Multi-specialty model can enhance care

Key Points

A woman schedules an appointment with an optometrist, complaining that her eye hurts. After being examined, the OD discovers a retinal tear. The patient then schedules an appointment with an ophthalmologist, waiting another day or two in pain.

"They're very much patient-driven, market-driven practices that allow each doctor to practice in a much more satisfying manner," said Richard Edlow, OD, who practices at Katzen Eye Group in Baltimore and serves as its chief executive officer. The 40-year-old practice employs 17 doctors-eight ophthalmologists and nine optometrists in two locations-who service more than 400 patients each day.

He said the challenge of building this type of practice is that there are a lot more moving parts when compared to a stand-alone practice, mainly because more services are being offered. From a human resource perspective, there is more staff to manage and accommodate. Are they coming to work on time, successfully completing their tasks, or answering the phones correctly? From a financial viewpoint, more income is needed because expenses are higher. Consider rent, utilities, payroll, employee benefits, or even office supplies. Then there's office flow. Are patients being seen quickly?

But the extra effort is well worth the end result, he said, adding that at Katzen Eye Group, three of the four highest volume doctors are optometrists, not ophthalmologists.

To build a successful multi-specialty practice, Dr. Edlow said optometrists must first move past archaic concepts, such as the idea that ophthalmologists are superior to optometrists.

"Optometrists need to make sure that the corporate culture of the group practice puts optometrists at the same independent level as ophthalmologists," he said. "They don't want to be subservient technicians, which is the way it was 20 to 30 years ago."

Additional benefits, challenges

Sometimes, the greater challenge stems from patients. He said it's just as important to break down their barriers of perception. Many falsely believe that they are better off seeing an ophthalmologist for every visit. However, patients with cataracts do not need to see a surgeon each and every time. Patients must be educated that all the practice's doctors are competent and deliver the best care possible.

Still, patients aren't the only ones who benefit. There are many economies of scale for the practice when it comes to diagnostic equipment or even productivity increases for office staff. Dr. Edlow explained that technology is spread out over more doctors and patients, so the return on investment is higher. Likewise, since most billing is electronic, a practice could easily increase billing volume without hiring additional staff.

Even developing an advertising or marketing strategy is easier. He said collaborative practices are already unique when compared to their competitors. They typically employ the "three Os"-ophthalmologists, optometrists, and opticians-which, when combined, serve as patient magnets.