OD Co-Management: Revolutionize Your Practice with

OD Co-Management:
Revolutionize Your Practice
with Winning Partnerships
Stanley B. Teplick, MD
Adjunct Professor of Ophthalmology
Pacific University College of Optometry
A New Paradigm
A new breed of techno-savvy patients demanding
state of the art vision correction technology will drive
providers to develop new and creative relationships.
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Refractive Procedure Growth
1,000,000
900,000
800,000
700,000
600,000
500,000
400,000
300,000
200,000
100,000
0
1990
1992
1994
1996
Source: Marketscope
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1998
2000
And Stagnation
800,000
procedures
2001
2004
2006
2007
Source: Marketscope
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2009
But Penetration of LASIK is Still Low…
12%
•
Demand is still high
•
Withstood the test of time
•
Afford > afraid
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Consumer Adoption
Google
Glass
Innovators
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Kale
Tablets
LVC
PC
Early
Adopters
Early
Majority
Late
Majority
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Laggards
Cell Phone
LASIK Demographics ARE Changing
25
20
Gen X
Gen Y
15
Young Boomers
10
5
0
18-29
30-35
36-40
42-45
Time
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46-50
51+
Changing Demographics
Boomers 50-65
Gen X 35-50
Gen Y 18-35
Musical Influence
Beatles
Alt
Pop
Drug of Choice
Pot
ETOH
OTC, Rx, OPMC
Education
College/Trade
Grad School
Less
Technology
Challenged
Computer
Mobile
Art
Classic
Graphic
Body
Procedure
Premium IOL
LASIK Monovision
Femto/WFG
Marketing
Reverse Mortgage Anti-Aging
Urinary Retention ED
(or its opposite)
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#1 Target
Gen Y—What Do They Want?
• High tech atmosphere
• Refreshments, WiFi, Cell Phone in Office
• Web/email/text contact and scheduling
• Sensible financial options
• State of the art equipment
• Concierge type service, no waiting
• Integrated care among providers
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A New Paradigm
Old Model  Comanagement
New Model  Integrated Eye Care
Purchaed istockphoto LP used in
RF4516
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History of Comanagement
“Why Can’t We Just Work Together…”
R. King, OD
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Historical Note
•
Ancient turf wars
•
Inherent bigotries
•
Total separation of practices
•
Lack of communication
•
Professional pride
•
Clubbiness
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MD Comanagement Styles
• See patient--keep patient
• See patient--refer back to OD
• Refer OD difficult contact lens fits
• Build a strong relationship with ODs
• Co-manage cataracts with Medicare modifiers
• Terminate primary care/dedicate to surgery
• Support Optometry as primary care provider
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What Does Ophthalmology Want?
• Access to surgical patients
• Access to new technologies
• Protection from managed-care and Medicare cuts
• Competitive advantage
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What Does Optometry Want?
• Access to primary care patients
• Education
• Quality surgical results
• Co-management
• Equity opportunities
• Parity with ophthalmology
LASIK can only be performed by a trained ophthalmologist and for specified reduction or elimination of myopia, hyperopia, and astigmatism as
indicated within the product labeling.
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Evolving Factors
• Factors driving towards integration
− Lower surgical volumes, lower insurance reimbursement,
competition, desired access to Optometric patient base
• Factors driving away from integration
−
−
−
−
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Increased pressure from professional groups and medical boards
Competition for managed care panels
Promotion of ‘Comprehensive Ophthalmologist’
Fear of ‘Optometric surgeon’
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2002 Joint Position AAO and ASCRS
• Justifiable circumstance
• Surgeon unavailable
• Patient cannot travel
• Not to be a routine management style
• Not an inducement to refer
• Patient must be informed of arrangement
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Joint Position of AAO and ASCRS
• Must be clinically appropriate and in the patient’s best
interest
• MD must confirm OD is legally entitled and trained for the
care
• Patient must have access to the surgeon
• Fees must reflect fair market value for services performed
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2001 Oregon Medical Board
“The Oregon BME expects operating Ophthalmologists
to be responsible for the total perioperative care of
patients on whom they perform surgery… this
responsibility cannot be transferred to Doctors of
Optometry.”
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Integrated Care Pearls
Nine Pearls for Today’s
Integrated Eye Care Network
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#9 - Make it Easy to Refer
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#8 – Develop Ethical Fee Structures
•
MD collects OD fees
•
OD collects MD fees
•
An LLC or PC collects all fees
•
Set and collect your own fees
Fee reduction to reflect co-management
•
•
Avoid financial schemes
−
Fees should reflect value of service
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#7 – Use Uniformed Documentation
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#6 – Ensure Consistent Informed Consent
• Optometrist understands exactly what their patient will
experience at the LASIK center
• Share results and statistics
• Alert to new technology and broadened range of treatment
• Ensure understanding of common associated issues such as
dry eyes, pupil size, astigmatism
• Access to all pre and post op forms including written
informed consent
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#5 – Reinforce the Role of the Surgeon
• Factors opposing
• Surgeon is the “cutter”
• Institutional entry into specialized medicine
• Direct to consumer advertising
• LASIK World
• Clear Choice Dental Implants
• Spinal Surgery Centers
• Cancer Centers of America
• Factors supporting… only you (and your patients)
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#4 – Provide Continuing Education
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#3 – Develop Creative Co-Marketing
• Include OD portal on your website
• Link to OD websites
• ‘Like’ OD practice page
• ‘Friend’ OD personal page
• Connect with OD practice on Linkedin
• Create Text message campaigns
• Place QR code promotions in the OD office
• Encourage use of smartphone apps
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Text Message Campaigns
Personal images
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QR Code Campaigns
Personal images
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QR Code Campaigns
Personal images
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Smartphone Apps
Personal images
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Smartphone Apps
Personal images
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Smartphone Apps
Personal images
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Smartphone Apps
Personal images
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#2 – Understand and Utilize Online Review Sites
Word of Mouth
Online Review
Sites
Broadcast Media
Cycle of Marketing
Mobile Apps
Mailings
Text Message/QR
Codes
Website
Social Networks
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#2 – Understand and Utilize Online Review Sites
Personal images
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#1
Develop/Enjoy
Lasting Friendships
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A New Paradigm
Personal images
It’s up to us as practitioners to pioneer and evolve
relationships which enhance patient care and optimize results,
respecting the quality of care we each deliver.
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Stanley B. Teplick, MD
teplick@europa.com
Adjunct Professor of Ophthalmology
Pacific University College of
Optometry
2014.03.13-RF8403
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affiliates. All other trademarks and trade names are the intellectual property of their respective owners.