REFRACTIVE SURGERY UPDATE

8 Things to Consider
When You Comanage LASIK

by Jeffrey M. Augsutine, O.D. and Robert G. Wiley, M.D.

You've probably heard from more than one laser center or ophthalmologist about why you should comanage laser vision correction with them. Still, integrating refractive surgery into your practice can be a challenge. You'll face decisions about the surgeon, laser center, laser type, informed consent, surgical outcomes, marketing, information standards, and legal and fair fee arrangements. These eight points can ease that process:

1. Your main objective. Keep this in mind always. You want to provide excellence in refractive surgery. So, the laser team—surgeon, technicians, center director, refractive coordinator and other staff—is your most important consideration. The more experienced the laser team, the more satisfied your patients are likely to be.

2. Communication. You must be able to contact the surgeon, refractive coordinator or center director at any time. Standardized information and data gathering is another key element in effective communications. This can help reduce errors over things such as preoperative analysis and complications. The center you deal with should have standards and protocols for scheduling, financing, pre-op data, post-op results and exclusion criteria.

3. Marketing. This key to any comanagement relationship. Internal marketing support through the center should focus on your practice with personalized brochures, videos, posters and signage. This internal marketing program doesn't need to glamorize the center or the surgeon. It should promote you as the expert.

4. Education. What kind of education can the center provide to you and your staff? It should let you observe procedures, provide wet labs and training in pre- and post-op care, and a review of clinical results. The center should also encourage education of your staff. Quality centers hire nationally known optometric educators for their programs.

5. Compensation. Comanagement fees are not financial incentives to steer patients, but compensation for services. You'll provide patients with educational, technical and emotional support before and after surgery. You deserve true and fair compensation for the care you give; not payment for a referral.

6. Image. The facility's image should be high-tech but not ostentatious. The best centers create situations where the patient bonds with the primary care doctor, not with the laser center.

Refractive surgery can generate enormous goodwill, but the laser center must funnel that goodwill toward you. It's important that the "wow" factor—that first-day post-op visit when the patient comments on his or her new visual acuity—occurs in your office.

7. Outcomes. The center should provide outcomes analysis, a necessity for quality comanagement. Outcomes analysis provides information the center needs to improve its results. It also aids in patient education and documents the benefits of comanagement.

8. Optometric oversight. Many progressive centers appoint an optometric board that establishes policies on marketing, gatekeeper issues and technology decisions. The board also gives quality feedback on issues concerning the future direction of the center.

To comanage refractive surgery successfully, you need the right tools. These include a world-class laser team, professional internal marketing and quality educational support. Only then can you embrace a true comanagement relationship that builds your practice.

When properly structured, comanagement helps you maintain a long-term relationship with the patient as his or her primary care provider. Your success at refractive surgery comanagement directly depends on your patients' perceptions.

Dr. Augustine is center director of The Toledo, Ohio, LASIK Center. Dr. Wiley has done 3,000 LASIK cases and exclusively comanages with optometry out of Cleveland, Toledo, and Fort Wayne and Marriville, Ind.