During the lecture, “Co-Management Conundrums: Fighting the Fear Factor,” Paul C. Ajamian, OD, in part, provided strategies to help fellow optometrists determine when a referral is necessary. 

“Using cases seen daily at one of the nation’s largest co-management centers [where I practice], attendees will hopefully feel more comfortable handling a variety of common, yet challenging, cases,” said Dr. Ajamian of his lecture.

Master the Clinical Interview

Patients rarely volunteer their critical ocular and medical history, Dr. Ajamian noted. That “sudden onset” vision loss patient who denied trauma? Turns out he'd been in hundreds of prison fights. That “3-week pink eye”? It was actually chlamydia, which was discovered after the right questions were asked. The right questions are those that enable you to get to a patient’s diagnosis and whether you can treat it in house or need assistance, said Dr. Ajamian. Pro tips: Be persistent, rephrase questions, and involve family members.

Know Your Limitations

Dr. Ajamian pointed out that while optometrists are all capable of more than they think, they also must not let their confidence overshadow their skillset. If after meticulous observation, the diagnosis and management feel above one’s head, referral is in the best interest of the patient, he stressed. ODs should refer to the doctor they feel is best for the case. Working with great doctors makes the optometrist look great, too, he explained.

Effective Co-Management

Effective co-management, Dr. Ajamian said, means managing more and referring smarter. In following this model, optometrists will provide superior continuity of care, build stronger specialist relationships, and grow their clinical confidence. OM