Read more from the Q&A issue

• Methodology: Keep the questions coming
• How can optometrists efficiently schedule ocular disease patients in light of the COVID-19 pandemic?
• How can optometrists create a successful dry eye disease spa?
• How can an optometrist include the patient’s opinion when it comes to glaucoma treatment?
• How can O.D.s differentiate the neovascular form of AMD from similar diseases?
• What should optometrists know about effective management of myopia?
• What is the value optometrists can provide and communicate for the fee charged?
• How can optometrists set up an appropriate fee schedule for specialty contact lenses?
• How can O.D.s get more engaged in luxury frame sales?
• How can optometrists get more new patients?
• How can an optometrist create a successful practice sans third party health plans?

A: As is the case with many circumstances in life, obtaining diabetic patient referrals from primary care physicians (PCPs) is all about building relationships and communicating well.

Here are some specific steps I’ve taken over the years that have served our clinic well to achieve this:

SET UP A PCP VISIT

As simple as it is, I would encourage doctors of optometry to visit with the PCPs in their area to ask them what they want communicated from diabetic eye exams. I’ve done so over the years, most recently with an internal medicine physician in our area, and his take mirrored that of others I’ve discussed it with:

Being a straight-to-the-point kind of person, he desires a quick, easy to read document that indicates the patient had their dilated eye exam, what date it was performed and whether retinopathy was present. This PCP knew who I was because of the reports our office had already sent and gratefully acknowledged the critical role that doctors of optometry play in educating patients about the importance of medication compliance, follow-up appointment adherence with their health care providers and maintenance of their prescribed diet and exercise regimens to control blood glucose.

However, some PCPs (or their patient services coordinator) may desire additional information about mutual diabetic patients. Thus an in-person visit, or at least a personal phone call, by the O.D. to introduce themselves and inquire about the feedback desired reinforces a genuine commitment to the patient’s overall well-being, as well as to meeting the PCP’s needs, which often leads to additional patient referrals of all kinds. It also never hurts to send the PCP's office a holiday gift basket or two in thanks!

Doing so can foster a thriving referral network.

PHONE THE PCP

When an urgent or emergent referral to another doctor is indicated, imaging studies need to be ordered, or lab work needs to be obtained for conditions such as such as diabetes, I’ve found that it’s always best to call the other practitioner and not rely on written communications alone. Calling and then following up with a written report (explained next) for the PCP to include in the patient’s record further cultivates a relationship of trust and communication, leading to future referrals.

DIAGNOSTIC TECHNOLOGIES

Respondents to OM’s Q&A Survey indicate the use of the following diagnostic technologies when examining diabetic patients.

(Respondents were able to provide multiple answers.)

 

 

CREATE A DIABETIC EYE EXAM REPORT

When a patient who has diabetes presents to our practice, our staff place our diabetic eye exam report form on the chart and complete as much of the report as possible prior to the patient being seen. Information on our diabetic eye exam report form includes:

• The PCP’s name/address/fax number
• The patient’s name, date of birth, date of their dilated diabetic eye exam and their last reported blood glucose or hemoglobin A1c.
• A check box indicating the presence of diabetic retinopathy (and whether treatment is needed)
• Any additional ocular pathology the PCP should know about
• When we will see the patient again
• The doctor of optometry’s signature and contact information

IMPRESS WITH IMAGES

When I did my fourth-year student externships at West Tennessee Eye in Memphis, the doctors there included color retinal photos of their patients with their diabetic reports to PCPs. Back then, I thought that was overkill. But then I saw how many of those PCPs referred new patients to the practice for diabetic eye exams and much more. Today, it’s easier than ever (and much less costly) to share color fundus photos and/or OCT images via the patient’s EHR using secure messaging. Having sent diabetic eye exam reports religiously throughout my career, I can attest to how much of a practice builder it is. PCPs appreciate and want that feedback because it also enhances their Healthcare Effectiveness Data and Information Set (HEDIS) measure scores. (See “HEDIS: An Overview.")

MAKE IT PERSONAL

Most EHR systems can generate diabetic patient letters automatically, but I use a quick, customized form letter on our letterhead that’s personally addressed, which stands out to the PCP.

WIN-WIN-WIN

At the end of the day, patients who have diabetes need their annual diabetic eye exams to preserve their sight, while PCPs and insurers need diabetic eye exams done to raise their HEDIS scores and increase their reimbursements. As doctors of optometry we are perfectly situated to provide this care or else another provider will fill the void. Doing so allows us to position ourselves to receive referrals of all types from PCPs, making everyone a winner. OM

DR. WROTEN is a partner at the Bond-Wroten Eye Clinics, a three-location private practice in southeast Louisiana, where he oversees its residency in primary care & ocular disease. He has lectured extensively and authored numerous articles on a variety of eye care topics.