- Optometric visits capture at risk patients between ages 15 –> 45 that PCPS do not see! We see them for blurred vision. We are the Entry point to health care that is critical before it gets costly.
- Optometric geographical distribution and office hours, makes us the ideal easy place for patients to come to, not a big central medical office that MD’s are forming for efficiency.
- Optometric contact with leadership provides access to contacting ACO leadership for entry points.
- Optometric technology – makes it easy to diagnose systemic disease via retina photography, cheaply, quickly and efficiently.
- Primary Care Optometry — providing referrals to OMDs is the most efficient use of OMD surgical skills
- Forming a Cooperative team and Branding ourselves in NY State would likely make us a sought out entry point for MD / OD healthcare partnerships. Requiring a paradigm shift:
- Retina Imaging Being Routine
- Standardized reporting to pcps
- Referring at risk patients to PCPS for consultation.
- Taking the initiative by dispensing educational materials
- Educating patients in our offices (as Dr Hom Suggested)
- Connecting patients with online dietary advice such as health letters written by leading physicians who promote diet and lifestyle changes
10 Years ago I earned nearly $50,000 in one year by providing medical optometry to my patients and I did not have to submit one insurance claim! After that year my income continued to increase every year. In several areas of the USA, optometric leaders are working on plans, similar to mine, to prove it is profitable for OD’s and MDs in ACOs (accountable care organizations) to be working together! Why wait for some outside agency to tell you what to do while stealing your profits! You can earn an extra $50,000 now while working on qualifying for the upcoming medical plans on your own! There is no reason we should not be qualifying by proving it works now!
AN ACTION PLAN: Here is my recommended NYOIPA plan for keeping ALL OF US in medical eyecare (ACOS), helping you earn the respect of the local medical community, while making you a lot more than $50,000!
I recommend every NYOIPA doctor commit to offering a $45.00 Retina Photography Screening for every patient that comes into their office (even one time for children). I can show you how to implement this program easily enough; I have done it. Each doctor should also commit to providing a simple fast check box report to the patient’s PCP, if anything systemic was found (this is becoming the standard of care now).
Establishing A Brand Name – The NY Optometric IPA: Every doctor in the IPA, who reports findings to local MDs should use the report above or one like it of their own creation. As part of your report letterhead, every report form should state your NYOIPA membership clearly and include a small copy of our logo:
A New York Optometric IPA Member
This is all there is too it!
An Overview: 10 years ago I implemented a medical eye care program and earned nearly $50,000 in increased profits that first year. I paid off my camera in 6 months. In addition I kept adding to my optometric medical income, year after year, by practicing the best medical optometry I could. We also developed a greater relationship with medical doctors in the community that lead to medical doctors asking their patients to get an update from us before their next medical visit! Are we not here to help our patients? If so, why not do so and get paid?
Here is what I did to get started. I purchased a brand new Topcon Retina Camera. I put it in the screening room and taught my techs how to use it. Next I put a computer viewing station (software to display the images) in every exam room (we had two exam rooms). Finally, I created a report format (get this and make it yours and use it) that I could send to every medical doctor my patients might see and I began using it daily! I educated my screening staff on what major diseases we could diagnose via high resolution retina photography (we call it digital retina imaging) and I gave them a script to learn. They were required to recite this script to all our patients and they were paid a commission for each patient who paid for the retina imaging.
Here is the essence of the script. The script explained a special offer to each patient: We told them that we could often diagnose the early signs of diabetes, hardening of the arteries, macular degeneration, glaucoma and more by retina imaging. In addition, if we caught diabetes or hypertensive retinopathy, we could potentially help them avoid, strokes, heart attacks, diabetic vision loss and more. The screening would cost just $40 (we upped the fee since to $45) and we would give them a report for their records.
How I earned $50,000 extra the first year and took GREAT care of my patients! Nearly 60% of my first years patients had the inexpensive screening done. As you know, a huge number of patients were diagnosed with Hypertensive Retinopathy (stage II or more) and many diabetics were discovered. A good number of our patients who we referred to their PCPs (after we took time to educate them!), made an effort and changed their lifestyle. A few, who were totally stubborn, did nothing and some had strokes, lost vision or even died prematurely! This reinforced my commitment to see that my patients got the best care possible, a retina imaging at least every other year if they were over 40! At least we try to do this every year so that they are educated and reminded of what optometry means to them.
We Educated Our Patients Using The Internet (other doctors newsletters) So It Did Not Take Much Time! We follow up on all our patients with Educational Materials (use this book free, I wrote it and made if free for everyone), in the form of handouts and links to free online health letters. Most patients made some effort to change their diet and lifestyle. Even if it was just adding omega 3 oils to their diets. Some cut carbs as I told them to do and lost over 100 LBS (one man did this in one year and has still kept it off 10 years later!). Seeing them yearly and educating them by emailing them links to newsletters etc does work (of course not for everyone). I was present at a meeting of alternative health care providers, last month, and was honored to hear an RN share, that I saved her daughter’s life. She related how I diagnosed her daugher (age 20) with stage II Nicking years earlier and got her to change her diet and lifestyle. I would not have claimed that I had saved her life, but she might be right. What could be more rewarding?
The Bottom Line (other than great patient care!): I was seeing nearly 2,500 patients a year 10 years ago. If 60% paid $45.00 for a screening (and I gave $5.00 to my techs), this earns you $60,000 net. Do the math: 2,500 x 0.6 = 1,500 1,500 X $40 = $60,000 I did not quite make that much but you can see how you can do so pretty easily. Most importantly you diagnose lots of disease you might not catch otherwise. The patients also get a referral to their PCP and end up with great health care. Your credibility soars with the patient and the local MDs. Its a win, win, win! Don’t forget too, that in addition, all the diagnosis you made from the screening require medical follow up. This now allows you to add still better care for the patients and have insurance pay for those visits. How often do you follow a diabetic? How about a hypertensive with boxcarring?
Want references to help you understand more about your role in total patient care? Here is how to cut the cost of health care and why you need to follow patients with hypertensive retinopathy.
WHAT IS HAPPENING WITH ACOS IN THE N.E.: 10 Months ago the Ct IPA achieved a contract with ProHealth Physicians for 380,000 lives! ProHealth is the biggest ACO in Ct. This was an excellent achievement. The Ct IPA has over 8 years of experience and over 150 doctors. It takes time and work but it does work. This is our 2nd year and we are probably wear Ct was in just 6 years! We are doing great!
ACOS ARE NOT GOING AWAY: It is just taking longer than we expected for them to become active and confident in their potential profitability (or so it is rumored). Medical groups are getting BIGGER! This means that we must be prepared so that we are not locked out of medial care when they do become the door to medical care.
IF CT. CAN DO IT WE CAN TOO! Our plan over the next year is to find a good contacts with ACO leadership and show them why they need us. Most ACOs are based on networks of medical doctors. Some of the younger MDS know optometry as a profession other than as “eyeglass” salesmen. However, the chain stores keep pumping out he image of “eyeglass” salesmen even when Pearle says, “Pearle Vision works hard to carry on Dr. Stanley Pearle’s legacy of expert eye care.” Why, because in the next commercial, they have their coupons for 50% off glasses and reveal their real focus. THE PROBLEM, with this is that MOST MDs perceive us as glorified eyeglass salesmen! Who needs and eyeglass salesman in an ACO?
CHANGING THE IMAGE OF THE PROFESSION: Most of the private practices in the NYOIPA have an image of who we really are, eye doctors. Some have gone as far as to specialize in Glaucoma, Dry Eyes and more. ACOs don’t know it yet, but what they are looking for is preventive medical care from Optometry. The conservative and progressive approach thinks that this means diabetes The creative and visionary approach (in my opinion) knows that in addition to diabetes, it means a holistic approach which is easy with retinal imaging. Diabetes is crucial but hypertensive retinopathy (vasculopathy) is nothing to be ignored! Duke Elder is quoted as having said, “The single most informative test other than an eye exam is an autopsy.” This was not a joke! He said it nearl 70 years ago! It is our job to provide this service and let the MDs know that we are involved in total patient care (holistic care). They don’t care if you Rx +.50 readers or keratoconus lenses. They want to know if they patient is at risk for diabetic blindness or a stroke from nicked vessels. This is what will keep down the cost to ACOs and make us invaluable. In addition to our professional skills and access to technology, we are geographically dispersed, which means that when the patients don’t come to their pcp, because of blurred vision, we will still see and catch the potential health disaster! THEY CANNOT DO THIS!
YOUR JOB AS AN IPA MEMBER DOCTOR:
- Keep your eyes and ears open for contact with ACO leadership! Remember this is about YOUR financial and professional future! If the network starts in your neighborhood, your will have profited from the work of all of us, now nearly 50 doctors!
- Support the NYOIPA by:
- Using VCD Labs for your private pay jobs! Remember their least expensive progressive lens, The Acuity, is your best lens. Rx it about 3 mm higher than center and always order the short 9 mm short corridor. Your IPA, your treasury gets 16% of all the money that NY IPA docs spend with VCD (its our lab!).
- Paying your small monthly dues will also help us build a treasury that will fund the needed costs of negotiations, legal contracts and future leadership.
- Be active in our email communications and on-line meetings.
We are just getting started!