How important is a good referral source of Family doctors & Pediatricians?

[q1we3]

Some questions for practicing ODs

Do ODs often visit family physicians and pediatricians to build a referral network? Is this a major deciding factor in having a busy practice? In general, what percentage of new patients come directly from other docs at your clinic? How many docs refer patients to you for eye exams?

Thanks

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[KHE]

Some questions for practicing ODs

Do ODs often visit family physicians and pediatricians to build a referral network? Is this a major deciding factor in having a busy practice? In general, what percentage of new patients come directly from other docs at your clinic? How many docs refer patients to you for eye exams?

Thanks

This is very hard to do. Virtually all GP and Ped MDs are trained to refer to ophthalmology. In most cases, the best you can hope for is benign indifference.

 

[q1we3]

This is very hard to do. Virtually all GP and Ped MDs are trained to refer to ophthalmology. In most cases, the best you can hope for is benign indifference.

That's not right, isn't optometry the first stop for eye care. Why sent primary eye care patients to ophthalmology? Do they really have no faith in our training? Or is it just a ego thing?

I mean its understandable if you don't want to refer your patient to a walmart doc, but there are enough PPs waiting for these patients that should be going to ODs first instead of OMDs. Maybe this is why PPs are not seeing enough patients, ODs are being cut out from one of the main sources of patients.

 

[KHE]

That's not right, isn't optometry the first stop for eye care. Why sent primary eye care patients to ophthalmology? Do they really have no faith in our training? Or is it just a ego thing?

I mean its understandable if you don't want to refer your patient to a walmart doc, but there are enough PPs waiting for these patients that should be going to ODs first instead of OMDs. Maybe this is why PPs are not seeing enough patients, ODs are being cut out from one of the main sources of patients.

It's not as if that's a new problem. It's always been that way.

The problem arises from the fact that as family practice docs and pediatricians go through medical school, they will likely interact with providers and students of every other "non-MD" profession on a somewhat regular basis EXCEPT optometry.

Couple that with the fact that if they rotate through an ophthalmology rotation, they will in most cases be told that if any patient at all has any eye problem whatsoever other than a need for glasses or contact lenses, and in most cases EVEN THEN then that family practice or peds doc had damn well better refer them to an "eye-MD" ophthalmologist and NOT an optomtrist or they (the pediatrician) will be sued out the wazzzzooooooo after that optometrist misdiagnosis the pink eye.

The problem is not with MDs or medical school education really. It's with optometric education. Optometry students don't interact with students from other disciplines outside of the ophthalmololgy department so those other students never see what optometrists are capable of.

 

[q1we3]

It's not as if that's a new problem. It's always been that way.

The problem arises from the fact that as family practice docs and pediatricians go through medical school, they will likely interact with providers and students of every other "non-MD" profession on a somewhat regular basis EXCEPT optometry.

Couple that with the fact that if they rotate through an ophthalmology rotation, they will in most cases be told that if any patient at all has any eye problem whatsoever other than a need for glasses or contact lenses, and in most cases EVEN THEN then that family practice or peds doc had damn well better refer them to an "eye-MD" ophthalmologist and NOT an optomtrist or they (the pediatrician) will be sued out the wazzzzooooooo after that optometrist misdiagnosis the pink eye.

The problem is not with MDs or medical school education really. It's with optometric education. Optometry students don't interact with students from other disciplines outside of the ophthalmololgy department so those other students never see what optometrists are capable of.

In Canada, GPs in most cases refer to ODs first then if the patient requires a surgery or further examination a referral is made to OMD. OMDs are just too busy to be diagnosing pink eye. But then again, if the court law in US says avoid ODs or else you will be in trouble, then there not much you can do.

 

[Tippytoe]

Gotta think-- why refer to an unknown when you can refer to a known. I get plenty of MD referrals but only after many years of a one-on-one encounters so they can see I'm not an idiot and one of the few that don't work in a warehouse store (would you really refer your patients to anyone in Walmart?)

A rule to rememeber for the real world:

Ophthalmologists are considered competent until proven otherwise.
Optometrists are considered incompetent until proven otherwise.

 

[q1we3]

Ophthalmologists are considered competent until proven otherwise.
Optometrists are considered incompetent until proven otherwise.

So true.

 

[KHE]

In Canada, GPs in most cases refer to ODs first then if the patient requires a surgery or further examination a referral is made to OMD. OMDs are just too busy to be diagnosing pink eye. But then again, if the court law in US says avoid ODs or else you will be in trouble, then there not much you can do.

That seems unlikely. In Canada, there are still large areas where optometrists aren't even prescribing topicals. Ontario only recently got that right. How is it possible that GPs would be referring en masse to a provider type that couldn't treat even the simplest of pink eyes?

 

[q1we3]

That seems unlikely. In Canada, there are still large areas where optometrists aren't even prescribing topicals. Ontario only recently got that right. How is it possible that GPs would be referring en masse to a provider type that couldn't treat even the simplest of pink eyes?

Ontario was one the last provinces to get prescription rights, although they did get orals as well which is great. ODs in other provinces have been prescribing topicals for a long time but not orals. Yes, the scope is limited compared to US but its getting better.

In regards to referrals, my family doc refers to couple of ODs, I have seen the referral pads. He has personally referred me and my parents to ODs number of times. My mother for dry eye for which OD gave drops and my father who ended up needing a cataract surgery, but was referred to OD first.

If anybody goes to GPs in Canada for eye issues, most likely they will see OD first. OMDs are just too busy it will take months to get an appointment for a non-emergency visit, socialized medicine remember. Why not see the OD first? That's what they are for and you are guaranteed to get an appointment within few day. If it something serious that requires OMD, OD will do the appropriate referral.

 

[swtster]

I've seen a lot of walk-in patients come in to see a GP for basic eye problems. Many don't even think about going to an OD first because OHIP will cover the walk-in visit with the MD (guaranteed), whereas they may not cover the OD visit, depending on the problem and/or your eligibility. Then the GP would refer to an OMD for the reasons mentioned by Tippytoe above, skipping the OD altogether.

I just think a certain Premier of Ontario screwed everything up for everybody when he changed the health coverage in 2004.

 

[mclem222]

Let me expand on why this happens.... A lot of ODs in the community don't know what the heck they are doing..yeah i said it..Its true....Combine that with the jack in the box ODs and boom...primary care docs don't have the trust in us that they should. I see patients that have seen the ODs around town and then back to their primary care and then referred to an ophthalmologist. The missed diagnoses are sickening...pseudotumor, orbital tumors, horner's syndrome with aneurysm, lyme disease...The ODs are good on the "eye diagnoses"...keratoconus, dry eye, cataract etc only... So when the primary care sees all the tough stuff are treated by OMDs guess who they are comfortable sending patients to? My brother's wife is a primary doc and she gets tons of patients who have been seen by an OD for weeks with a terrible diagnosis and missed and then refers it to my brother. Guess what? Suddenly the patient is diagnosed and treated. Watering down our numbers by adding more people doesn't add more confidence or skill. It just gets weaker candidates and makes it more palatable for us to end up working in all corporate. Enlisting every tom dick and harry into your army doesn't make your army better, it just means your body count is higher when you go into battle.