Patients depend on us for our expert advice. By working with high-quality sub-specialists, you can be reassured your patients are receiving the best care. At the same time, it is important to know your referrals are going to doctors who believe in cooperative care. As you know, the closest practice may not always be the best, so it is important to direct your patients to the type of provider you would want for your own treatment. Don’t give them a list of specialists, rather, give them the name of who you want them to see. Making a strong recommendation instills in the patient confidence in the procedure and your referral. Patients will go the extra distance when they know that is where you would go, and that the outcomes and service will be the best there is.
Here are four steps that will help you establish a network of specialists for your advanced medical and surgical eye care consults.
IDENTIFY THE BEST SPECIALISTS
Find out from your colleagues, optometry school or local state associations, which reputable surgical practices in your area co-manage with providers. Often, those practices can demonstrate a history of supporting optometry, testifying for optometric scope bills and educating O.D.s with meaningful, and not just marketing, CE. I have found these practices, in general, often use the latest technological advancements to produce superior results in refractive and cataract procedures.
MAKE CONTACT
After you’ve identified the practices that have excellent track records for patient care and surgical outcomes, call the one or more center directors or surgeons to let them know of your interest in working with them. Schedule a meeting, for example, a lunch, a visit from the doctors or a visit by you to the surgeon’s practice. Establishing a rapport with the doctors at the referral center on a personal and professional basis creates a strong foundation for working together to mutually benefit the patient.
OBSERVE
Observing the surgical process in action is important for you to hear and understand nuances (e.g. testing protocols, changes to protocols with certain anatomical issues or medications being used) with the surgery your patient will be undergoing. Scrubbing in for a procedure along with the surgeon is important to evaluate their skills and learn about newer procedures you may be less familiar with. You also get the see the staff and doctors in action, which will be an indicator of how your patients will be treated at this facility.
Finally, ensure you have the resources, such as post-op instruction guidelines, brochures, maps and surgeon bios, that you need. This facilitates the referral process for you and your patients as you get started working with the surgical practice.
Ensure the Success of Your Network
TO MAKE YOUR CO-MANAGEMENT NETWORK SUCCESSFUL, I RECOMMEND THE FOLLOWING, WHICH HAVE BOTH SUSTAINED AND STRENGTHENED MY RELATIONSHIP WITH SURGEONS.
- Keep Communication high. To start, provide pertinent details, such as preferences, like monovision targets and which eye, to the surgeon, so everyone involved is on the same page and there are, therefore, no surprises. Often, you have known the patients for years, so also communicate any nuances, such as patient occupations or hobbies like tae kwon do and current contact lens powers for monovision, that will aid in decision-making for different IOL options or monovision targets.
This is one of the most powerful parts of a co-management relationship. A doctor who has an established relationship can add so much value with input into a surgical consult.
Second, make sure to promptly provide post-operative information to the surgical facility regardless of whether the patient is healing normally or has a post-operative complication. Having information on the first eye can facilitate the planning of the surgery on the fellow eye. (By the way, it’s a two-way street! The operating surgeon and facility should also share promptly any deviations from normal during the surgical portion of the care). - Help the patient succeed. Many times, a key ingredient to the success of the procedure is encouraging the patient along the way. Reassurance is a primary ingredient to how the patient is feeling through the normal and, sometimes, complex processes of healing.
- Have fun, and keep learning. Having been involved with referral centers and the co-management of surgical care my entire career, I have yet to be “bored.” The advancement of existing procedures and the development of new procedures is constant and fascinating! Stay engaged. Attend CE and hands-on courses that give you added information about the procedures. Constantly learning together as co-managing partners is, above all, fun! Don’t forget to enjoy it!
- Bill properly for the care you provide. Co-management involves getting paid for the portion of care you provide, according to Medicare guidelines. The transfer of care occurs back and forth between the surgeon and the co-managing doctor, with both parties participating in patient care.
MAKE THE REFERRAL
Now, you are ready to make the referral(s). Make the appointment for the patient, and be sure you communicate your findings to the practice.
GET GOING
It is a privilege to be a part of an ongoing expansion of more specialized treatments for the refractive, medical and surgical eye care of patients. As new procedures and technologies are developing, I would encourage you to stay involved and excited. The rewards are seen in many ways, not just in the expanded opportunities to provide care, but also in the added trust your patients have in you. OM
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