Setting Up a Patient’s Referral Appointment

The vast majority of ophthalmic surgical patients are referred to surgeons by optometrists. Some optometrists fear that sending a patient to another provider will mean that the patient is lost forever. However, taking charge of the referral process demonstrates to the patient that you are trustworthy and concerned about their long-term health, which helps ensure their eventual return. Building relationships with referring ophthalmologists helps smooth the patient’s transition from OD to MD back to OD. Plus, the better a referring ophthalmologist knows an optometrist, the more likely that ophthalmologist will trust him or her with a patient’s postoperative care. Having started my career in a bustling surgical practice with a high referral volume and then transitioning to an optometric private practice with multiple doctors, I can speak from both sides of this issue. I’ve assembled a few tips for an optometrist who is considering taking control of their patient’s referrals.

WHEN TO REFER, AND TO WHOM

A rule of thumb: Refer promptly when the problem presenting is not within the realm of your treatment expertise or scope of practice. For many patients this will be when surgical intervention is required. Ophthalmology has many subspecialties, offering a vast array of providers from which to choose, including ophthalmic plastic surgery, cornea/external disease, cataract/refractive surgery, glaucoma, vitreoretinal disease, pediatric conditions, and neuroophthalmology. Rather than providing a patient with a list of practices and allowing him or her to choose a doctor, ODs should choose the provider who best suits the patient's needs. This choice may be based on specialty, surgical skill, or even bedside manner. Explaining to your patient that the ophthalmologist to whom you are referring them has experience in a particular field of eye care will instill confidence in the referral and will reassure the patient that you are in control of their ocular health. When the OD says, "Mr. Jones, I want you to see Dr. Gupta to help with your cataract surgery because I think that her personality and practice style best fit your needs and wants,” the OD stays at the helm of the patient’s health.

GETTING TO KNOW YOUR NETWORK

Get to know your referring doctors. This can be done by attending their education seminars or visiting their offices to introduce yourself. Putting a face to the name on the referral is an important part of building a working relationship. Whenever possible, exchange telephone numbers so you can promptly refer important cases or offer patient management advice. Technology is also important. Knowing about the surgical and medical platforms used by your referring ophthalmologists allow for a more seamless referral process because the optometrist better understands the type of care the patient will receive. Ask questions to your referring surgeons. Knowing about surgical complication rates, patient satisfaction percentages, and office flow dynamics may help you choose the right surgeon for each particular patient.

PREAPPOINTING THE PATIENT

Your office staff should book an examination with the referring surgeon after you and the patient decide which ophthalmologist would best fit their needs. It is imperative that the optometrist takes a leading role in this part of the eye care continuum. You are the expert. Giving the patient a list of doctors in the area to call is not good practice, as this increases the chance that the patient will not contact the surgeon you recommended—or may not follow up at all. Booking an appointment for the patient, or preappointing the patient, allows direct communication between ODs and surgeons. Write a letter introducing the patient and their specific needs, and include any test results that may help shorten their visit at the surgeon’s office. If the referring surgeon requests any paperwork prior to referral, complete these forms and send them to the surgeon’s office. Don’t be afraid to request an update on the patient via a letter or a call. Preappointing the patient will build a relationship with your office staff and the referring doctor’s office staff. These staff interactions are key, as they help to ensure the patient returns to your office. Patients who need to reschedule a surgical consultation should do so with the provider you recommended.

KEEP TRACK OF YOUR REFERRALS

After an appointment has been arranged, your staff should note on a calendar the upcoming surgical consultation. Write the patient’s name and the referring doctor’s name on the date of the scheduled examination. This allows you to be on the lookout for correspondence. Keeping an active role in referrals will help assure the patient’s prompt return to your practice. Don’t be timid. Call the referring doctor to request correspondence and ask questions as needed. If patients seem to disappear into the deep abyss, call the office to let them know. Sometimes the patient needs to be reminded that follow-up is needed, and other times the surgeon’s office may have simply made an oversight.

DON’T PUNT

Optometry should take the lead in the referral process, rather than punt the patient to a random surgeon and hope for the best. Communication is key to successful referrals and is a two-way street. If you are not happy with the way patients are being treated, then you have the power to change your referral source. Don’t be afraid to take control.