amd

speciality eye care

Create a Center for the Prevention of AMD

How to make AMD risk prevention part of your practice.

STEVEN F. SOPHER, O.D., PARKVILLE, MD.

Americans fear vision loss more than they fear cancer, HIV/AIDS, stroke, heart disease, diabetes and other serious health problems, says an American Foundation for the Blind national opinion poll. This is especially important, as baby boomers approach the age group in which vision problems, including AMD, are more common.

Because AMD is so devastating and has impacted so many of my patients, I wanted to be proactive in reducing the risk for developing this potentially blinding disease. So in January of 2009, I opened the Macular Degeneration Risk Prevention Center as part of my optometric practice.

Here, I discuss the steps I took to accomplish this.

1 I DESIGNED MANAGEMENT PLANS BASED ON RISK FACTORS.

While risk factors, such as age and gender, are not modifiable, other risk factors for this disease are.

Here’s a look at my management protocols for the modifiable risk factors:

▸ Supplementation. We acquire a macular pigment optical density (MPOD) level of all patients older than age 21. If their pigment level is low, we prescribe supplementation in order to re-establish a healthy MPOD layer. (We provide this supplement at my practice, should patients be interested in purchasing it.) Once this is achieved, we may modify a patient’s dosing based on existing risk factors.

▸ Blue light-filtering lenses. When patients present to our dispensary, my optical staff briefly discuss the importance of sunwear and, specifically, the benefits of blue light-filtering lenses. They say: “These lenses reduce the harmful effects of high-energy visible light and blue light absorption, both indoors and outdoors. This light has been shown to be a risk factor for developing AMD.”

▸ Healthy diet. Many AMD risk factors, including obesity, high cholesterol, hypertension and cardiovascular disease, can be managed by maintaining a healthy diet of green vegetables and omega 3 fatty acids. I’m not a nutritionist, so I don’t get too heavy into the science behind omega 3s. But we certainly do prescribe omega 3 fatty acid supplements, which we have in our office, and explain to patients that these supplements can facilitate the absorption of carotenoids and macular supplements into the blood stream.

▸ Smoking. When a patient divulges on their patient history form that he/she smokes cigarettes, I inform these patients of the risks of smoking and, specifically, the effect it can have on AMD. We also monitor the patient’s smoking habits, and update his/her smoking history on follow-up examinations.

2 I TRAINED MY STAFF.

In order for staff to thoroughly understand the science behind MPOD measurements and supplementation, I made sure they were fully educated on the anatomy and pathophysiology of how AMD occurs. One way I’ve done this is by having my staff watch educational videos to better understand AMD.

In terms of communication with patients, I have made sure my staff can answer basic questions about AMD as well as explain what we’re doing during their exam and how we’re hoping to reduce their AMD risk. This is important because if I’m not present to perform a test when patients return for followup visits, my staff can explain MPOD numbers, how they’ve improved and when the patient should return for a follow-up visit.

3 I MARKETED THE CENTER.

Risk reduction should be established to brand your practice as one specializing in preventative eye care to differentiate you from your competition.

The process should start with e-mails to patients. For my new patients, these e-mails provide a basic understanding of the AMD testing, supplementation and follow-up care we provide. We send e-mails to existing patients as well reminding them of our preventative services.

Radio and television advertising is another key aspect in a solid marketing plan. We’ve partnered with a local radio station that has played testimonials for our practice, and I’ve also gone to the studio and recorded radio spots that address AMD. In addition, we’ve partnered with a video company to create and produce 30-second cable TV commercials.

Also, utilize your social media pages. We update our Facebook page on a regular basis with information on supplementation, blue filtering lenses, genetic testing, etc.

In addition, go into your community to expand your patient base. For instance, we reached out to companies in which people work from computers and experience fluorescent lighting throughout the day. We contacted their HR departments and discussed how our practice screens and manages AMD and its association with the work environment.

Benefits to the patient and practice

In today’s economic environment, most procedures and services we provide are insurance-based, and, more often than not, our reimbursements are being reduced. Establishing the Macular Degeneration Risk Prevention Center has afforded me the opportunity to create a residual income model that is independent from insurance reimbursement. Managing the risk factors of AMD turns patients into annuities as you monitor their status. For example, a hypertensive patient should visit the practice three to four times a year.

Each “at risk” patient represents approximately $320 in annual non-insurance based gross revenue to my practice. This represents four bottles of macular supplementation at $80 per bottle. In four years, we have added a brand new income segment to the practice. In 2013, we project that sales from the supplements we offer will exceed $270,000 as we prescribe about 250 bottles of supplementation per month. In addition, there has been significant revenue created at point of sale in the optical from blue-filtering lenses.

By finding ways to modify risk, we are potentially preventing the development of a devastating disease that is rapidly reaching epidemic proportions. Patients are very impressed with our approach to reducing risk for developing AMD. Our patient compliance in the program is very high, and many of these patients have referred family members and friends to the Center.

Screening thousands of patients and restoring them to healthy levels of MPOD has been one of the most rewarding experiences of my professional career. OM

Dr. Sopher opened The Macular Degeneration Risk Prevention Center as part of Lens ‘n Eye in 2009. He also started PreventingAMD.com, an AMD consulting company. E-mail him at drsopher@lensneye.com, or send comments to optometricmanage ment@gmail.com.