"Prevention" in eye care practice

[anwesha.ghosh]

How would you define "Prevention" in your practice?

I am writing an article on Prevention and thus lookinng for different views on "prevention" within the vision care profession. Please feel free to provide your comments.

[EyeSore]

What are you trying to prevent ? Remakes , Glaucoma , Missed appointments , Shrinkage

[anwesha.ghosh]

What are you trying to prevent ? Remakes , Glaucoma , Missed appointments , Shrinkage

Hi. I mean't prevention of vision problems. I am speaking here in a generic sense in order to understand what prevention means in the line of work of different eye care professionals. Will be happy to hear your take on it.

[erichwmack]

If we are talking about medical prevention then I am glad you are writing the article. Too many optom's are still in the business to chrun out RX's for glasses and contacts and focus on the dispensary. I believe that for optometry tro survive in the future they/we need to think less about the dispensary and more about providing good medicine. Meaning providing a medical exam and not a costco glx/contacts type exam. Using preventative techniques in the exam room will be better for the patients, give the doc's more major medical insurance reimbursements, and start to change the lackluster view of optometry when compared to MD's, DDS, etc... Some of the techniques/equipment that are readily available and should be used by every OD are retinal photography, OCT, ERG/VRG, Nicox for Sjogrens/AMD, and demodex epilations. All of these are billable and they are services that most patients would want done if they knew about them. I am tired of hearing about doc's complaining about low insurance reimbursements, shrinking margins in the dispensary and the looming online apocalypse. Its about time that doctors start performing actual comprehensive exams and when they do they will start to see a whole new profit center, the exam room!

[EyeSore]

With "Prevention" in mind , and not treatment . Don't smoke , Wear your sunglasses , Have a good diet , Get your vitamins and you may even try a little prayer .

[fjpod]

Diabetes control, anti oxidants.

[Jubilee]

Our office is making the conversion to a "wellness" based model. Essentially focusing on education so patients know their risk of eye and systemic disease. With that knowledge we can help them take action be it through nutrition, smoking cessation, vitamins, even weightloss to assist them in their actions.

We aren't all the way there yet, part of it will have to wait til we are in our new facility and have space.. but I am excited to see where it goes.

[anwesha.ghosh]

Hi erichwmack. Thanks a lot your response. It will certainly help me with my article. You have touched up upon a very important point about the optometry practice: comprehensive eye exam leading to early detection, something that can also boost the role of the prescriber. What in your opinion is the main reason that is stopping eye docs from recommending comprehensive eye exams & focusing on detection?

[anwesha.ghosh]

Hi Jubilee. I would like to know more about your "wellness" model. How do you educate patients? Do you educate them individually i.e. tell each patient what specific conditions they may be at risk of or collectively i.e. tell every patient about some of the most common conditions that one can prevent. I am also curious if you educate patients on UV related risks?

[erichwmack]

I think the problem started with the rise of luxottica and the retail optometry business model. docs started seeing huge profit margins in the dispensary and it overshadowed the revenue from the exam room. Of course normal business rules dictate that you nurture your profit centers and so the result was an optom/dispensary on every street in the country. Some private and some a turn-key franchise type. Prospective students were being told how much $ you can make with relatively short higher education and you can be your own boss and sell high profit eyewear etc....So a glut of optometrists have been flooding out of the schools ever since and these new docs have been focused on making their business successful around the dispensary. However, the double edged sword of huge companies like luxx and essilor are that once they get enough control of the industry they can start to nibble away the profit margins. This is happening in a big way today. The big companies are buying all the other companies that make frames, lenses, contacts, insurance companies etc... and worse yet are directly competing with docs by making and selling their products online or in their retail locations or to the huge big boxes (Walmart/Costco) at lower wholesale costs. So to come back to your question I think what is holding many docs back from offering comprehensive eye exams is a lack of confidence in the education for this type of practice, a fear of investing in the proper exam equipment, and a stubborn mindset that the dispensary must provide the main source of profit.

There are other facets worth mentioning. MD boards are very eager to restrict what OD's are allowed to do but that can change with time and strong leadership. Also, the public mindset of OD's is that of a glasses and contact lens prescriber and the OD's have no one to blame but themselves for that. Spending the last 30+ years focused on a dispensary business model has created that image.

I think a similar phenomenon is happening with pharmacists right now. A record number of people are and have been enrolling in pharm school for the past 10 years because the potential $$$$. (I know this firsthand, after I graduated with a chemistry degree 13 years ago I was told by my school advisors to go into the pharm program because it was an easy job with a large salary. Much more that I would make working in the chemical science field.) There is now a pharmacy on every corner. Every big box retailer now has a pharm department. People can get their RX's online. I also don't know too many people that converse with their pharmacist for expert advice, the respect isn't there. The mindset is that the MD's prescribe and are the experts, the pharmacists are the people that take your money when you pick up the RX.

Thats my two cents anyways.

[sabmortez21]

For me prevention in general knows the basic steps to avoid any type of eye complications. Like eating fruits and vegetable rich in vitamin A and avoid direct contact in the sun as it contains high radiation. This is the most common type of prevention that we even teach to our children.

[Robert Martellaro]

Exercise regularly, quit the recreational and illicit drugs no later than about age 50 (boohoo), or when the doctor looks you straight in the eye and asks if your affairs are in order, and get a physical with optometry and dentistry at intervals that are appropriate for ones age, health, and family history.