Every day, patients walk into optometry clinics for comprehensive eye exams, contact lens evaluations, and even medical office visits. Most patients don’t understand that the eyes are part of the whole complex system of the body and that changes within that system can cause myriad ocular problems. If we adopt the role of being gatekeepers for primary care, we can help direct patients to early diagnoses of systemic problems they may not yet be aware of.

Unless you practice in a tertiary or referral center, most of your patients come in for routine care. Given the nature of our typical treatment and management regimens, it is now more important than ever to be an active participant in the overall health care of your patients.

This article offers some tips on how to step up your game and become more involved in your patients’ general well-being.

EMBRACE THE MEDICAL MODEL

Optometrists operate in a relationship business. We thrive when our relationships with our patients, our staff, and even the larger medical community are intact. Think about a funnel bringing patients through your clinic. The more involved you become in treating and managing a wide range of conditions, the more you will be seen as a leader in this role, and the more patients can fit into your funnel.

Some diseases and conditions necessitate that we communicate with other physicians. Following are some options and opportunities for establishing relationships with other health care providers who are involved in the care of our patients.

Put It in Writing

The easiest and simplest way to communicate with comanaging physicians is by writing a letter. Most EHR systems allow easy letter generation. Our office has a form that gets filled out for each diabetic eye exam to communicate the most important findings to that patient’s other doctors.

Note Any Medication-Induced Ocular Changes

Some medications are known to have potential ocular side effects. Patients on such drugs should be closely monitored, and any changes should be shared with the patient’s primary care physician, rheumatologist, etc. Hydroxychloroquine sulfate (Plaquenil, Sanofi-Aventis), for example, comes with the guideline to monitor patients taking the drug for any macular changes.1

Know When to Call in Support

Patients who develop uveitis may have a systemic association that requires lab work and other examinations in order to better understand their diagnosis. Some ODs will order their own lab work, whereas others will refer the patient back to his or her primary care physician for determination of the underlying cause. Using a standardized form to outline and explain routine lab work can provide a helpful resource to community doctors and show the OD’s understanding of the eye-body relationship.

Comanaging conditions such as Sjögren syndrome with a rheumatologist or helping to diagnose diabetes and track a patient’s progress with a comanaging endocrinologist helps build that relationship and provides a smooth transition among providers in the holistic management of the patient.

GETTING STARTED

If you have the drive and desire to be a leader in providing comprehensive care for your patients, then you are a step ahead in embracing the medical model in eye care and strengthening your position not only as an optometrist, but also as a primary care provider to the community at large.

Of course, the best way to ensure that things get done efficiently and effectively is with the support of your staff. We conduct regular office training to teach our staff members about different medical conditions and how they affect the eye, body, and overall patient. Staff members who can troubleshoot or notice when things aren’t quite right can help guide us all down the right path.

Most of us practice in communities that are home to many other providers. My practice is near several large hospitals with associated primary care providers and specialists scattered all through the city. Most of these providers understand the importance of the two-way relationship between themselves and eye care practitioners in enhancing the care of their mutual patients. Get to know the providers around you with whom you may share patients. Introduce yourself, drop off your business card, ask what type of communication they prefer, etc. They’ll remember those who show interest in being part of a team effort.

BE THE GATEKEEPER TO YOUR PATIENT’S HEALTH

Optometrists are at the forefront of medicine. We have the advantage of being able to detect some conditions before they affect the rest of the body. In this front-line position, we can help direct patients to a proper early diagnosis that may save months or years of doubt, uncertainty, and frustration. However, this can only happen when we can drive the bus of patient care toward its necessary destination.

We may not have all the answers, but that’s okay. We can help each patient along the way to live the way he or she wants. By creating a gatekeeper mentality within your practice, you can transform your care beyond the routine and into the extraordinary.

  • 1. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy - 2016. March 2016. American Academy of Ophthalmology. www.aao.org/clinical-statement/revised-recommendations-on-screening-chloroquine-h. Accessed January 21, 2020.