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In Your Head | Sept/Oct '15

What’s Your Take on the New ASCRS/AAO Comanagement Guidelines?

John Berdahl, MD

John Berdahl, MD

I support the joint ASCRS-AAO comanagement position. In our rural state of South Dakota, many patients travel hours for care. Additionally, optometrists have often been lifelong eye care providers for patients and are usually very well equipped to meet the needs of their patients.

Ultimately, we should all strive to do what is best for patients, and, in many cases, I believe that entails comanagement with good follow-up access to surgeons, should the need arise.  

John Berdahl, MD, is a clinician and researcher with Vance Thompson Vision and Sanford Health in Sioux Falls, South Dakota. Dr. Berdahl may be reached at johnberdahl@gmail.com.

Michael Cooper, OD

Michael Cooper, OD

My take is quite simple. As an optometrist, these comanagement guidelines clearly galvanize in writing the relationship between ophthalmology and our profession. Although optometrists are categorized as nonsurgical providers, the ASCRS and AAO nevertheless recognize that there is a need and desire between both parties to integrate care in the best interest of our patients.

My hope is that collaborative care for any surgery, whether it ranges from cataract to aesthetics, improves communication among our colleagues. Working within the confines of our health care system mandates, these opportunities for cross-pollination will allow us to unite in order to share and truly coexist meaningfully in this space. We all have the same aim: to deliver amazing care.

Michael Cooper, OD, is an optometrist at Windham Eye Group, a collaborative MD-OD private practice in Willimantic, Connecticut. Dr. Cooper may be reached at coopadre@gmail.com; @TheCoopadre.

Gregory D.  Parkhurst, MD, FACS

Gregory D. Parkhurst, MD, FACS

For patients who need cataract and refractive surgery, two heads are better than one. We applaud the recent ASCRS/AAO updated comanagement guidelines because they provides patients with seamless access to just that.

Head Number One: The Family Eye Care Integrated Optometrist

In an integrated ophthalmic surgery delivery system, a dedicated family eye doctor has the opportunity to develop a doctor-patient relationship over an extended period of time. This bond, often built over years, delivers quality and value to patients because it gives the optometrist an opportunity to understand the vision demands of each individual patient.

Head Number Two: The Surgeon

An ophthalmic surgeon’s surgical skill, expertise, and best judgment is honed and maintained with high surgical volumes and frequency of time spent in the operating room.

Given the shift in patient demographics and needs, this integrated, cooperative partnership approach will become not only beneficial but also completely necessary in order to meet the eye care needs of our patients. One of the main things we teach in our full-time perioperative care rotation at the University of the Incarnate Word (UIW) Rosenberg School of Optometry is how patients maximally benefit when we work together as one unit.

UIW is leading the way in training the next generation of optometrists during mandatory in-house rotations in integrated care. These graduating optometrists get to observe firsthand the intricacies of a legitimate integrated eye care system, where the patient is first seen in the primary care optometric office and information is transferred to the surgeon’s office, where the surgeon is able to verify objective criteria within that surgical location. A customized treatment for that patient is developed and performed, and the patient is then delivered back to the primary care facility once the early surgical care has been completed. The students easily see the benefits of refractive and cataract surgery for their patients and how to participate in the delivery of that care in a meaningful, quality, and sophisticated way.

Gregory D. Parkhurst, MD, FACS, is a cataract and refractive surgeon and the Physician CEO of Parkhurst NuVision in San Antonio, Texas. Dr. Parkhurst may be reached at gregory.parkhurst@gmail.com; @gregparkhurstmd.

Justin Schweitzer, OD, FAAO

Justin Schweitzer, OD, FAAO

The joint position paper from the AAO and ASCRS in regard to postoperative and comanaged care of postsurgical patients is a positive reflection of successful postoperative care provided by optometrists that has been occurring for many years.

In a rural practice setting similar to where our center is located, comanaged care has become standard practice. This has occurred due to long hours of driving to where surgical care is received, weather hazards causing travel to be impossible, and patients’ desire to receive care from their primary eye care provider.

The goal of both ophthalmology and optometry is to provide our patients with an exceptional experience and to achieve the best possible surgical outcome. The joint position paper acknowledges this, and it will elevate patient care for the future.

Justin Schweitzer, OD, FAAO, is in practice at Vance Thompson Vision in Sioux Falls, South Dakota. Dr. Schweitzer may be reached at justin.schweitzer@vancethompsonvision.com.