Eyeworld Daily News

EW SHOW DAILY 34 A dding a retina MD to a general ophthalmology practice can be a great revenue source if man- aged right, said Laurie Oliver, COE, administrator at Retina Health Center, Ft. Myers, Fla. Still, you have to know what you're getting into, she warned. Ms. Oliver addressed this topic at "The ABCs of Retina in a General Ophthalmology Practice," a course in the ASOA Program. If you think that retina may be a good fit for your general ophthal- mology business, track the retina referrals that your practice makes for about 3 months, Ms. Oliver recommended. That way, you can get a sense of how much business you could keep in-house if you had a retina specialist on board. Decide if you want to bring on an MD who specializes in medical retina, such as in-office injections and lasers; or surgical retina, which involves ASC- and ER-based procedures. If the physician does both areas, it can be hard to sched- ule postop follow-ups or last-minute complications as he or she may not be in the office every day. If you don't think you have the volume to bring in a retina specialist full time, speak with other general ophthalmology colleagues in your area about sharing a specialist, Ms. Oliver suggested. "That's a good way to ease into it," she said. When discussing compensation, the typical target is 40% of the busi- ness that the specialist brings in, said Ms. Oliver. Additionally, her practice will pay for a portion of malpractice insurance according to how many days they work in the office. You'll also likely need to bring a retina technician on board, Ms. Oliver said. Sometimes the retina specialist already works with a trusted one. You'll want to double check state regulations about the scope of what a retina technician can and cannot do, she said. Other logistics for adding retina Patient flow is a major differentiat- ing factor between retina and gen- eral practices. While a patient in a general practice may be in and out in an hour, retinal patients may take 1½ to even 3 hours to complete testings and the exam, she said. A major expense to consider when adding retina is the equip- ment, Ms. Oliver said. "It's a mini- mal investment of $140,000," she said, referring to various diagnostic and testing devices that general oph- thalmology practices do not have. Another outlay is for the drugs, which tend to be expensive. Ms. Oliver works at one of the largest retinal practices in the country, and it purchases $100,000 of drugs a week. Many retina MDs will use Lucentis (ranibizumab, Genentech, South San Francisco) or Eylea (aflibercept, Regeneron, Tarrytown, N.Y.) to treat patients, although some will use the generic and less costly Avastin (bevacizumab, Genentech), especially when the patient is paying out of pocket. To help promote your new retina business, the MD should meet with local doctors face to face. However, carefully toe the referral line; if you get a retina referral from another general practice, treat the patient for the retinal issue but then send him or her back to the referring practice for other medical concerns and optical needs, cautioned Ms. Oliver. Another possibility is having general ophthalmologists perform retina injections, said Ms. Oliver. If you decide to use this approach, be sure the patient is comfortable with it and the physician can treat any conditions or complications that arise from the injections. EW Tuesday, April 29, 2014 Meeting Reporter Using a retina business to grow your practices by Vanessa Caceres EyeWorld Contributing Writer U nderstanding the impor- tance of communication and using effective tech- niques in patient interac- tions is vital to achieving best patient satisfaction and results, a speaker said here. Mike Besserman, senior key account manager, Northeast, Alcon (Fort Worth, Texas), presented the session "Enhancing Patient Engage- ment: Staff to Patient Interaction," a course in the ASOA Program. He outlined six steps for improving communication with patients. He showed a video of an elderly female patient who went to a physi- cian's office for care and was so unhappy with her interactions with the receptionist, technician, and ophthalmologist—who were cold, dismissive, and brief—that she de- cided not to have cataract surgery. After he showed the video, he asked the packed audience where the staff in the video went wrong. People called out their responses, including that the patient felt like an "unnecessary person," "they [the staff] look miserable," that the staff had "no empathy," and that staff members were lacking etiquette, from not addressing the patient by name to not saying "please" or "thank you." He said that while staff can see many patients in one day, they need to remember to be responsive and caring to each and every patient that they see. "To that patient, they're the only patient," Mr. Besserman said. "Empathy is important." Approximately 55% of commu- nication is nonverbal, so more than half of the opportunity to impact a person has taken place before a word has been said. A total of 38% is voice inflection. If staff is interacting with patients over the phone, they need to be aware of the impact that the way they speak is making on patients, he said. People can detect anger, frustration, or indifference on the phone, and this can lead to issues in effectively communicating. The last 7% is vocabulary, and for this, staff should be aware of the language that they are using with patients. Using medical jargon can be jarring to patients and lead them to become confused or unable to understand the information being discussed, he said. "I'd ask you, if you're going to take something back to your prac- tice, it's this information," he said. Six steps for best patient/staff interaction by Erin L. Boyle EyeWorld Editor Mr. Besserman discusses the importance of communication in patient interactions.

• Cover