Lets keep this civil people...
In the now closed "Good Doctor" thread, some interesting points had been brought up about why todays ODs may need to be into medical management and the possible over-specialization of our OMD's. I wanted to go back to that conversation (not the blast "insert your opposing O here") and really think/move through this here...So I will repost the parts in that thread that I think were moving in this direction...
Originally posted by Jubilee
Maybe the reason more Optometrists are going towards Medical Management is because so many of the Ophthamologists are specializing and refuse to see patients without a referral and certain tests done prior.
On more than one occasion I have had patients showing signs of real ocular emergencies, and when trying to cut the chase and go for a straight referral (my doctor is one who doesn't get into treating more than allergies and simple infections) I was comfronted with people telling me that without a proper work up Mr/Mrs Smith will not be getting an appointment. Only after I did a full work up, including fields, photography, tomography etc would they see the patient. "We don't do work ups, we treat the patients with the actual problem"
Have a man being seen this AM with a history of Acute Glaucoma that basically destroyed his vision in the right eye a few years ago. (pressure 44!) Called with blood filling the eye yesterday... previous OMD refused to see him till we made sure it wasn't just a simple trauma and then if he was needing to be evaluated it would be a couple of days.. afterall we aren't talking of saving someone's sight since he is already blind in that eye...
So as far as I am concerned, I am happy that some ODs out there do embrace medical management and are willing to help, do the work ups and aid these people....
Harry followed up with his rational that part of this is due to the 3rd party insurances and the fact that ODs bill less that MDs...
Originally posted by HarryChilling
I have seen this trend here as well, the OMDs are trying to milk every patient for every possible diagnostic test whether needed or not. I have found that you can always justify a test and billing the most tests is how they get paid. It is actually becoming more and more difficult to get patients in to see OMDs, so then it has become a necessity for ODs to move towards medical management. Do you think that OMDs might one day specialize themselves into a corner?
I also think that HMOs have a great deal of meddling that has muddyed the waters. Lets face it ODs bill alot less than what an OMD is capable of billing for that same patient, so they are more likely to want to defer the primary care to an OD to cut costs, they can also defer the exam as routine and then it's the vision plan that covers it, not the health plan. I think this model is a cause for great strife in all facets of health care, not just eyecare. I have actually swithced gears from bashing ODs (sorry guys and gals, I know you'll miss me :D) to actually putting more bashing towards the insurance companies. It is getting to the point where enogh is enough. Me and my wife pay some pretty hefty premiums and I am sure most pay more than us, but for you pay into a system and what you get out their is some pretty big inconsistency. Maybe we should change insurance companies names to something that starts with an "O" so that we can start to see them who they really are, our worst competition. They take the eyecare dollars out of our patients pockets before they step into our stores and then further expect our stores to discount to their clients.
How do others out there feel? Is it the evil insurance empires following the premise of Michael Moore's Sicko, the natural evolution of the business (which means opticians will move into refracting) or something else?
Please once again.. keep this conversation civil and on track...
Cassandra
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