentis was statistically superior to Avastin in removing the fluid from the eye that can cause vision loss.

Meanwhile, Philip J. Rosenfeld, M.D., Ph.D., professor of ophthalmology and retina specialist at Bascom Palmer Eye Institute, whose research on the two drugs played a catalytic role in CATT, has said that it's “reassuring to learn that both drugs are equally effective, and Avastin can serve as a low-cost alternative to Lucentis.”

The CATT study is a two-year, federally funded multicenter, single-blind, noninferiority trial, in which 1,208 neovascular AMD patients received bevacizumab or ranibizumab injections on a monthly schedule or on an as-needed basis with monthly follow-up.

CALIFORNIA CO-LOCATION PRACTICES BILL IS APPROVED IN COMMITTEE

Healthcare Plan Ownership Bill Clears First Hurdle

■ California Assembly Bill (AB) 778 (Atkins D-San Diego), which would allow an optical company, an optical goods manufacturer or distributor, a registered dispensing optician or a non-optometric corporation to own a healthcare service plan that provides visioncare services, has passed in Committee, enabling it to continue to move up the legislative ladder. AB 778 would also enable the aforementioned parties to share profits with the healthcare service plan, contract for specified business services with the healthcare service plan and jointly advertise visioncare services with the healthcare service plan, while also prohibiting behavior designed to influence or interfere with the medical decisions of an O.D.

According to the California Optometric Association (COA), the sponsor of the legislation is Luxottica, which has been involved in litigation with the State of California over the business model utilized in its subsidiaries: LensCrafters and Pearl Vision. The COA, which opposes the bill in its current form, says the litigation generally revolves around Luxottica and LensCrafters' relationship with optometrists employed by the vision plan EyeMed. (Luxottica also owns EyeMed.)

In 2002, California's Attorney General filed a suit against Pearl Vision alleging the unlicensed practice of optometry, use of deceptive marketing and unfair business practices (see: http://ag.ca.gov/news alerts/print_release.php?id=666.)

“The Attorney General contends, and COA agrees, that the business model utilized violates California statutes that prohibit economic relationships between optometrists and opticians,” the COA released in a statement to OM. “They (Luxottica/LensCrafters) seek to avoid adverse court decisions by utilizing legislation to create an exemption to the statutes in question.”

Although current California law prohibits O.D.s from engaging in business relationships with optical manufacturers or retailers and constitutes such a relationship as a misdemeanor, the current law also permits a healthcare service plan to both hire and contract with licensed professionals and to engage in a business relationship with any entity.

“The ambiguity in the current law has led to years of litigation, and it's really limited and halted the growth of eyecare access in the state,” says Eliot Grossman, O.D., president of EyeExam of California, Inc., a Luxottica-owned licensed vision care service plan that employs optometrists to deliver eyecare. “So, the ambiguity is hurting patient choice and the economy.”

Dr. Grossman noted that Pearle Vision “decided to leave the state completely because of the instability and on-going litigation.”

Dr. Grossman is also a member of The Californians For Healthy Vision coalition, a group comprised of healthcare organizations, such as Aetna, trade groups, such as the National Association of Optometrists and Opticians and the California Retailers Association, and Luxottica-owned optical retailers, such as LensCrafters, who support AB 778.

EHR COURSE INTRODUCED

JCAHPO Offers Staff Training in Electronic Records

■ How do you provide your staff with training on electronic health records (EHR) systems before the system is running live in your practice? The Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO) has developed an answer: the course “Electronic Health Records (EHR) Training.”

Supported in part by an educational grant from Compulink Business Systems, this course, a comprehensive simulation with interactive video screens, addresses four learning objectives:

► the key differences between EHRs and manual paper records;
► the challenges and benefits of using an EHR system;
► the information needed to complete an EHR;
► navigation through a typical EHR system.

The course allows test takers to proceed at their own pace while receiving practice in entering data through an EHR system developed specifically for an ophthalmic practice. The cost of the course is $15 ($10 for JCAHPO members). For more information or to order the course, visit www.actioned.org, or call (800) 284-3937.

Management MEMO

Staff Referrals: An untapped source of new patients

Bob Levoy, O.D., Roslyn, N.Y.

■ In addition to their family members, your staff members likely have a wide circle of friends, new people they meet socially and perhaps a presence on Facebook, Twitter and other social media—all of which offer opportunities to recommend, when appropriate, your practice.

Question: How many new patients have your staff members been directly responsible for bringing into your practice in the last six months? A few? A lot? None? Not sure?

If employees aren't recommending your practice, it may be because they haven't thought about their role in out-of-office public relations or aren't sure what to say. These are easily rectified.

Action steps:

At your next staff meeting, discuss the unique opportunity everyone has to bring new patients into the practice starting with family members and friends. Other potential patients include new people they meet socially, who (learning what they do) have questions or concerns about their eye health, contact lenses, a child's vision, computer-related vision problems, etc.

Role play what to say and how to best say it when dealing with these issues—and recommending your office in a manner that's low-key and professional.

To facilitate referrals in such situations, print business cards for each member of your staff. Include all the usual information (practice name, address phone number and website), and add the staff member's name and title. (Ask if staff members prefer the use of only their first names).

These cards will also be useful if patients need to reach staff members about their bill, insurance, appointment, contact lenses or numerous other matters. This “personalizes” such contacts and further bonds patients to your practice.

Reality check:

Cards of course, are only tools. For your staff to be effective referral sources for your practice, they have to truly like their jobs and be proud of the practice. Also, they must be kept up-to-date on the scope of services and materials in your practice and experience first-hand, your optometric skills, thoroughness and caring ways. Then, they can be genuinely enthusiastic of the practice and you.