THE CARROT OR THE STICK?

DRY EYE disease diagnosis and management is unique in eye care because it presents an opportunity to build a practice or, if overlooked, increase the risk of a practice floundering.

Here I discuss the carrot (reward) and stick (punishment) associated with DED.

THE CARROT

Often, practice management consultants tout the potential gains of addressing DED in optometric offices. For example, elective DED treatments, such as intense pulsed light, were once housed almost exclusively in “dry eye centers of excellence.” Today, however, these treatments are available in several practices.

Research supports the potential benefit of these treatments for DED patients. In addition, as they’re elective procedures, patients don’t have to jump through the hoops often inflicted by managed care to receive these treatments. And, for our part, as doctors, we don’t need to worry about timely reimbursements.

Something else to consider: With proper patient selection and presentation, most practices have a wide patient base to treat.

In addition, a practice’s embrace of DED management can lead to greater patient satisfaction and, thus, practice annuity. That annuity can be more far reaching than anticipated too, when considering that the typical demographic of a DED patient is a middle-aged woman — likely to be the medical decision maker of her immediate and extended-family.

THE STICK

Turning a blind eye to DED can be a costly mistake beyond the fact that patients may seek another healthcare provider:

• Unnecessary spectacle remakes. A total of 15% of all spectacle lens orders require remakes. Certainly, well-managed opticals may be as low as 5%, but could those numbers be driven lower still? Yes! And the reason is that many of these patients continue to experience blur because they have undiagnosed DED, which causes an unstable tear film and, thus, blur. Make a point of assessing these patients for the chronic condition, treat them, and they can achieve satisfaction with their spectacles, while you can decrease your spectacle remakes.
• Dissatisfaction with contact lenses. More than 30 million Americans wear contact lenses, and 2/3 of those wearers are female, reports the CDC. Among contact lenses wearers, 50% range between the ages of 25-44, but only 25% are age 45 or older. The dropout rate has been consistently 15% to 17% for more than a decade, even with advances in technology and materials. Considering the demographic overlap of patients who leave contact lens wear and those most vulnerable to DED, is the dropout rate influenced by the symptoms of DED? I would argue, yes. Thus, these patients should be assessed for DED as well.

ENJOY THE CARROT

If a practice wants to satisfy patients and reap personal satisfaction and financial rewards, treating DED is a must. It’s always better to enjoy the carrot and steer clear of the stick. OM

DR. HAUSER provides clinical care for patients at TearWell: Advance Dry Eye Treatment Center and the Advanced Care and The Eye Center at Southern College of Optometry. She is a consultant, speaker or board member for: Akorn, Alcon, Allergan, BioTeck, BioTissue, Lumenis, NovaBay, Paragon Vision Sciences, Rysurg, TearLab, TearScience, Shire, Science Based Health and DryEyeCoach.com .