As I drafted the last President’s Column presenting a Declaration of Optometric Independence, I was about to share the message to nearly 300 industry executives at the Vision Monday Global Leadership Summit prior to Vision Expo East.
It seems fitting today as I depart Washington, D.C., after having met with several members of Congress and senators that I share my version of the Optometric Bill of Rights.
The first five, in this issue, concern the rights of practitioners. With the national discussions of health care reform, it’s critical that optometry is clear with where we believe the profession must be, so we begin with the first five rights of optometrists.
First Amendment – Equitable Reimbursement – optometrists and ophthalmologists shall receive equal reimbursement for the same services regardless of the payer. There is currently discrimination in managed Medicare, some Medicaid and obviously in ERISA plans and even (possibly without common knowledge) traditional commercial insurers. Optometry, through the AOA and state associations, will need dues dollars and support in fighting for equal reimbursement for equal services.
Second Amendment – Truth and Transparency – optometrists shall be provided with easy-to-understand full disclosure statements by managed vision or health plans to more easily determine if joining a panel makes financial and professional sense for his/her practice. In particular, as in some managed vision plan carve outs of medical eye care – when there is disparity between reimbursement or scope of services provided between optometry and ophthalmology – the plan will clearly disclose the disparity and the optometrist can then determine if the lower reimbursement or limited scope of services provided is in the patients’, his/her practices’ or the professions’ best interest to join the panel.
Third Amendment – Optometric Co-Management and Intra-Professional Referrals – optometrists in all practice settings shall work closely with their optometric colleagues to ensure all patient needs are met by optometry whenever appropriate. This is a natural evolution for our profession and very successful in limited areas of the country for some specialties. There are thousands of patients who can benefit from vision therapy, low vision, sports vision and specialty contact lens referrals. In addition, based on experience, equipment limitations or practice settings, some optometrists choose to refer glaucoma and other medical eye conditions. In the future, those optometrists will first look to their optometric colleagues. The patients will be promptly returned to their family optometrist for care not based on the referral.
Fourth Amendment – Fair and Reasonable Reimbursement for Services Provided – The AOA will provide its members with tools and information to ensure that no optometrist shall ever have to make patient-care decisions based on the economics of reimbursement. Eye examination reimbursement will cover all costs of providing the services and a reasonable profit. The provision of professional services or materials will all cover the costs of providing the products or services and a reasonable profit.
Fifth Amendment – Lifetime of Learning and Professional Growth – all optometrists shall continue to commit to a lifetime of learning to ensure the best patient care possible. In addition, the optometric profession will never stop striving to provide necessary care to patients in need and will set no limits on the expansion of scope when it is in the patient’s best interest.
Because our patients are the focus of all we do, the next issue will conclude with my view of patient rights from a presbyopic perspective of optometric care.