Certain ODs welcome to participate in new ASCRS integrated program

By Gretchyn M. Bailey, NCLC, FAAO; Editor-in-Chief, Content Channel Director, Optometry Times

The American Society of Cataract and Refractive Surgery (ASCRS) recently announced a new program for the organization’s 2013 annual meeting next month, to which certain categories of optometrists are welcome.

The organization will offer a non-surgical educational program to advance an integrated eye-care model in which optometrists and ophthalmologists work together, according to a prepared statement from ASCRS. Called the Integrated Ophthalmic Managed Eyecare Delivery Model (IOMED), this model was created by the ASCRS IOMED task force, which included three ophthalmologists and five optometrists.

The new educational track will be held at ASCRS’ annual meeting April 19 to 23. Optometrists who register for the track must certify that they meet one of the following categories:

• Employed by an ophthalmologist

• Employed by a medical school (not a college of optometry)

• Employed by a managed-care provider

• Employed by the military

• Employed by industry/manufacturer

• Employed by a corporate center (such as TLC or Omni)

Note that as of 3 years ago, these categories of optometrists were permitted to attend the ASCRS annual meeting through the organization’s administrators association, American Society of Ophthalmic Administrators (ASOA).

Those ODs attending were required to attest that they would not use what they learned beyond the scope of practice in optometry.

Optometrists who attend this year’s track will earn continuing education (CE) credits, unlike in years past.

“In the past, ASCRS would allow ODs to attend but not offer CE credits,” said Marlane J. Brown, OD, FAAO, of Minneapolis and member of the IOMED task force. “The other difference is that optometrists have been actively invited in, rather than simply ‘allowed.’ I feel the task force had a great deal to do with this.”

ASCRS’ initiative to create an integrated education track is about 5 years in the making, according to IOMED task force chairperson Stephen S. Lane, MD, of St. Paul, MN.

“There’s going to be an explosion of patients who will need care,” Dr. Lane said. “With the cutback in ophthalmology residency positions, from a [resource] standpoint, ophthalmologists alone or optometrists alone cannot possibly see all of the patients who will need care in the next decade or two.”

A better model is needed in order to see patients effectively and efficiently, he noted.

“There’s an opportunity to have patients seen with a seamless continuity of care between optometry and ophthalmology-care can be more effective and efficient if done within an integrated model,” he said.

Dr. Lane does not refer to co-management, the traditional way that optometrists and ophthalmologists have shared patient care. In an integrated eye-care model, MDs and ODs share the same ideals and principles of practice and, sometimes, even the same building, he said.

“Patients stay within a single-care model that’s not splintered,” Dr. Lane said. “This allows for a friendly working relationship between optometrist and ophthalmologist, rather than some of the antagonistic ways that have occurred in the past.”

Integrated approach?

However, some optometrists don’t see the initiative as integrated.

“They are saying by their actions that this is a business decision to employ ODs to help their practices, not to educate ODs to help patients,” said Jack Schaeffer, OD, who is in private practice in Birmingham, AL. “Education is the key. It should never be restricted.”

Dr. Lane acknowledged that independent optometrists were not included because they are not part of an integrated-care model.

“The independent non-integrated OD, like the independent non-integrated ophthalmologist, is, in my opinion, a breed that with the expansion in population growth will have an ever-increasingly, difficult time caring for the number of patients who need to be seen,” he said.

Political concerns are another reason that independent ODs were not included. In the past, optometrists in Kentucky and Oklahoma used education they received at ophthalmology meetings as a jumping-off point to expand scope of practice.

“ASCRS does not want to provide an opportunity to have that fight so it can be used against our members,” Dr. Lane said. “It’s unfortunate because I believe the vast majority of optometrists have no interest in doing surgery.”

Dr. Schaeffer claims that ASCRS members are looking to change a model that works perfectly well.

“ODs are integrated already with MDs,” he said. “Our practice and many others work with retina, ocular plastics, pediatric, and general ophthalmologists. Is ASCRS saying these relationships deliver a lower level of care? Will all ASCRS practices incorporate this new model?”

The majority of ASCRS members employ ODs, according to Dr. Lane, and it follows to provide education to those employees.

“That doesn’t include every optometrist in the United States,” Dr. Lane said. “We welcome our members who want to educate all members of their staff, including administrators, technicians, and yes, optometrists. This isn’t all that different from having our administrators attend our meeting. This concept may progress to where there may potentially be an ASOA-like group of optometrists who have an independent meeting inside our meeting.”

Impetus for change

Dr. Brown also hopes that this year’s educational track is a small start of larger change.

“I don’t disagree with the concern and anger of private practice optometrists,” she said. “But I don’t agree with the fact that this anger should exclude all ODs from being involved in an educational forum. The more we learn, the more we can share. I am looking at this as baby steps to integrate all of optometry with all of ophthalmology. I think the ODs who see this as an insult are a very small percentage. Many ODs who want to attend a meeting like ASCRS may not be in private practice.”

IOMED task force members are waiting to see how this year’s track is received before making more changes.

“I personally hope we can allow more optometrists to attend in the future,” Dr. Lane said. “We need to be patient and have an open mind. We have to satisfy the needs of our membership, and this is a wonderful first start.”