Regardless of chosen profession, I would argue that most recent graduates are excited to make an impact in the working world. For optometry school graduates, the opportunities to do so are many, particularly in the realm of diabetes, this issue’s theme. Consider this: In 2021, the most recent statistics from the American Diabetes Association, close to 12%, or 38.4 million, of the U.S. population had diabetes. Additionally, close to 27%, or 9.6 million, of the US population with diabetes also had diabetic retinopathy, according to a recent study in JAMA Ophthalmology (see bit.ly/OM2405DRPrevalence).
So, how, specifically, can new graduates make a difference when it comes to this disease?
Navigating Billing & Coding
Determining whether to bill a diabetic patient’s vision care plan or medical insurance can be confusing. Despite the new optometrist’s best of intentions, the wrong choice can garner an audit. To prevent this, I recommend working with staff on distinguishing among the different codes and billing options required by each plan and medical insurance, while understanding that the OD is ultimately the one responsible for any coding mistakes.
Specifically, both the new OD and staff must know how to read and understand the different co-pay and out-of-pocket amounts for both vision care plans and medical insurance. Proper education allows the opportunity to provide the highest level of service and protects you and your practice from unwanted scrutiny from third-party carriers. OM
Talk it out
Beginning with the very first patient encounter, briefly discuss the epidemiology of diabetes. Then, talk about the possible risks that uncontrolled and high blood sugar (as found on A1C bloodwork) have on their body (e.g., heart attack, etc.), and eyes (e.g., early cataract development, diabetic eye disease, and glaucoma).
Next, educate patients about the specific action steps they can take to keep diabetes at bay. As an example, 30 minutes of walking or another type of low-intensity daily exercise, combined with a low-fat diet decreases type 2 diabetes development by close to 60%, according to a National Institutes of Health study (see bit.ly/43JmATe.) What’s more, exercise benefits blood glucose level control in those who already have the disease, staving off heart disease and nerve damage, according to the Centers for Disease Control.
Finally, explain the importance of regular comprehensive eye exams and follow-up visits, as they relate to diabetes. Translation: Emphasize that the best care is not possible without patient compliance to scheduled exams.
Offer screenings
In addition to providing education to patients on how diabetes affects their bodies and ocular health, new ODs can also offer peace of mind through retinal health screenings via ocular coherence tomography, fundus photography, and/or electroretinogram testing.
Offering these screenings can be as simple as mentioning that both technologies often enable early detection of the disease, allowing for early intervention that can slow the progression of diabetes and prevent permanent vision loss. A Caveat: Always explain to patients the out-of-pocket cost associated with screenings, so there are no surprises.)
Something else to keep in mind: Baseline photos can be effective in instilling patient compliance to exercise, a healthy diet, and follow-up visits. (See “Navigating Billing and Coding,” below.)
Join the team
Communicating with a patient’s diabetic care team (e.g., primary care doctors, internists, endocrinologists, dieticians, etc.) enables everyone to be on the same page regarding effective management. Further, having a solid relationship with these one or more specialists is reassuring to the patient that they’re going to get the same level of care across the board. OM
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