I am embarrassed to admit it took me a while to truly appreciate the value of social networking, but it is now integral to how I practice optometry. To clarify, when I use the term social networking, I am not referring to social media, although that has its place. Rather, I mean the building of real, lasting relationships based on personal interactions. In the health care industry, networking can come in many forms, from establishing mentors to meeting colleagues and friends across various specialties.
Many clinicians focus on what we alone can do for our patients, and we are proud of our abilities to treat and manage various conditions, much to the joy of our patients. However, as the scope of optometric care continues to grow, more of us are becoming more specialized. My practice focuses heavily on refractive surgery, glaucoma, and the anterior segment. We do provide comprehensive eye care, but we refer out for certain conditions. I am knowledgeable about the retina, but I have no problem telling a patient that I would like my retina colleague’s second opinion on what I’m seeing.
I view comanagement as an extension of my knowledge base that I use to ensure my patients receive the best care possible. Collaborating with other health care providers engenders trust among your patients, which benefits you, your comanaging partners, both practices, and your patients.
PLANT SEEDS OF TRUST
Warren Buffet is credited with saying, “Trust is like the air we breathe—when it’s present, nobody really notices; when it’s absent, everybody notices.” As cliché as it may seem, it’s true. Trust is essential in the relationships we establish with our patients and our comanaging partners. So, how do we build that trust?
Identify and get to know the other doctors in your area. This may include primary care providers, endocrinologists, cardiologists, rheumatologists—any physician who may comanage your patients. Try to meet as many of them as possible to put a face to the name. I have taken what might nowadays be considered more of an unconventional approach to accomplishing this task by going door to door to meet my local colleagues.
Local events that bring the community together are another great way to meet other providers, so take advantage of those opportunities. You should also make it a priority to attend continuing education events, sponsored dinners, and local, state, and national meetings. At these get-togethers you have a chance to exchange contact information and arrange one-on-one meetings, which I have found to be extremely valuable in building new relationships with managing providers. During these meetings, find out what services they provide, whether they have a subspecialty (eg, glaucoma, dry eye, retina), and what conditions they are comfortable with managing. Offer ways to help them and be of assistance, so that each party can successfully comanage patient care and create opportunities to grow together in the community. If done properly, great relationships will likely flourish over time.
REAP THE REWARDS
Once you have established great relationships with several comanaging partners, each provider will start to see significant benefits. Imagine the following scenario: You see a patient with visually significant cataracts, and that patient came to your office thinking they maybe just needed an updated pair of glasses. After your thorough examination, you explain to the patient that while you could simply update their eyeglass prescription, the best way to optimize their vision is with cataract surgery. After some discussion, the patient elects to undergo an evaluation with your local cataract surgeon. Your patient ultimately opts to have surgery and returns to you for postoperative care. After successfully navigating the patient through the postoperative period, you finally update their eyeglass prescription appropriately.
The patient now sees even better than they would have otherwise and is extremely pleased with their care. The surgeon experiences practice growth from the new referral and the cost of their surgical services. You benefit from providing the highest quality care for your patient, which gains their trust, and the practice grows from providing the postoperative and other services.
STRENGTH IN NUMBERS
Comanagment is also crucial for navigating more urgent situations. In my first year practicing optometry, I had put in motion many of the suggestions I listed above. I met with local ODs, all the ophthalmologists in the area, and even a few of the primary care providers. I was fortunate to be able to develop a great relationship with one of the ophthalmologists, who happened to be a glaucoma specialist.
One Friday afternoon, a younger patient came into the office complaining of blurred vision, halos around lights, and mild discomfort in his right eye. I worked in a big box retail location at that time, so our medical diagnostic equipment was lacking. However, I still completed a thorough examination and discovered his IOP was 68 mm Hg OD!
I hid my emotions, but I was panicking internally; I had never seen IOP that high. I followed the standard protocol of administering any IOP-lowering agents I had in-office to his eye and closely observed as the IOP steadily declined. However, I wasn’t comfortable waiting until the following day to see how he was doing; an IOP that high for a patient in his 30s with no remarkable history was a big red flag. Thanks to the budding relationship I had established with the local glaucoma specialist, I was able to get my patient into the office for an emergency consult. The ophthalmologist quickly performed a microinvasive glaucoma procedure, and, to this day, the patient’s vision is great. My relationship with that local MD allowed me to quickly care for my patient and prevent him from experiencing any vision loss. (I now work for that same ophthalmologist, and the patient from this story refuses to see anyone but the surgeon and me for his eye care.)
IT’S A WIN-WIN
The trust I have established with my local colleagues has led me to provide high-caliber care for my patients who, as a result, have developed greater trust in all of us, collectively. Thus, collaborative care is a fantastic way to enhance patient care and quality of life for all involved.
