When it comes to surgical comanagement, the key to success is for the optometrist to have full knowledge of all surgical procedures available to patients, paying particular attention to inclusion and exclusion criteria for each individual. This allows the optometrist to feel confident that he or she is pointing each patient in the correct surgical direction, carrying out the appropriate tests, and advising the patient of the relevant risks and complications. Patients should ultimately reach the surgeon with a better idea of which treatments they are and are not suitable for. At the Wellington Eye Clinic, we strive to maintain this protocol among all optometrists to best achieve continuity of care and to minimize the surgeon’s valuable chair time when possible.
OPEN COMMUNICATION
An everyday open-door policy works well, and the ability to discuss individual patients at that moment and while they are fresh in everyone’s minds is ideal. Regular meetings and email updates are essential, as is in-house training involving all members of staff.
Attendance at conferences such as the European Society of Cataract and Refractive Surgeons (ESCRS) annual meeting can be hugely beneficial and help to keep optometrists abreast of up-and-coming procedures before they have even reached the clinic.
THE PATIENT EXPERIENCE
Patients should feel a continuity of care and professionalism across the board. From optometrist to ophthalmologist, we should all be on the same page to instill confidence in the patient to proceed with surgery. To do this, we first need to be confident with our knowledge. Confidence follows from experience and regular, continual training.
With regard to postoperative care, the optometrist’s role is to reinforce the happy patient’s result. This helps the clinic’s outward image and increases word-of-mouth referrals. More important, counseling, reassuring, listening to, and guiding less-satisfied patients toward a good result is key. Turning around an unhappy patient can be hugely satisfying for all involved and can reflect well on the clinic as a whole. I feel it is the experienced optometrist’s role to manage these patients as far as is possible.
GROWING INVOLVEMEMNT
I envision optometry having greater involvement in shared care. In trained hands, and with open communication between ophthalmologists and optometrists, there is potential for this approach to work well. In Ireland, there is still some division between ophthalmology and optometry, and, in order for this to improve, better relations must be formed between the two groups before shared care can be an option.
Optometrists need better insight into the treatment pathways ophthalmologists regularly use, and this requires advanced training and experience working alongside ophthalmologists. I hope to see a better blend of care spread among optometrists, general practitioners, and ophthalmologists. When this is achieved, it ultimately should provide better access for patients to the right care at the right time.
