Opinion: Optometrists could help ease California's doctor shortage - The Reporter

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Opinion: Optometrists could help ease California's doctor shortage
[SIZE=-1]The Reporter[/SIZE]
[SIZE=-1]When people think of optometrists, they often think of glasses and contact lenses. But doctors of optometry do much more than just help the near- and farsighted -- we provide comprehensive eye health care. We diagnose and treat injuries and serious eye ...[/SIZE]
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[SIZE=-1]http://news.google.com/news/more?ncl=dYYrQvNMQF0116M&ned=us[/SIZE]

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[Kristin Bartlett]

Good article!

 

[Stephen G. Hlis O.D.]

Bunk!
Then we'll see VSP somehow convince California legislators to lower its medical fee schedules and be apart of VSP to be competitive with EyeMed.

COA needs to roll its sleeves up and write legislation to protect our profession from being taken advantage by VCP's.

 

[Joe DiGiorgio O.D.]

It will enable optometrists, who practice in every corner of our state, to provide medical services, such as influenza and shingles immunizations, certain types of wound care, certain laser procedures, and other noninvasive technology.

Seems like utilizing a great resource especially in underserved areas by highly trained ODs.

Wait...can ODs in California used topical steriods or treat glaucoma as trained?

 

[Lisa Heuer]

Seems like utilizing a great resource especially in underserved areas by highly trained ODs. Wait...can ODs in California used topical steriods or treat glaucoma as trained?

Yes, we can use topical steroids if TPA. Those who graduated after 2008 or completed a certification course have limited glaucoma privileges. Our problem is more about getting access to patients due to so many HMO's, esp in the metropolitan areas.

 

[Joe DiGiorgio O.D.]

Yes, we can use topical steroids if TPA. Those who graduated after 2008 or completed a certification course have limited glaucoma privileges. Our problem is more about getting access to patients due to so many HMO's, esp in the metropolitan areas.

Got it. HMO's do a great job of keeping ODs out. Not sure if any willing provider legislation works with HMOs. Maybe our friends from Texas know?

 

[Lisa Heuer]

Got it. HMO's do a great job of keeping ODs out. Not sure if any willing provider legislation works with HMOs. Maybe our friends from Texas know?

They sure do. 90% of my requests for a consult are for things I'm perfectly capable of doing myself.

It's very frustrating because (a) you feel like you're passing the buck and letting your patient down, (2) you lose the revenue for those tests, procedures, and office visits, (3) many times the patient is denied the care I want them to have, and (4) I almost never get a report back from the other provider.

 

[Ken Elder]

An undersupply of ODs in California? HAHA!

 

[Craig Steinberg OD JD]

Yes, we can use topical steroids if TPA. Those who graduated after 2008 or completed a certification course have limited glaucoma privileges. Our problem is more about getting access to patients due to so many HMO's, esp in the metropolitan areas.

Many of the HMO's in California contract out their vision care to VCP's. So, the patients come in as a VCP patient, and there is no option for providing medical care, it has to be referred back to the HMO. So, a typically scenario might be the employed person that has an HMO and VSP. They come in for routine care and you find they likely have glaucoma, or need a workup. Your job at that point is done, other than the referral. It's a lot like the "old days" before TPAs. Even a red eye patient is a problem. We can bill the VCP for the visit and Rx the med, but if they were a PPO patient we'd 99 code an office visit, Rx the med, and have the patient back for the VCP exam when the red eye was gone.

So, it isn't a scope of practice issue. It's an insurance coverage issue.

 

[Richard Pagan]

Many of the HMO's in California contract out their vision care to VCP's. So, the patients come in as a VCP patient, and there is no option for providing medical care, it has to be referred back to the HMO. So, a typically scenario might be the employed person that has an HMO and VSP. They come in for routine care and you find they likely have glaucoma, or need a workup. Your job at that point is done, other than the referral. It's a lot like the "old days" before TPAs. Even a red eye patient is a problem. We can bill the VCP for the visit and Rx the med, but if they were a PPO patient we'd 99 code an office visit, Rx the med, and have the patient back for the VCP exam when the red eye was gone.

So, it isn't a scope of practice issue. It's an insurance coverage issue.

in your example I would be billing the pt out of pocket for the red eye visit, and have them back for the routine exam through the vcp. Why aren't you doing that?

 

[Russell Lee]

in your example I would be billing the pt out of pocket for the red eye visit, and have them back for the routine exam through the vcp. Why aren't you doing that?

Because most patients are not willing to pay, say $100+ for an out of network provider, vs a $10 copay for an in network provider.

 

[Richard Pagan]

Because most patients are not willing to pay, say $100+ for an out of network provider, vs a $10 copay for an in network provider.

If they refuse to pay then I would send them elsewhere, and would not provide any services.