From what I am reading (and I could be wrong) it appears that the forces that are shaping up to be selling “lives” to us as OD’s view us as eye glass salesmen. Let me share why and why this should be a concern we deal with.
A couple years ago and OD came to me for a job. I offered him a weeks trial. We mutually parted ways a week later. He did not think I did enough volume for him and I did not think he cared enough about patients to work in my office. When I met him a month later he had signed a contract to work for the “Franchise Holder” of a big box optical store. He explained to me that his contract said he had to see a minimum of about 35 patients a day to earn his keep and a maximum of 50 was expected. He also had to promise to not do any medical eye care but to refer it out!
I said to him, “that is going to burn you out in a short time!” He said to me, “I am making the money I want and yes it will burn me out but I have a plan. You see the leaseholder is probably going to lose the lease and they seem like they are willing to give it to me if I can do what they want. When I have the lease I will hire other ODs to do the work and I will not be under such high pressure volume to make me sick. With two our three OD’s in my employ in a few years I will be far more successful than I can ever be in your practice. Your practice is a ‘dream practice’ but I need to make a lot of money and quickly. ” I never saw him again or want to.
This has got to be happening all over the USA. Now Luxotica was aware of the image issue of its “Sears optical and Pearl but they began trying to push for the LensCrafters docs to be more medical.” They did not want to be left out. That is why their plan is called “EyeMED” So what should the world of MD’s and Insurance companies think of us when many ODs do factory work in big box stores?
Many years ago, when Bill and Hillary were around the HMO’s locked us out, as I have written elsewhere because the “gatekeeper pcps” felt we were “shoe salesman” as one told me; especially since the Sears Optical was near the shoe department. It was also so the PCP could refer to his hospital buddy the OMD who referred back to him. This is how they networked. After a big struggle we got laws like “any willing provider” and this nonsense stopped. But it is not nonsense if the Big Box Volume store with OD’s appear to be practicing as we do or we appear as they do!
How do we differentiate ourselves from the eye glass pushers? We don’t want to give up vision care and become OMDs. We need to clearly place ourselves in a group that has been credentialed. We have to prove we have been educated by regular CE courses. We have to have the right equipment, we have to keep up our license and insurance coverage. I am not one for board certification. Any JC Penny OD could be board certified and what would that mean? What we need is to be group that can provide medical as well as vision care and by our group credentialing process differentiate ourselves from what medical care justifiably views as “eyeglass salesmen.”
When you get a bad hair cut you do not stop going to hair cutters. You find a different hair cutter. It is the same with all professions. Vision Source, is on the right track to create the image of a high quality team. VCD can however do it on the state wide basis with OD support and that is more important and something that VS has not done. VCD, appears to be on the path to make OD’s much more profitable, than VS has done. Perhaps at some point we can work as a team for image and profitability. There are good groups out there that represent good docs who can and will provide medical care not just eye glasses. We also must not view VCD and state IPAs as the domain of ODs. We will and MUST team up with OMDs so that we can provide for the absolute best care patients need.
The great thing is that with us doing the simpler medical services that do not require surgery the ACO’s can have a much more profitable relationship with us than a team of MDs only! It will be up to us to see the medical things we do best like Glaucoma, Cataracts, Diabetes, Pink Eye etc. It will be up to us to quickly refer to our partner OMDs the surgical needs, and some of the care that is highly related to complex general health issues. This will meet the needs of reducing duplication of services by sharing electronic records and keep the services in the hands of the most efficient providers. Now it is up to us to organize and prove that we will be the most efficient care providers.
At this point in the creation of this new health care paradigm, I could certainly be wrong and this is just my opinion and not necessarily the opinion of the entire group. We will all temper our ideas as ObamaCare of some sort takes form. I don’t think anyone knows what the final structure of our healthcare system will look like. It is evolving and so our our thoughts. One thing is CERTAIN, we must be organized and we must be able to sell our selves. So, no matter how you look at it, for now we are on the right path.
Dr Joseph Ross, President NYIPA