If you ask most optometrists what the standard of care is for any given condition or presentation, most will offer up a variation on the same answer: "It's whatever 51% of my colleagues would do." That's pretty scary, considering that 1% is a dangerously small margin--especially if you are unlucky enough to find yourself in a court of law. Nonetheless, it's a basic principal of practice and a reality that is not likely to change anytime soon.

To further complicate matters, technology is not only advancing rapidly, but its also being readily adopted, thus creating new gold standards that are hard to reach--particularly now, as our economy is ailing. This creates quite a conundrum for many O.D.s. You want to offer the highest possible level of care, but you can't necessarily provide it yourself. So, what are your options?

As I see it, if you want to offer the very best to your patients, you have three choices:

-Refer out to your a local ophthalmologist.

-Start investing in the latest and greatest new equipment.

-Start seriously considering intra-optometric referrals.


M.D. Referrals

Optometry has been doing this since the dawn of time, so I don't really need to tell you how this works. But, I would urge you to take a closer look at how a moderate investment in technology (not necessarily the "big ticket" items) could help you to dramatically improve patient care, while simultaneously making the O.D./M.D. comanagement relationship more meaningful.

For example, some 53% of respondents to Review's Diagnostic Technology Survey say they are considering purchasing (or have recently purchased) a digital fundus camera (see "New Technology Pays Dividends"). Chicago optometrist Thomas R. Benthien is one such doctor and, in his case, the technology has been a lifesaver--literally. It helped him detect a patient's brain tumor before it was too late.

In fact, survey respondents gushed about the benefits of digital fundus photography because, when they do need to refer to an M.D., they can easily share retinal photos. What's more, it drastically enriches the experience with the patient because you can sit down and visually explain what's going on. This impresses patients, and it helps alleviate some of their fears.


Invest in Yourself

Youve got to spend money to make money. This phrase wouldn't be a cliche if the words didn't continue to ring true. Just ask Utah optometrist Darin R. Cummings. He says his new OCT paid for itself in less than eight months! Likewise, Oregon optometrist Terry Steckman says his new nerve fiber analyzer is a great investment because he doesn't have to refer as much.

Instruments in this category can't be bought with chump change.But, despite their price tags, a lot of O.D.s make it work, either by financing or through manufacturer lease programs.


Band of Brothers

Heres another cliche: Blood is thicker than water. So many optometrists shy away from referring to their O.D. colleagues out of fear of losing their patients. This is misguided. Who do you really think would rather see you close shop? The colleague who you sits next to you at state association meetings or organized ophthalmology?

It may not be a reality for you, but many optometrists are making significant investments in diagnostic technology. If you forge relationships with fellow O.D.s, you will be doing your profession a favor by elevating the public's perception of optometry and of you--to say nothing of the loyalty that your colleague will likely show you in return. Of course, patients benefit from intra-optometric referral by reduced travel and wait times, and usually lower cost and more personalized care.

When new technology is utilized, patients benefit. And, when you keep it in the family, everybody benefits. I hope youll work together to make that the new standard in this high-tech world.