Comanagement used to be the sort of thing a niche group of ODs would do if they had the inclination and legal authority to get involved in some elements of medical care. When optometry was still synonymous with glasses and contact lenses, comanagement was a choice. More often than not, optometrists would refer out their medical cases and just concentrate on taking care of the patient’s optical needs—if they even returned to the practice at all.
Not any more. The profession, and the public’s expectations of it, have advanced. Trouble is, ophthalmologists aren’t always supportive, to put it mildly. Too often, they still see optometric advancement as a competitive threat encroaching on their domain rather than as a resource that can help them. Increasingly, optometrists have the clinical skills to practice full-scope care, but not a willing partner on the MD side who sees it as mutually beneficial. That needs to change.
This month, we begin a six-part series that delves into the tricky business of making these relationships work better, called Comanagement Connections to reflect the primacy of the person-to-person interactions at the heart of a successful partnership. ODs, MDs and, to some extent, patients all have to be on the same wavelength about what they expect of each other.
“Comanagement represents cooperation,” observes Paul Ajamian, OD, at the outset of the first installment of the series. Dr. Ajamian, of course, was a member of the optometric vanguard that made comanagement a reality, beginning in the 1980s with the creation of the Omni Eye Centers.
Among the virtues Dr. Ajamian credits Omni’s success to was the modeling of good behavior. “The practice was predicated on not doing anything that would compete with the referring OD: no optical, no contact lenses and no primary care. Add to that the automatic return of each patient, a meaningful letter back and ongoing continuing education to move the profession forward, and a transformative model was born,” he explained to us a few years back in a retrospective on comanagement’s impact.
That sense of mutual respect and trust is what to strive for as you strengthen your relationships with ophthalmology. I think we’d all agree that cooperation and reconciliation are needed in many spheres of life right now, eye care included.
“No man is an island,” wrote the English poet John Donne nearly 400 years ago. No optometrist is either these days. And the same goes for the ophthalmologists who, in a prior era, neither wanted nor needed any help serving their patients. We wish you the best of luck in strengthening these all-important bonds.
This month, we’re also pleased to welcome Danica Marrelli, OD, to our editorial board. Dr. Marrelli is a glaucoma expert who works hard to advance optometric skills in this area, both among the students she teaches at the University of Houston College of Optometry and the wider field of practicing optometrists who attend her lectures or read her articles. We’re excited to showcase her expertise in these pages.